As an industry, we're experiencing what could be called the democratization of patient information. It's a long-term process, evidence for which can be found in the evolution of the Continuity of Care Record (CCR), personal health records (PHRs) and ongoing penetration of electronic health records (EHRs) among community hospitals and providers.
While all three types of electronic medical records signify increasing accessibility to health care information, CIOs and other health care IT executives must understand the differences between CCRs, PHRs and EHRs in order to explain these distinctions to boards and senior management and justify purchasing decisions.
The CCR's objective is to foster and improve continuity of care and reduce medical errors while ensuring transportability. As such, the CCR provides a minimum standard of health information transportability with the most relevant and timely facts about a patient's condition. Its technology is vendor-neutral and it can be read via Web browser, PDF or word processor.
A PHR enables consumers to store summarized information about their health conditions, medications, lab results and procedures. A slew of PHRs have emerged in the last year, many health-plan generated, as an important tool for consumers to take more initiative in managing their own health. That's especially true in chronic disease management and with the advent of health savings accounts.
Although the American Health Information Community, a federal advisory body, is working on interoperability standards for PHRs, the lack of a standard for what goes into PHRs is the biggest problem. Chaos could result if everyone walked around with a disk of personal data that didn't follow any standards, or maintained online versions of personal documents, lab results, radiology images or other kinds of records in no particular order or format.
The EHR is aimed at clinician use and its content is much more detailed than the PHR or the CCR. You might call it the "big file cabinet" of all clinical information. It is primarily used for online applications that can be integrated and shared by multiple providers.
The time is now
EHR penetration in health care is at an inflection point in the technology adoption curve. The time has arrived for a truly affordable, easy-to-implement, Web-based EHR for the independent community hospital. With a Web-based EHR, community hospitals now have access to health information systems meeting two primary requirements: anytime/anywhere access and interoperability.
Traditional vendors serving this space have lacked the interoperability to link multiple facilities. And most systems reside on client/server platforms so most of the processing takes place on the user's PC. Browser-based systems are now available, however, and they offer a range of access options to physicians and patients — and the larger universe of public health, research agencies and RHIOs.
New tools and processes for developing true browser-based, thin-client systems have also made it possible for community hospitals to acquire this 21st-century technology at an affordable price point previously unavailable to them.
Note that the benefits of EHR implementation go beyond ROI calculations. Think about a patient who arrives at an ER unconscious and unaccompanied. Would that patient do better at an ER that has access to all of the patient's previous clinical history, including take-home meds, or one that has a paper chart located somewhere in the hospital's basement? Would the physician treating that patient deliver better care and be less likely to be involved in malpractice litigation at the hospital having the EHR? Would the hospital have less chance to be sued if all of that patient's medical records were immediately available to the ER physician upon the patient's arrival?
And what if you or a loved one were that patient? Which scenario would you chose? Even better, suppose that same patient had his CCR on a USB drive attached as a necklace? We really aren't that far away
Mr. O'Pry is president and CEO of IntraNexus, Virginia Beach, Va.
Ms. Darling is COO at IntraNexus.
Source: Vol. 11 •Issue 12 • Page 10, CCRs, PHRs and EHRs, What do they mean for health care IT?,