Welcome

In a project for the Office of the National Coordinator of Health Information Technology, The National Alliance for Health Information Technology has finalized definitions for six critical health information technology terms. The terms defined are electronic medical record (EMR), electronic health record (EHR), personal health record (PHR), health information exchange (HIE), and regional health information organization (RHIO). The dual interpretations of HIE as both a process and an entity, created a need for a sixth term - health information organization (HIO) – to clarify the difference between the process of information exchange and the oversight and accountability functions necessary to support that process.

Thanks to invaluable input from work group members and a broad range of participants at the two public forums and during two public comment periods, the work coalesced around some major themes, which helped to identify gaps and reach consensus on the definitions for each of the terms.

Interoperability is the common thread running through health IT terms. Interoperability is the essential factor in building the infrastructure to create, transmit, store and manage health-related information.

Nationally recognized standards are required to enable the flow of information. EHRs, PHRs, and HIE require the use of nationally recognized interoperability standards to enable the flow of information reliably, consistently, accurately, and securely.

The principal difference between an EMR and an EHR is the ability to exchange information interoperably. An EMR aligns with the prevailing state of electronic records today (whether the record is branded an EMR or an EHR). However, the movement of the industry is toward electronic records that are capable of using nationally recognized interoperability standards, which is a key defining component of an EHR. With the passage of time, electronic records not capable of exchanging information interoperably will lose their relevance. Thus the term EMR is on course for eventual retirement.

Control of information distinguishes EHR from PHR. The information in a PHR, whether contributed from an EHR or through other sources, is for the individual to manage and decide how it is accessed and used. Electronic portals of information on an individual that are hosted by a provider or payer organization, without transferring the control of the information to the individual, are not PHRs but rather examples of giving individuals access to information in an EHR.

Records contain health-related information. Because of their historical origin, the prevailing terms for electronic records retain an outdated differentiation based on a “medical” or “health” orientation. In fact, both types of records can and do contain a broad range of health-related information, and the differentiation is now along the lines of readiness to make that health-related information interoperable. In this report, health-related information refers to clinical and administrative, health and wellness data and information.

HIE is process. HIO is an oversight organization and RHIO is a type of HIO. In many instances, HIE has been used to describe both the process of health information exchange and the entity overseeing and governing the exchange. Consequently, HIE and RHIO were often used interchangeably. To provide greater clarity, three terms are defined to achieve both separation of meaning and a construct to accommodate a wide range of current and future organizations for information sharing.

The full report from the Alliance summarizes the deliberations and conclusions of the two work groups. It concludes with a look forward, envisioning how the terms can support an interoperable infrastructure to realize the benefits of health IT.

Click here for the final report

Click here for a version of the final report that is 508 compliant