Automated EMR machine

I have always been intrigued by the term and acronym  ‘EMR’ (Electronic Medical Record).   That’s right, term and acronym. Some people use ‘EHR'(Electronic Health Record)  or even PHR (Personal Health Record).

There are a few published definitions of the acronym ‘EMR’ on the web, but some of the differences are not obvious. As I understand it, the gist is that an EMR is a subset of an EHR; that once diagnosis metadata is added to  an EMR, it becomes an EHR.  Compilations of EHRs make a PHR… or something like that.

It’s almost like calling a soft taco a burrito as soon as you add beans. Descriptive, but are they really that much different?  Is the hunger of someone looking for a soft taco likely to be sated by eating a burrito?

This brings me to the term EHR. Many companies literally call themselves “EMR vendors”. What does this mean? Are they selling records or selling applications/services that  involve electronic records?  The linguistic problems where the meaning of the term becomes more strongly associated with the acronym is very interesting.

Saying “I want to implement an EMR”  is almost like saying “Hold on, I need to go the ATM Machine.” At some point, we don’t care what the acronym stands for, it has become the noun in question. I don’t have any specific gripes with using acronyms as words, but I wonder if there is a more precise word or term we can use for… It takes a minute to even think of how to use the acronym correctly… an “EMR management product”.

Additionally, why is there such a focus on the words electronic and record? All three of the leading terms have the word ‘record’ in them,two of them have the word ‘electronic’.   Are these systems we are implementing really just about records? Or are they about improving connectivity and collaboration between doctors  to allowing better care and reporting?

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2 Responses to “Automated EMR machine”

  1. Rick Orlowski, MD Says:

    Ideally, EMR’s can and should be about enhancing care, efficiency, and collaboration. These are honorable and satisfying goals and would make a great contribution to patient care.

    Unfortunately, much (most) of the effort has been perverted to satisfy mindless government documentation requirements. The main purpose seems to be to provide enough check-mark items for a government auditor to pass the daily note as “not fraudulent”. Lost is the emphasis on appropriateness, accuracy and concise delivery. The regulators only want to see that you have enough verbiage for 14 check-marks. They do not care and have no way of knowing if you actually did the right thing in the patient encounter. “EMR” daily notes are typically very frustrating to actually read. When I encounter one from an outside practice I scan about 6 pages of government fluff and try to find the 3 or 4 meaningful sentences that will help me help the patient. Given today’s climate of government authorized bounty hunters who have enormous financial incentive to “find” “fraud” and who have total immunity then the sorts of documents have become a necessity. Doctors and EMR vendors know the game and are forced, at gunpoint, to play it.

    There is another dark side to EMR’s. Notice that current efforts to “unify” records and reporting come along with efforts for the government to control all of health care. When government controls all of health care they can justify virtually any manipulation of the public on an individual level–you know, you have to do such and such because it’s good for “our” health. Having EMRs reporting to the government gives regulators a handy, powerful and potentially omnipotent tool to control individuals. What better way to gain detailed information about nitty-gritty details of your subjects.

  2. orlowski Says:

    Perhaps we should petition the HL7 comittee to provide a ‘relevant information’ section for their notes specification…

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