PHR, EHR, EMR, can all make HIT a bit confusing PDQ (Pretty Darn Quick). Certainly everyone agrees what the letters in the three acronyms stand for – Personal Health Record, Electronic Health Record, and Electronic Medical Record. Yet the terms are often misunderstood and misused – even within the industry.
The two most often used interchangeably, albeit incorrectly are EMR and EHR. To the layperson and even to healthcare professionals it may sound like there is very little difference between an Electronic Health Record and an Electronic Medical Record, but there are clearly defined distinctions, depending of course on who is doing the defining.
Health Level 7, part of the American Standards Institute (ANSI, another acronym!) was tasked back in 2003 by the Institute of Medicine to come up with a definition for EHR. HL7 based its definition not on what an EHR is, but what it does. It defined an EHR as an integrated system that had to have nearly 110 clearly defined functions. HL7’s definition of EHR stressed the idea that an EHR is not necessarily a single solution or software provided by a single vendor, but was the first to describe an EHR as a system whose required functions, based on their definitions, could be provided by different applications and vendors within a single medical practice, hospital, or other healthcare facility.
The concept of EHR as an integrated system was reiterated by the Healthcare Information and Management Systems Society (HIMSS), which defines EHR as, “a real-time, secure, point-of-care, patient-centric information resource for clinicians.” The Certification Commission for Health Information Technology (CCHIT), a non-profit organization that has been awarded the contract by the US Government to certify EHRs, currently uses the HL7 criteria as the basis for issuing its certification.
All of this is as opposed to an EMR. Before the concept of an integrated system and the term EHR was introduced, EMR was kind of the “catch all” phrase, and it could easily be seen how an EMR could be thought to be the same in concept as an EHR. However today, EMR has a clear definition. It is a legal term referring to a patient’s medical records. Indeed an EMR is the literal electronic version of a patient’s paper medical record, and therefore EMRs are technically an aspect of the integrated EHR.
This brings us to the new kid on the block – the PHR. On the surface the PHR may sound very similar to an EMR, but once again there is a technical and critical difference. The EMR has that definition as a legally recognized and valid medical record. Moreover, while the PHR shares the medical history aspects of a person’s EMR – the PHR is the only electronic medical record that is controlled by the consumer – usually via a web-based portal.