Health - Treatments
By: - at July 11, 2013

EHR, EMR, PHR – The Digital Future of Health Data

The Digital Future of Health Data
Health care united statesHistory has shown that there will be economic benefit in understanding our environment more effectively through digitization of data (Atkinson & McKay, 2007). Digitization of health data is given many different terms including Electronic Medical Record (EMR), Electronic Health Record (EHR), and Personal Health Record (PHR). The different combinations of entities enabled to modify the record, the content of the record, and functionality determine the proper definition. The data within all these records are fairly similar, especially in the case of comparing the EMR and EHR, although with subtle differences described in the subsequent paragraphs.

The Electronic Medical Record
Medical recordsThe EMR is a little more than the electronic version of the paper chart and differs from the EHR in that it does not possess the “inherent capacity to use nationally recognized interoperability standards to send and receive [health data] ("The national alliance," 2008).” The EMR can be thought of as a building block for the EHR as the EMR generally references a one-time medical encounter and can contain both structured and unstructured data (Hebda & Czar, 2013). The EMR is created by the care facility and is owned by the facility and is never edited by the patient or outside health entities (Hebda & Czar, 2013). The Institute of Medicine (IOM) defines the EMR as a record which possesses the following functionality: “health information and health data, results management, order entry support, and decision support (Wager, Wickham-Lee & Glaser, 2009).” Until a national health data infrastructure can be developed and utilized, the EMR will remain present. The capabilities of cloud computing, or internet based storage and computing, may eventually phase out the EMR due to the strict demands of patient for increased support and connectivity. This has happened in other industries where data collection has moved to the cloud, including tax computing software, financial analysis software, etc.

The Electronic Health Record
doctor helping patientConnectivity and support of the patient are the essentials for the Electronic Health Record (EHR). The Institute of Medicine (IOM) has defined eight core functions for the EHR including: “health information and data, results management, order/entry management, decision support, electronic communication and connectivity, patient support, administrative processes, reporting and population health management ("Key capabilities of," 2003).” The possibilities for including all of these components of health data can be daunting and is likely why as of 2011 over half of all physician offices and non-federal acute care hospitals hadn’t even implemented the basic EHR ("How many providers"). The first four functions were present in the EMR, and the additional functions encompass the large scale theory of the EHR. The EHR is a compilation of patient medical data and is meant to span the entire patient medical history.

The Personal Health Record
Blood in test tubesThe Personal Health Record (PHR) is a software management tool for patient medical data. Software like MicroSoft’s HealthVault ambitiously seeks to integrate EHR data based on standards identified in the Continuity of Care Document (CCD) format with patient entered health data. The PHR holds promise in enabling patients to collect their own data, i.e. nutrition, exercise, vital signs, and run analysis to produce real-time health advice. One interesting event was the termination by Google for their PHR service Google Health. Google is viewed as a leader in cloud services and stated that the closing of their PHR service was done due to lack of successful overall implementation (Brown, 2011). Google has been always been at the for-front of providing free Software as a Service (SaaS) tools paid for by advertising to the masses. Perhaps the implementation was too low to spur the revenue from advertisers to justify the intense upkeep of such a SaaS. I strongly feel that it is likely Google still has a team of developers and policy analysts keeping tabs and working on this product, as I feel time will bring the PHR into the realm of the heights reached in the implementation of a similar SaaS of online banking.

Digital Health Data for Positive Health Outcomes
Regardless of the success of any particular category, health digitization has the potential to eliminate redundant data entry, reduce patient medication error, and increase communication through improved legibility and unfettered health information access (Tavakoli, Jahanbakhsh, Mokhtari & Tadayon, 2011). It is spurred by the characteristic of humans to gain full understanding. By gaining access to de-identified patient data, we gain great opportunities for advanced research which will enable our societies to define optimal health outcomes for every situation.





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