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This is an old revision of this page, as edited by 65.119.207.34 (talk) at 15:44, 10 March 2009 (→I agree). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

EHR Vs EMR

I do not agree that EHR and EMR should be merged as a single entry in wikipedia.

Electronic Health Record is increasingly being used to descibe a shared longitudional health record that is composed of relevant summaries and clinical information collected from other Electronic Medical Records or entered directly into the EHR. EHRs are currently being implemented in the UK and Canada. A national EHR is under consideration in Australia. EHRs are oriented toward sharing of clinical data across diverse stakeholders.

Electronic Medical Record is a detailed records of clinical events and interactions. EMR Commercial-off-the-shelf (COTS) software has been available from vendors such as Cerner, IDX, OACIS. These producst typicaly include order-entry, results reporting, electronic prescribing, clinical decision support, charting, clinical notes. An EMR represents the day-to-day events of a patient. In a stand-alone setting, a doctors surgery may run stand-alone EMR software (or shared amongst the pratice) to manage pathology/radiology requests and results, prescribing, clincial notes as well as follow-up, diary functions etc.

In summary, EHR is ideally a shared longitudional health summary record. EMR is a detailed day-to-day medical record. As they have different meanings they should not be merged.

References:

EHR Definition, Attributes and Essential Requirements Version 1.0 - HIMSS definition of EHR.

Healthcare informatics article on the the difference between EHR and EMR.

--Pgillogley 01:22, 26 February 2006 (UTC)[reply]

I agree. EHR is recognized as a distinct entity - typically operating across a large geographical area and a large number healthcare institutions. While there are many models, the only one that has gained much traction is a centralized database, where HL7 messages from various institutions are normalized, identified and then stored in a massive data repository.

Contrast EMR has in my experience two different but related meanings - either the system run within a hospital that will show a medication chart, lab results - or for a doctor in the community. Either way - this shows detailed information. Often a summary of an entire encounter may be summarized into a single electronic document, which is then stored in the EHR.

Within the Healthcare IT industry EHR and EMR are distinct (though often confused) terms.

--Kelsey Grant 08:13, 23 March 2006 (UTC)[reply]


I also agree they should be separate. I found a useful layperson's summary of this topic that seems on target:

- EMR (Electronic Medical Record): Owned and controlled by the healthcare provider, it contains information about the services provided by a single provider to a patient.

- PHR (Personal Health Record): Owned and controlled by the patient or care-giver. It contains an overview of ALL key aspects of the patient's healthcare from ALL providers including medications, conditions, procedures, allergies, past locations of car, etc

- EHR (Electronic Health Record): The combination of an EMR+PHR in which the data is shared between the two systems.

I found this in a briefing given by the head of MEDEM who was helping launch the iHealthRecord system. http://www.connectlive.com/events/medem/# It also seems to agree with the Medical Records Institute's synopsis on this topic. http://www.medrecinst.com/uploadedFiles/MRILibrary/StatusReport.pdf

--[User:LarsonBennett] 16 April 2006

I support some method of explaining the differences between the alphabet soup now developing (ie: EHR, EMR, CCR, PHR, EPR, CMR....). Please consider that there is great value to the nonmedical, non-IT user of Wikipedia in merging the articles Electronic health record, Electronic medical record and Continuity of Care Record into a common article with subsections explaining the distinctions and expanding each topic. Fragmentation of a field is a real problem in Wikipedia, and makes it difficult for users to get fully informed about a topic if they aren't aware of the terms and nuances. Instead of an encyclopedic approach, many small and often incomplete articles are written. Reading these 3 articles, it is hard to see the similarities and distinctions that the discussers in this talk section know about. Given the lead sentence of each article being so similar, I don't think a disambiguation page with a sentence on each topic would be helpful either.
So, why not take a single term (I suggest Electronic health record since it is growing in popularity and use), and redirect all other terms to the EHR article? Then EMR and CCR (and any other new terms introduced by the industry) could be defined and related to EMR as subsections of the EHR article. The EMR article is more comprehensive than the EHR article at this moment, so adding it to EHR would be a nice enhancement.--Ryanjo 02:56, 27 July 2006 (UTC)[reply]


I think that EMR and EHR should definitely be merged. Everything we have written under the "issues" section is equally applicable to EMRs as it is to EHRs. For example, privacy, interoperability, etc. applies to both. The differences between the two designations are wonky and not worth the added confusion of creating two separate articles. Although I am fairly new to Wikipedia, I think it seems silly to have two pages with such similar intents. I dislike the fact that the content of the two pages are so dissimilar--EMRs have more in common with EHRs than not. These definitions are changing all the time; I have heard industry folks use them interchangeably, or with different understandings of their meaning. I know you found good-looking distinctions online, but in reality the distinctions are nebulous. --Kawanazii 19:08, 7 August 2006 (UTC)kawanazii[reply]
It is reasonable to have EMR as a subset of EHR. It is commonly accepted industry practice to refer to an EMR as a product limited in scope solely to the electronic patient chart. EHR, on the other hand, is a much more comprehensive term and refers to the electronic chart along with supporting modules such as scheduling, disease management, decision support, HL7 lab connectivity, security and audit, patient portal and, in some instances, practice manegement. CCHIT certification requirements exceed the scope of EMR. Interoperability is a separate and distinct designation that is encompassed within an initiative called IHE (integrating the healthcare enterprise). IHE includes basic sharing of lab results in a universally accepted format (LOINC) and un-codified text. The ultimate goal is semantic interoperability, or true machine to machine transferrable codified data. An open source data model, such as Medicapaedia, mapped to standards such as SnoMed, CPT, ICD-9 and LOINC may be the surest and fastest solution to this immense challenge.

David Winn, M.D., FAAFP Founder and CEO, e-MDs —Preceding unsigned comment added by 70.129.204.236 (talk) 03:33, 6 April 2008 (UTC)[reply]

The merger question (as you can see from this discussion section) has been hotly contested for several years. Kawanazii & I announced a merge in 2006, but were thwarted by an IP user, possibly one of the several IP addresses who craftily insert commercial links to favored EMR products or sponsored websites. As a fallback position, to give Wikipedia readers a comprehensive article about the various electronic forms of medical data (ie: EHR, EMR, CCR, PHR, EPR, CMR....), I suggest all editors who want to contribute to information on electronic healthcare recordkeeping focus their work to enhance this EHR article.Ryanjo (talk) 17:02, 6 April 2008 (UTC)[reply]

Major format and content revision

I added some new sections, including content from electronic medical record to help make distinctions, and did some formatting an added an image from the health informatics page. All the previous content is there! --Ryanjo 02:12, 30 July 2006 (UTC)[reply]

Merge with Electronic Health Record is imminent!

Hi, I agree with you that the EMR and EHR articles should be merged. How do we go about doing that? --Kawanazii 19:12, 7 August 2006 (UTC)

I think I'll post on the EMR discussion page that it will be merged into the EHR page if no objections, since the content of the EMR page is already in the EHR page, plus more. If no protests in a day, replace the text of the EMR page with the Redirect command, targeting the EHR page (see Wikipedia:Redirect). Regards, --Ryanjo 22:10, 7 August 2006 (UTC)[reply]
I that thats a bad idea, but I am not going to defend my position, because I am used to it not mattering on the Wikipedia. - 69.47.132.138 03:15, 9 August 2006 (UTC)[reply]

I'm sorry, but you cannot merge EMR into EHR and have EHR as the remaining page. EMR is used far more often to describe the software that is being discussed than EHR is. If in any doubt about that, check out the Wordtracker or Overture search tools and you will see that far more people are searching for Electronic Medical Records than anything else. 200.49.144.222 23:21, 10 August 2006 (UTC)[reply]

I think this issue (use of EMR & EHR) is best addressed by this merge than by two separate articles:
Ryanjo 01:03, 11 August 2006 (UTC)[reply]

Smart merge and/or term clarification

Dear all, please see Talk:Electronic medical record#Smart merge and/or term clarification for continuation of the merge discussion with a view to making a clear resolution. — Donama 13:39, 27 September 2006 (UTC)[reply]

Rename to "Electronic health record"

This article should be renamed (as per WP:TITLE and WP:CAPS) to "Electronic health record"). Is that okay by all? — Donama 04:36, 29 September 2006 (UTC)[reply]

Agree. Ryanjo 23:47, 29 September 2006 (UTC)[reply]
  • Support, there is no legitimate reason for it to be capitalized. It is only capitalized now because it is frequently expressed as an acronym (EHR). Unfortunately, many articles on Wikipedia are incorrectly capitalized for the same reason. The capital letters of acronyms fool people into thinking the expanded term should be capitalized and many sources capitalize the first mention of a term so that the origin of the acronym is made clearer. After the first mention, they usually refer to it by acronym only, so people rarely see it uncapitalized (although the writers may not know it is supposed to be uncapitalized themselves, either). -- Kjkolb 02:36, 30 September 2006 (UTC)[reply]

Seems to have been done. Andrewa 09:24, 6 October 2006 (UTC)[reply]

Contribution to Interoperability subsection

A paragraph was added to the Interoperability section, which I have "commented out", pending further review:

The AAFP believes the ASTM CCR standard is a clinically sophisticated and technically robust solution to the need for both portability and interoperability of patient health information stored in physicians’ EHRs. We believe the ASTM CCR will provide a near term benefit by making those products and services which are compliant with it more desirable to new purchasers of EHRs, thus making it possible for the New Model of family practice to go from concept to reality at an accelerated pace. The AAFP recommends to its members that they select EHR products, services, and vendors of HIT that are ASTM CCR compliant or in the process of adopting the ASTM CCR. Vendor recognition and acceptance of the value to be gained by complying with the ASTM CCR is borne out by the fact that over twenty-five vendors of HIT software have been involved in its ongoing development and have participated in two demonstrations of ASTM CCR interoperability in 2004 and 2005.

My comments are:

The text above is not formatted for an encyclopedia ("We believe"...who is "we"?) and is unreferenced. It reads as if it was lifted from a sales site. It does not describe what ASTM standards are, why they are deserving of mention here, and how it will improve EHR interoperability. The contributor of this text should reformat these statements and provide references, rather than purchasing recommendations.

Ryanjo 03:20, 28 December 2006 (UTC)[reply]

Ideas for creating a free EHR =

EHR/EMR's are EXPENSIVE... or cheap and not that useful. I've developed some great ways to ENTER patient encounters quickly and efficiently (this I thought would be the hard part). Now, I'm struggling on how to organize this data... how to keep demographics organized, current medications, etc. Could a wiki be set up for this?? Other opensource solutions??

http://www.edrawer.com/ looks useful, but at about $5k is not an affordable applications.

Thoughts? —Preceding unsigned comment added by 71.125.233.52 (talk • contribs)

Greetings, I noticed that you posted twice on this Talk page about starting a discussion on developing a free/low cost EHR. While undoubtably that is interesting to many, the Talk page is exclusively reserved for discussion about the editing of the article. Your post is likely to be removed again (not by me). I suggest approaching this in a few other ways:
  • Start your own wiki discussion/posting group on Wikia (it's free). Then post messages on the forums (below) to notify interested parties, who may post there. Just don't post invitations or links on Wikipedia Talk or article pages though, unless your Wikia page has referenced material that could be used in the article.
  • Join one of the on-line forums on EHR such as EMRupdate or DocsBoard.
Ryanjo 16:06, 3 February 2007 (UTC)[reply]

Personal bias and "niche" creation of EMR and EHR

I strongly disagree with those who would espouse their own definition of the differences between EMR and EHRs.

There is no standardization in terminology regarding these acronyms, no matter how strongly one or more people assert it to be true.

Furthermore, the distinctions are often subtle, fluid, and subject to marketing whims of companies that are trying to establish a niche for their product.

If some people espouse a separation of terms for localized storage versus distributed storage of health data, Wikipedia is not the place to attempt to do so.

There is already a lot of disagreement between centralized storage at a local site versus localized storage at a central site.

These differentaitions are relevant to the Internet and Information Technology as a whole, not specifically to Electronic Health (Medical) Records.

It is a disservice to the world at large to attempt to co-opt terms for marketing reasons.

I vote to merge EMR with EHR on Wikipedia.

I agree. The merge request has been taken away for some reason though. Donama 01:52, 28 September 2007 (UTC)[reply]
I am going to add a merge tag back. Donama (talk) 22:55, 31 March 2008 (UTC)[reply]

Contribution to Social and organizational barriers section

Two paragraphs was added to the Social and organizational barriers section, which I have "commented out", pending further review:

While many believe that the implementation of electronic health records is a solution for the ever-increasing cost of health care, others believe that they will instead create more problems rather than providing a solution. Privacy advocates, consumer groups, and civil libertarians are concerned with privacy violations which may occur once information is made available electronically. Others are concerned with additional expenses which will be incurred while implementing EHR. Physicians have identified that much of the evidence available regarding the cost-savings associated with EHR is published by vendors and by others who have a stake in the success of EHR implementation. Without evidence, published by unbiased sources, of EHR's financial savings for individual physicians, many are resistant to invest in a system which they are not confident will provide them with a return on their investment.

One primary reason that organizations are so resistant to EHR implementation is that such implementation would result in significant changes in their daily operations. Changes will occur in how patient and patient care information is collected, stored and communicated. Those changes will require education, skills training, continuous improvement, and the proper management to help assist in the transition from paper to electronic health records.

The author should provide references for the statements in these two paragraphs, and replace the weasel words. The rest of the article is heavily referenced, and this material should be supported similarly by citations. Ryanjo 00:40, 12 June 2007 (UTC)[reply]

Including product endorsements in the article

Several recent edits have been placed in this article, basically consisting of product placements. While these products may be noteworthy, they are being given undue emphasis. The recognized method for mentioning commercial products in an Wikipedia article covering a general topic, such as EHR, is to include a statement covering the general principle or scope of the product type, with a footnote containing the product name and a link (if necessary and useful, not just to a sales site).

For example, this provides little information and a lot of sales hype:

However, a new template-based supplementary EHR system, called “Julius” could bring satisfaction among physicians. It does not require any repetition of data recording, nor more effort from clinicians. The Julius system is composed of three subsystems: (1) the Concept Data Service (CDS) which is the starting point where clinicians can define the variables they want to record; (2) the Template Data Service (TDS) which is the subsystem where individuals are allowed to easily compose the new templates or edit old ones; and (3) the Patient Data Service (PDS) that manages and stores patient data. The Julius system is beneficial and compatible for EHR. In addition, it has received positive feedback from clinicians so far, since it provides the opportunity for health care professionals to adjust the system according to their specific needs. [22]

Could be rewritten as a more informative, less pandering:

Newer EHR systems are being introduced to simplify data recording. <reference here>

I plan to wait a few days for those contributers work on these edits to make them more impartial and suitable for Wikipedia, before doing the edits myself. Comments anyone? Ryanjo 00:57, 20 June 2007 (UTC)[reply]

I "commented out" the product endorsement, and preserved the reference> Ryanjo 11:42, 14 July 2007 (UTC)[reply]

I vote no to merge Personal Health Record (PHR) with EHR/EMR

The difference between the scope of a personal health record and an electronic health record/electronic medical record is the difference between a flash drive and a centralized server.

The order of magnitude, scope of purpose, portability, user base (individual versus entire nation or hospital) and numerous other distinctions are substantial. Furthermore a personal health record may not be specific to any particular EMR/EHR.

It is a different animal not only in terminology but also in physical dimension and implementation. I vote to keep Personal Health Record as a separate article. Physadvoc 20:32, 12 July 2007 (UTC)[reply]

Thanks for the information. Instead of merging Portable digital personal health record to here, I've redirected it to Personal health record. --Alynna 17:39, 13 July 2007 (UTC)[reply]

Note: An EHR can be an personal health record, if it is a person-centric EHR (what contemporary EHRs are these days). Donama 01:50, 28 September 2007 (UTC)[reply]

PHRs available commercially?

I removed the line that states that PHRs are available for purchase online. The reference cited made no mention of that claim and therefore was a dishonest citation.

The negative implication by the statement was that commercial online companies could acquire all your health data and then sell it back to you.

This is an argumentative speculation by detractors of the concept of a personal health record, not a reality.

Physadvoc 19:27, 15 July 2007 (UTC)[reply]

It sounds more like you removed a potentially true statement because you don't want people to think about the possibility! Perhaps it would be more honest and complete to write something like "the commercial sale of PHR information is a potential threat/danger of such information being available as electronic files"? -69.87.200.188 20:57, 26 July 2007 (UTC)[reply]

Disagree 69.87.200.188. This is meant to be an encyclopaedia so we shouldn't state untruths and in most cases don't need to remind people about possibilities. Let's include only factual, referenced informatics as per Wikipedia guidelines. Donama 01:49, 28 September 2007 (UTC)[reply]

30% reduction in article size

In some cases I removed the same sentence that was repeated 10 times!

I know that there are lots of people trying to make a buck on electronic health record systems, but gosh! if you make the article unreadable by everyone jockeying for their little phrasing of the same sentence over and over again, no one reads the article!

Try to keep fact minutiae, if you must include it, in the footnotes. By the way, some footnotes were repeated 4 times as well. Physadvoc 01:45, 16 July 2007 (UTC)[reply]

I can no longer find some of the toughest criticisms of problems with EHR:
  1. Several studies in peer-reviewed journals found that outcomes were worse with EHR, including increased mortality, than in comparison groups.
  1. There is now a loophole in the HIPAA rules which allow hospitals to merge psychotherapy records with general medical records, which removes the special protection given to psychotherapy records. Patricia Galvan, a lawyer, sued a hospital when they disclosed her psychotherapy records, despite specific assurances, to an insurance company which then used their misinterpretation of her therapist's notes to deny her disability.
Why were these deleted? Nbauman 18:32, 9 August 2007 (UTC)[reply]

If you don't cite the reference, don't make a blanket statement. I read the Archives of Internal Medicine article, and it said no such thing as was initially claimed. It is now quoted correctly. If you would like to claim something, read the referenced article before "quoting" it.

Also, a single lawyer's lawsuit is not the focus of this Wikipedia article. Lawyers will sue about anything.

I didn't cite a single lawyer's lawsuit, I cited a Wall Street Journal article which interviewed privacy experts on all sides. In lawsuits, hospitals and other defendants often have to disclose information about their policies that they've never before disclosed publicly. Galvan's lawsuit disclosed the fact that despite their assurances to patients that psychotherapy records are confidential, hospitals do disclose psychotherapy records in ways that are not required by law and are harmful to patients. These disclosures are the result of entering records into EHRs. This is an example of how EHRs can sacrifice patient privacy and confidentiality, and harm patients. This danger is important enough to include in a Wikipedia article about EHR. How would you like it if your most private information was entered into a public record if you challenged a disability determination?
I cited the Archives article when I first included it in the article, as I recall. I saw a reference to these problems in last week's NEJM, and I'll get back to this after I read it.
Generally speaking, EHRs have a lot of potential, and work well in places like the VA system, but when people try them out elsewhere, they often don't work and sometimes do more harm than good. Anyone who writes about EHRs should acknowledge their successes and their failures. Nbauman 13:50, 14 August 2007 (UTC)[reply]
I just re-read the Archives article, and it says in the Conclusion: "As implemented, EHRs were not associated with better quality ambulatory care."[1] That's the authors' conclusion, and that's what the Wikipedia article should say about that study. Nbauman 13:57, 14 August 2007 (UTC)[reply]

End-of-life directives

The article seems to make no mention of living wills, health care proxies, etc. Electronic health record systems must make active provisions for making such end-of-life directive information available -- and DNR orders etc prominent! -69.87.200.188 20:54, 26 July 2007 (UTC)[reply]

Good point! I added it in as a type of information contained in medical records...

Barriers of EHR

Studies suggest that healthcare records are fragmented and inaccessible which is leading to adverse affects on the quality of healthcare as well as patient safety.  A proposed solution to the problem is the implementation of information technology (IT) as a means of storing electronic heath records and therefore improving the status of healthcare.   The Electronic Health Record (EHR) is a database and associated application software that a provider maintains regarding patient's wellness and encounters with various health care services.  A recent survey of U.S. primary care physicians found that almost 75% indicated that these applications could reduce errors; 70% perceived IT as potentially increasing their productivity; over 60% indicated that IT tools have the potential to reduce costs and help patients assume more responsibility (1).  However, there has been a lag in the utilization of information technology in physicians’ practices in the U.S.  In 2001, less than 17% of primary care physicians had implemented EHR.   There are noteworthy barriers to implementing EHR into practice including high initial costs, complexity and quality of EHR programming, as well as privacy concerns.  Barriers concerning the high initial cost also take into account the uncertainty of the pay-offs incurred following the installation of an information technology system.  The preliminary cost of EHR in ambulatory care may range anywhere from $16,000 to $36,000 per physician.  Additionally, maintenance and decreased revenue from patients during the transition period must also be accounted for.  Research indicates that the complexity and quality barriers are quite significant among physicians as well (1).  According to Healthcare Financial Management Association (HFMA) research (2005), hospitals face a number of barriers in acquiring and implementing EHR systems. Of the 176 healthcare finance executives who participated in the survey, 62 percent responded that a lack of national information standards and code sets is one of the most significant barriers to EHR adoption. Fifty-nine percent reported that a lack of available funding is a significant barrier; 51 percent reported concern about physician usage; and 50 percent expressed concern over a lack of interoperability (2).  Studies also indicate that physicians consider the effort and time involved in learning how to use these programs as an important barrier.  In addition, one study indicated that 86% of physicians surveyed felt that the vendors’ inability to provide acceptable products as a significant barrier to information technology implementation in their practices.  Privacy concerns also arise regarding the implementation of EHR and information technology.  A large number of these systems are web-based.  Physicians and patients fear that EHR may not be secure as a result.  The concern is even greater when wireless Internet is introduced into the picture (1). Overcoming these barriers will require subsidies and performance incentives by the payers and government. Also, certification and standardization of vendor applications that permit clinical data exchange will be required to achieve greater interoperability. In addition greater security of medical data must be guaranteed (3).


References

(1) J.G.Anderson, E.A. Balas, computerization of primary care in the United States, Int.J.Healt Inform.Syst. Inform.1(3)(2006) 1-23

(2) Overcoming Barriers to Electronic Health Record Adoption; Results of Survey and Roundtable Discussions conducted by the Healthcare Financial Management Association http://www.hhs.gov/healthit/ahic/materials/meeting03/ehr/HFMA_OvercomingBarriers.pdf

(3) J.G. Anderson. Social, ethical and legal barriers to e-health. Int J Med Inform. 2007 may-Jun;76(5-6):480-3. Equb 2006 Oct 24. --Hwangju (talk) 22:53, 22 February 2008 (UTC)[reply]

EHR's are not EMR's

Basically, an EMR is a hospital database of patient encounter information, usually within a healthcare institution such as a clinic or hospital. This record should not be available to other institutions.

The EHR is more of a combination of health & medical record information for individuals and can include PHR, EMR, Dental, Chiropractic and public health information. The EHR is the health application that could form the back-bone for a RHIO to which all health institutions would need to connect to, through established interoperability standards.

___________________________________________________________ 

Anthony O. Oloni, MD, MPHi, CPHI

Medical Director & Physician Informatics Consultant PHICON (Public Health Informatics Consultants) Division of Preventive Medicine Associates, Atlanta

Clinical Informatics & Information Specialist Georgia Poison Control Center Hughes Spalding Children's Hospital Grady Health System 80 Jesse Hill, Jr. Dr., SE

Box 2822, Acworth GA 30102 Phone: Cell (678) 886 7992; Office (678) 354 6144; Fax (678) 302-6330 Email: Anthony.Oloni@PHICON.org | Company Web: www.PHICON.org

an EHR is NOT an EMR

There must be certain requirements met in order for a system to be considered an Electronic Health Record. NAHIT recently released HIT definitions concerning this very topic, and clearly outlined the differences. An Electronic Medical Record is defined 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. An Electronic Health Record however, is an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.

In order for a system to be considered an EHR, it must possess interoperability standards defined at a national level based upon the ability of the record to be utilized across more than one organization. This becomes even clearer as the government slowly works towards rewarding an interoperable system through higher reimbursement for organizations that have an EHR in place. —Preceding unsigned comment added by 206.145.28.20 (talk) 16:31, 30 July 2008 (UTC)[reply]

What does the literature say?

Perhaps we should look to the literature to guide this discussion. I'll add the appropriate citations but I wanted to quickly state the electronic health record (EHR) is the standard label at this point in time. Electronic medical record (EMR) can in some instances be the medical/physician specific area of the EHR -but when the EHR is integrated there is a challenge identifying the EMR from the EHR. The personal or even individual health record is yet another subcategory of the EHR. These comments may in fact prove wrong as change is so rapid in this area.

Real problem is there are too many consultants and academics wanting to name things as if we're discovering new stars or new elements. The only problem is we are really frauds as renaming things is not a discovery, it's theft. Let's look at sensible ways to link pages together so the end user is able to find what they are looking for with little to no effort? P.A.P. (talk) 03:06, 2 October 2008 (UTC)[reply]

Do we need a section on "Comparison of EHR software solutions"?

I suggest that this section either be deleted or expanded to encompass all available software. Also, it has no bona fide references verifying the data presented. It really adds nothing worthy of Wikipedia unless it is expanded or referenced. In view of the fact that potential references will likely point to commercial sites, it would be appropriate simply to delete it, and focus on improving the general information in the rest of the article, instead of providing a sales guide. Other editors please comment. Ryanjo (talk) 02:31, 24 November 2008 (UTC)[reply]

Piecemeal versus comprehensive treatment

So much of the material under EHR and EMR covers the same ground, yet does not adequately distinguish between the two. The Obama administration is supporting widespread adoption of "certified EHR", so that is probably how electronic health care records will be referred to, regardless of the differences. It seems to me this topic needs to be addressed in its entirety, with the different record types explained in terms of who will create them, who will use them, and how they will be used. So I think EHR, EMR, PHR, and all the others need to be merged into a single article, but I have no idea how to title it! Wgieric (talk) 20:28, 27 February 2009 (UTC)[reply]

Virtualization

Several of the EMR software solutions are listed as multi-platform. However, at least Amazing Charts (which I use) only runs natively on Windows XP & Vista. Some users have run it using a Virtual Machine on Macs -- the reliability on Linux is more doubtful. Therefore, I have added the qualifier using virtualization to the listing. Other editors should modify the listings similarly if the EMR is not native but can run by emulator. Ryanjo (talk) 18:40, 7 March 2009 (UTC)[reply]

I agree

I agree that EHR and EMR be combined as a medical office assistant student and medical office receptionist I use an EHR and have studied simulations of both EHR and EMR's and they are basically the same thing with a different name. It's a waste to have to articles that should be merged.

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