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EMR, EHR, and PHR – Why All the Confusion?

Posted on April 7, 2011 by Trevor Hodge

This blog post was created in collaboration with my colleague and fellow blogger Dennis Giokas.

The use of digital health records is accelerating worldwide. As we meet with our colleagues in other countries we often discover confusion – and in some cases disagreement – with the definition of terms associated with digital health records.

Read the new blog post by Dennis Giokas to learn how the definitions have evolved and about other digital records: EMR, EHR, and PHR and now aEMR and H/HIS – What’s with these systems?


The description of these health records has become quite complex especially when we consider users, care settings, the data, and of course the technology. Three terms are commonly used to describe digital health records – electronic medical record (EMR), electronic health record (EHR) and personal health record (PHR). Unfortunately, the definition of these terms varies throughout the world and this creates confusion, both within and outside the e-health industry.

Interestingly, once we break down definitional barriers we find there is a lot of commonality, so why all the confusion?

In an effort to gain some clarity on this question, we looked at a number of EHR deployments and associated definitions (many definitions are not explicitly stated) globally, including our own. We’ve listed our sources at the end of this post for your reference.

As one reviews the different definitions two dimensions start to emerge that could possibly differentiate the three terms.

The first is the completeness of the information, namely:

  1. the concept of a partial health record that holds a portion of the relevant health information about a person over their lifetime
  2. the concept of a complete health record that holds all relevant health information about a person over their lifetime

The second is the custodian of the health information, namely:

  1. (a) health care provider(s)
  2. (a) person(s)

So in very simple terms the most common use of the three terms appears to be:

  1. Electronic Medical Record – a partial health record under the custodianship of a health care provider(s) that holds a portion of the relevant health information about a person over their lifetime.  This is often described as a provider-centric or health organization-centric health record of a person.
  2. Electronic Health Record – a complete health record under the custodianship of a health care provider(s) that holds all relevant health information about a person over their lifetime.  This is often described as a person-centric health record, which can used by many approved health care providers or health care organizations.
  3. Personal Health Record – a complete or partial health record under the custodianship of a person(s) (e.g. a patient or family member) that holds all or a portion of the relevant health information about that person over their lifetime.  This is also a person-centric health record.

For those of us located in Canada, the confusion in part comes from how the technology is marketed.

We also have software products called Electronic Medical Records (EMRs).  These EMR products are primarily used by physicians in their office or in an out-patient clinic.  The term EMR has traditionally not been used to describe software products marketed at other points of healthcare service in Canada. (e.g. hospital, continuing care, public health, mental health and so on).

How would you explain the terms EMR, EHR and PHR?  Is there another way to view and describe these types of health records?  Will the terms EMR and EHR become moot when fully interoperable electronic health records become more commonplace?  Let us know what you think!

Have a comment about this post? We’d love to hear from you.

Reference list (in alphabetical order)

  • Australia – What is a PCEHR?
  • Austria IHE in the Austrian Electronic Health Record
  • Belize Belize Health Information System
  • Canada – Canada Health Infoway website
  • Croatia – e-Health Croatia Success Story
  • Denmark – e-Health Strategies:  European Country Reports Database
  • Estonia – E-Health initiatives in Estonia and e-Health Strategies: European Country Reports Database
  • EU – European countries on their journey towards national eHealth infrastructures (Final European progress report) and individual country reports
  • Finland – eHealth Roadmap– Finland,  e-Health Strategies:  European Country Reports Database and Sharable EHR systems in Finland
  • France – The DMP : a project that is structuring the development of e-health in France and e-Health Strategies:  European Country Reports Database
  • Hong Kong – What is eHR?
  • ISO TC210 – Electronic Health Record Definition, Scope, and Context
  • Japan – Japan’sIT Strategic Headquarters and Transforming healthcare with information technology in Japan: A review of policy, people, and progress
  • Netherlands – e-Health Strategies:  European Country Reports Database and eHealth in the Netherlands : Policies, developments and status of cross-enterprise information exchange in Dutch healthcare
  • New Zealand – National Health IT Plan
  • Norway – e-Health Strategies:  European Country Reports Database and Consent-based access to core EHR information: Collaborative approaches in Norway
  • Saudi Arabia – e-Health
  • Singapore – Information technology and improving patient safety in Singapore hospitals : Turning ideas into action
  • Spain –  e-Health Strategies:  European Country Reports Database and National Health System of Spain Annual Report
  • Sweden – The Swedish National Patient Overview (NPO) and e-Health Strategies:  European Country Reports Database
  • Turkey – eHealth Strategies Country Brief: Turkey
  • U.K. –  Summary Care Records (SCR) and e-Health Strategies:  European Country Reports Database
  • U.S.A.ONC – What’s the Difference between Electronic Health Records and Personal Health Records?,  HITECH Act Definition , and (from the ONC blog) EMR vs EHR – What is the Difference?
  • U.S.A. – HIMSS – Electronic Medical Records vs. Electronic Health Records: Yes, There Is a Difference and EHR: Electronic Health Record

 


thodge 100Trevor Hodge

As Executive Vice President, Trevor Hodge is responsible for Infoway‘s investment strategies, information and technology directions, electronic medical record investment program, as well as project investments in Western, Northern and Atlantic Canada.

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