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?
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