Three labels of electronic medical cards are conventional in the western world – Electronic Health Record (EHR), Electronic Medical Record (EMR) и Personal Health Record (PHR).
Before making wild guesses on what the similarities and differences of these three terms are, we need to come to a decision on what this Electronic Medical Card is. Let us start from that there are two measurements of medical data – what information is stored (or information density) and who is the custodian of this information.
Two cases are possible for the first measurement of the information density:
- A system storing all records on the condition of a person on all medicine directions during the whole life of a patient.
- A system storing some certain records on the patient’s condition in a certain medicine field during the whole life of a patient.
The second metrics is the information custodian which is typical in terms of the following options:
- An organization providing medical services.
- Individual patient.
Thus, in a simplified form, the three types of electronic medical cards can be defined as:
Electronic Health Record (EHR) — stores the information on all medical illnesses; a specially authorized (Health Authority) center is the custodian of information. Medical records are official data and can be accessed by other health authorities and similar providers of medical services as well as laboratories, state establishments and so on for the improvement of health services quality.
Electronic Medical Record (EMR) – stores the information on a certain medical field (for instance, dentistry), a clinic or a practitioner doctor is the custodian. Usually it has the form of electronic version of sickness record of a patient in this very establishment.
Personal Health Record (PHR) – stores some information, the patient itself or a representative of their family is the custodian of the information and responsible for its density and quality.
Usually, when speaking on EMR, people hardly take PHR into account; a patient is frequently not so expertized to input something more than their demographic data and the simplest health data (allergies, inherited illnesses, and vaccinations, taken medicines, data on surgical interventions and other things usually asked by a therapeutic at the visit). If exactly PHR is considered, such systems are not very interested for large providers of medical services.
EHR or EMR are more likely to be considered. Even though the storage method is almost the same, EHR systems put strict regulations on the information security, the audit of the information access, etc. For instance, disclosure of the record on oncological or venereal diseases in the patients’ record, even if the data are encrypted, can cause negative consequences for a patient in case of unauthorized access. You can search for news on an unauthorized access to systems of this kind and the consequences of this.
Turning to Health Level 7 (HL7) and the standard “HL7 EHR-System Functional Model” we know that this standard was developed for specially authorized centers or large providers of medical services, and that nowadays 322 functions and 2310 inspection criteria are typical for the EHR system.
Thus, when reading a regular press release from a company on Electronic Medical Record, it is always interesting which exact system is considered and what is to be implemented in it.
Whether the companies’ representatives consider the same or have some other realities in their minds still remains a question.
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