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What is an EMR (Electronic Medical Record) or EHR (Electronic Health Record)?

One Type of Digital Patient Health and Medical Record

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Updated October 23, 2012

Digital records kept by your doctor's office, your insurance company or the facilities where you are a patient, are called EHRs (electronic health records) or EMRs (electronic medical records.) Both names are used interchangeably.

Born of Health Information Technology, EMR systems are intended to keep track of a patient's entire health and medical history in a computerized, electronic format. By keeping these potentially vast records in this manner, they are more easily retrievable, and can make a patient's navigation through the healthcare system much safer and more efficient.

EMRs have not been adopted nearly so quickly in the US as one might expect. Lack of standardization, and issues of security and privacy have stood in the way of their implementation.

EMRs are comprised of two kinds of records. Older records, generally pre-2000, are usually scanned and stored in a graphic format or pdf. These might include anything from doctors' notes to x-rays or other test results such as ultrasounds or MRIs. Since some of those records were recorded by hand, some may be illegible. Further, because of the processes used to shift from paper to digital records, or for recording new digital records, many mistakes were simply replicated, or even created by the digital conversion.

More recent records may be electronically native. That means they were never stored in any fashion except as a digital record. If your doctor records notes as you talk, or if you are issued a prescription from a computer printer, then your current records are being kept natively in digital form.

The federal government has defined a complete EMR system as containing four basic functions: computerized orders for prescriptions, computerized orders for tests, reporting of test results, and physician notes. An individual doctor's practice, facility or insurance company's system determines on its own which of those records will be kept, making it more or less complete.

In 2009, as a part of the Economic Stimulus, the federal government began offering incentives to providers to encourage implementation of electronic health records. The incentives are in the form of rebates or reimbursements based on a set of criteria called Meaningful Use. (Learn more about Meaningful Use and challenges with getting it implemented.)

EMRs are not the only form of digital patient record. Patients may create their own PHR (personal health record). Hybrid systems are also in use.

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