Difference between revisions of "Electronic medical record"

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''(This article was taken from Wikipedia)''
An '''electronic medical record''' ('''EMR''') is a computerized medical record created in an organization across inpatient and outpatient environments that is used to document, monitor, and manage health care delivery within organizations such as a [[hospital]] or physician's office.<ref name="HIMSSemrvsehr">{{cite web |url=http://www.himssanalytics.org/docs/wp_emr_ehr.pdf |title=Electronic Medical Records vs. Electronic Health Records: Yes, There Is a Difference |author=Garets, Dave; Davis, Mike |publisher=HIMSS Analytics, LLC |date=26 January 2006 |accessdate=08 May 2013}}</ref> Electronic medical records tend to be a part of a local stand-alone health [[information]] system that allows storage, retrieval and modification of records.


An '''electronic medical record''' ('''EMR''') is a computerized medical record created in an organization that delivers care, such as a hospital or physician's office.<ref>http://www.providersedge.com/ehdocs/ehr_articles/Electronic_Patient_Records-EMRs_and_EHRs.pdf</ref> Electronic medical records tend to be a part of a local stand-alone health information system that allows storage, retrieval and modification of records.
==Contribution under UN administration and accredited organizations==


==Contrast with paper-based record==
The United Nations World Health Organization (WHO) administration intentionally does not contribute to an internationally standardized view of medical records nor to personal health records. However, WHO contributes to minimum requirements definition for developing countries.<ref name="WHOMRM">{{cite web |url=http://whqlibdoc.who.int/wpro/2002/9290610050.pdf |format=PDF |title=Medical Records Manual - A Guide for Developing Countries |publisher=WHO |date=March 2001 |accessdate=08 May 2013}}</ref>


Paper based records are still by far the most common method of recording patient information for most hospitals and practices in the U.S.<ref>"Use of Electronic Health Records in U.S. Hospitals," New England Journal of Medicine, March 25, 2009</ref>  The majority of doctors still find their ease of data entry and low cost hard to part with.  However, as easy as they are for the doctor to record medical data at the point of care, they require a significant amount of storage space compared to digital records. In the US, most states require physical records be held for a minimum of seven years. The costs of storage media, such as paper and film, per unit of information differ dramatically from that of electronic storage media. When paper records are stored in different locations, collating them to a single location for review by a health care provider is time consuming and complicated, whereas the process can be simplified with electronic records. This is particularly true in the case of person-centered records, which are impractical to maintain if not electronic (thus difficult to centralize or federate). When paper-based records are required in multiple locations, copying, faxing, and transporting costs are significant compared to duplication and transfer of digital records.{{Citation needed|date=February 2010}}  Because of these many "after entry" benefits, federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic medical records. Congress included a formula of both incentives (up to $44K per physician under Medicare or up to $65K over 6 years, under Medicaid) and penalties (i.e. decreased Medicare/Medicaid reimbursements for covered patients to doctors who fail to use EMR's by 2015) for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the [[American Recovery and Reinvestment Act of 2009]].<ref>U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 412, 413, 422 et al. Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Final Rule</ref>
The United Nations accredited standardization body [[International Organization for Standardization]] (ISO) however has settled on some standards in the scope of the [[Health Level 7|HL7]] platform for health care informatics. Respective standards are available with ISO/HL7 10781:2009 Electronic Health Record-System Functional Model, Release 1.1<ref name="ISO10781">{{cite web |urlhttp://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?csnumber=46087 |title=ISO/HL7 10781:2009 - Electronic Health Record-System Functional Model, Release 1.1 |publisher=ISO |date=2009 |accessdate=08 May 2013}}</ref> and subsequent sets of detailing standards.


One study estimates electronic medical records improve overall efficiency by 6% per year, and the monthly cost of an EMR may (depending on the cost of the EMR) be offset by the cost of only a few "unnecessary" tests or admissions.<ref>{{cite journal |author=Evans DC, Nichol WP, Perlin JB |title=Effect of the implementation of an enterprise-wide Electronic Health Record on productivity in the Veterans Health Administration |journal=Health Econ Policy Law |volume=1 |issue=Pt 2 |pages=163–9 |year=2006 |month=April |pmid=18634688 |doi=10.1017/S1744133105001210 |url=http://journals.cambridge.org/action/displayAbstract;jsessionid=7C274D08947B0625B3B540BEF2E70367.tomcat1?fromPage=online&aid=416400}}</ref><ref>{{cite web|title=VistA:Winner of the 2006 Innovations in American Government Award|url=http://www.innovations.va.gov/innovations/docs/InnovationsVistAInfoPackage.pdf|publisher=The Ash Institute for Democratic Governance and Innovation at Harvard University's John F. Kennedy School of Government|format=PDF}}</ref> Jerome Groopman disputed these results, publicly asking "how such dramatic claims of cost-saving and quality improvement could be true".<ref>{{cite news|title=Obama's $80 Billion Exaggeration|url=http://online.wsj.com/article/SB123681586452302125.html|accessdate=3 March 2010|date=12 March 2009|publisher=Wall Street Journal|author=Jerome Groopman & Pamela Hartzband}}</ref>
==Privacy concerns==
A major concern is adequate confidentiality of the individual records being managed electronically. According to a 2006 LA Times article, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and over 600,000 payers, providers and other entities that handle providers' billing data have some access.<ref name="LATExpos">{{cite news |author=Foreman, Judy |title=At risk of exposure |publisher=Los Angeles Times |date=26 June 2006 |url=http://articles.latimes.com/2006/jun/26/health/he-privacy26 |accessdate=08 May 2013}}</ref>  


However, the increased portability and accessibility of electronic medical records may also increase the ease with which they can be accessed and stolen by unauthorized persons or unscrupulous users versus paper medical records as acknowledged by the increased security requirements for electronic medical records included in the Health Information and Accessibility Act and by recent large-scale breaches in confidential records reported by EMR users.<ref>"Griffin Hospital reports breach of dozens of patient medical records", CtPost.com, March, 29, 2010</ref><ref>Kate Ramunni; "UCLA hospital scandal grows" Los Angeles Times, August 05, 2008</ref> Concerns about security contribute to the resistance shown to their widespread adoption.
In the United States, this class of information is referred to as protected health information (PHI), and its management is addressed under the [[Health Insurance Portability and Accountability Act]] (HIPAA) as well as many local laws.<ref name="CodeLawsUS">{{cite web |url=http://www.gpo.gov/fdsys/pkg/CFR-2012-title45-vol1/xml/CFR-2012-title45-vol1-sec164-501.xml |title=US Code of Federal Regulations, Title 45, Volume 1, Section 164.501 - Definitions |publisher=U.S. Government Printing Office |date=01 October 2012 |accessdate=08 May 2013}}</ref>  


There is also the issue of etiquette and kindness.  The medical consultation is an intimate and trusting form of humanb to human relationship. Some consider it is rude to introduce a computer into this sort of consultation/relationship as it depersonalizes it.
In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care.<ref name="EUDir95">{{cite web |url=http://www.dataprivacy.ie/viewdoc.asp?m=&fn=/documents/LEGAL/6aii.htm |archiveurl=http://web.archive.org/web/20070928142238/http://www.dataprivacy.ie/viewdoc.asp?m=&fn=/documents/LEGAL/6aii.htm |title=EU Directive 95/46/EC - The Data Protection Directive |publisher=Office of the Data Protection Commissioner |archivedate=28 September 2007 |accessdate=08 May 2013}}</ref>


Handwritten paper medical records can be associated with poor legibility, which can contribute to medical errors.<ref>{{cite web | last=Institute of Medicine | first= | year=1999 | url=http://fermat.nap.edu/catalog/9728.html#toc | title=To Err Is Human: Building a Safer Health System (1999) | publisher=The National Academies Press | accessdate=2006-06-20}} {{Dead link|date=September 2010|bot=H3llBot}}</ref> Then again it is arguably, extremely easy to click and print off completely wrong medications, requiring no actual cognition on the part of the medical practitioner, and potentially therefore far MORE dangerous.  Pre-printed forms, the standardization of abbreviations, and standards for penmanship were encouraged to improve reliability of paper medical records. Electronic records help with the standardization of forms, terminology and abbreviations, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies.<ref>{{cite web | publisher = EMR Software Pro | year = 2011 | url = http://emrsoftwarepro.com/health-information-exchanges-and-the-emr-selection-process/ | title = EMR Software Information Exchange, January 25, 2011 }}</ref><ref>"Health Information Exchanges and Your EMR Selection Process," New England Journal of Medicine, January 25, 2011</ref>
==Technical standards==
Though there are few standards for modern day EMR systems as a whole, there are many standards relating to specific aspects of EMRs. These include:
* [[Health Level 7|HL7]] - message format for interchange between different record systems and practice management systems
* [[ASC X12|ANSI X12]] ([[Electronic data interchange|EDI]]) - A set of transaction protocols used in the US for transmitting virtually any aspect of patient data
* CEN - CONTSYS (EN 13940), a system of concepts to support continuity of care
* CEN - EHRcom (EN 13606), a standard for the communication of information from EHR systems
* CEN - HISA (EN 12967), a services standard for inter-system communication in a clinical information environment
* [[DICOM]], a standard for representing and communicating radiology images and reporting


In contrast, EMRs can be continuously updated (within certain legal limitations - see below).  The ability to exchange records between different EMR systems ("interoperability"<ref>Adapted from the IEEE definition of interoperability, and legal definitions used by the FCC (47 CFR 51.3), in statutes regarding copyright protection (17 USC 1201), and e-government services (44 USC 3601)</ref>) would facilitate the co-ordination of healthcare delivery in non-affiliated healthcare facilities.  In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management and public health communicable disease surveillance.<ref>{{cite web | format = PDF | publisher = Healthcare Information and Management Systems Society | year = 2003 | url = http://www.himss.org/content/files/EHRAttributes.pdf | title = EHR Definition, Attributes and Essential Requirements | size = 152&nbsp;[[Kibibyte|KiB]] | accessdate = 2006-07-28}}</ref>
===Interoperability towards sharing records===
 
In the United States, the development of standards for EMR interoperability has been at the forefront of the national health care agenda at least since the mid-2000s.<ref name="SAPCMS0609">{{cite web |url=http://www.cms.hhs.gov/MissionVisionGoals/Downloads/CMSStrategicActionPlan06-09_061023a.pdf |archiveurl=http://web.archive.org/web/20090121021249/http://www.cms.hhs.gov/MissionVisionGoals/Downloads/CMSStrategicActionPlan06-09_061023a.pdf |format=PDF |title=CMS Strategic Action Plan 2006–2009 |publisher=CMS |date=16 October 2006 |archivedate=21 January 2009 |accessdate=08 May 2013}}</ref> Many physicians currently have computerized practice management systems that can be used in conjunction with a [[health information exchange]] (HIE), allowing for first steps in sharing patient information (lab results, public health reporting) which are necessary for timely, patient-centered, and portable care.
== Contribution under UN administration and accredited organizations ==
Paper based records also increase a medical officers workload with referrals, letters and call backs often serviced by the doctor themselves rather than medical administrative staff.  In addition, electronic medical records seldom have the capacity to accept hand drawn images which make anatomical precision difficult.
 
The United Nations [[World Health Organization]] (WHO) administration intentionally does not contribute to an internationally standardized view of medical records nor to personal health records. However, WHO contributes to minimum requirements definition for developing countries.<ref>[http://whqlibdoc.who.int/wpro/2002/9290610050.pdf]</ref>
 
The United Nations accredited standardization body [[International Organization for Standardization]] (ISO) however has settled thorough word for standards in the scope of the [[HL7]] platform for health care informatics. Respective standards are available with ISO/HL7 10781:2009 Electronic Health Record-System Functional Model, Release 1.1<ref>[http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_detail.htm?csnumber=46087]</ref> and subsequent set of detailing standards.
 
==EMRs in the United States==
 
===Usage===
Even though EMR systems with a computerized provider order entry (CPOE) have existed for more than 30 years, fewer than 10 percent of hospitals as of 2006 have a fully integrated system.<ref name="SM001">Smaltz, Detlev and Eta Berner. ''The Executive's Guide to Electronic Health Records.'' (2007, Health Administration Press) p.03</ref>
 
In the United States, the CDC reported that the EMR adoption rate has steadily risen to 48.3 percent at the end of 2009.<ref>[http://www.nuesoft.com/blog/are-more-doctors-adopting-ehrs/ Are More Doctors Adopting EHRs?] Retrieved March 31, 2011</ref>This is an increase since 2008 when 38.4% of office-based physicians reported using fully or partially electronic medical record systems (EMR) in 2008.<ref>National Center for Health : United States, 2008] Retrieved December 15, 2009</ref> However, the same study found that only 20.4% of all physicians reported using a system described as minimally functional and including the following features: orders for prescriptions, orders for tests, viewing laboratory or imaging results, and clinical notes.
 
===Legal status===
Electronic medical records, like medical records, must be kept in unaltered form and authenticated by the creator.<ref>National Archives and Records Administration (NARA): [http://palimpsest.stanford.edu/bytopic/electronic-records/electronic-storage-media/critiss.html Long-Term Usability of Optical Media] Retrieved July 30, 2006</ref> Under data protection legislation, responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, [[PET]], MRI, ultrasound, etc. The patient, however, according to [[HIPAA]], has a right to view the originals, and to obtain copies under law.<ref>Medical Board of California: [http://medbd.ca.gov/consumer/complaint_info_questions_records.html Medical Records - Frequently Asked Questions] Retrieved July 30, 2006</ref>
 
===Technical features===
 
Using an EMR to read and write a patient's record is not only possible through a workstation but depending on the type of system and health care settings may also be possible through mobile devices  that are handwriting capable.<ref>Handwriting and mobile computing experts: [http://www.medscribbler.com/handwriting_electronic_medical_records.html] Retrieved August 20, 2008</ref> Electronic Medical Records may include access to Personal Health Records (PHR) which makes individual notes from an EMR readily visible and accessible for consumers.
 
===Event monitoring===
Some EMR systems automatically monitor clinical events, by analyzing patient data from an Electronic Health Record to predict, detect and potentially prevent adverse events.  This can include discharge/transfer orders, pharmacy orders, radiology results, laboratory results and any other data from ancillary services or provider notes.<ref>[http://rods.health.pitt.edu/Technical%20Reports/2002%20JAMIA%20Event%20monitors%20in%20PHS.pdf M958 revision-Event monitors in PHS 1-02-02.PDF<!-- Bot generated title -->]</ref>
 
==EMRs in Europe==
 
There is no common standard on EMR in Europe neither in the entire member states of the [[European Union]]. Exception is with those states where health care system is unified, as in United Kingdom.
 
===EMRs in Ambulances===
Ambulance Services in Australia have recently introduced the use of EMR systems <ref>[http://emergencymedicalparamedic.com/emr-for-paramedics EMR in Ambulances], "Emergency Medical Paramedic", May 5th 2011, Retrieved Jun 4th 2011</ref> The benefits of EMR in Ambulance include the following: better training for paramedics, review of clinical standards, better research options for pre-hospital care and design of future treatment options <ref>[http://www.ambulance.vic.gov.au/annualreport0809/VACIS.htm Ambulance Victoria Annual Report], “Ambulance Victoria”, October 4 2009, Retrieved Jun 4th 2011</ref>
 
===GP2GP project===
 
GP2GP is an NHS connecting for Health project in the United Kingdom. It enables GPs to transfer a patient's electronic medical record to another practice when the patient moves onto the listctice.<ref>[http://www.connectingforhealth.nhs.uk/delivery/programmes/gp2gp GPsGP Website]</ref>
 
==Privacy concerns==
A major concern is adequate confidentiality of the individual records being managed electronically.{{Who|date=January 2010}} According to the ''LA Times'', roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and over 600,000 payers, providers and other entities that handle providers' billing data have some access.<ref>{{cite news |first=Judy |last=Foreman |title=At risk of exposure |publisher=Los Angeles Times |date=26 June 2006 |url=http://articles.latimes.com/2006/jun/26/health/he-privacy26 |accessdate=9 September 2010 }}</ref>


In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the [[Health Insurance Portability and Accountability Act]] (HIPAA) as well as many local laws.<ref>US Code of Federal Regulations, Title45, Volume 1 (Revised October 1, 2005): [http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?YEAR=current&TITLE=45&PART=164&SECTION=501&SUBPART=&TYPE=TEXTPrivacy of Individually Identifiable Health Information (45CFR164.501)] Retrieved July 30, 2006</ref>
The future vision of many connected health systems is the ability to connect the electronic medical record system to an [[electronic health record]], creating a shared and portable collection of a patient's health data. This sharing will have to include elements of granular permissions at the data type level and the ability for patient generated content to be "tagged," allowing the provider to maintain clinical integrity of information.


In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care.<ref>European Parliament and Council (24 October 1995): [http://www.dataprivacy.ie/viewdoc.asp?m=&fn=/documents/LEGAL/6aii.htm EU Directive 95/46/EC - The Data Protection Directive] Retrieved July 30, 2006</ref>
==EMR vs. EHR==


==Technical standards==
Consult [[Electronic health record#EMR vs. EHR|this article]] for more about the comparisons between an "electronic medical record" (EMR) and an "electronic health record" (EHR).
Though there are few standards for modern day EMR systems as a whole, there are many standards relating to specific aspects of EMRs. These include:
* [[HL7]] - messages format for interchange between different record systems and practice management systems.
* [[ASC X12|ANSI X12]] ([[Electronic Data Interchange|EDI]]) - A set of transaction protocols used in the US for transmitting virtually any aspect of patient data.
* CEN - CONTSYS (EN 13940), a system of concepts to support continuity of care.
* CEN - EHRcom (EN 13606), a standard for the communication of information from EHR systems.
* CEN - HISA (EN 12967), a services standard for inter-system communication in a clinical information environment.
* [[DICOM]] - a standard for representing and communicating radiology images and reporting


===Interoperability towards sharing records===
==Regulatory compliance==
In the United States, the development of standards for EMR interoperability is at the forefront of the national health care agenda.<ref>[http://www.cms.hhs.gov/MissionVisionGoals/Downloads/CMSStrategicActionPlan06-09_061023a.pdf]</ref>  EMRs, while an important factor in interoperability, are not a critical first step to sharing data between practicing physicians, pharmacies and hospitals. Many physicians currently have computerized practice management systems that can be used in conjunction with a [[health information exchange]] (HIE), allowing for first steps in sharing patient information (lab results, public health reporting) which are necessary for timely, patient-centered and portable care.


The future vision of many connected health systems is the ability to connect the electronic medical record system to a personal health record creating a "shared record".  This sharing will have to include elements of granular permissions at the data type level and the ability for patient generated content to be "tagged" allowing the provider to maintain clinical integrity of information.  An example of this can be seen in implementations of connected health platforms that have this capability built in like HealthyCircles. <ref>[HealthyCircles Record Sharing Framework https://www.healthycircles.com/p_record_sharing.aspx]</ref>
Regulatory standards and recommendations that may affect an EMR include:


== Regulatory compliance ==
* [[HIPAA]]
* [[HIPAA]]
* [[Health Level 7]]
* [[Health Level 7]]
Line 79: Line 41:
* [[21 CFR Part 11]]
* [[21 CFR Part 11]]


==Electronic Medical Records in Veterinary Medicine==
==Notes==
In UK veterinary practice, the replacement of paper recording systems with electronic methods of storing animal patient information escalated from the 1980s and the majority of clinics now use electronic medical records. In a sample of 129 veterinary practices, 89% used a Practice Management System (PMS) for data recording.<ref>Gill, M. (2007) Attitudes to clinical audit in veterinary practice, Royal Veterinary College elective project, unpublished work</ref> There are more than 10 PMS providers currently in the UK. Collecting data directly from PMSs for epidemiological analysis abolishes the need for veterinarians to manually submit individual reports per animal visit and therefore increases the reporting rate.<ref>Carruthers, H. (2009) Disease surveillance in small animal practice, In Pract, 31(7): 356-358</ref>


Veterinary electronic medical record data are being used to investigate antimicrobial efficacy; risk factors for canine cancer; and inherited diseases in dogs and cats, in the small animal disease surveillance project [http://www.rvc.ac.uk/VEctAR 'VEctAR'] (Veterinary Electronic Animal Record) at the Royal Veterinary College, London, in collaboration with the University of Sydney and [http://www.rxworks.com RxWorks].<ref>VEctAR (Veterinary Electronic Animal Record) (2010) from http://www.rvc.ac.uk/VEctAR/</ref>
An element or two of this article is reused from [http://en.wikipedia.org/wiki/Electronic_medical_record the Wikipedia article].


==References==
==References==
<references>
<references>


<!---Place all category tags here-->
[[Category:Health informatics]]
[[Category:Health informatics]]
[[Category:Software systems]]

Latest revision as of 18:48, 6 August 2014

An electronic medical record (EMR) is a computerized medical record created in an organization across inpatient and outpatient environments that is used to document, monitor, and manage health care delivery within organizations such as a hospital or physician's office.[1] Electronic medical records tend to be a part of a local stand-alone health information system that allows storage, retrieval and modification of records.

Contribution under UN administration and accredited organizations

The United Nations World Health Organization (WHO) administration intentionally does not contribute to an internationally standardized view of medical records nor to personal health records. However, WHO contributes to minimum requirements definition for developing countries.[2]

The United Nations accredited standardization body International Organization for Standardization (ISO) however has settled on some standards in the scope of the HL7 platform for health care informatics. Respective standards are available with ISO/HL7 10781:2009 Electronic Health Record-System Functional Model, Release 1.1[3] and subsequent sets of detailing standards.

Privacy concerns

A major concern is adequate confidentiality of the individual records being managed electronically. According to a 2006 LA Times article, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and over 600,000 payers, providers and other entities that handle providers' billing data have some access.[4]

In the United States, this class of information is referred to as protected health information (PHI), and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws.[5]

In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care.[6]

Technical standards

Though there are few standards for modern day EMR systems as a whole, there are many standards relating to specific aspects of EMRs. These include:

  • HL7 - message format for interchange between different record systems and practice management systems
  • ANSI X12 (EDI) - A set of transaction protocols used in the US for transmitting virtually any aspect of patient data
  • CEN - CONTSYS (EN 13940), a system of concepts to support continuity of care
  • CEN - EHRcom (EN 13606), a standard for the communication of information from EHR systems
  • CEN - HISA (EN 12967), a services standard for inter-system communication in a clinical information environment
  • DICOM, a standard for representing and communicating radiology images and reporting

Interoperability towards sharing records

In the United States, the development of standards for EMR interoperability has been at the forefront of the national health care agenda at least since the mid-2000s.[7] Many physicians currently have computerized practice management systems that can be used in conjunction with a health information exchange (HIE), allowing for first steps in sharing patient information (lab results, public health reporting) which are necessary for timely, patient-centered, and portable care.

The future vision of many connected health systems is the ability to connect the electronic medical record system to an electronic health record, creating a shared and portable collection of a patient's health data. This sharing will have to include elements of granular permissions at the data type level and the ability for patient generated content to be "tagged," allowing the provider to maintain clinical integrity of information.

EMR vs. EHR

Consult this article for more about the comparisons between an "electronic medical record" (EMR) and an "electronic health record" (EHR).

Regulatory compliance

Regulatory standards and recommendations that may affect an EMR include:

Notes

An element or two of this article is reused from the Wikipedia article.

References

<references>

  1. ↑ Garets, Dave; Davis, Mike (26 January 2006). "Electronic Medical Records vs. Electronic Health Records: Yes, There Is a Difference". HIMSS Analytics, LLC. http://www.himssanalytics.org/docs/wp_emr_ehr.pdf. Retrieved 08 May 2013. 
  2. ↑ "Medical Records Manual - A Guide for Developing Countries" (PDF). WHO. March 2001. http://whqlibdoc.who.int/wpro/2002/9290610050.pdf. Retrieved 08 May 2013. 
  3. ↑ "ISO/HL7 10781:2009 - Electronic Health Record-System Functional Model, Release 1.1". ISO. 2009. 
  4. ↑ Foreman, Judy (26 June 2006). "At risk of exposure". Los Angeles Times. http://articles.latimes.com/2006/jun/26/health/he-privacy26. Retrieved 08 May 2013. 
  5. ↑ "US Code of Federal Regulations, Title 45, Volume 1, Section 164.501 - Definitions". U.S. Government Printing Office. 1 October 2012. http://www.gpo.gov/fdsys/pkg/CFR-2012-title45-vol1/xml/CFR-2012-title45-vol1-sec164-501.xml. Retrieved 08 May 2013. 
  6. ↑ "EU Directive 95/46/EC - The Data Protection Directive". Office of the Data Protection Commissioner. Archived from the original on 28 September 2007. http://web.archive.org/web/20070928142238/http://www.dataprivacy.ie/viewdoc.asp?m=&fn=/documents/LEGAL/6aii.htm. Retrieved 08 May 2013. 
  7. ↑ "CMS Strategic Action Plan 2006–2009" (PDF). CMS. 16 October 2006. Archived from the original on 21 January 2009. http://web.archive.org/web/20090121021249/http://www.cms.hhs.gov/MissionVisionGoals/Downloads/CMSStrategicActionPlan06-09_061023a.pdf. Retrieved 08 May 2013. 
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