In the process of doing research in this somewhat new and complicated field, I've have definitely been struggling with the ambiguity in terminology. There are just too many things that are too similar and it's making my eyes cross. So here is my attempt at demystifying some of it...
EMR | Electronic Medical Record
Created by clinicians, for clinicians. This is basically just a digital version of your medical chart at a clinic or hospital, including health information, notes about diagnoses, surgeries, and other care provided while in a hospital overnight. The catch here is that EMRs are specific to provider locations, so you have one at every institution that has provided you care. While this information is not readily available to you, you have the right to request it be printed out for you.
AMR | Ambulatory Medical Record
The same thing as an EMR, but for outpatient care. This means places like urgent-care clinics, physician clinics, and at-home medical care.
EHR | Electronic Health Record
The word 'health' is meant to be more broad, or encompassing than the word 'medical'. Your EHR incorporates all of your medical information from ALL of you care providers, and follows you to whatever institution you go to. All authorized physicians involved in your care can access this record, as well as share it with specialists, laboratories, etc.
PHR | Personal Health Record
Just as it sounds, the PHR is the equivalent of an EHR, but for patients. Patients set up, access, and manage their own PHRs which CAN include all of the same information as their EHR (diagnoses, medications, immunizations, family medical histories, and provider contact information). This information can come from the your clinicians, from medical devices, or just manually from you. I emphasize the word 'can' here because PHRs are not legally required to include ALL of your PHI.
PHI | Protected Health Information
This is all of your medical information. Like, ALL of it. Everything from medical records, billing records to enrollment and claims records, and everything in between. It's all the info that providers use to make medical decisions about you. Under HIPAA, you have the right to request your PHI and have a copy printed for you...but it probably won't be the easiest thing in the world.
So just a quick recap here: Your EHR contains your PHI. Your PHR contains some of your PHI. You don't have access to your EHR, but you DO have access to your PHI. Make sense? No? Well you can thank the HIPAA...
HIPAA | Health Insurance Portability and Accountability Act
There are two parts, the first simply makes sure that you have health coverage if you lose or change jobs. The second part aims to standardize the mechanisms, security, and confidentiality for electronic health data.
Meaningful Use
Basically, medical providers get kudos for using an EHR that's actually productive. If the providers meet the objectives in the long list of requirements for "meaningful use", then they get financial incentives. But they have to prove this every year to claim their prize.
Now that THAT is over with, this makes a little more sense now...
The Gartner Hype Cycle
This methodology predicts the typical pattern of new technology evolution over time
Here is this methodology applied to healthcare provider applications:
EMR | Electronic Medical Record
Created by clinicians, for clinicians. This is basically just a digital version of your medical chart at a clinic or hospital, including health information, notes about diagnoses, surgeries, and other care provided while in a hospital overnight. The catch here is that EMRs are specific to provider locations, so you have one at every institution that has provided you care. While this information is not readily available to you, you have the right to request it be printed out for you.
AMR | Ambulatory Medical Record
The same thing as an EMR, but for outpatient care. This means places like urgent-care clinics, physician clinics, and at-home medical care.
EHR | Electronic Health Record
The word 'health' is meant to be more broad, or encompassing than the word 'medical'. Your EHR incorporates all of your medical information from ALL of you care providers, and follows you to whatever institution you go to. All authorized physicians involved in your care can access this record, as well as share it with specialists, laboratories, etc.
PHR | Personal Health Record
Just as it sounds, the PHR is the equivalent of an EHR, but for patients. Patients set up, access, and manage their own PHRs which CAN include all of the same information as their EHR (diagnoses, medications, immunizations, family medical histories, and provider contact information). This information can come from the your clinicians, from medical devices, or just manually from you. I emphasize the word 'can' here because PHRs are not legally required to include ALL of your PHI.
PHI | Protected Health Information
This is all of your medical information. Like, ALL of it. Everything from medical records, billing records to enrollment and claims records, and everything in between. It's all the info that providers use to make medical decisions about you. Under HIPAA, you have the right to request your PHI and have a copy printed for you...but it probably won't be the easiest thing in the world.
So just a quick recap here: Your EHR contains your PHI. Your PHR contains some of your PHI. You don't have access to your EHR, but you DO have access to your PHI. Make sense? No? Well you can thank the HIPAA...
HIPAA | Health Insurance Portability and Accountability Act
There are two parts, the first simply makes sure that you have health coverage if you lose or change jobs. The second part aims to standardize the mechanisms, security, and confidentiality for electronic health data.
Meaningful Use
Basically, medical providers get kudos for using an EHR that's actually productive. If the providers meet the objectives in the long list of requirements for "meaningful use", then they get financial incentives. But they have to prove this every year to claim their prize.
Now that THAT is over with, this makes a little more sense now...
The Gartner Hype Cycle
This methodology predicts the typical pattern of new technology evolution over time
- Technology Trigger: A potential technology breakthrough kicks things off. Early proof-of-concept stories and media interest trigger significant publicity. Often no usable products exist and commercial viability is unproven.
- Peak of Inflated Expectations: Early publicity produces a number of success stories—often accompanied by scores of failures. Some companies take action; many do not.
- Trough of Disillusionment: Interest wanes as experiments and implementations fail to deliver. Producers of the technology shake out or fail. Investments continue only if the surviving providers improve their products to the satisfaction of early adopters.
- Slope of Enlightenment: More instances of how the technology can benefit the enterprise start to crystallize and become more widely understood. Second- and third-generation products appear from technology providers. More enterprises fund pilots; conservative companies remain cautious.
- Plateau of Productivity: Mainstream adoption starts to take off. Criteria for assessing provider viability are more clearly defined. The technology’s broad market applicability and relevance are clearly paying off.
Here is this methodology applied to healthcare provider applications:
Hype Cycle for Healthcare Provider Applications, Analytics and Systems, 2013
(green=pure analytics; yellow=contains analytics component)
It's good to know we've started on the plateau where investments actually start to pay off. With the state our healthcare system is in right now, we could really use some inspiration. It is time to start leveraging this massive amount of health data we've been collecting to improve preventative health and raise the US lifespan to where it should be.
References:
http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/healthit/phrs.pdf
http://www.healthit.gov/providers-professionals/faqs/what-are-differences-between-electronic-medical-records-electronic
http://searchhealthit.techtarget.com/definition/ambulatory-medical-record
(green=pure analytics; yellow=contains analytics component)
It's good to know we've started on the plateau where investments actually start to pay off. With the state our healthcare system is in right now, we could really use some inspiration. It is time to start leveraging this massive amount of health data we've been collecting to improve preventative health and raise the US lifespan to where it should be.
References:
http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/healthit/phrs.pdf
http://www.healthit.gov/providers-professionals/faqs/what-are-differences-between-electronic-medical-records-electronic
http://searchhealthit.techtarget.com/definition/ambulatory-medical-record