Health Information Technology in Healthcare: Frequently Asked Questions (FAQ) 1

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1 Health Information Technology in Healthcare: Frequently Asked Questions (FAQ) 1 1. What is an Electronic Health Record (EHR), an Electronic Medical Record (EMR), a Personal Health Record (PHR) and e-prescribing? Is there a difference between an EHR and an EMR? Both an EMR and EHR are software applications that enable health care providers and institutions to record, access and analyze patient medical information in a digital format. These applications capture and manage patient health care information in a way that is more efficient, accessible and secure than traditional paper-based medical record systems. By definition, there is a difference between the two. The National Alliance for Health Information Technology (NHIT) defines them as follows: a. EMR: The electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from single organization who are involved in the individualʼs health and care. The Office of the National Coordinator (ONC) has created a certification process to ensure that the users of electronic health information technology will be using systems that meet the identified standards for security, interoperability and functionality. ONC has established a program to review and approve entities as Authorized Testing and Certifying Bodies (ATCBs). These ATCBs will certify vendor products to ensure that the EMR software is able to demonstrate the required functionality for the various stages of Meaningful Use. b. EHR: The aggregate electronic record of health-related information on an individual that is created and gathered cumulatively across more than one health care organization and is managed and consulted by licensed clinicians and staff involved in the individualʼs health and care. By these definitions, an EHR is an EMR with functional interoperability (See definition of interoperability below ). i. HealthInfoNet as the statewide health information exchange for Maine provides a community-wide EHR accessible to providers from within their organizationsʼ EMR. (see Health Information Exchange below) 1 Adapted from Taconic Health Information Network and Community s (THiNC) website

2 c. PHR: An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual. d. E-prescribing (erx): Computer technology in which physicians use handheld or personal computer devices to review drug and formulary coverage and transmit prescriptions to a printer, EHR-S or pharmacy. e-prescribing software can be integrated with existing clinical information systems to allow access to patient-specific information to screen for drug interactions and allergies. 2. What is interoperability, and how does it work? Interoperability is a term used to describe the ability of EMRs, EHRs, PHRs, laboratory information systems, electronic prescribing systems and other health information technology systems to transmit and receive data using standardized data protocols. When health information systems are able to securely and reliably exchange information, they are considered interoperable. Certified EMRs are compliant with national standards for interoperability, security and patient privacy. 3. What is Health Information Exchange (HIE)? HIE is the electronic movement of health-related information among organizations according to nationally recognized standards. 4. What is a Health Information Organization (HIO)? An HIO is an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards. HealthInfoNet is Maineʼs statewide health information exchange organization. HealthInfoNet works with Maine hospitals, health systems, and providers to facilitate clinical information sharing so that a patientʼs clinical health information follows them where ever they are seen in the state. 5. Why should physicians adopt EMRs? For the physician, an EMR provides functionality that supports all the clinical tasks that occur throughout the cycle of care--computerized physician order entry (CPOE), real-time, point-of-care clinical decision support; maintenance of problem and allergy lists, e-prescribing with automated drug utilization review, vital sign charting and tracking, lab and radiology test results reporting, automatic generation of clinical summaries, and clinical care reminders. An EMR can: Integrate with practice management systems to help streamline the business side of a medical practice

3 Report events relevant to public health and safety Enable the secure, authorized exchange of patient medical information between health care systems Offer providers secure remote access to medical records when and where they are needed Provide a patient portal to enable patient control of personal health records and facilitate patient/practice communications. 6. How can EMRs help improve patient safety? An EMR system can help reduce errors related to illegible handwriting on treatment orders and/or prescriptions, inadequate or incomplete patient information, or a lack of specific knowledge required to make a fully-informed clinical decision at the point of care. 7. Can an EMR impact a practiceʼs bottom line? A study reported by The American Journal of Medicine found the net financial benefit of implementing a full electronic medical record system was $86,400 per provider over a five-year period. Of this total, savings in drug expenditures made up the largest proportion of the benefits (33% of the total). Almost half of the total savings came from a combination of decreased radiology utilization (17%), reductions in billing errors (15%), and improved charge capture (15%). The title of the article is A Cost-Benefit Analysis of Electronic Medical Records in Primary Care and can be found on the Tools and Resources page of Maine Quality Countʼs EHRs to Improve Care Web Page. 8. What financial incentives are available to practices for using EMRs? Right now, the federal government is providing compelling financial incentives for the adoption of EMR technologies within the American Recovery and Reinvestment Act of 2009 (ARRA) known as the Health Information Technology for Economic and Clinical Health Act (HITECH). The HITECH Act authorized the Centers for Medicare and Medicaid Services (CMS) to offer financial incentive payments to eligible physicians for the meaningful use of certified EHRs. Beginning in 2011, providers certified as demonstrating meaningful use can receive up to $44,000 - $63,750 in bonus payments under the CMS EHR Incentive Program. The exact amount is dependent on the providerʼs volume of Medicare or Medicaid patients. See and - TopOfPage for the indepth overviews and information on the Medicare and Medicaid EHR incentive programs. 9. What is the federal governmentʼs definition of meaningful use?

4 The American Recovery and Reinvestment Act of 2009 specifies three main components of meaningful use: 1. The use of a certified EMR in a meaningful manner, such as e-prescribing. 2. The use of certified EMR technology for electronic exchange of health information to improve quality of health care. 3. The use of certified EMR technology to submit clinical quality and other measures. Simply put, "meaningful use" means providers need to show they're using certified EMR technology in ways that can be measured significantly in quality and in quantity. (Source: Where can I get I find a list of federally certified Electronic Medical Record Systems? A list of federally certified EMRs can be found at Is the CMS EHR Incentive Program available only to practices newly implementing one of these systems? What if our practice has already implemented one? The CMS EHR Incentive Program is available to any eligible provider who demonstrates meaningful use of their EMR; it is not limited only to providers newly implementing an EMR. That said, practices that already have an EMR in place will need to demonstrate that their EMR is certified by the federal government (see Q9 above), and that they meet the meaningful use objectives outlined by CMS. 12. Where can I learn more about meaningful use of electronic health records? Electronic health records play a critical role in getting to a higher quality, safer, more effective health care system. To learn more about the meaningful use of electronic health records, and to get the latest updates, visit the Office of the National Coordinator of Health Information Technology website at: meaningful_us e_-_providers/ What is the relationship between meaningful use and the Patient Centered Medical Home? One way to think about the relationship between meaningful use and the Patient Centered Medical Home (PCMH) is that the two together represent the current best vision we have for a sustainable model to deliver high value healthcare at an affordable cost. An EMR used correctly ( meaningful use ) becomes the information management infrastructure for powering the workflows in a PCMH. Meaningful use can be thought of as simply an operational definition of the information management

5 requirements for supporting a PCMH. (Source: Jeff Hummel, MD, MPH, Medical Director, Washington & Idaho Regional Extension Center ) 14. What is the Physician Quality Reporting System? Physician Quality Reporting System (PRQS), formerly known as the Physician Quality Reporting Initiative (PQRI), is a physician quality reporting system that offers government incentive payments for eligible physicians who satisfactorily report data on quality measures for covered professional services furnished to Medicare beneficiaries. In order to receive the benefit payments, physicians must provide PQRS quality indicators to CMS for a specific reporting period. EMRs are designed to automatically track PQRS quality indicators, thus facilitating physician participation in the program and improving the quality of care. For additional information, link to the following website Are there financial incentives available to practices that use e-prescribing? (e- Rx) Eligible providers (EPs) who meet federal requirements can participate in either the CMS e-rx program or the CMS EHR Incentive Program. Each program has its own payment incentives and penalties. More information on the erx Program can be found on the CMS website at More information on the CMS EHR Incentive Program can be found at Programs/ 17: How is patient health information protected in an EMR? Certified EMRs are required to comply with privacy and security regulations mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients rights regarding control of that information. The Privacy Rule was designed to enable the appropriate sharing of personal health information with authorized stakeholders involved in patient care. Still have questions? For more information, submit questions to rec@hinfonet.org or phone Gemma Cannon at , or Additionally, please visit an expanded FAQ developed by the American Medical Association at the following link: