EMR s, EHRs, PHRs, questions and answers

1. EMRs, EHRs, PHRs, questions and answers Emily Barey, RN, MSN Director of Nursing Informatics Epic systems, Verona, wisconsin

2. Welcome • Emily Barey RN, MSN • Director of Nursing Informatics, Epic Verona, Wisconsin • Role of the industry vendor

3. What is an EMR? EHR? PHR? • Electronic Medical Record • is the digital version of the paper chart, located at the clinic or hospital where you receive care • Electronic Health Record • is a broader data set written by the entire care team; designed to follow the patient across different care settings • Personal Health Record • is like an EHR but entirely entered and managed by the patient http://www.healthit.gov/providers-professionals/faqs/what-are-differences-between-electronic-medical-records-electronic

4. What is in an electronic record? Before EHR • Past History & Problems • Medications you take • Allergies you have • Clinical notes • Vital signs • Scanned documents • Results and Images After EHR

5. Can I see my record? • Patient Portal vs. PHR • Shared record with your doctor via a portal • Personal health record that you enter all the data • What is shared? • Determined by organization and capability of software vendor • Proxy access • Consent to see your child’s record or elderly parent, spouse

6. Why use an EHR? A clinician point of view A patient point of view A shared record with you Better care Convenience Continuity of care But sometimes they still ask me the same questions, why? The software system The policy of the healthcare organization Learning a new paradigm to verify and update • Accessibility • Legibility • Alerts & Reminders • Avoid duplication and decrease cost • Follow patient preferences • Research • More!

7. Who Uses an EHR? Nursing Home Hospital Your Home Doctor’s Office Surgery Center

8. Interoperability How does my record move electronically? Why doesn’t it ALWAYS work? Some EHR systems can’t send messages yet in the standard language Role of EHR Certification Government program called Meaningful Use requires use of an EHR that can send standard messages • Computers can talk to each other • Often they need an interpreter • Government standards determine the “language” the EHR computers must send messages to each other in • Basic data set today, growing all the time what can be shared

9. Lack of Interoperability What if my doctor or hospital doesn’t use an EHR? Copy & Fax Machines US Postal System You carry your record It isn’t available

10. Is my record safe? • HIPAA & HITECH • Health Insurance Portability & Accountability Act • Health Information Technology for Economic & Clinical Health Act • Sharing the record to coordinate care • Audit trails of access 1. http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html 2. http://www.healthit.gov/patients-families/protecting-your-privacy-security

11. Questions To ask your Provider • Can you sign up for access to your shared medical record? • Can your provider share your record electronically with other providers if necessary?