Colleagues,
For National Health IT Week 2018, I have been ruminating about the theme of Supporting Healthcare Transformation, described as: “the many ways in which health IT is driving transformation in healthcare delivery including improvements in quality and safety, interoperability, advances in innovation, and patient and consumer activation and engagement.”[1]
The Office of the National Coordinator for Health Information Technology (ONC) defines an electronic health record (EHR) as “a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.”[2] Although we started with the term Electronic Medical Record (EMR), we in informatics have been working with this EHR definition for more than ten years. Recently, Judy Faulkner, Epic Systems founder and CEO, made waves suggesting we change the terminology to Comprehensive Health Record (CHR) to reflect more broadly the reach of the patient care applications.[3] Zane Burke, President of Cerner, concurred and pointed out how their clinical applications are moving towards a CHR approach as well, specifically citing population health tools and interoperability solutions. [4] Even health systems have weighed in on the topic, with UCSF Center For Digital Innovation suggesting that since no single vendor EHR system is comprehensive, and there must be interoperability.[5] Given this, they suggest CHR should stand for “connected health record,” not comprehensive health record.
My take on this Health IT semantic debate, is that these terms – EMR, EHR, CHR – neither accurately describe the clinical systems we have in place, nor go far enough to describe the impact they have on contemporary patient care. I propose that we begin thinking of these clinical information systems as operating systems (OS) akin to Microsoft Windows, Apple MacOS or iOS, or Google Android. After all, these healthcare systems manage everything: the clinical, financial, and operational aspects of health care. Furthermore, like other non-healthcare OS, these information systems have become the central hub for other medication-use technology and applications to interface with and exchange information. These healthcare OS are not merely another Departmental application, there are THE way in which health care is delivered across all settings in our contemporary era.
So now that we have our terminology on point, where does this leave us? As informaticists we are in the exciting and fortunate position to design, build, implement, integrate, optimize and innovate the most important healthcare tool of all: the healthcare operating systems (HealthOS). For this year’s National Health Week, let us transform healthcare delivery for our patients through the safety, efficacy, efficiency and economical impact of the HealthOS. Let’s transform healthcare beyond the EHR!
Respectfully,
Joe Lassiter, MS, PharmD
Immediate Past-Chair | ASHP Section of Pharmacy Informatics & Technology
President & Managing Advisor | The Robertson Group (TRG)
[1] HIMSS. National Health IT Week 2018. https://www.healthitweek.org/points-engagement. Accessed October 2018.
[2] Office of the National Coordinator for Health Information Technology (ONC). 2018 Mar 21. https://www.healthit.gov/faq/what-electronic-health-record-ehr. Accessed October 2018.
[3] Healthcare IT News. 2018 Mar 6. https://www.healthcareitnews.com/news/judy-faulkner-comes-himss18-chrs-her-mind. Accessed October 2018.
[4] Healthcare IT News. 2017 Oct 13. https://www.healthcareitnews.com/news/epics-rival-ehr-vendors-say-they-too-are-making-chr-switch. Accessed October 2018.
[5] Electronic Health Record? Comprehensive Health Record? Connected Health Record! 2018 Mar 13. http://connectinghealthdata.com/connected-health-record. Accessed October 2018.
Immediate Past-Chair | ASHP Section of Pharmacy Informatics & Technology
President & Managing Advisor | The Robertson Group (TRG)
[1] HIMSS. National Health IT Week 2018. https://www.healthitweek.org/points-engagement. Accessed October 2018.
[2] Office of the National Coordinator for Health Information Technology (ONC). 2018 Mar 21. https://www.healthit.gov/faq/what-electronic-health-record-ehr. Accessed October 2018.
[3] Healthcare IT News. 2018 Mar 6. https://www.healthcareitnews.com/news/judy-faulkner-comes-himss18-chrs-her-mind. Accessed October 2018.
[4] Healthcare IT News. 2017 Oct 13. https://www.healthcareitnews.com/news/epics-rival-ehr-vendors-say-they-too-are-making-chr-switch. Accessed October 2018.
[5] Electronic Health Record? Comprehensive Health Record? Connected Health Record! 2018 Mar 13. http://connectinghealthdata.com/connected-health-record. Accessed October 2018.