E M I L Y B A R E Y , R N , M S ND I R E C T O R O F N U R S I N G I N F O R M A T I C SE P I C S Y S T E M S , V E R O N A , W I S C O N S I N

EMRs, EHRs, PHRs, questions and answers

WELCOME

• Emily Barey RN, MSN• Director of Nursing

Informatics, Epic Verona, Wisconsin• Role of the industry

vendor

WHAT IS AN EMR? EHR? PHR?

• Electronic Medical Record• is the digital version of the

paper chart, located at the clinic or hospital where you receive care

• Electronic Health Record • is a broader data set written by

the entire care team; designed to follow the patient across different care settings

• Personal Health Record • is like an EHR but entirely

entered and managed by the patient

http://www.healthit.gov/providers-professionals/faqs/what-are-differences-between-electronic-medical-records-electronic

WHAT IS IN AN ELECTRONIC RECORD?

• Past History & Problems• Medications you

take• Allergies you have• Clinical notes• Vital signs• Scanned documents• Results and Images

Before EHR

After EHR

CAN I SEE MY RECORD?

• Patient Portal vs. PHR• Shared record with your

doctor via a portal• Personal health record that

you enter all the data

• What is shared?• Determined by

organization and capability of software vendor

• Proxy access• Consent to see your child’s

record or elderly parent, spouse

WHY USE AN EHR?

A clinician point of view

• Accessibility• Legibility• Alerts & Reminders• Avoid duplication and

decrease cost• Follow patient

preferences• Research• More!

A patient point of view

• A shared record with you• Better care• Convenience• Continuity of care• But sometimes they still ask

me the same questions, why?• The software system• The policy of the healthcare

organization• Learning a new paradigm to

verify and update

Who Uses an EHR?

Nursing Home

Doctor’s Office

Surgery Center

Hospital

Your Home

INTEROPERABILITY

How does my record move electronically?

• Computers can talk to each other

• Often they need an interpreter• Government standards

determine the “language” the EHR computers must send messages to each other in

• Basic data set today, growing all the time what can be shared

Why doesn’t it ALWAYS work?

• Some EHR systems can’t send messages yet in the standard language• Role of EHR

Certification• Government program

called Meaningful Use requires use of an EHR that can send standard messages

LACK OF INTEROPERABILITY

What if my doctor or hospital doesn’t use an EHR?

• Copy & Fax Machines• US Postal System• You carry your record • It isn’t available

IS MY RECORD SAFE?

• HIPAA & HITECH• Health Insurance

Portability & Accountability Act

• Health Information Technology for Economic & Clinical Health Act

• Sharing the record to coordinate care• Audit trails of access

1. http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html2. http://www.healthit.gov/patients-families/protecting-your-privacy-security

QUESTIONS TO ASK YOUR PROVIDER

• Can you sign up for access to your shared medical record?• Can your provider

share your record electronically with other providers if necessary?