The Need for Interoperable and Portable Electronic Medical Records

The Trials and Tribulations of EMRs and EHRs

Interoperable and Portable Electronic Medical Records

Handwritten paper medical records are inevitably giving way to electronic medical records (EMRs). Although digital medical records have been around for at least 30 years significant financial investment over the past decade has resulted in data portability and accessibility that was previously not available. Although the velocity of innovation and progress of EMRs is increasing, there are still several hurdles to overcome, and the implementation of new medical data systems has received some criticism from health-care journalists and commentators for its seeming lack of accountability and empowerment.


The two acronyms – EHR and EMR – are often used interchangeably. But as the Office of the National Coordinator for Health Information Technology (ONC) notes, there is a difference between electronic health records (EHRs) and EMRs. EMRs predate EHRs and were intended for clinician use only. EHRs attempt to go further and encompass a broader spectrum of data than EMRs.

Meaningful Use – a set of standards that are supposed to ensure that health dollars spent on EHRs result in productive outcomes – essentially mandates that EHRs be interoperable. This directive requires unlocking health data and connecting different systems creating a “many to many" model (in contrast to "point to point" model) meant to increase the utility of one’s personal medical data. However, Fred Trotter, an established health-care data journalist and author, argues in his article “What Can Meaningful Use Learn From

” that EHRs are not yet able to exchange data and communicate, so the American health-care system might arguably still be in the era of EMRs.

What is blocking health system interoperability?

Doctor Karen DeSalvo, who currently acts as the Assistant Secretary of Health for The Office of the National Coordinator for Health Information Technology, writes about the complaints of ‘health information blocking.’ This practice impedes the exchange and use of electronic health information and is one of the barriers to interoperability.

While most digital health advocates support the goal of information sharing that would presumably improve medical care and save money DeSalvo states, “some individual participants in the health care and health IT industries have strong incentives to exercise control over electronic health information.”

In April 2015, the ONC submitted a report to Congress on information blocking, and the authors proposed actions that can curb the practice, as well as stipulating that there should be more transparency in health IT markets.

Another cited barrier to successful EMRs interoperability is a complex mix of technological issues and policy interactions. Trotter appeals for one person to be appointed to tackle these highly specialized issues and devote all his or her time to the role.

Portability of EMRs

Portability of one’s personal health data is another important concept that relates to creating standardization among the syntax used to create health records and the ability to easily transport this data across disparate systems. Many studies have shown that portable and easily transferable data can considerably improve health-care services and enhance patient care. However, portability of EMRs is a challenge that has not generally been solved yet and still needs to be perfected to secure a coordinated health-care system.

Safe and secure exchange of digital health information remains one of the priorities of the digital health movement. It has been suggested that cloud storage, password protection and encryption are all measures health-care providers can take to make portable EHRs more secure.

Closing health IT gaps

To advance health information sharing, on July 28, the ONC announced more than $38 million in grant awards to 20 organizations from 19 states across the country. One thing the awardees will be expected to work on is increasing the integration of health information. A community health peer-learning program is also predicted to help communities improve data aggregation, data portability and data analysis, all with the goal to achieve better outcomes and smarter health-care spending.


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