What Is the Difference Between EMR and EHR?

In healthcare, the terms electronic medical records (EMRs) and electronic health records (EHRs) are often used interchangeably. However, the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) notes that there is a significant difference between the two terms.

The question is, what is the difference between EMRs and EHRs, and what role do they play in the roadmap towards national interoperability?

What does EMR Mean?

Electronic medical records are digital versions of paper records found in clinical settings like physician offices, clinics, and hospitals. EMRs collate notes and information collected by clinicians and staff in these clinical settings to assist with diagnosis and treatment.

Additionally, EMRs help track data over time and identify opportunities for clinicians to help patients improve healthcare quality, like preventive screenings and visits.

Put simply, an EMR is a digital version of a patient’s chart, with medical and treatment history from one practice. In practicality, this means that EMRs stay in place and do not get shared unless requested by a patient’s new doctor.

What Does EHR Mean?

Electronic health records go beyond the standard collection of clinical data in a provider’s office to give a more inclusive and longitudinal history of a patient’s health records, because they contain information from all clinicians involved in that patient’s care.

Unlike EMRs, which are kept in one place, EHRs are designed to share information with other healthcare providers, including laboratories and specialists, to follow the patient throughout the healthcare continuum.

The History of EMRs

While it’s up to the provider to choose whether they will use an EMR or an EHR, it’s important to note that historically, EMRs paved the way for EHRs to have more advanced capabilities. In the 1960s, doctors and healthcare providers used handwritten paper medical records and paper filing systems to keep patient medical history.

By the mid-1960s, academic centers began to develop their own clinical information systems for storing electronic medical information. The first EMR system was developed in 1972 by the Regenstrief Institute, but adoption of the system was limited to government hospitals and other larger institutions due to its high cost.

The rise and availability of the internet in the 1990s enabled faster, easier access to health information online, setting the stage for web-based EMRs to emerge in the early 2000s. Coupled with industry-wide recognition that electronic medical records systems needed to be developed, EMRs emerged to access information remotely in an appealing and affordable manner for physician use.

Advantages to using EMR systems include:

• Standardized and more efficient record keeping for clinician notes, assessments, lab results, and other clinical documents that can be shared internally with authorized members of a healthcare team at a clinical site
• Reduction in errors related to misinterpreting handwriting or transcription

Despite these advantages, there are minor drawbacks to using EMR systems. The first is that EMRs can be costly, with additional features such as patient portal or integration with a medical billing partner sometimes costing more money.

Second, EMRs don’t always support the consistent, fast care collaboration that’s often needed in modern health systems, which can leave some users frustrated and can put care outcomes at risk. However, for some clinicians, like psychiatrists and other specialists who don’t often collaborate with other clinicians, EMRs provide a simple solution to keep and maintain patient records electronically.

The Shift from EMRs to EHRs

While both EMRs and EHRs can help healthcare be more efficient and less costly, EHRs provide additional insights that inform clinical decisions and go beyond clinical data to focus on the total health of each patient throughout the healthcare ecosystem.

As healthcare and care coordination became increasingly complicated, EMRs no longer suited the needs of clinicians or the administrative needs of healthcare staff.

The shift towards EHRs occurred in the early 2000s, when President George W. Bush doubled the budget for healthcare IT projects, and the National Health Information Coordinator was created with a call for industry-wide adoption of EHRs by 2014.

President Obama further supported the drive towards EHRs as part of the American Recovery and Reinvestment Act (ARRA), which directed additional funding and incentives to healthcare professions to adopt electronic health records for “meaningful use.” ARRA allocated $19 million to be used to digitize health care records in the United States to optimize EHRs and increase data interoperability.

Between 2006 and 2011, adoption of an EHR system increased from 29% to 73%. In 2012, 71.8% of office-based physicians reported using any type of EHR system. According to the Centers for Disease Control and Prevention, use of any EHR system increased by over 295% from 2001 to 2012.

The Rise of EHRs in Hospitals

While adoption of EHRs in physician offices increased, hospitals have also greatly increased their use of EHRs. According to an ASTP/ONC brief, 97% of hospitals nationwide used EHR data in 2017, compared to 87% in 2015. ONC noted that from 2015 to 2017, the greatest increase in the use of EHR data was for identifying high-risk patients, care gaps, approaches to query for patient data, and areas for quality improvement.

By 2024, EHR adoption has flourished, not just due to federal mandates, but because healthcare providers and hospital systems have experienced firsthand how seamless data exchange and enhanced clinical insights drive better care decisions. This has resulted in a notable elevation in the overall quality of care, making EHR systems an indispensable part of healthcare.

Moreover, platforms like PointClickCare’s Marketplace have emerged as game-changers, offering a wide range of integrated third-party applications and services, allowing providers to customize their EHR experience, adding tools for specialized clinical needs, administrative efficiency, and advanced analytics.

Advantages of EMRs Compared to EHRs

EHRs are software that can securely document, store, retrieve, share, and analyze information about an individual patient’s care. EHR systems are hosted either locally or remotely with remote systems being “cloud-based” or “internet-based.”

EHRs have many advantages compared to EMRs, including:

• Viewing a more complete patient medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory test results from one or multiple clinicians or health systems
• Accessing to evidence-based tools that can help clinical decision-making
• Automating and streamlining provider workflows
• Allowing a patient’s medical information to move with them, enabling physicians to stay apprised of their care with other physicians

However, as with any type of technology, there can be drawbacks. Some of the challenges of EHRs include data security, maintenance costs, and other administrative issues. The transition to EHRs can also cause frustration among clinicians who expect electronic records to make care more efficient but are left feeling that EHRs increased their workload.

The Path to Interoperability through Health IT

While EHRs are fundamentally advantageous as healthcare interoperability evolves, care coordination requires more than an EHR or EMR to fully leverage the true potential of healthcare data and information exchanges to better inform clinical decision making.

After achieving more widespread adoption of EHRs, Congress passed the 21st Century Cures Act in 2016, which aimed to improve interoperability by enabling data sharing across disparate networks, reducing information blocking, advancing a trusted exchange framework for exchange between health information networks, and promoting patients’ ability to have greater access to their health information.

The Cures Act intended to reduce clinicians’ regulatory and administrative burden to create a health system where health information and data “flows appropriately and securely to patients and their clinicians to coordinate care, reduce costs, and make care faster and less duplicative.”

To do this, ONC launched the Health IT Certification Program to provide assurances that EHRs meet the technological capabilities, functionality, and security requirements adopted by the U.S. Department of Health and Human Services.

For example, many clinicians currently may not be alerted in real time through their EHR or EMR that their patient has presented to the emergency department. And if they are alerted, they may not be able to access clinical documents or get the key information that may get lost in the mix of broader data reporting processes.

A way to close this gap is by leveraging health IT services, like encounter notification technology and alerting, that provide clinicians and care managers with real-time, customizable, and actionable information that easily integrates into their workflows to better manage care coordination.

The Future of Health IT Integration with EHRs

In healthcare, the shift towards a national health IT infrastructure builds upon the use of EHRs to transform healthcare, in coordination with health information data exchange to better connect siloed health care data in real time. While EMRs are sufficient for some clinicians to meet meaningful use requirements and their clinical workflows, widespread adoption of EHRs is the first step to promoting interoperability.

Coupled with the increased use of healthcare data exchange and other health IT tools that provide targeted insights into workflows, EHRs help provide better health care by enhancing all aspects of patient care.

This includes lower costs, increased efficiencies, improved coordination, and more awareness for and access to preventative medicine—all while promoting a person-centered approach.

As the healthcare industry seeks to move towards value-based and whole-person care, the use of certified health IT like EHRs and its integrated solutions will continue to move the needle towards interoperability that will better healthcare quality, administration, and care. If you’re ready to explore how a seamlessly integrated EHR can boost your organization’s efficiency, let’s start a conversation. Reach out to PointClickCare to learn more.