What EMR Systems Do Hospitals Use? A Comprehensive Guide

As the healthcare industry evolves, hospitals and health systems are turning to electronic medical record (EMR) and electronic health record (EHR) systems to streamline operations, improve patient care, and meet regulatory requirements. 

With many options available, it can be challenging to choose the best fit. In this guide, we'll explore the history, benefits, features, and top systems used by hospitals.

The Evolution of EMR/EHR Systems: From Paper to Digital

The transition from paper-based medical records to digital EMR/EHR systems has been gradual, spanning decades. In the 1960s and 1970s, a few hospitals began experimenting with electronic record-keeping. Widespread adoption was slow due to high costs, limited functionality, and resistance to change.

In the 1990s and 2000s, computer technology advances and concerns about medical errors and inefficiencies renewed interest in EMR/EHR systems. The HITECH Act of 2009 provided financial incentives for hospitals and providers to adopt certified EHR technology, accelerating the shift to digital records.

Today, the majority of US hospitals use EMR/EHR systems. According to the Office of the National Coordinator for Health Information Technology, as of 2017, 96% of non-federal acute care hospitals had adopted certified EHR technology, but their sophistication and interoperability varies widely.

Benefits of EMR/EHR Systems for Hospitals

Implementing an EMR/EHR system requires a significant investment of time, money, and resources, but the potential benefits are substantial and wide-ranging. Some key advantages include:

1. Improved efficiency and productivity: EMR/EHR systems automate manual tasks like chart retrieval, order entry, and prescription refills, saving staff time, reducing paperwork, and streamlining workflows. One study found that nurses in hospitals with advanced EHR systems spent 19% less time on documentation and 24% more on direct patient care than nurses in hospitals with basic EHR systems.

2. Better quality of care and patient outcomes: EMR/EHR systems provide real-time access to current patient information, including medical history, medications, allergies, and test results. This can prevent errors, avoid duplicated services, and support evidence-based decision making. Studies show that hospitals with advanced EHR systems have lower rates of adverse drug events, hospital-acquired infections, and mortality than those with less advanced systems.

3. Cost savings and ROI: Despite the substantial upfront costs of implementing an EMR/EHR system, many hospitals see a positive return on investment through increased efficiency, reduced errors and redundancy, and improved billing and reimbursement. A RAND Health study found that widespread EMR/EHR adoption could yield $81 billion annually in net benefits, driven by savings from improved safety and efficiency.

4. Easier sharing of patient data: EMR/EHR systems facilitate the secure exchange of patient information between providers, hospitals, and other healthcare organizations. This is important in today's fragmented healthcare system, where patients receive care from multiple providers across different settings. Interoperability standards like HL7 and FHIR enable systems to communicate and share data, supporting care coordination and continuity.

5. Enhanced security and reduced risk: EMR/EHR systems provide robust security to protect patient data from unauthorized access, breaches, and cyber attacks. This includes encryption, access controls, audit trails, and backup and disaster recovery.

By reducing reliance on paper records, EMR/EHR systems minimize the risk of lost, stolen, or damaged charts. However, hospitals must still implement strong security practices and comply with HIPAA regulations to safeguard patient privacy.

Key Features of Hospital EMR/EHR Systems

Most EMR/EHR systems offer a core set of functionalities to support clinical workflows and patient care. Key capabilities include:

Electronic charting and documentation

EMR/EHR systems allow clinicians to electronically document patient encounters, assessments, and treatment plans using structured templates and free-text fields, creating a legible, searchable record accessible and shareable by authorized users. Many systems also support voice recognition and natural language processing to streamline documentation.

Computerized provider order entry (CPOE)

CPOE modules allow providers to enter medication, test, procedure, and referral orders electronically, reducing errors from illegible handwriting, transcription mistakes, and incomplete information. CPOE often includes clinical decision support tools that alert providers to potential drug interactions, contraindications, or dosing errors.

Clinical decision support

EMR/EHR systems offer real-time guidance and recommendations to clinicians based on evidence-based guidelines, best practices, and patient-specific data. This may include alerts for overdue screenings or immunizations, alternative treatments suggestions, or risk scores for conditions like sepsis or readmissions. By presenting the right information at the right time, clinical decision support can improve quality of care and patient outcomes.

Interoperability and health information exchange

EMR/EHR systems must exchange data with other systems and organizations to support care coordination and population health management. This includes lab and imaging systems, pharmacies, public health registries, and other providers' EHRs. Standards like HL7 and FHIR provide a common language and format for data exchange, while health information exchanges (HIEs) act as hubs for sharing data across communities or regions.

Patient portals and engagement tools

EMR/EHR systems include patient-facing portals for health information access, provider communication, prescription refills, and online appointment scheduling. Some systems offer mobile apps, telehealth capabilities, and remote monitoring tools to support patient engagement. Empowering patients to take an active role in their care can improve satisfaction, adherence, and outcomes.

Which EMR Is Used by Hospitals?

Hospitals use various Electronic Medical Record (EMR) systems to manage patient information and healthcare operations. The most common EMR systems include those provided by Epic Systems Corporation, Oracle Cerner, and MEDITECH, among others. These systems are designed for inpatient settings and are chosen for their comprehensive functionality and integration with other healthcare services and departments.

What Is the Most Used EMR System?

The most used EMR system in hospitals is provided by Epic Systems Corporation, holding nearly 38% of hospital installations in the United States. Oracle Cerner follows with about 22% of the U.S. hospital EHR market share. These systems are preferred for usability, advanced features, and integration with healthcare services.

What System Do Most Hospitals Use?

Most hospitals use EMR systems to support inpatient care. The most commonly used systems are developed by Epic Systems Corporation and Oracle Cerner, due to their comprehensive features and widespread adoption in the healthcare industry.

What Are the 4 Types of EMR?

The provided web pages do not list four specific types of EMR, but EMR systems can be categorized based on their functionality and healthcare settings. These include certified EMR systems, cloud-based EMR systems, mental health EMR systems, and EMR systems for specific medical specialties or practice sizes.

What Is an Example of an EMR?

An example of an EMR is the system provided by Epic Systems Corporation, widely used across healthcare settings, including community hospitals, academic medical centers, and independent practices. Epic's EMR system is known for its robust features and ability to integrate with other healthcare services.

Factors for Hospitals to Consider When Choosing an EMR/EHR

With so many EMR/EHR options available, hospitals must carefully evaluate their needs and priorities when selecting a system. Some key factors to consider include:

1. Size and type: Larger hospitals and integrated delivery networks may need enterprise-level solutions, while smaller hospitals and critical access facilities may prioritize ease of use and affordability. Specialty hospitals may need EHRs with specific modules, such as oncology or behavioral health.

2. Integration with existing systems: Hospitals have complex IT systems like lab, radiology, and pharmacy. It's important to choose an EHR that can seamlessly integrate with these systems to avoid data silos and workflow disruptions.

3. Interoperability and data sharing: As value-based care and population health initiatives gain traction, hospitals need EHRs that can easily share data with other providers, payers, and public health entities. Look for systems that support standards like HL7 and FHIR, and participate in health information exchanges.

4. Vendor experience and market share: Consider the vendor's track record in the hospital EHR market, including experience with similar-sized organizations and overall market share. A larger market share may indicate a more stable and well-resourced vendor, but potentially less personalized service.

5. Total cost of ownership: Besides initial software and hardware costs, hospitals must consider ongoing expenses like maintenance, upgrades, training, and support. Some vendors offer subscription-based or pay-as-you-go pricing models that are more affordable for smaller hospitals.

6. Cybersecurity and compliance: Hospitals must prioritize EHR security and compliance with regulations like HIPAA due to the increasing threat of cyber attacks and data breaches. Look for vendors with strong security features, such as encryption, access controls, and monitoring, and a track record of protecting patient data.

7. User experience and training: An EHR is only as effective as its users, so choose a system with an intuitive, user-friendly interface and robust training and support resources. Consider the vendor's approach to implementation and training, as well as their ongoing customer support and user community.

How Do I Choose an EMR System?

Choosing an EMR system involves considering factors like practice size, medical discipline, and needed features. Look for a system that improves workflows, offers interoperability, and has a patient portal. The system should support clinical decision-making and reduce errors. Review top EMR systems used by peers and consider cost, usability, and vendor support.

Challenges and Future Directions of EMR/EHR Systems

Despite significant EMR/EHR progress, hospitals still face challenges in optimizing these systems for quality, safety, and efficiency. Some key issues include:

1. Usability and physician burnout: Many clinicians report that EHRs are time-consuming, cumbersome, and distracting, contributing to burnout and dissatisfaction. Hospitals must work with vendors to streamline workflows, reduce click fatigue, and tailor systems to specific specialties and user roles.

2. Interoperability and data blocking: Despite improved standards, many hospitals still struggle to exchange data effectively with other systems and organizations. Vendors may engage in data blocking, restricting the flow of information, and legacy systems may lack necessary interfaces and protocols.

3. Cybersecurity and privacy: As EHRs become more interconnected and cloud-based, they're more vulnerable to cyber attacks and data breaches. Hospitals must invest in robust security measures, such as encryption, access controls, and monitoring, and train staff on best practices for protecting patient data.

4. Cost and maintenance: Implementing and maintaining an EHR system can be a financial burden for hospitals, especially smaller and rural facilities. They must balance advanced functionality with limited budgets and IT resources.

The future of EMR/EHR systems will be shaped by key trends and innovations, including:

1. Artificial intelligence and machine learning: AI and ML technologies can transform EHRs by automating tasks, identifying patterns and anomalies, and providing personalized clinical decision support. For example, AI algorithms could analyze patient data to predict readmission risk, suggest treatment plans, or flag errors or omissions in documentation.

2. Voice recognition technology improvements may lead to EHRs incorporating virtual assistants and natural language processing to streamline documentation and information retrieval. Clinicians could dictate notes, order tests, and retrieve patient data using conversational interfaces, reducing the need for typing and clicking.

3. Blockchain and distributed ledgers: Blockchain technology could enable secure, decentralized sharing of patient data across organizations and systems. By creating an immutable, tamper-proof record of transactions and permissions, blockchain could help overcome trust and interoperability challenges in current EHR systems.

4. Patient-generated health data: As wearables, remote monitoring devices, and mobile health apps become more common, EHRs will need to incorporate more PGHD for a comprehensive view of patient health and behaviors. This could enable proactive, personalized care and support population health management.

5. Social determinants of health: There is growing recognition that social and environmental factors, like housing, education, and access to healthy food, play a significant role in health outcomes. Future EHRs may include more data on social determinants of health (SDOH) to help clinicians identify and address barriers to health and well-being.

Conclusion

EMR/EHR systems are essential for hospitals and health systems to improve patient care quality, safety, and efficiency. By digitizing and integrating patient data, these systems support clinical decision making, care coordination, and population health management. 

However, choosing and implementing the right EMR/EHR system requires careful consideration of an organization's specific needs, priorities, and resources.

As healthcare evolves, EMR/EHR systems must adapt to meet the changing needs of patients, providers, and payers. This may involve incorporating new technologies like AI and blockchain, integrating patient-generated and social determinants data, and prioritizing interoperability and data sharing. 

Hospitals that effectively use EMR/EHR systems to drive quality improvement, cost savings, and patient engagement will thrive in the value-based care era.