EMR vs EHR: Looking at Behavioral Health Software

What is an electronic health record (EHR)? What is an electronic medical record (EMR)? What’s the difference?

These are some of the first questions I asked myself when I got a job at an EHR software company.

Turns out, there’s not a perfect answer because each software platform is a little different. It’s hard to draw an exact line between an EMR and an EHR because platforms come in all shapes and sizes nowadays.

However, there are a few basic differentiators that separate a classic EMR from a classic EHR.

To start, it’s helpful to think of the EHR as an evolution of the EMR.

Now, that doesn’t mean the EMR has gone extinct. Quite the contrary – EMRs remain a preferred software solution for many treatment providers.

The difference here lies in the breadth of software functionality. In very simple terms, an EMR is a more contained solution, whereas an EHR is a more dynamic solution. But there’s more to that story, which we get into below.

What is an EMR?

An EMR is an electronic version of the traditional paper health records system.

It was the first digitization of the practice, marking a huge technological step forward in health IT.

The idea was to leverage modern software to digitally manage all the moving parts of a provider’s operation. Streamlining documentation, automating manual processes, consolidating thousands of paper charts in a single system – the EMR injected computerized efficiency into a previously offline process.

As a result, the EMR enhanced organizational performance and enriched patient care while simultaneously reducing the chance for human error.

The main characteristic of an EMR, in comparison to an EHR, is that an EMR contains a patient’s medical and treatment history from a single practice.

The extent of a patient’s records in an EMR only spans the treatment that occurred within that one organization. In this way, EMRs provide a closed digital treatment environment.

The issue here is interoperability. EMRs don’t typically “talk nice” with other software systems. In fact, some of them don’t speak to others at all.

The individual features in an EMR may even be fairly powerful, but those solutions are unable to integrate with external systems. It’s not a platform that’s capable of pulling in a variety of information from different systems to build an exhaustive patient record.

This is the limitation of the EMR.

Because it’s a digital reflection of an organization’s paper system, the EMR doesn’t necessarily transform a provider’s operation. The medium is updated, but the provider’s workflow is relatively unchanged and/or restricted.

EMRs made health records digital and easier to manage, but they didn’t maximize or enrich the wealth of information that can be leveraged for a patient’s care.

What is an EHR?

By design, electronic health record software was meant to be a dynamic improvement on the blueprint laid by the EMR.

It was the software solution that unlocked the possibility for patients to build a comprehensive digital health record – one that incorporated all medical history from all their providers.

The key update from the EMR that made this possible was, of course, interoperability.

Rather than a siloed record within a single practice, the EHR promoted a focus on the total health of a patient.

By being able to integrate with other systems, EHRs can compile the full picture of a patient’s health. In order to provide the best possible care to their patients, every last bit of information is potentially relevant.

From a software perspective, that means integrating with lab management or e-prescribing software, CRM and RCM solutions, and even the EHRs of other providers. No matter the external software system, an EHR can pull in the necessary information to maintain a holistic, up-to-date health record.

This seamless integration is important for two reasons. First, the very function of interoperability sets the EHR apart from the EMR.

And, second, that integration empowers even more dynamic workflows in the platform.

The interoperability of EHRs promotes the free (and secure) flow of information between a patient’s record and each stakeholder in their care.

The ability to easily collect information from every provider that treats a patient, and have that information be compiled in one place, is the most modern, comprehensive treatment experience we can deliver to patients and providers.

By being able to incorporate multiple systems into a single patient’s health record allows the system to work even more for the provider. Consider the benefit of the following workflow:

1. Patient comes in for appointment
2. Patient reports symptoms, which are recorded in the system
3. Doctor orders lab tests, powered by a lab management integration in the EHR
4. Patient gets tests done
5. Lab results are automatically reported back to the provider and generate in the patient’s chart in the EHR
   Doctor’s office sends results to patient via secure instant messaging in the patient portal
   Next time the patient is treated, those results will provide the most current context to treat the patient further

Can you spot how many links in this chain would be present in an EMR?

EHR vs EMR: Final Thoughts

The answer to that question is numbers 1 and 2. An EMR would not be able to order labs right in the system because it wouldn’t be able to integrate with a lab management system.

In an EMR, numbers 3-7 must be done manually or in a much less efficient manner. Either way, there is room for improvement in both the patient and provider experience.

To wrap things up, let’s break down those key differences between EHRs and EMRs one last time.

EMRs

• Digitization of the practice (electronic documentation, increased efficiency and accuracy from paper system)
• Encompasses a patient’s treatment at a single practice
• Not interoperable, cannot integrate with external systems

EHRs

• Digitization of the practice
• Encompasses a patient’s treatment at each and every provider they go to
• Real-time updates to the patient’s medical information
• Interoperable with other proprietary systems
• Seamless integration with external software
• Dynamic workflows that connect complex treatment instances across separate software platforms

Sigmund Software is an EHR software company, so, if you ask us, we prefer EHRs over EMRs.

However, that doesn’t mean an EMR isn’t the right choice for a variety of treatment providers. Some organizations have modest software needs that an EMR can satisfy.

For other organizations, an EMR is the biggest jump from a paper system they’re willing to make. In this way, an EMR can be a stepping stone of sorts to an eventual EHR implementation.

Sometimes, an organization needs a test run with the more economical EMR before they can wrap their head around an EHR experience.

We will say, however, that the world is progressing in the way of the EHR.

EHR Software at Sigmund

With the emergence of enterprise software and wearable technology, there’s a growing demand for patients to have complete control over their health information. Consumers now see real value in engaging with their health with data.

As a result, the EHR’s design is much more conducive to that trend than the EMR. If you’re thinking about how you can provide the best treatment experience to your patients, EMR software may not cut it forever.

And, just as a heads up, if you think that your organization requires an EHR rather than an EMR, a brand new search begins. You’ll have to navigate the wide spectrum of EHR technology to find the right software solution.

Even though it’s the most modern medical software, functionality can vary from EHR to EHR, especially in behavioral health. That’s why it’s important to go into a search for an EHR with a sense of what you need out of this kind of tech.

To assist organizations in answering this question, we’ve written a number of blog posts that explore the ins and outs of a modern EHR platform.