Daily Archives: December 7, 2010

Most in the medial field know the acronym EHR (Electronic Health Record) and EMR (Electronic Medical Record) but many do not understand the difference between the two. The National Alliance for Health Information Technology defines these two as follows (2008):

Electronic Medical Record: an electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization.

Electronic Health Record: an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff across more than one healthcare organizations. The United States government via Health and Human Services/Office of the National Coordinator provides incentives via the HITECH Act to move the nation toward adoption of Electronic Health Records. On July 13, 2010, HHS provided a clarification of the benchmarks providers must demonstrate to receive the incentive payments for adopting a “certified EHR”. This document is over 850 pages in length that highlights some of the details of meaningful use. Many thought leaders, providers, and policy makers believe that Moving away from a primary “paper-based” system to an “Electronic Health Record” will improve quality and reduce costs of the health care system. Making the transition requires time, money
and effort.

Technology evolves at a rapid pace. Moore’s law states that processors double in speed about every 18 months. This concept with the computer chip allowed manufacturers to develop personal computers at a low cost. IBM and other large companies focused their sales groups on high profit main frame computers. Businesses learned that they could save money by adopting personal computers. Businesses then Adopted servers with wired connections to personal computers (PC) and installed the software they needed on the server. Businesses that use servers need to pay for the software, the server, and have have IT individuals install firewall protection, conduct back up, maintenance, etc. The high speed Internet now provides a means for businesses, including physician practices to lower their costs and reduce their administrative work via cloud computing (see article related to what is cloud computing?).

Interesting to note the Wall Street Journal article on Monday, July 26, 2010 titled “microsoft, Google Vie to Sell US Cloud Mail”. The author of the article (Amir Efrati) shares two interesting confirmation of using cloud computing for business and government: (1) the General Services Adminstration certified that Google’s cloud-based “e-mail and word-processing service, known as Google Apps, meets security requirements to qualify for use by the agency”. If a large government agency that requires high security of information uses cloud-based solutions, shouldn’t small businesses? And (2) the estimated number of users would be about 15,000 government employees. Note that “the GSA often helps shape how other agencies acquire technology”.

The government understands that cloud-based computing can save money for US taxpayers. The WSJ article states “a report from the Obama administration’s chief information officer says the concept could help trim the federal government’s $76 billion annual budget for computer equipment and software”. The government would pay a set fee per user per year and would only need to maintain an Internet connection.

If the government is moving toward cloud computing with thousands of employees, should any physician practice with less than 100 employees adopt EHR systems based on the practice needing to buy and maintain a server?