Electronic Health Records (EHR), Electronic Medical Records (EMR), and Personal Health Records (PHR): What's the difference?

EHR and EMR are often used synonymously. However, a difference was proposed by the National Alliance for Heath Information Technology (an industry-led alliance that has recently dissolved) and their definitions created a distinction. Whether their definitions and the distinction it creates will continue and enter into general usage remains to be seen.

Basically, as proposed by NAHIT, EMR are the electronic records created by and accessible to a single clinical entity, such as a doctor's office or a group practice or a hospital. By this definition, ICANotes is an EMR.

Since an individual is likely to be treated by more than one clinical entity (for example, a patient may see a psychiatrist, a dermatologist, and a family practitioner), it would be advantageous if all the different EMR records were electronically combined into a "superchart" containing the records of all the different clinicians treating that patient. This superchart is the EHR.

The EHR superchart could contain all the records in the individual EMRs or it could contain just summaries like ASTM’s Continuity of Care Record (CCR) or HL7’s Continuity of Care Document (CCD).

How the EHR superchart would be organized and where it would be stored and who would manage it is being debated. Clearly, if the EHR superchart were securely stored and accessible with the patient's permission via the internet, then new providers would have fast access to the patient's entire record, an obvious advantage in case of an emergency. Also, by storing all of the patient's clinical records in a single electronic database, unnecessary duplication of testing and inappropriate combinations of medications could be avoided. Other efficiencies can be imagined.

PHR is basically synonymous with the EHR superchart. It is an older term, coined before the emergence of computers, and was originally conceived of as a record that would be obtained and updated and stored by the patient, perhaps on paper.

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