There is no such thing as a comprehensive health record

The folks at recently published EHR vs. EMR – What’s the Difference?

It’s a good, but at times too high-level and could have been a bit more substantive in terms of real problems and potential solutions (but I suspect this was "landscape" summary so I can’t fault them too much). It talks about what is an EMR, EHR, and PHR from a definitional perspective and goes on to give a good summary of how often each term is used (with Google stats) and why vendors are still calling themselves EMRs.

I think the general debate of whether it’s an electronic health record (EHR) versus an electronic medical record (EMR) or a personal health record (PHR) is really silly. It’s like saying that your bank records kept at the bank versus the copy they give you at home via online banking versus what you see at the ATM versus what you put into Quicken are all somehow different records — they are not. They are the same financial record (yours!).

EHRs, EMRs, PHRs, are all views of a single person’s health record that doesn’t really exist anywhere in totality — they are simply slices. Thinking that we’ll ever have a comprehensive record for anyone is like saying there’s one comprehensive financial record for a person that would include their taxes, bank statements, 401k statements, etc. There are aggregators like and that do financial data aggregation because there is no single source for a financial record and there never will be (too many players).

Healthcare data is far more detailed and even more volumnious and far harder to aggregate. Good luck trying to unify these definitions.

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2 thoughts on “There is no such thing as a comprehensive health record

  1. It is OK to say that but when you need care you need the best you can get. Some are obviously better than others but when the record is patient oriented rather than user oriented you have a better chance. No point in having your credit card only when you require a home loan. And you can bet your bottom dollar that when the bank wants to consider a loan (especially these days) they will have as much information as they possibly can to consider your application because if they get it wrong it costs them unlike physicians or hospitals.
    Most mistakes in medicine are made not by not knowing but by not looking. Most neglect is now from not managing people and their healthcare properly.
    Remember the aviation industry 60 to 70 years ago – it was nowhere near as safe as now. Contrarily medicine is not nearly as safe and I cannot believe that physicians do not routinely check drug interactions with electronic prescribing. Double, triple data entry is so ridiculous and that is where many of the errors and the ‘98,000’ avoidable deaths occur.
    It is not rocket science to produce a health record – and not just an extract as the Googlers and Microsofts are doing – but a progressive record which will have to be controlled by the patient who travels with the record if it is virtual.
    Imagine anybody keeping a log book for the car at the mechanic’s workshop.
    Of course, these definitions are for the geeks who are becoming as prodigious as the healthcare managers who are, largely, responsible for the massive increases in healthcare costs in the US.
    The KISS principle needs to be invoked.

  2. Agreed that these are all views of the same type of data. The challenging goal is to have a centralized system of record. While nobody owns all of your financial data, there are systems of record like credit scoring agencies and the IRS that require standardized data on every business and individual’s financial situation.

    Will there be a system of record? Too many players, yes that’s correct. Detailed and voluminous need not matter if we can decide on standards.

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