Monday, June 16, 2008

EMR, PHR, HIE, Aieee!

If I go overboard in explaining acronyms here it is because I can hardly stand the things. I understand their necessity, especially in writing, but when assumptions are made regarding their usage that's when barriers to information access start going up in the name of jargon. Perhaps I'm overly aware of them due to my journalism background, my human resources experience where some days all I did was demystify the acronyms involved in the Family & Medical Leave Act (FMLA, which will never mean Fellow of the Medical Library Association to me), or because I'm new to the field and trying to find covert ways to get my colleagues to explain and pronounce acronyms and listserv names so I don't sound like a dork.

Librarianship and Information Technology (IT) are fields loaded with acronyms, and combining the two in the area of health/medical informatics is especially deadly. The fact that there are over 100 controlled vocabularies in the Unified Medical Language System® (UMLS®) where nearly every language vocabulary itself is also an acronym, and you'll see why I nearly went insane last year trying to tackle comprehension of UMLS® as part of my coursework.

This is why I was relieved to see a focused effort to not only clarify the acronyms involved in electronic medical/health records (EMRs and EHRs) and other health IT issues, but also the meaning behind the words themselves instead of tossing them around to look trendy and in the know. However, the Life as a Healthcare CIO source cited by Kevin, MD began with a sea of acronyms so I knew I needed to dig deeper to the original source. I do have a lot of respect for healthcare Chief Information Officers (CIOs), by the way, and this is exactly how they talk. I was a babysitter for one of them 2 states away as a 15-year-old and that connection is how I got my foot in the door & interested in the health information field.

The National Alliance for Health Information Technology (NAHIT) recently issues a 40 page pdf report on what two workgroups (one for records, one for network) who used a 'comprehensive literature review'*, forums and comments to propose definitions for health IT infrastructure.

Without further ado (click the image to enlarge),

Concise, jargon-free descriptions that clearly define the difference between EMRs, EHRs & PHRs. Brilliant! I don't think most people (except healthcare IT and their stakeholders) need to be as concerned about the network terms, but personally I appreciate the proposed distinctions between these different types of medical records and hope they are adopted so everyone is on the same page with terminology as EMR, EHR & PHR usage becomes more common. They even envision a health informatics future of (click image to enlarge)

Now the big question posed by The Health Blog: Do people even care? Interesting post and comment thread there, and combined with my own suspicion of Google Health's 'no advertising unless our partners include it under our terms' I think medical librarians need to have an increased role in EMRs, EHRs & PHRs because I'm not convinced other entities are looking at things from the perspective of patients as more than sources of data and revenue. We are experienced not only in information organization, but in information-seeking behavior and consumer health literacy and I'm not hearing much about how these are being incorporated in PHRs or patient-accessible EMRs and EHRs.

* I also hope medical librarians were involved in this 'comprehensive literature search', perhaps my colleagues in the Medical Informatics Section. The report states what sources were reviewed by the work groups, but not how they did their search to obtain the sources. The degrees and titles of those on the work groups don't seem to indicate the inclusion of medical librarians, but it doesn't indicate if other sources helped collaborate on the project.