Talk:Electronic medical record/Archive 1

Merge? [2006]
Aside from the merge, a good first step would be to verify the content of both articles and remove the unsourced sections. At once the articles are properly sourced and formatted it may simplify this question. Alan.ca 16:44, 1 December 2006 (UTC)

EHR seems to be much more up to date in the way health informatics are described than in this article. Should they be merged or do they mean something different? Donama 02:09, 25 November 2005 (UTC)

Electronic Medical Record is the standard terminology. I havn't heard EHR with any regularity. If anything, EHR should be put into this article. [July 10th 2006, xdxfp.]

From my (a physician) point of view the EHR holds more information than only medical information. This should be mentioned in the definition of the EHR as well as in the definition of the EMR. While a [EMR or EPR will hold patient and medical information the EHR will go beyond and hold health information which not necessarily has to be linked with medicine or patient. E.g. Nutritive information, fitness and wellness information --Oemmler 07:03, 26 October 2006 (UTC)

Support
EMR and EHR should be combined. They are both held to the same medical/legal standards. In addition, it is important to consult the AHIMA - American Health Information Management Association. They are the resource for the requirements for both. L. Blumenthal, RHIA, PMP. Registered Health Information Management Administrator. Project Management Professional. (Lalato10 (talk) 23:54, 15 March 2009 (UTC)).
 * Donama 02:09, 25 November 2005 (UTC)
 * EMR should be a subsection under EHR qualifying the differences alluded to by Udo Altmann in the opposition below. Hiberniantears 20:55, 16 December 2005 (UTC)
 * I agree with this suggestion as seen in my other comment--Oliver Emmler 07:05, 26 October 2006 (UTC)
 * The terms EMR and EHR are most definitely related and should be referenced within the same article. —Preceding unsigned comment added by 64.132.225.250 (talk) 20:34, 29 April 2008 (UTC)
 * I'm neutral on whether to title the page EMR, EHR or something else, but these should all be under one banner Luxorp (talk) 02:54, 29 December 2008 (UTC).

The MEDICARE AND MEDICAID HEALTH INFORMATION TECHNOLOGY: TITLE IV OF THE AMERICAN RECOVERY AND REINVESTMENT ACT passed in the United States uses the term EHR, and "meaningful use" criteria that are being defined make it clear that exchange of information, ability to incorporate lab and other data, CDS capapbility etc. are expected. Practicality dictates that EMR should merge into EHR. The precise definitions, as well as confusion about them can be discussed early in the successsor EHR topic. BMDampbellc (talk) 12:03, 2 August 2009 (UTC)

Oppose

 * A health record has a broader approach containing all health data, not necessarily such from diseases --Udo Altmann 09:09, 25 November 2005 (UTC)
 * Agree: EMR is a very narrow term and disenfranchises most other disciplines. Also Patient record needs to be in bracket as this term is also used for the record.
 * I better understand the differences now, Udo, and I strongly agree with you. The articles should be improved to highlight the difference. But, in merging I mean for EMR to be a sub-section of EHR article. What do you think? Donama 00:51, 19 December 2005 (UTC)
 * On the one hand this would be logical, on the other hand I have the feeling that more work has be done with respect to the medical record aspect. So we have a little bit of the same discussion as the relationship between health informatics and medical informatics. Sigh! Both articles (EMR and EHR) have their weaknesses and appear unsystematic, so a merge in conjunction with a refurbishment could help. And in this case EMR would be a specialisation of EHR.  --Udo Altmann 08:43, 19 December 2005 (UTC)


 * See another oppose vote on the Talk:Electronic Health Record page (Donama)

I oppose merger of the terms. The EMR is the legal part of the EHR. Owned and managed by the care giver, the EMR is an objective record which documents care delivered by a professional. The EMR is part of the EHR, but only that part generated at the clinical care delivery level. The EHR crosses all boundaries of care and includes multiple types of services, including such records as over-the-counter medications and complementary medicine care. --Charlene Marietti, 9/19/2006

I also oppose the merger for reasons already discussed. Please refer to the published work "EHR Implementation: A Step-by-Step Guide for the Medical Practice" for a more detailed description of the distinction. -- Grant Z Price, 5/20/08 —Preceding unsigned comment added by 75.44.168.113 (talk) 15:43, 20 May 2008 (UTC)


 * Oppose (medical is a sub set of health ) Sanjiv swarup (talk) 07:50, 9 July 2008 (UTC)


 * Oppose there is no other good reason i can give as everything is mentioned above by many editors and they prove a point, so the merging should not be done. Edeskonline (talk) 13:43, 9 July 2008 (UTC)


 * Oppose The two terms are not interchangeable and they represent two completely different concepts in healthcare IT. Refer to the HIMSS Analytics white paper on the subject: there is a difference. http://www.himssanalytics.org/docs/WP_EMR_EHR.pdf Juliew8 (talk) 00:57, 13 March 2009 (UTC)

Broad definition confusion
It is likely the term EMR is going to stick as the general term for the category and others will via for subset and superset status. Health informatics and medical informatics are too broad for general use because they are often used to also include the description of information passed between diagnostic equipment and databases. They will not gain popular use and will likely remain for governments and health executives only. All these terms may also undergo further change in understanding as newer technologies that allow for dynamic scanned forms combined with embedded handwriting and text entry come to the fore. A good way to handle the definitions might be including in each a brief description of the contrary term and a link.
 * These terms EMR, EHR, have broad and conflicting understandings within the community that uses them. Originally an EHR was an electronic "hospital" record and is following the definition you are wanting to give as a more comprehensive record. The term CCR, clinical care record, was formerly used in discussion as the patient portion of the "hospital" record. Some morphing occurred as the federal government started to discuss an universal patient medical record, a CCR. As it became apparent in the challenges of collecting intelligible data the term CCR became reduced to an enemic data set of its former self, being little more than name, address and medical/prescription contacts. The CCR term is rapidly falling out of use but again may morph back into what it was originally. The reason for this is the American Medical Association now is using the term electronic health record, EHR, to describe what is more commonly known as an EMR. This has totally usurped the "hospital" meaning, I believe in an effort to make more physician compliance in purchase and use.

The bottom line is that the software is designed to hold 'medical' records, not 'health' records. So, the term EMR is far more discriptive. —Preceding unsigned comment added by 200.49.144.200 (talk) 00:24, 14 July 2008 (UTC)

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 Redirect). Regards, --Ryanjo 22:10, 7 August 2006 (UTC)


 * 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)

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. A day's notice is not enough for this kind of change! I have restored the Electronic Medical Records page as discussion should continue on this issue, rather than just deleting it out of hand at short notice. 201.231.205.164 23:44, 10 August 2006 (UTC)


 * I think this issue (use of EMR & EHR) is best addressed by this merge than by two separate articles:
 * Both search terms (EMR and Electronic medical record) can be redirected to Electronic Health Record, so searches for either will end up there.
 * The first section of the Electronic Health Record article concerns differentiating the various electronic health documents, and there is a large subsection on Electronic medical record. Certainly there is room to expand that section to differentiate EMR & EHR if needed.
 * There is tremendous overlap, and thus repetition, in EMR & EHR concepts and issues. the sections of both articles are almost the same, although the EHR sections are better organized and referenced.
 * All of the content from the original Electronic medical record article was transferred to Electronic Health Record, organized, and references added, by several editors.
 * Although EMR is still equally common in the US commercial software offerings, the trend is increasingly to development of EHR products (which are both records and quality instruments) and use of the the term EHR to describe a patient's electronic record by govermental, standards and regulatory agencies (see Bulletin of the World Health Organization, Bush Address on Health IT, & US Dept. of HHS Criteria on EHR), the IT and investment sectors (Tekrati Research News), and the medical records software association HIMSS (HIMSS Electronic Health Records Vendors Association (EHRVA) strongly supports President Bush’s ... recent statements regarding benefits of electronic health records.).


 * Finally, the merge issue has been discussed since November of 2005, when the first merge notice was placed on these pages, not for 1 day. I have followed the debate & made small edits to both the EMR and EHR pages, and the EHR article is the best organized and informative. I hope that your reverting the EMR page also represents a commitment to improving it. -- Ryanjo 01:20, 11 August 2006 (UTC)

Well, in an ideal world I would like to spend time improving the EMR page. I will try to take some time to look and it and encourage some other people with an interest in EMR to do so also. I actually think that whether or not the the trend is increasingly towards development of EHR products is irrelevant. The majority of people out there are still searching for EMR. In light of this, why not have an EMR page with an EHR subsection in it, and then redirect the EHR page to EMR? Socially, EMR is the more common term. So IF there has to be a redirect, it should be EHR to EMR. Secondly, are more Doctors using EMRs or EHRs right now, at this moment in time? Finally, all of the content has not beem transferred over, I noticed a couple of things very quickly that did not survive the transfer. 201.231.205.164 01:44, 11 August 2006 (UTC)


 * I understand your points; we can agree to disagree. Good luck, Ryanjo 03:05, 11 August 2006 (UTC)


 * I think I understand your points, but I don't think that basing a taxonomy on popularity instead of definitions is a good idea. An EMR is a type of EHR, regardless of how many google hits each one is getting.  Therefore the redirect really should be from EMR to EHR.  In addition, like Ryanjo, I agree that it is redundant to have two pages; the entire section on "Issues" from the EHR page is equally appropriate on the EMR page.  In any case, acknowledging the fact that EMR is perhaps the more popular term, I think the Solomonian solution is to really to discuss the popularity of the term EMR in the initial paragraph on the EHR page, or something like that.--Kawanazii 15:34, 11 August 2006 (UTC)

Kawanazii - The public get what the public want. The public call what is being discussed here an "Electronic Medical Record" more than they call it "Electronic Health Record". Taxonomy should be based on popularity. For example, if many so called "important" people and organizations came out over the past few years and said "the banana from now on shall be known as the yelfruit", would banana be defined in wikipedia as yelfruit? I hope not! And to keep on the fruit theme...a lemon is a type of citrus fruit. Should lemon be removed from the wikipedia and be merged into the citrus fruit as a subsection? I hope not! How about we agree some boundaries for what an EMR is, what an EHR is, and then amend the two pages to help distinguish between them? 200.49.144.222 22:19, 11 August 2006 (UTC)


 * This ego storm is getting tedious. Kawanazii and I have done what we could to improve the article(s) on electronic records. The distinctions you are asking for are there in the EHR article. The content can be expanded or improved within the EHR article, if new info develops. The "people" can find their "banana" in the EHR article, just create a redirect. The reason that the EMR article isn't better is because of the very fact that new content (referenced in ample links above) is developing for EHR, not EMR. Don't look at searches, look at content. "What the public wants" is how to script a reality TV show, not a reference work. Ryanjo 02:05, 12 August 2006 (UTC)

I'm not sure how this is an ego storm! It is just a discussion to try and ensure wikipedia is defining the correct terms in this area. Electronic Medical Records has been the term used to describe this type of software for around the last 15 years. The only reason Electronic Health Record came about around 4/5 years ago was due to large EMR vendors finding themselves behind in selling this software. And so they conveniently created a new category, EHR. These large (now) EHR vendors have a lot of pull, which is why you are seeing all of those organisations you quoted before using the term EHR. However, the majority of Doctors still use the term EMR. And for good reason: this is more than just taxonomy. What EHR has turned into is no longer a tool just to serve physicians/clinics/hospitals, but instead the EHR tries to serve other parties, incorporating issues such as PHR, billing sofware and government interests in the documentation. At issue is that the EMR is a tool to help doctors keep patient medical records. The EHR now implies that this documentation does not belong to the doctors, the true users of these products. Now what is behind the attempted change from EMR to EHR is the desire to remove the doctor as the owner of the databases. Please don't help to propagate this questionable move by mirroring it on Wikipedia. And if you want content, look to KLAS, the organisation that rates EMR product user satisfaction http://www.healthcomputing.com/vendordirectory/ - yes, they use EMR. And, the most popular forum to talk about this topic on the internet (whose posters are the users of this software, doctors)? Yes, http://www.emrupdate.com also calls this an EMR. Also, I should point out that CCR has it's own page on Wikipedia. It would be ridiculous if CCR were to be defined separately but EMR did not have its own definition page. The EMR and EHR pages will be further improved in due time to bring out the distinction. They should both remain, in my humble opinion. Inglesenargentina 19:26, 15 August 2006 (UTC)
 * Above noted. I am a physician in active practice, and I have used or been exposed to many of the EMR and now EHR products. My observations are:

I sincerely withdraw the "ego storm" comment. I'm just a little tired of unregistered users reverting the work of contributing editors. The "banana" line was the last straw...Regards Ryanjo 18:22, 13 September 2006 (UTC)
 * There is ample information in the EHR acticle to answer any and all EMR questions, it is better written, and all future initiatives will be in EHR. So that is why someone (not I) suggested merging the articles almost one year ago. EMR won't be erased, it will just be placed into a larger and evolving context.
 * The transition from EMR (limited and owned by one practitioner and facility) and EHR (open and interoperable) is a future mandate by the US Agency for Healthcare Research and Quality. President Bush mentioned it in his State of the Union address. EMR ain't goin' nowhere.
 * The electronic software companies "go where the money is." They aren't driving the EMR to EHR transition. We docs want our records from the X-ray centers and hospitals interactively, we want to cut down our enormous telephone, fax and staff requirements. The insurers want to cut down duplication and waste. The patients want access to their records, and the ability to transfer and update them. (This is better referenced in the EHR article, than in the EMR article).
 * CCR is a more specific modality developed for information transfer, an information standard. There may be a move to merge that also, if it become outdated or a historical subtopic.
 * I don't consider the fact that people mix up EHR with EMR to be a reason for 2 articles. It is an even a better reason for one good comprehensive article, with redirects from the likely search terms.

CCHIT
The "Public implementations" sections is incorrect in stating that CCHIT certifies EMR products. In fact, the CCHIT only certifies EHR software. Ryanjo 22:41, 26 September 2006 (UTC)

I disagree. See the following list of CCHIT certified products: http://www.cchit.org/certified/2006/CCHIT+Certified+Products+by+Product.htm - here I can count 6 "EMR" or "Electronic Medical Record" products. I can only count 5 "EHR" or "Electronic Health Record" products. Inglesenargentina 17:38, 27 September 2006 (UTC)


 * The EMR name is, as usual, misapplied to EHR products. Almost all are actually EHR products. For example, GE Centricity, EpicCare, NexGen and Misys, although labeled EMR for branding and upgrade continuity reasons, are functionally EHR software by virtue of interconnectivity and multiprovider integration. Ryanjo 03:41, 30 September 2006 (UTC)


 * I removed the CCHIT section just added to the article, and have pasted it below. It seems either a little spam-ish, or is too verbose. Either way, does it warrant a section in this article?

"While saying nothing about a particular EMR's usability or fitness for a particular practice, there is a certification or "seal of approval" that assures that a minimum of the functions listed above as well as security and installation issues have been worked out. Here are some details on the Certification Commission for Healthcare Information Technology (CCHIT), http://cchit.org/. CCHIT certifies ambulatory electronic health records (EHR), which are designed for physician offices and clinics, where most Americans receive healthcare. As a Recognized Certification Body for health information technology in the United States, CCHIT is an independent, non-profit organization that sets the benchmark for electronic health records.  + A CCHIT Certified product has been tested and received compliance with 100 percent of criteria gauging functionality (the ability to create and manage electronic records for all patients, as well as automating workflow in a physician’s office); interoperability (a first step in the ability to receive and send electronic data to other entities such as laboratories); security (the ability to keep patients’ information safe); and installation of the product. In October 2006, CCHIT was deemed a Recognized Certification Body by the Department of Health and Human Services."


 * You should be aware that some strongly oppose CCHIT. It's probably spam.  As it stands CCHIT is probably a bad thing. My opinion anyway. 72.16.237.230 (talk)  —Preceding undated comment was added at 20:08, 30 December 2008 (UTC).

Smart merge and/or term clarification
Building on the extensive pre-existing discussion about "merging EMR and EHR", I feel like the approach to the has been a bit too simplistic so far -- hence no clear or satisfying resolution. &mdash; Donama 13:34, 27 September 2006 (UTC)

Here's what we appear to have:


 * EMR and EHR are two different things, although there is clearly some conceptual overlap.
 * I don't think there's dispute on that point. &mdash; Donama 13:34, 27 September 2006 (UTC)


 * Some consider EMR to be a slightly earlier term deriving from anglophone countries, especially USA whereas EHR derives more from Europe and Australasia. Thus, there are probably some simple linguistic and political reasons for why one term is seen as "more dominant" by different groups.
 * Is this correct? If so, with consideration to a direct merge and having to choose the article title, I think we should be biased towards the more current term used by more countries. &mdash; Donama 13:34, 27 September 2006 (UTC)


 * Health is commonly considered to be a broader concept than medicine and thus EMR is considered by some to be a subset of EHR.
 * I understand this is the view of various openEHR people. Do we agree? If so, EMR should be merged into the EHR article as a subsection unless or clearly defined as a child article of the EHR article for the sake of clarity. &mdash; Donama 13:34, 27 September 2006 (UTC)


 * Looking at the overlapping concept, apparently clinicians traditionally think of it as an "EMR" whereas the IT/informatics people think of it as an "EHR".
 * Is this the case? If this is the case, and the two terms are synonymous, then a direct merge could be in order. I doubt this though, because it seems clear the terms have distinct semantic meaning as well as distinct syntactical meaning. &mdash; Donama 13:34, 27 September 2006 (UTC)

Your thoughts?
 * My opinion is pretty clear, stated in multiple postings above. It doesn't make sense to have two articles; it is clear that EMR is a subset of EHR, and can be adequately handled within an EHR article, with searches for the "EMR" term satisfied by Redirect to EHR. I am a practicing physician in the US, and also working with our local multiple-hospital association on implementing EHR products. Over the past 3 to 4 years, all the discussions have been EHR, since it is the solution for multiple entities, like hospitals, labs, different provider offices. The US national priority is EHR. Whatever the prior use of the term "EMR" was in the US, it is almost always used incorrectly now, to describe what is really "EHR". I am frustrated that the primary reasons given NOT to merge EMR into EHR is to continue this incorrect usage. Ryanjo 16:16, 27 September 2006 (UTC)

As time tells
(Eaugsten 13:52, 21 June 2006 (UTC))

At the most recent TEPR 2006 and other industry events these terms are slowly being defined by the medical community.
 * EMR is the broder term for an electronic version of a patients chart. In this scenario one patient can have many EMR's, one for each provider he is seen by.
 * EHR is more closely defined as the aggregate of patient medical information from multiple sources - hospitals, out-paatient... this is what the Whitehouse has been pushing since President Bush created a sub-Cabinet position devoted to healthcare IT and stated that he expects 50 percent of practices to adopt EMR technology by 2014.
 * PHR, Patient Health Record is a portable record of medical infoamtion kept current by the patient and conected to other systems and data.
 * CCR, is a sumary of medical information relative to a specific case used between providers for continuit of care.

Sign here if you vote to merge with EHR

 * Alan.ca 06:00, 11 October 2006 (UTC)
 * Donama (talk) 01:08, 20 October 2009 (UTC)

Sign here if you vote there should be no merger

 * Fredchap (talk) 15:46, 7 September 2008 (UTC)
 * Oemmler 06:56, 26 October 2006 (UTC)

Discussion
In my opinion these articles are way too lengthy for terms that are clearly not defined by the industry that defined them. I propose to begin the merge process or remove the merge tags after 14 days as this merge has been backlogged since Jan 2006. Alan.ca 06:00, 11 October 2006 (UTC)

EMR and EHR should not be merged. EMR is a patient's chart maintained by a physician or a group of physicians (e.g. clinic) where the physician(s) have the legal liability for the patient's chart notes. The EHR is the public health record (e.g. hospitals, labs, DI) where the government has the legal liability for the notes.Fredchap (talk) 15:46, 7 September 2008 (UTC)

Continuing... "Smart merge and/or term clarification" section
Almost a month onwards since I posted this discussion and just one response from Ryanjo (who has continually pushed for a resolution on this too). I think this indicates we need to be bold and go ahead and act. &mdash; Donama 03:08, 22 October 2006 (UTC)

My question now is whether: &mdash; Donama 03:08, 22 October 2006 (UTC)
 * 1) EMR should be merged as a subsection of EHR (as is currently suggested by the merge tags); OR
 * 2) EMR is a significant enough topic in terms of kilobytes of content that a summary of it is provided in the EMR section of the EHR article and we keep this article here? (as patterned by many good summary-style articles already (eg. Proto-Indo-European language).

My vote would obviously go to option number 2. Any total merge of either EMR into EHR or EHR into EMR will only be playing into the marketing hands of the software vendors on one of the sides. I see EMR and EHR as distinctive entities, and both have their place in the future of Healthcare IT. Both articles should stay on Wikipedia to avoid a commercial bias, but obviously they still need more cleaning up (if only there was time in this life to do everything you want to...). Inglesenargentina 17:17, 23 October 2006 (UTC)

Merge: I agree with being bold...but my last attempt to merge was frustrated by an unregistered IP user who compared the merge of EMR & EHR to changing the name of a banana (!?) Of course, no contributions were made to the articles by the loudest voices. Anyway, Donama, you have made a good effort and clarified the issues. Maybe some new editors will come by over time and either clean up or push to merge. Regards, Ryanjo 01:10, 24 October 2006 (UTC)
 * It is mystifying to me why having one article comparing and contrasting the various forms of electronic medical information is commercial bias. A good article is, by its nature, balanced. If there are biased comparisons, it will be evident to the reader in a comprehensive article, not a narrow one.
 * It is just unfortunate that contributors on Wikipedia can allow articles to languish without making edits, but will write passionately opposing any changes.
 * Perhaps it is just the name EHR or EMR. Maybe there is support for simply "Health records in digital format" as a title.

Ryanjo - it does not matter if the final article is biased or balanced, the fact that either EMR or EHR disappears as a title, giving it less visibility, is biasing one term over the other, and falling into the commercial vendors on one side. The issue of internal article bias is completely separate. Even the name "Health Records in digital format", nice idea as it is, is obviously biased towards one of these two names. I am very busy and do really want to help edit the articles to further improve them, and perhaps an idea is that I know others who would also be excellent helpers in this area if only I could persuade them to join Wikipedia and pitch in. Watch this space. Inglesenargentina 19:48, 3 November 2006 (UTC)
 * Inglesenargentina, Wikipedia is not about keeping vendors happy so I don't think we should care whether giving EHR or EMR more visibility plays to the vendors who use one term. We can only look at this from the point of view of explaining what EHR and EMR entails to readers.
 * What I deduce from your comments here is that in terms of semantics it wouldn't really matter what the article title was because they basically mean the same thing. That only leaves us with one decision -- which article title? I suggest EHR for all the reasons outlined above. Can we move on with this? &mdash; Donama 11:56, 5 November 2006 (UTC)

Addtion to EHR
From my (a physician) point of view the EHR holds more information than only medical information. This should be mentioned in the definition of the EHR as well as in the definition of the EMR. While a [EMR or EPR will hold patient and medical information the EHR will go beyond and hold health information which not necessarily has to be linked with medicine or patient. E.g. Nutritive information, fitness and wellness information --Oemmler 07:03, 26 October 2006 (UTC)

Medical informatics
Most of this article discusses medical informatics. I'd suggest it be moved there unless this page is brought back to the original topic of EMRs (about which I know nothing). --Diberri | Talk 00:07, Aug 26, 2004 (UTC)


 * Medical informatics is a sub- speciality of HI and should be recognised as such. (unsigned comment)


 * Diberri, if you think that is the case remove the information from this article and paste it into Medical informatics! It doesn't mean you need to move this whole article. To me at least an electronic health record is a clear concept and its clear to me that its an important and notable one in terms of its worthiness to be included in Wikipedia. Wikipedia articles should be arranged/named in such a way that readers don't get spin but get unbiased information. This is the whole reason why the name change is being discussed. &mdash; Donama 01:24, 9 November 2006 (UTC)

fs: the way i've usually seen "medical informatics" or "clinical informatics" used (i work in this industry) is about "clinical content." stuff like flowsheets (to document blood pressure and stuff), that sort of thing. i think EMR or EHR is quite a bit broader than "medical informatics".


 * "medical informatics" is a sub set of Electronic medical record  Sanjiv swarup (talk) 10:52, 18 February 2008 (UTC)

Merge both to Electronic document (healthcare)
To answer the concern that "either EMR or EHR disappears as a title, giving it less visibility, is biasing one term over the other, and falling into the commercial vendors on one side", I propose merging to a new article, titled Electronic document (healthcare). This is well-established on Wikipedia when terms have similar names (see wake). If you need an example of what a mess of articles can result from a basic topic being fragmented into many short articles, see List of ethics topics.

Advantages of this single merged name are: There is an existing article Electronic document on Wikipedia, so a template link could be place there, in the format:
 * not a part of any product name, and isn't a an attractive commercial name
 * can't be abbreviated to either EMR or EHR, and doesn't contain the word "record", so it can encompass any digital information that applies to patients in the future, such as voice, digitized photos or images, internet sites (there is a blog where the author has posted his screening studies for Alzheimers disease), etc.
 * is general enough to encompass any new terms that come into being. (the very important function of an encyclopedia of being complete)
 * can provide the very important function of an encyclopedia in comparing and contrasting the types of documents that are presently used

Another option could be Electronic document (patient care).

If the Electronic documents (healthcare) article is created from the EMR & EHR articles, redirects should be done from both merged articles and the existing EMR and EHR dismbiguation pages. I think this could work, if everyone can see the advantage of a single article that is complete, defines comparisons, and has the potential to incorporate new types of documents. Ryanjo 21:18, 5 November 2006 (UTC)


 * I feel like this is changing the meaning of the concept. An electronic health/medical record is a record (not necessarily a document). It typically is in fact a bunch of many documents (though that term document is too hazy to be useful). I would strongly oppose this. &mdash; Donama 01:10, 9 November 2006 (UTC)


 * Why call it Electronic patient record (healthcare)? or...just Electronic patient record since I don't think there any kinda of patients except the healthcare kind. Both queries can redirect here. Dawhitfield 01:39, 10 November 2006 (UTC)
 * Couldn't support this. I think we are going down the wrong path. There is no need to invent a new name. It's confusing and uninformative.
 * This in particular is not a good idea I think. There is already the concept of "personal health record" (or PHR). (Healthy people who have their health information aren't called patients so let's just get back to "person"). And the EHR concept is a superset of PHR; this is already understood in health informatics so I'm not going to go into explanation. Essentially a given EHR contains information associated with a single person, but it's not all about that person. &mdash; Donama 01:21, 11 November 2006 (UTC)

You have knocked down my straw horse (Electronic patient record (healthcare)), and quite appropriately. As I have frequently written here, EHR is the master concept (at this time), and all other terms are subsets. But there is a group of editors who think an article called EHR is unacceptable. Thus the absurditity of bending over backwards to satisfy all concerns. Back to the drawing board. Ryanjo 03:27, 12 November 2006 (UTC)


 * I propose we go ahead and merge them to EHR as originally suggested. There is no sustained opposition and it's been backlogged since last year. &mdash; Donama 11:36, 20 November 2006 (UTC)
 * I would say that I have been fairly sustained opposition to merging under EHR. If you do so, without realizing it, you will be favoring one group of medical software vendors over another. Inglesenargentina 22:43, 20 November 2006 (UTC)

Go ahead and merge. Being "fair" to vendors is not a goal of Wikipedia. Ryanjo 01:49, 21 November 2006 (UTC)

Being biased to one group of vendors should not be a side-effect of Wikipedia. How do we know you are not affiliated with a software vendor that calls their product an EHR, and you only trying to get a marketing advantage through Wikipedia? There should be a level playing field - EMR and EHR are separate things, there should be two entries, and they should draw out the differences between them. Inglesenargentina 17:18, 24 November 2006 (UTC)

Unsourced statements
These sections are entirely unsourced. There was one citation that lead to home page of a web site for interopability, but none for Caveates and Concerns. I propose these sections should be deleted if someone cannot source the statements under the headings within two weeks. It seems this article has become a blog for the concept. Alan.ca 19:40, 1 December 2006 (UTC)
 * Interoperability
 * Caveats and concerns


 * Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability.

This has a source but is obviously less than accurate. C++ implementations can provide better performance and similar interoperability, and the better security offered by java and .net is on the wrong level to achieve better patient data security and confidentiality. 83.80.64.130 13:31, 10 July 2007 (UTC)SJCE

Please choose to either remove or fix the tech limitations section. 802.11g is limited to 54 Mbps according to the wiki (and everything) and where did the 108Mbps come from? The mention of VB and C++ as poor languages needs to be qualified. I know of at least one CEO of an EMR company that is proud to have chosen c++. Languages are misrepresented when it is suggested that age alone diminishes there usefulness. —Preceding unsigned comment added by 72.16.237.230 (talk) 20:16, 30 December 2008 (UTC)

All this talk about EMR sickens me.

I am developing a handheld integrated patients medical and clinical record in TEXT, SOUND and IMAGE in 15 major world languages. My own EMR + my heart, lung sounds, X´ray, Lab results, is in 7 laguages - tired of repeating medical history on my travels.

R.Yartey Mensa-Annan, MD(Bern) Kingosvej 59, 2th, DK 2630 Taastrup, Greater Copenhagen, Denmark ryma oky —Preceding unsigned comment added by 217.219.108.69 (talk) 10:37, 9 September 2007 (UTC)

Concerns about the Customization section
This section refers to the idea of a Concept Processor model. This is not an industry standard term or idea, but is instead a methodology for content entry that is marketed by a single EMR vendor. There are hundreds of EMR vendors offering a variety of methods for entering and customizing clinical content. There is no reason for this vendor's particular methodolgy to be called out in this article. My suggestion would be to add a section called "Encounter Documentation Models" and to then list the many different methods available for entering content into a clinical encounter via an EMR or to remove this Concept Processor mention altogether. —The preceding unsigned comment was added by 75.67.237.226 (talk) 01:51, 23 April 2007 (UTC).

The technology of concept processing is not simply a methodology for data entry. It is an industry technology recognized by CCHIT, as well as other notable industry stakeholders including HIMSS and the AAFP. As you have rightly stated, there is a wide range of methods used for data entry. Concept processing, along side voice recognition, transcription and templates are plausibly the most recognized. Several EMR applications use Concept Processing technology. Most notably Praxis EMR that was rated #1 EMR in the US in the 2008 AAFP User Satisfaction Survey www.aafp.org/fpm, and Med Data Links L.L.C http://www.conceptprocessor.com/about.html.IBS2008 (talk) 19:17, 14 July 2008 (UTC)

problem editing references
Cannot edit references section. Edit screen comes up with only:

"==References== "

Despite there being 27 references.

Malfunction? —Preceding unsigned comment added by 70.20.210.79 (talk) 20:15, 5 February 2008 (UTC)

mass deletion of EMR
This is an article about EMRs. Another editor is mass deleting every mention of EMRs and changing them to EMRAMs, which are not the same thing. It doesn't make sense to delete every mention of EMRs in an article titled EMR. It would be fine to write a different article about EMRAMS Careful Cowboy (talk) 19:37, 11 November 2008 (UTC)

EMRAM / EMR / EHR Confusions & Corrections
2008 & Future Medical Training Texts use the acronym EMRAM for training & accouting purposes. The acronym EMR has caused an array of confusion within the medical accounting community as comparisons to EHR have been overly emphasized. EMR & EMRAM do indeed represent the same thing as defined in the medical community. The government has recognized the acronym EMRAM to represent anything to do with Electronic Medical Recording as EMRAM represents the overall spectrum of Medical Recording in a retrospective format. —Preceding unsigned comment added by Dr france maine (talk • contribs) 20:56, 11 November 2008 (UTC)


 * I doubt this information. A google search on EMRAM reveals nothing of the sort.  If this is true, the article should be updated, citing the "government."  It's not a reason to delete every single mention of electronic medical records from the electronic medical record article. Careful Cowboy (talk) 21:13, 11 November 2008 (UTC)
 * I agree. The assertion that EMR is synonymous with EMRAM must be verifiable via a reliable source. OhNo itsJamie  Talk 23:04, 11 November 2008 (UTC)


 * What is the alleged meaning of EMRAM in this discussion? I am only familiar with EMRAM as an acronym for the HIMSS Electronic Medical Record Adoption Model.  I am somewhat surprised there has been no mention here (unless I missed it) of the consensus definitions of EMR and EHR published by the National Alliance for Health Information Technology.  Or is that a sore subject?  Joncaire (talk) 22:30, 2 December 2008 (UTC)

Please choose to either remove or fix the tech limitations section. 802.11g is limited to 54 Mbps according to the wiki (and everything) and where did the 108Mbps come from? The mention of VB and C++ as poor languages needs to be qualified. I know of at least one CEO of an EMR company that is proud to have chosen c++. Languages are misrepresented when it is suggested that age alone diminishes there usefulness. —Preceding unsigned comment added by 72.16.237.230 (talk) 20:16, 30 December 2008 (UTC)