If you recognize the differences between EMRs and EHRs, pat yourself on the back…but then realize that you’re just halfway “there,” if your goal is ultimately a purchase of some type of electronic record-keeping for your medical health facility.

Your next step is to decide which product your practice needs. To make that decision, do some thorough research. Evaluate your clinic’s workflow, determine where the gaps or bottlenecks are, and assess your need for interoperability with other facilities in the network of healthcare providers your patients use. Also consider factors like the computer-literacy levels of your staff and the willingness of your physicians and clinicians to buy into new technology that might require a change from their existing routines or a lengthy transition period.

Armed with the results of your research, you’ll have a checklist to take with you when you meet potential venders. You can use that list to carefully assess proposed system and formulate a clear picture of how each one—whether it’s called an EMR or an EHR—measures up to meeting as many of your requirements as possible.

Not everyone in the health industry has wrapped their brains around the differences between EMRs and EHRs, according to the National Alliance for Health Information Technology definitions of the terms. So, if you’re shopping for some form of paperless system of recordkeeping and all that goes along with it, you may run into conflicting terminology. What some vendors market as EHRs may in fact be EMRs, or vice-versa.

The bottom line is to become aware, yourself, of the differences. That way, you can evaluate potential systems with a realistic grasp of how they will perform for your practice.

The National Alliance for Health Information Technology (NAHIT) has nailed down the difference between EMR and EHR by generating a definition of each. We already looked at the definition of EMR, which has a more specific focus.  In other words, it’s a more in-depth record of a single diagnosis or treatment. Plus, it tends to be more practical for specialists.

An EHR, on the other hand, is more comprehensive in scope and application. NAHIT defines EHR as “the aggregate electronic record of health-related information on an individual that is created and gathered cumulatively across more than one health care organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care.”

Even though the acronyms for EMR and EHR are often used interchangeably (even on this blog, I must admit), it’s not really a case of “you say to-MAY-to and I say to-MAH-to.” There are significant differences between the two. For those who are considering a purchase now or at some point down the road, it might be a good idea to learn what those differences are.

We’ll start with EMR, which of course stands for “Electronic Medical Records.”

According to the National Alliance for Health Information Technology (NAHIT), an EMR is “the electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization involved in the individual’s health and care.”

Other signs CCHIT has assumed the role as the “official” certifying body for government-approved electronic health records include its recent announcement that it has revised its strategies for certification.

CCHIT said it has come up with three certification strategies—dubbed “paths to certification”–to replace the one approach already in place. The three levels of certification CCHIT proposes are:

1. EHR-C certification - given to EHRs that “significantly exceed minimum Federal standards requirements.”

2. EHR-M certification - a lower cost designation for electronic prescribing, personal health records, registries, and other technologies that would be “focusing on basic compliance with Federal standards and security” and would “appeal to providers who prefer to combine technologies from multiple certified sources.”

3. Low-cost, site-level certification - This would provide a way for those who develop their own EHRs or put them together from noncertified sources to qualify for the HITECH incentives.

For more information, see CCHIT.org.

Those who have been appointed to assign details to implementing the far-reaching goals of the HITECH Bill haven’t issued any kind of a decision about what will qualify as a “certified” EHR. However, CCHIT appears to have placed itself in the first position on the runway.

It recently developed a guide that “maps the criteria to the characteristics of a qualified electronic health record (EHR) as specified in the American Recovery and Reinvestment Act of 2009 (ARRA) and highlights the 09 criteria changes” and also changed “its certification program timelines to adapt to the new requirements of ARRA.”

Using (“meaningfully,” I might add) a “certified” EHR will be key for doctors, clinics, and hospitals who wish to qualify for financial incentives offered in the HITECH act.

In the ongoing discussion about the topic, there’s much speculation about what in fact will constitute a “certified” EHR. Although CCHIT is never specifically mentioned in the HITECH Act, many are speculating it will take a stamp of approval from CCHIT to be considered “certified.”

However, that’s not a given. Government and healthcare leaders are cloistered away in meeting rooms this summer sorting through that very issue, among dozens of others the stimulus package stirred up, in order to pin down the specifics by the end of the year, as promised.

For starters, let’s look at what CCHIT is.

The acronym stands for the Certification Commission for Healthcare Information Technology. On its website (cchit.org), the CCHIT is described as a private, nonprofit organization that certifies electronic health records and their networks.

CCHIT’s stated mission is “to accelerate the adoption of robust, interoperable health information technology by creating a credible, efficient certification process.” The commission’s machinery includes a nine-member board of trustees, twenty-one commissioners, and an additional 170 workgroup members. All involved are volunteers who represent various aspects of the field of health information technology.

The ongoing discussion about the HITECH Act and what it means to healthcare providers includes lots of back-and-forth about what in fact will constitute a “certified” EHR. In that conversation, the name “CCHIT” comes up frequently.

Over the next few days we’ll take a look at that organization and its potential role in the upcoming changes promised by the government’s effort to encourage widespread adoption of EHRs through financial incentives.

News about the HITCH Bill centers on adoption incentives through Medicare reimbursements. But that’s not all the HITECH Bill does. It also provides money for:

- The Office of the National Coordinator of HIT
- Research for comparative effectiveness for the Agency for Healthcare Research and Quality
- Indian Health Service
- Community health centers for the Health Resources and Services Administration
- Veterans Administration
- Department of Agriculture—telemedicine funding
- Upgrades to the Social Security Administration’s HIT systems