How often do you pay bills or fees online? How often do you check your credit balance directly on your phone, without going to the ATM and printing a tiny piece of paper? We sometimes don’t realize just how paperless we are.

The paperless concept is also felt in the medical industry. Electronic Medical Records (EMR) systems take the classic paper chart and give it a digital dimension, as a way to streamline healthcare, and even ensure better care for patients.

But what are they exactly, and do they improve the medical system?

EMRs 101: What Are They, Exactly?

The National Alliance for Health Information Technology defines EMRs as “an electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.”

They are digital versions of all the information one can usually find in a patient’s chart:

  • Medical history
  • Medications
  • Diagnoses
  • Allergies
  • Lab results
  • Physician notes

But they are more than just a digitalization of the paper chart. When they are ‘done right’, or widely implemented across a medical system, EMR can allow better communication and coordination between multiple parties in charge of the care of the same patient.

A family doctor, therapist, surgeon, and other health care provider of the same patient can have the same information about the patient; at the institutional level, electronically available, easily accessible point-of-care information helps streamline treatment plan creation based on the patient as a whole, helping enhance health outcomes.[1]

Electronically available, easily accessible point-of-care information helps streamline treatment plan creation based on the patient as a whole, helping enhance health outcomes.

The Benefits of an EMR

When talking about EMR and its benefits, there are two notable dimensions to consider. One, of course, is the patient. EMRs should ultimately lead to improved care for the patient. Otherwise, they serve no purpose at all.

The second dimension has to do with the medical institutions and doctors.

  1. For Patients

EMR has the potential of offering a more complete view of a patient because they can compile a lot of different data. What’s more, that data can be easily transferred or made accessible both in a timely and safe manner.

Before EMR programs, or in places where they are still not used, a patient’s file would have to be physically transported if the patient moved to another doctor, city, state, or country. Moreover, paper charts can be lost, misplaced, or their information can be incomplete, which can ultimately affect the wellbeing of the patient if they are seeing a doctor for the first time.

People rarely know everything about their medical situation. And during emotional events, they can forget to disclose part of that information to their doctor. Just think if you’ve been in a car accident and are rushed to the hospital.

Even if you’re still conscious, that’s a moment where emotions are running high, and you can easily forget to tell the treating doctor you’re allergic to certain pain medication. If you get prescribed that medicine, that’s an extra health crisis you and your doctors have to deal with. But, with an EMR system, the doctor could have had all your relevant medical information on hand.

Here are some other benefits of EMRs:

  • Quicker assessment and care;
  • Improved diagnosis;
  • Tracking patient evolution over time;
  • Reducing patient errors;
  • Better follow-up;
  • Evidence-based decisions, even in crisis situations.
  1. For Doctors and Clinics

One obvious benefit for EMR as far as clinics are concerned is less hassle in physically handling and storing patient files.

Hospitals and other health institutions can sometimes be overwhelmed by the sheer volume of paper they must handle. If the clinic only has 1000 patients, that’s 1000 paper charts, which are only comprised of a single piece of paper.

Then, there’s storing, which requires space or room designed for just that purpose. That room must be kept safe because it contains sensitive patient information that legally you cannot be careless with. Then, when the patient comes in, someone has to physically retrieve that file from the secure room. Files will be stored based on a system, usually alphabetically.

But if a nurse or a doctor who was returning a file makes a mistake, and files an “M’ file in the “N’ section, then it can be a genuine nightmare to sift through all the files to try and find it. And if it’s lost, the hospital can be liable.

But that’s just one benefit of EMRs.

Others include[2][3]:

  • Optimized workflow;
  • Reduce administrative costs;
  • Provide automatic alerts and reminders;
  • Improved patient documentation;
  • Less room for mistakes and liability lawsuits;
  • Increased security;
  • Tracking treatment plans and medications.

The American Recovery and Reinvestment Act of 2009

The American Recovery and Reinvestment Act of 2009 (ARRA)[4] was a stimulus package that included $19.2 billion to be invested in health information technology for health institutions to implement EMR systems. The act stipulated that healthcare providers had until January 1, 2014, to convert paper charts and prove conversion was successful by showing “meaningful use.”

This term “meaningful use” essentially stipulates the purpose and EMR software must serve, both for the patient and the hospital[5][6]:

  • Improve health safety;
  • Improve healthcare quality;
  • Improve efficiency;
  • Reduce healthcare disparities;
  • Improve doctor-patient interaction;
  • Improve coordination of medical care;
  • Secure and keep patient information private.

Essentially, the act recognizes that implementing an EMR just for the sake of it is not a sustainable solution. Doctors, practices, and healthcare institutions must go from paper to digital as long as they can prove that by doing so they are ultimately improving the services they offer to their patients, regardless of how these services look like.

EMRs play a valuable role in blended care healthcare models – and more efficient practice management is just the start.

As such, they play a valuable role in blended care healthcare models – and more efficient practice management is just the start. Surveys of primary care showed their numerous benefits had an impact on healthcare delivery through improved information access, practitioner productivity, more accurate invoicing, lowered record-keeping costs, better patient satisfaction, and even improved health outcomes.[7]

EMRs vs. EHRs: Are They the Same?

Along with the EMR term, you are likely to hear about “EHR” too, sometimes even used to convey the exact same thing. But are they?

At their core, just one word is different: medical, versus health.

While a lot of people believe them to be the same thing, some experts like those from the National Coordinator for Health Information Technology (ONC) believe they signify two different things altogether.[8]

And that can be the case in practice as well, with an EMR software having different features than an Electronic Health Record (EHR) system. A health institution or a doctor could very well opt for one of them without realizing they may not come with the features they need, in which case they are making a needless investment that could end up costing them later on.

There is another key distinction between EMRs vs EHRs:

  • An EHR system could contain EMR information, meaning the patient’s digital paper chart which has all information about medical history, allergies, and treatment.
  • But according to the National Alliance for Health Information Technology, EHR data “can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization”.[8]

So EMRs are designed to be used throughout one institution, while EHRs can go beyond that and gather data relating to a person’s overall health, even if not medical in nature.

In real life, however, these lines tend to be rather blurred, so as a doctor or representative of a health institution on the market for and EMR or EHR, the golden rule is always looking at the features of the software before making a purchase, and see if it addresses your needs.

That is the only way to know that the system you are going to implement will be beneficial to your practice.

5 Top EMR Systems To Consider

As we’ve already seen, the best EMR for your virtual care practice will be the one that can address your unique requirements.

Fortunately, today’s advancing medical technology offers ample flexibility for practitioners – it’s now possible to find flexible primary and behavioral healthcare systems with a combination of functions. Providers also cater to different practice sizes and budgets, so consider whether your practice could benefit from the following features:

  • Digital records – Would you like to be able to access patient and record data from a variety of digital platforms, such as a mobile app?
  • Billing and invoicing – Some platforms issue invoices automatically and straight to the patient. Others come with integrated payment systems that accept consultation fees and related expenses through 3rd parties such as PayPal.
  • Scheduling – Does a dedicated patient portal sound helpful, or would you like to give new potential clients a chance to book consultations?
  • Compliance tracking – Ensuring you’re practicing within the legal restrictions and requirements imposed by your state can be made easier with easily-accessible records.
  • Prescription issuing and monitoring – Are you looking for a telehealth or telepsychology system that supports the prescription of medication?
  • Capacity for promoting better patient health engagement – e.g. Can patients keep track of between-session notes and progress? Are they encouraged to log in and proactively search for information on their particular mental health issue?
  • Adequate security and data protection – e.g. Do they offer HIPAA-compliant communications as part of a larger system?

Before you opt for one EMR over the other, consider too what marketing needs your practice could benefit from. As well as coming in a lot of different shapes and sizes, some systems even provide assistance with growing your business by listing you as part of a directory. Some others, often called white-label platforms, can be customized so that you can present everything under your own brand.

Here are some of the most popular EMR systems on the market right now:

EMRDetails
eClinicalWorkseClinicalWorks is an EHR system that also contains EMR features such as:

  • Appointment Scheduling
  • Charting
  • Compliance Tracking
  • E-Prescribing
  • Handwriting Recognition
  • Meaningful Use Certified
  • ONC-ATCB Certified
  • Self Service Portal

It is one of the most popular EMR systems to date, with over 850,000 medical professionals around the globe currently using it in their practice. You can find different versions for hospitals and smaller practices, as well as features for billing and patient engagement.

NameeClinicalWorks
Price$499+ monthly
Good ForPrescription, Practice Management, Client Communications
Websitehttps://www.eclinicalworks.com/
EMRDetails
AllScriptsAllscripts Professional EHR is a solution designed for mid-size to small practices, with EMR features such as:

  • Appointment Scheduling
  • Charting
  • Compliance Tracking
  • E-Prescribing
  • Self Service Portal

This system works with a user-friendly interface that doctors can use to update patient files even through mobile devices, cutting down the time spent on paperwork significantly. The provider also offers additional systems for practice finances and patient engagement.

NameAllScripts Professional EHR
PriceDepends on product/service
Good ForAnalytics, Client Communications, Data Integration
Websitehttps://www.allscripts.com/solution/professional/
EMRDetails
CernerCerner is a company that offers various solutions to hospitals and practices, including EHR services.

It has integrated clinical, financial and operational tools all under one singular interface, meaning that Cerner could potentially help health care providers in all aspects of their activity.

Example solutions for providers cover areas such as:

  • Analytics
  • Patient Engagement
  • Pharmaceuticals
  • Behavioral Health
NameCerner
PriceDepends on product/service
Good ForAnalytics, Client Communications, Data Integration
Websitehttps://www.cerner.com/
EMRDetails
Practice Fusion EHRPractice Fusion is a cloud-based EMR system with the following features:

  • Appointment Scheduling
  • Charting
  • Compliance Tracking
  • E-Prescribing
  • Meaningful Use Certified
  • ONC-ATCB Certified
  • Self Service Portal
  • Voice Recognition
  • On-Call Scheduling
  • Patient Records Management
  • Physician Management
  • Recurring Appointments
  • Messaging
  • Progress Tracking

It is designed to help independent practices face many logistical and patient management challenges easily, cutting down a lot of unnecessary costs and making the entire practice more efficient.

NamePractice Fusion
PriceDepends on product/service
Good ForPractice Management, Client Communications, Small-Large Providers
Websitehttps://www.practicefusion.com/
EMRDetails
EpicCareEpicCare EMR doesn’t have as many features as the other systems on this list but does focus solely on EMR services. So, if that’s what you need, EpicCare can be quite a useful tool for hospitals, clinics, independent practices, and other medical organizations.

  • Features include:
  • Appointment Scheduling
  • Compliance Tracking
  • Self Service Portal
  • Voice Recognition
  • Team Collaboration
  • Accountability System

EpicCare can be especially valuable for smaller practices, or those who already have a practice management system in place, and only need to take care of digitizing patient records. In this context, an EHR with additional services can sometimes come with higher costs that the practice doesn’t necessarily need. An EMR-only system is, therefore, more appropriate.

NameEpicCare EMR
PriceDepends on license
Good ForSmall practices, Customization, Practice Management
Websitehttps://www.epic.com/software

Final Thoughts

So, are we paperless yet?

According to an ONC report published in 2014, around 83% of doctors were using an EHR, while 74% were using a certified EHR.[9] Since a lot of these systems include EMR features, we don’t really have data on how many doctors use EMRs alone, but the type of system itself isn’t really the point.

The point is the fact that an overwhelming number of doctors had embraces digitizing patient records in 2014, and by now the numbers would have most likely increased – note, the number refers to the number of doctors, not institutions. An institution could adopt such a system, but the medical professional could very well reject it or have another member of staff update patient files on the EMR.

So we are indeed going paperless in the medical sector, for better or for worse. As for whether they work or not, a lot of evidence we have right now isn’t anything to brag about. Early studies find almost no boost in efficiency, while newer ones seem to be more hopeful.[6] But as we move forward, technology will improve, and no doubt EMRs and EHRs will leave a much more impressive mark on our medical system.

References

  1. ^ Khalifa, M. (2017). Perceived Benefits of Implementing and Using Hospital Information Systems and Electronic Medical Records. Studies in Health Technology and Informatics, 238, 165.
  2. ^ Wang, S. J., Middleton, B., Prosser, L. A., Bardon, C. G., Spurr, C. D., Carchidi, P. J. & Kuperman, G. J. (2003). A cost-benefit analysis of electronic medical records in primary care. The American Journal of Medicine, 114(5), 397.
  3. ^ Jones, M., Koziel, C., Larsen, D., Berry, P., & Kubatka-Willms, E. (2017). Progress in the enhanced use of electronic medical records: data from the Ontario experience. JMIR Medical Informatics, 5(1), e5.
  4. ^ NTIA. (2009). American Recovery and Reinvestment Act of 2009. Retrieved from https://www.ntia.doc.gov/page/2011/american-recovery-and-reinvestment-act-2009
  5. ^ DesRoches, C. M., Campbell, E. G., Rao, S. R., Donelan, K., Ferris, T. G., Jha, A. & Blumenthal, D. (2008). Electronic health records in ambulatory care—a national survey of physicians. New England Journal of Medicine, 359(1), 50.
  6. ^ Manca, D. P. (2015). Do electronic medical records improve quality of care? Yes. Canadian Family Physician Medecin de Famille Canadien, 61(10), 846.
  7. ^ Khalifa, M. (2017). Perceived Benefits of Implementing and Using Hospital Information Systems and Electronic Medical Records. Studies in Health Technology and Informatics, 238, 165.
  8. ^ Garrett, P., & Seidman, J. (2011). EMR vs EHR–What is the Difference. HealthITBuzz. Retrieved from: https://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference
  9. ^ Heisey-Grove, D. & Patel, V. (2015). Any, Certified, or Basic: Quantifying Physician EHR Adoption. ONC Data Brief, No. 28. Office of the National Coordinator for Health Information Technology: Washington DC.

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