EHR-EMR-PHR or how does an EHR differ from an EHR?
Earlier in the comments and in the article, I mentioned that in the western world, three designations of the EHR are accepted - Electronic Health Record (EHR), Electronic Medical Record (EMR) and Personal Health Record (PHR).
Before guessing at the coffee grounds, what these three terms look like or differ from, you need to decide what is this very Electronic Medical Card. To begin with, there are two dimensions of medical data — what information is stored (or completeness of information) and who is the custodian of this information.
For the first measurement, completeness of information, the following two cases are possible:
• A system that stores all possible records about the patient's condition, in all areas of medicine, throughout the patient's life.
• Systems storing strictly defined records of the patient's condition, in a specific area of ​​medicine, throughout the patient's life.
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The second dimension, the keeper of information, which is characterized by the following options:
• An organization that provides medical services.
• The patient as a private individual.
This picture shows possible options:
Thus, in a simplified form, three types of electronic medical records can be defined as:
Electronic Health Record (EHR) - stores information on all medical diseases, the custodian is a specially authorized center (Health Authority). Medical records are official data, may be available to other authorized centers and similar representatives of medical services, as well as laboratories, state. institutions, etc. to improve the quality of health care.
Electronic Medical Record (EMR) - stores information regarding a specific medical field (for example, dentistry), the custodian is a clinic or a medical practitioner. This is usually an electronic version of the patient’s medical history in this particular institution.
Personal Health Record (PHR) - stores some medical information, the custodian, or rather the responsibility for the completeness and quality of information, is the patient himself (or his representative, for example, a family member).
Usually, when people talk about EHR, they hardly mean PHR, the patient is often not competent enough to enter more than their demographic data and simple health data (allergies, hereditary diseases, vaccinations, medications taken, surgical data, etc. which is usually asked by any general practitioner at the reception). If all the same it is said about PHR, then such systems are of little interest for large providers of medical services.
Most likely, they mean either EHR or EMR. And although the method of storing medical data is unlikely to be very different between these systems, EHR systems impose serious requirements for protecting information, auditing access to information, etc. For example, disclosing the presence of a record of cancer or venereal diseases in the patient's card, even if the data is encrypted, may have negative consequences for the patient in the event of unauthorized access. If you wish, you can find news about unauthorized access to such systems and the consequences of this.
The Office of the National Coordinator for Health IT (ONC), which is part of the National Alliance for Health Information Technology (NAHIT), decrypts the same abbreviations as follows (this time without translation):
The EHR: It has been established that it has been gathered together and has been consulted by the licensed physician.
It has been created, gathered, managed, and consulted.
PHR: An online record of the individual.
Returning to Health Level 7 (HL7) and the “ HL7 EHR-System Functional Model ” or “HL7 Functional Model of EHR” standard, which I described in a previous article , we now know that the standard is designed for specially authorized centers or large health care providers, and that for the typical EHR system, today, there are 322 features and 2310 validation criteria.
Thus, when you read the next press release from some company about the Electronic Medical Card, you always want to know which system of the three presented above is meant and what exactly will be implemented.
Do company representatives mean the same thing, or do they have some other reality in their heads?
Before guessing at the coffee grounds, what these three terms look like or differ from, you need to decide what is this very Electronic Medical Card. To begin with, there are two dimensions of medical data — what information is stored (or completeness of information) and who is the custodian of this information.
For the first measurement, completeness of information, the following two cases are possible:
• A system that stores all possible records about the patient's condition, in all areas of medicine, throughout the patient's life.
• Systems storing strictly defined records of the patient's condition, in a specific area of ​​medicine, throughout the patient's life.
')
The second dimension, the keeper of information, which is characterized by the following options:
• An organization that provides medical services.
• The patient as a private individual.
This picture shows possible options:
Thus, in a simplified form, three types of electronic medical records can be defined as:
Electronic Health Record (EHR) - stores information on all medical diseases, the custodian is a specially authorized center (Health Authority). Medical records are official data, may be available to other authorized centers and similar representatives of medical services, as well as laboratories, state. institutions, etc. to improve the quality of health care.
Electronic Medical Record (EMR) - stores information regarding a specific medical field (for example, dentistry), the custodian is a clinic or a medical practitioner. This is usually an electronic version of the patient’s medical history in this particular institution.
Personal Health Record (PHR) - stores some medical information, the custodian, or rather the responsibility for the completeness and quality of information, is the patient himself (or his representative, for example, a family member).
Usually, when people talk about EHR, they hardly mean PHR, the patient is often not competent enough to enter more than their demographic data and simple health data (allergies, hereditary diseases, vaccinations, medications taken, surgical data, etc. which is usually asked by any general practitioner at the reception). If all the same it is said about PHR, then such systems are of little interest for large providers of medical services.
Most likely, they mean either EHR or EMR. And although the method of storing medical data is unlikely to be very different between these systems, EHR systems impose serious requirements for protecting information, auditing access to information, etc. For example, disclosing the presence of a record of cancer or venereal diseases in the patient's card, even if the data is encrypted, may have negative consequences for the patient in the event of unauthorized access. If you wish, you can find news about unauthorized access to such systems and the consequences of this.
The Office of the National Coordinator for Health IT (ONC), which is part of the National Alliance for Health Information Technology (NAHIT), decrypts the same abbreviations as follows (this time without translation):
The EHR: It has been established that it has been gathered together and has been consulted by the licensed physician.
It has been created, gathered, managed, and consulted.
PHR: An online record of the individual.
Returning to Health Level 7 (HL7) and the “ HL7 EHR-System Functional Model ” or “HL7 Functional Model of EHR” standard, which I described in a previous article , we now know that the standard is designed for specially authorized centers or large health care providers, and that for the typical EHR system, today, there are 322 features and 2310 validation criteria.
Thus, when you read the next press release from some company about the Electronic Medical Card, you always want to know which system of the three presented above is meant and what exactly will be implemented.
Do company representatives mean the same thing, or do they have some other reality in their heads?
Source: https://habr.com/ru/post/257241/
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