Is the Defining of HIT Terms by ONC/NAHIT Going to Matter?

The National Alliance for Health Information Technology (Alliance) tasked by the Office of the National Coordinator for HIT is working on the final definitions for 5 HIT terms: Electronic Health Record (EHR), Electronic Medical Record (EMR), Personal Health Record (PHR), Regional Health Information Organization (RHIO), and Health Information Exchange (HIE). Public comments on the currently revised definitions can be made through April 19th at the website www.definitions.nahit.org.

Although the work on the definitions is commendable and on the surface suggests that this will help the national effort on interoperability, imposed definitions have a funny way of taking on a life of their own. Unlike standards which can be imposed by some type of governing body, definitions, like any in the English language, evolve over time and take on the nuances of the persons and groups using the words. While standards impose a black and white view of things, definitions, especially those items being defined above, suggest more of a broad range of characteristics with minor rather than major nuances (e.g., EMR vs. PHR).

Although the academic world may be able to embrace these definitions and appreciate their significance and nuance, I suspect those of us non-academics working in HIT, and surely our clinical colleagues and their patients, will have great difficulty in understanding and clearly defining these terms using these definitions. We only need to look at the continued interchangeable use of the terms case management and disease management to understand how those of us on the front lines, involved in patient care, utilize terms in practical rather than academic ways.

If this work on definitions helps facilitate our interoperability efforts, then I am all for them. I just do not expect these terms and their related definitions to be accepted by the “rank and file” as the “law of the land.”