EMR v. EHR
The terms electronic medical record (EMR) and electronic health record (EHR) are often used interchangeably.   Technically, there is a distinction, but it's one that's been blurred by common usage.  While it may seem a little picky at first, the difference between the two terms is actually quite significant.  The EMR term came along first, and indeed, early EMRs were “medical.” They were for use by clinicians mostly for diagnosis and treatment.  At a minimum, EMR systems replicate all aspects of your paper charting. They are designed to facilitate all the documentation you do in your office already—lab results, visit notes, diagnostic test results, insurance information, demographics, health histories, medication information and more. 
On April 27, 2004, almost 5 years before the American Recovery and Reinvestment Act and the HITECH Act of February 2009, President George W. Bush, signed Executive Order 13335 establishing the Office for the National Coordinator of Health Information Technology. The purpose of ONCHIT was to facilitate the infrastructure, adoption and interoperability of the EHR. President Bush stated his vision on several occasion for every American to have an EHR by 2014. Since then, the electronic health record has been on the fast track of development. The terms electronic medical record (EMR) and electronic health record (EHR) has been used interchangeably. However, they are very separate entities.
The following info is pulled from 3 major sources regarding the EMR/EHR definitions and meaningful use. It is a combination of information from [www.himssanalytics.org]; [www.himssanalytics.org]; . In the author’s opinion, these are 3 very influential organizations in relation to the development of the Electronic health Record in the United States.
HIMSS Analytics definitions
The term EMR was first introduced at the Mayo clinic in 1880 by Dr. Henry Plummer, MD who believed it was important for each patient to have their own file. This EMR was called patient-oriented record. Later, in the 1960's Dr. Larry Weed, MD at the University of Vermont changed the focus of the patient-oriented record from the patient to the illness or disease. He felt it more important to document in the patient's record the problem, identified signs and symptoms of illness, diagnostic tests performed and plan. Dr. Weed, MD introduced the method of the SOAP format for documentation. Over a period of time with the introduction of computerization in medicine the patient's file changed to the EMR which is a computerized compilation of a patient's medical history. It provides patient medical information for healthcare providers. The EHR represents the ability to easily share medical information among the various entities involved in the patient's well-being such as of care healthcare providers, payers/insurers, including the government.(Hersh,2009)
Definition of an Electronic Health Record (EHR):
The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any healthcare delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, diagnostic and radiology reports. The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting. Currently more interest is seen in the development of the personal health record (PHR) in which the patient is in control of aspects of the medical record. PHR allows the patient to communicate with healthcare providers and monitor progression of care. The patient becomes an integral member of the healthcare team working with providers to improve outcomes.(Hersh,2009)
Hersh,W. (2009)BMC Medical Informatics and Decision Making. A stimulus to define informatics and health information technology.9,24.
The definitions that HIMSS Analytics proposes for these terms are as follows:
Definition of an Electronic Medical Record (EMR):
The EMR is a basic digitized replication of the paper record. It provides basic information for the EHR. The EHR represents the ability to easily share medical information among stakeholders and to have a patient s information follow him or her through the various modalities of care engaged by that individual. Stakeholders are composed of patients/consumers, healthcare providers, employers, and/or payers/insurers, including the government. 
The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting. 
What's the difference between EMR and EHR?
Electronic medical records (EMRs) are a digital version of the paper charts in the clinician’s office. An EMR contains the medical and treatment history of the patients in one practice.  An EMR is a digital copy a patient’s physical chart that can be found in a hospital or a clinic. An EMR contains a patient’s information, including medical history, a list of medications, and list of allergies. EMR helps a health care professional keep track of a patient’s quality of care and keep’s track of a patient’s medical data. This environment supports the patient s electronic medical record across inpatient and outpatient environments, and is used by healthcare practitioners to document, monitor, and manage health care delivery within a care delivery organization (CDO). The data in the EMR is the legal record of what happened to the patient during their encounter at the CDO and is owned by the CDO. EMRs have advantages over paper records. For example, EMRs allow clinicians to:
- Track data over time
- Easily identify which patients are due for preventive screenings or checkups
- Check how their patients are doing on certain parameters—such as blood pressure readings or vaccinations
- Monitor and improve overall quality of care within the practice
- Improve disease surveillance and advancement of public health interventions (See this article review for a discussion of this use.)
But the information in EMRs doesn’t travel easily out of the practice. In fact, the patient’s record might even have to be printed out and delivered by mail to specialists and other members of the care team. In that regard, EMRs are not much better than a paper record. 
EHRs, on the other hand, are essentially EMRs with the capacity for greater electronic exchange; that is, they may be able to follow patients from practice to practice and allow for things like data exchange and messaging between physicians,  presently assumed to be summaries like ASTM s Continuity of Care Record (CCR) or HL7 s Continuity of Care Document (CCD), is owned by the patient and has patient input and access that spans episodes of care across multiple CDOs within a community, region, or state (or in some countries. 
An EHR (Electronic Health Record) also contains patient data, but is more focus on a patient’s total health. It is a compilation of data from all health care providers that have had contact with that patient. The purpose of an EHR is so that when a patient’s data is passed to other organizations, a health care provider will have an overall summary of the patient. Having that data ready allows for better patient care. EHRs are designed to reach out beyond the health organization that originally collects and compiles the information. They are built to share information with other health care providers, such as laboratories and specialists, so they contain information from all the clinicians involved in the patient’s care. The National Alliance for Health Information Technology stated that EHR data "can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization." 
The information moves with the patient—to the specialist, the hospital, the nursing home, the next state or even across the country. In comparing the differences between record types, HIMSS Analytics stated that, “The EHR represents the ability to easily share medical information among stakeholders and to have a patient’s information follow him or her through the various modalities of care engaged by that individual.” EHRs are designed to be accessed by all people involved in the patients care—including the patients themselves. Indeed, that is an explicit expectation in the Stage 1 definition of “meaningful use” of EHRs. 
And that makes all the difference. Because when information is shared in a secure way, it becomes more powerful. Health care is a team effort, and shared information supports that effort. After all, much of the value derived from the health care delivery system results from the effective communication of information from one party to another and, ultimately, the ability of multiple parties to engage in interactive communication of information. 
What They Do
EHR systems can help physicians and office staff better navigate patient information before, during and after an office visit. Here are just a few of the multiple things that an EHR system may capture during a typical clinical visit.  Before a patient even steps into your office, manage scheduling, patient registration and insurance status, health history, insurance status and medication lists, electronically preview a patient's medical history.  During a patient's clinical visit, type in your clinical documentation, electronically prescribe medication, order tests and labs. 
After the patient leaves, manage billing, claims submittal and coding. Electronically communicate with their consulting providers, payers, labs and pharmacies. In some cases, allow patients to view their results through a patient portal. 
Benefits of EHRs
With fully functional EHRs, all members of the healthcare team have easy access to the current patient information allowing for more coordinated, patient-centered care. With EHRs:
- The information gathered by the primary care provider tells the emergency department clinician about the patient’s life threatening allergy, so that care can be adjusted appropriately, even if the patient is unconscious.
- A patient can log on to his own record and see the trend of the lab results over the last year, which can help motivate him to take his medications and keep up with the lifestyle changes that have improved the numbers.
- The lab results run last week are already in the record to tell the specialist what she needs to know without running duplicate tests.
- The clinician’s notes from the patient’s hospital stay can help inform the discharge instructions and follow-up care and enable the patient to move from one care setting to another more smoothly.
- The patient's medical history, provider visits, specialist visits, diagnostics tests, special/radiologic procedures, laboratory data, medication profiles and future appointments can be viewed and reviewed by all members of the healthcare team and used to prevent duplication as well as make informed clinical decisions to improve patient outcomes.
Certified EHR Technology
The Centers for Medicare & Medicaid Services states that Certified EHR Technology is either a:
- Complete EHR that meets the requirements included in the definition of a Qualified EHR and has been tested and certified, or a
- Combination of EHR Modules in which each constituent EHR Module has been tested and certified and the resultant combination also meets the requirements included in the definition of a Qualified EHR. 
The author opines the EMR is a digitized record of a single medical based encounter. The EHR is the digitized health history of a patient within a healthcare organization/entity. It is capable of sharing/exchanging relevant data with other non-related healthcare organizations required by law or at the patient consent. It includes the EMR.
- Garrett, P., Office of Communications ONC. Seidman, J. PhD. Director Meaningful Use, ONC. EMR vs. EHR – What is the Difference? www.himssanalytics.org/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference. January 4, 2011.
- What's the difference between EMR and EHR? https://www.ama-assn.org/ama/pub/physician-resources/health-information-technology/health-it-basics/emrs-ehrs.page
- Garets, D., Davis, M., Electronic Medical Records vs. Electronic Health Records: Yes, There Is a Difference. A HIMSS AnalyticsTM White Paper. HIMSS Analytics, LLC January 26, 2006. www.himssanalytics.org
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- Birkhead, G. S., Klompas, M., & Shah, N. R. (2015). Uses of electronic health records for public health surveillance to advance public health. Annual Review of Public Health,36(1), 345-359. doi:10.1146/annurev-publhealth-031914-122747. http://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-031914-122747
- Garrett, P., & Seidman, J. (2011, January 4). EMR vs EHR – What is the Difference? Retrieved September 9, 2015, from http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/