Types and applications of electronic health records, and definitions
| EHR type and application | Definition* |
|---|---|
| Type | |
| Electronic health record (EHR) | EHRs are electronic platforms that contain health-related data collected during medical care in practices, clinics and other medical settings from various sources, connected to form a network of patient clinical data. EHRs can also incorporate software that allow straightforward physician ordering practice (CPOEs), even including safety features, or that guide physicians through clinical decision-making with up-to-date guidelines (CDSS). |
| Electronic medical record (EMR) | EMRs are routinely collected data sources that contain standard medical and clinical data gathered during medical care in an individual location of a practice, clinic or other medical setting. When the data are shared among different locations and units, it becomes a network and is considered an EHR (i.e., an electronic chart system in a primary care practice that cannot be accessed by any other entity is an EMR, whereas a hospital system in which laboratory data, affiliated clinic charts, etc., are all accessed under 1 platform is an EHR). |
| Application | |
| Clinical decision–support system (CDSS) | A CDSS is an application that supports health providers in performing health care by mining data of an EHR or EMR, and providing guideline-specific recommendations. These systems can often identify errors or missing data, and display alerts or messages through the EHRs. |
| Computerized physician order entry (CPOE) system | CPOE systems are electronic ordering technologies in which physician orders can be entered and processed in a computerized way, often mimicking the workflow found in clinical settings. CPOE systems can be more advanced and identify ordering mistakes, display preferred treatments by individual patient EHR query, or even set up blocks with medication-interaction orders. |
| Personal health record (PHR) | PHRs are electronic platforms (often online interfaces such as websites) that securely store patient’s health information and allow patients to engage actively in their own health. Often, they can add information to a PHR, can exchange it with health providers, see test results, make appointments or receive educational information. We consider PHRs to be only those platforms that are tethered to an EHR, where information can be exchanged in both directions (otherwise, if patients are simply adding data but not viewing any of their data, we consider it an ePRO). |
| Telehealth | Telehealth is the use of telecommunication technologies (telemonitoring) to improve the provision of care. This allows for care to be provided at a distance and therefore to maintain clinical contact with patients at home without requiring the same amount of resources to be dispensed. Examples of telehealth are blood glucose–monitoring machines tethered to an EHR that integrate blood glucose levels (taken by the patient at home) into the EHR automatically (and can send an alert in the EHR interface to the clinician if the values are out of a predefined range and action must be taken), and, increasingly, mobile health data collected by wearable devices. |
| Electronic patientreported outcomes (ePROs) | ePROs are health-related data recorded by the patient themselves in electronic form, often through a website or application. Whereas ePROs have often been used in clinical trials, we also consider ePROs to be any data that have been collected by the patients themselves and tethered to an EHR or PHR. An example would be a patient pain diary, in which a pain score and information are entered daily on a website or via a smartphone application, and these data are added to an EHR, which the clinician can monitor and consult during a visit. |
↵* These definitions are our own working definitions used for this project and have been adapted from HealthIT.gov11 and CMS.gov.12