Digital Health 101February 27, 2022

Top EHR Systems

Capable Health Team

Electronic health record (EHR) systems are much more than a digital medical chart. These records help medical professionals unlock health information and create more comprehensive care for their patients, while connecting all the clinicians involved in a patient’s care. EHR systems are a crucial part of effective care delivery and increase positive outcomes for patients and providers. And yet for healthcare institutions of all sizes, selecting and implementing the right EHR system is a major investment of time and resources. There are a plethora of systems to choose from, and understanding the key benefits and use cases of each is essential to meeting the demands of a health organization and those it serves.

What Are EHR Systems?

An EHR is a digital version of a patient’s medical history. Since this history is electronic, these records are updated in real time and help make information available instantly and more securely to teams of medical professionals. These digital health records generally contain the medical and treatment histories of patients, but EHR systems are intended to go beyond collecting and operationalizing standard medical data alone. According to the Office of the National Coordinator for Health Information Technology, these virtual systems often become an essential part of a healthcare organization’s IT infrastructure.

EHR systems help health organization provide care by providing:

  • Medical Data Storage: EHR systems store a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results (among other items)

  • Decision-Making Tools: EHR systems create an entry point to evidence-based tools that providers can leverage to make decisions about a patient’s care day-to-day

  • Workflow Automation: EHR systems automate and streamline provider workflows to help close the loop between content and the care plan, promoting better clinical outcomes

These systems contain information from all clinicians involved in a patient’s care. The goal is to use standard information formats—like the FHIR standard—so patient data can easily be shared safely and securely across multiple healthcare organizations, including:  laboratories, specialists, medical imaging providers, pharmacies, emergency facilities, and school and workplace clinics (to name a few). This cross-system communication is referred to as “interoperability,” the way that EHR systems exchange information and help healthcare professionals track and update treatment progress for patients. 

Common information stored in these digital records include:

  • Administrative and billing data

  • Patient demographics

  • Progress notes

  • Vital signs

  • Medical histories

  • Diagnoses

  • Medications

  • Immunization dates

  • Allergies

  • Radiology images

  • Lab and test results

Use of EHR systems helps to make care seamless and provides greater efficiency and effectiveness for providers. 

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How to Use EMR Systems

The experience of actually using an EHR or EMR system starts with transitioning paper-based charting into the new digital environment, and after that, a healthcare worker uses a computer or mobile device, such as a tablet, to view and enter patient data. A doctor or nurse may highlight the screen when discussing lab results with a patient, for example, and mobile devices can help enable conversations during these interactions. As a healthcare worker becomes more comfortable with the EHR system, screen-scanning speed, browsing speed, and accuracy will improve making the experience feel more seamless over time.

What Are Common Types of EHR Systems?

As recently as a decade ago, nine out of 10 U.S. doctors updated their patients’ records on physical paper, by hand, and stored them in on-site file boxes. This stands in stark contrast to today, where more than 96 percent of office-based medical providers have adopted an EHR system. Remaining hospitals and healthcare organizations that have not yet embraced digital systems tend to be smaller and more likely to be specialized facilities, such as psychiatric hospitals. With the need for this type of system so widespread, there are many options out there for what system to best adopt. 

Healthcare organizations are also incentivized to use digital data tools, such as an EHR system. In fact, the Health Information Technology for Economic and Clinical Health Act helped compel many providers to start using electronic data recording and sharing technology, proven to improve care quality and increase transparency. 

And yet, implementing or switching between EHR systems is not a simple task—it is an often overwhelming challenge. Luckily, there are always opportunities to optimize workflows or improve system-wide data even after adopting an EHR provider. 

When selecting an EHR system, there are many options available that generally fall into two types of system categories: cloud-based or locally hosted. 

Cloud-based EHRs

Cloud-based EHRs are scalable and often be implemented more quickly. In general, they reduce upfront EMR software costs and can offer higher levels of IT service availability than in-house services. At the same time, there are more data security considerations for cloud-based systems, and may offer less control to healthcare institutions compared to on-site option options. 

Locally hosted EHRs

Locally hosted EHRs entail software and data that is housed on an institution’s server computers on location. This option is helpful when high-speed internet is not an option and outsourcing data security is not preferred. That being said, an institution will need to take responsibility for keeping its servers secure and perform regular data backups. 

What Are the Top Five EHR Systems?

While large vendors such as Epic and Cerner represent more than 50 percent of the EHR systems used today, smaller vendors and proprietary systems are still an important part of servicing more rural and specialized healthcare organizations. That said, the top five EHR systems listed by market volume include:

  • Epic: Epic’s software is used across academic medical centers, community hospitals, dental clinics, retail clinics, rehab centers, and independent practices (among others). More than 250 healthcare organizations and more than 250 million patients in the U.S. use Epic’s electronic medical record system. John Hopkins Medicine, for example, uses Epic to create one chart that follows patients throughout the multiple specialty areas where they may receive care. 

  • Cerner: Cerner aims to work at the intersection of healthcare and information technology to connect people and systems all over the globe. Banner Health, for instance, implemented Cerner’s system to improve efficiency at their outpatient clinics by streamlining their adult intake form. The modified intake form decreased the average time required for documenting the form, as well as a reduction in the average number of clicks within the form (among other benefits).

  • MEDITECH: MEDITECH’s EHR system touts that it measurably saves time and effort among hospital staff and nurses, while helping to increase clinic volume. The company’s goal is to empower healthcare organizations large and small with better tools for secure and effective care. King’s Daughters Medical Center, a nonprofit acute-care hospital with 99 beds, leveraged MEDITECH’s EHR system, which resulted in time saved, efficiencies gained, and created a closer collaboration between nurses and physicians.  

  • Evident, a CPSI Company: While Evident owns a much smaller portion of overall EHR system market share compared to other systems on this list, users of their systems have seen measurable results from using their technology. One Texas hospital, for instance, saw that charting time went down from 25-30 minutes to 5-6 minutes, and the readability of the patient data led to less insurance denials, as a result of Evident’s EHR system. 

  • Allscripts: Allscripts aims to build open, connected communities of health through generating and providing insights that change the delivery of care. One client, Springhill Medical Center, a privately owned full-service hospital serving Southwest Alabama, leveraged Allscripts to help  double yearly patient volume from 25,000 to 50,000 in three years, without significantly increasing staffing. 

This list of EHR systems is not exhaustive, there are many other EHR systems available. Selecting the best EHR system for an organization's specific needs takes significant planning and thorough decision-making. Understanding resources, timeline, support, and setting realistic expectations becomes crucial when evaluating the top EHR systems. Being detailed and intentional about making the right decision is vital, as these virtual records become an essential part of a healthcare organization’s IT infrastructure for delivering quality care to patients.

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