Electronic Medical Records: Common Questions Answered

Cathy Reisenwitz profile picture
By Cathy Reisenwitz

Published
7 min read

The global market for Electronic Medical Records will reach almost $40 billion by 2024, a 6.9 percent compound annual growth rate from the 2015 valuation of $21.4 billion, according to predictions from Coherent Market Insights.

Okay, so what are these very valuable Electronic Medical Records (EMRs)? Are they different from Electronic Health Records (EHRs)? You’ve got questions. I’ve got answers.

In this article, I’ll explain what EMRs and EHRs are and address other common related questions.

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What are medical records?

Medical records are created when a hospital or doctor’s office records and stores information about a patient. This data includes what brought the patient in, what happened during the visit, health history, current medications, ailments, treatment plans, and more.

What is the electronic patient record?

Electronic patient records or electronic medical records are literally just a digital version of a patient’s medical record. These digital records can be as simple as a scanned copy of a paper record or as complicated as a multi-field, multi-drop-down, multimedia, dynamic form.

What is the Electronic Health Record?

Technically, health records are broader and encompass more data than patient records. But in practice, the two terms are usually interchangeably because medical records can also include self-reported data, data from wearables, etc.

What are EHR and EMR?

While EHR and EMR technically refer to the records themselves, in reality, people usually mean electronic medical (or health) records software when they say EHR or EMR.

Throughout this piece, I will use EMR and EHR interchangeably.

Who uses EHRs?

Nearly every healthcare provider uses an EHR. This includes private practices, medical groups, and hospitals. More specifically, the vast majority of ambulatory surgical centers, specialized clinics, hospitals, and general physician specialized clinics use EHRs.

What are the subcategories of EMR?

There are a few, but the big ones are inpatient EMR vs outpatient EMR. Cloud-based versus on-premise used to be a big distinction, but the trend is clearly toward cloud-based EHR software. An on-premise EHR can cost $40,000 to set up. The monthly price for cloud-based EHR includes infrastructure and maintenance costs, greatly reducing your implementation costs.

What should buyers look for in an EHR?

Support

It may not be the thing you think about first when making a purchase, but customer support is going to be important.

Choosing an EHR with poor support can mean you’re left with a system that’s poorly set up and hard to configure later. Or you could be paying money for an EMR that no one in your practice knows how to use because training was poor. Or your system could malfunction for weeks while you wait for a reply from support.

UI

HealthcareITNews polled 95 executives in October 2016 about the features most likely to encourage EHR use among their physicians and nurses. The most-cited attribute was improved UI, and 47 percent put it in the number-one spot.

It makes sense. A hard-to-use, hard-to-learn system is going to be used less than one that’s easy to learn and use. Your EHR can only be as helpful as the people in your organization who fully utilize it.

Integrations and Interoperability

Data silos kill hundreds of thousands of patients and waste billions of dollars each year, according to Intermountain Healthcare CIO Marc Probst. Probst made a case for federally mandated healthcare interoperability standards at the CHIME16 Fall CIO Forum.

Meanwhile, the College of Healthcare Information Management Executives is pushing organizations to adopt a national patient identifier, which could help providers pass information about patients between healthcare organizations without interoperable health technology.

When comparing EMR systems, "Interoperability is at least as important as functionality," said Michael Gagnon, CTO at Vermont Information Technology Leaders. Gagnon also told Healthcare Dive that providers choosing between vendors should buy the system they’ll need next year and the year after that.

Fully 60 percent of executives said they planned to integrate their EHRs with other technologies in 2017 in order to boost adoption. HealthcareITNews asked healthcare executives about the types of interoperability projects healthcare organizations will be working on in 2017. Hooking into external databases, such as health information exchanges, was on the list for 65 percent of respondents. Connecting intra-organization applications was on 58 percent of executives’ list. Connecting medical devices to existing systems was a priority for 37 percent.

Reporting

You want an EHR that makes it easy to attest for Meaningful Use and PCMH. That means, at the very least, don’t buy a system that requires you to create a ticket for customer service to get the reports you need. You also want an EHR that makes it intuitive and fast to pull the information you’re looking for.

ONC

To qualify for incentives under MACRA’s Merit-based Incentive Payment System or Stage 3 of Meaningful Use, healthcare providers must use the 2015 edition of their EHRs starting in 2018, according to Politico. When shopping for an EHR, check out the ONC’s list of 2015 EHRs.

According to our research, the Top 20 Most Popular EHR Software options are:

  1. eClinicalWorks

  2. McKesson

  3. CureMD

  4. Practice Fusion

  5. Allscripts

  6. Greenway

  7. Cerner

  8. Kareo

  9. HealthFusion

  10. iPatientCare

  11. Epic

  12. e-MDs

  13. Athenahealth

  14. Nextgen

  15. NueMD

  16. Praxis

  17. SOAPware

  18. Amazing Charts

  19. Advanced Data Systems

  20. AdvancedMD

How do nurses feel about EHRs?

Not awesome.

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How do EHRs impact patient safety?

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What’s next for EHRs?

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Artificial intelligence and machine learning

According to Healthcare Data Management, artificial intelligence is a top-10 healthcare information technology trend for 2017. The executives polled by HealthCareITNews agree, with 34 percent saying artificial intelligence was among the emerging technologies they plan to invest in during 2017. Machine learning was on the list for 21 percent, and 19 percent said cognitive computing.

One thing you need for machine learning and AI is lots of data. And that’s one thing healthcare has tons of, due to an explosion in sensors, bioassays, genetic sequencing, home health-monitoring devices, and behavioral data logged in mobile health (mHealth) apps. In fact, the volume of healthcare data grew by 50 percent for many healthcare executives between 2014 and 2015.

For this reason, Gartner predicts that, within two years, up to a quarter of HDOs will have a dedicated chief data officer for strategic information governance and tactical management of data. Just as an example of what physicians are doing with this data, some are more accurately tracking and regulating diabetic patients’ blood sugar levels using data from body-worn sensors, as well as lifestyle data logged into mHealth apps.

Precision medicine

Another thing all this data makes possible is precision medicine, or disease treatment and prevention tailored to each person based on their unique genes, environment, and lifestyle.

Of the executives polled by HealthCareITNews, 63 percent said they’re going to invest in prescriptive analytics in 2017 and 21 percent said genomics tools. In 2016 there was a lot of hype around precision medicine, with Microsoft launching a program to cure cancer by 2026.

Consolidation

Going back to interoperability, one way to get there is for the industry to choose one company and go with it. Computerworld recently described the current state of healthcare delivery, and EMR specifically, as “reminiscent of the state of office productivity software in the business world during the '90s.” That is, when businesses were choosing between Microsoft and Apple for the enterprise.

The benefits of choosing one system are myriad. Third-party vendors would only need to figure out how to integrate with one system, for example. And besides interoperability, it would be nice to be able to not have to learn a new system when changing jobs.

Conclusion

If you have any lingering, unanswered questions about EHR, let me know what they are in the comments. And if you’re shopping for a new system, check out our electronic medical (or health) records software directory, where you can compare your options side-by-side, read reviews from users on everything from customer support to UI, and filter your options by features.


Looking for Medical Practice Management software? Check out Capterra's list of the best Medical Practice Management software solutions.

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About the Author

Cathy Reisenwitz profile picture

Cathy Reisenwitz is a former Capterra analyst.

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