Electronic Health Records (EHR) --

Electronic Health Records (EHR) -- Pharmacy

Electronic Medical Records

An Electronic Medical Record (EMR) is a computerized, longitudinal (captured over time) record of a patient's care and health information, including "patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data . . . radiology reports" (HIMSS, 2010), and more. Although the terms EMR and EHR are often used interchangeably, an Electronic Health Record system (EHR) refers specifically to the software applications that are used to capture EMR data. There are many EHR systems on the market currently; this paper will compare three systems in use in ambulatory (outpatient clinic and physician office) settings: Practice Partner® from McKesson Corporation, GE Centricity®, and Sage Intergy. All of these systems have received certification from the Certification Commission for Healthcare Technology (CCHIT), a national non-profit organization that, performs "a rigorous inspection of an EHR's integrated functionality, interoperability and security." (CCHIT, 2010).

The Practice Partner system is recognized for its "intuitive" user interface (UI) and ease of use. It is modeled on a Microsoft® Windows style UI that is familiar to the vast majority of computer users, and is organized on screen with different "tab" sections (e.g., medications, vital signs, lab results, medical history) to look like a paper chart (McKesson, 2008). GE Centricity is reportedly "created by non-physicians, and is not user friendly." (GE Centricity, n.d.)

It can be difficult to compare pricing without in-depth analysis of price quotes because many features and options can vary pricing widely. For example, of the three vendors, only Sage does not appear to charge additional fees for setting up standard electronic interfaces to other systems (Florida Medical Society, 2010), thus interface costs need to be added in for the other systems. All of the vendors claim to have strong security from the application side (McKesson, 2010; General Electric Corporation, 2010; Sage, 2010) and features that help protect patient confidentiality, for example, being able to designate certain patients' electronic records as accessible by only an authorized individual. (McKesson, 2010).

It is somewhat difficult to compare technical support and troubleshooting services, as the information available on each vendor is sometimes "apples to oranges." For example, GE Centricity simply offers "support" (no specifications given) and claims to resolve user issues in "< 2 hours" (Florida Medical Association, 2010). Practice Partner offers technical support access via email and web, with problem resolution time from "right away [to] 2 hours" (Florida Medical Association, 2010). Sage simply lists a "portal" for customer technical support, with an average problem resolution time ranging from "30min -- 8 hrs [sic]" (Florida Medical Association 2010).

All three systems typically require a practice to install the EHR software onto on-site servers, although they all appear to require only standard "off-the-shelf" hardware, and all of them also offer Application Service Provider (ASP) access as an option. (McKesson, 2010, General Electric Corporation, 2010, Sage 2010). Because all three systems are applications that reside on the practice's hardware, back-up of the server data seems to fall on the shoulders of the practice itself to manage this process (Compliant Backup, 2010).