Electronic Health Records 101

Alright - so we talk about Electronic Health Records, the direction of healthcare and the technology which encapsulates the medical field, but, it must be noted that a lot of the terms we throw at you have rather verbose descriptions which are important to understand in order to appreciate what's to come. So, class, welcome to The Smart Med Card's Thirst Thursday: Drink Up!

Electronic Health Records (EHR)

 

When you have visited a care provider, whether it be a hospital, physician, clinic...etc, a record of that visit was kept. That record contained the detailed outline of your status of health, treatments, medications and so on. That record, though, was unique to the care provider, and existed no-where outside of that institution. This data would be stored on some sort of storage unit (generally a Networked Computer Server) where it could be retrieved and edited, again, only within that institution. So, each visit, within each department, a new record would be created and entered into the system. This concept worked well for monitoring and storing data, but did not work well for creating useable, singleton reports of a patient's history. Here is what I mean:

Figure 1: Pre-EHR [1]

If you look to the left at Figure 1: Pre-EHR [1], you will see, on the far left, a line of data silos (yes, like grain silos). Each silo represents a particular aspect or 'chunk' of an institution that keeps records on you. So, you have labs, nursing, procedures..etc keeping their own record sets on you. This method of storage is great in terms of efficiency in editing and maintaining your records within a particular 'chunk', but, when a complete patient profile needs to be created to determine effect of treatment or within research and data analysis, there is no easy solution. On the right side of this image it tells us that a patient profile is created by logging into separate interfaces for each silo [1].

Figure 2: EHR [1]

With respect to the concept of EHR as we are hearing about it today, here is what they are talking about. Looking at Figure 2: EHR [1] at the left, we again have the silo concept (far left) where each 'chunk' of an institution is keeping records on you (this time using a system-wide patient ID), but this time EHR software, along with an institution-wide unified vocabulary, allow for the both the gathering and formatting of a patients complete history in one location (no separate interface for each silo). A unified vocabulary means that each time a record is created in some location of an institution, they will use terminology/codes to create your record so anyone else in a separate department can access that information using the same terminology/codes. This way, a single large-scale software program can create different views of a patients complete profile as well as allow for unified data research and statistical analysis [1].

So, to conclude, what we mean by EHR, are not the separate records on a patient stored on computers, but rather, we are talking about the large-scale infrastructure required to collect and maintain all of a patients records in such a way that data can be searched, entered, maintained and studied in a single location within a single application.

Sources Cited:
[1]MITRE Center for Enterprise Modernization. 2006. Electronic Health Records Overview. McLean, Virginia. (PDF version of document downloaded August 25, 2011).