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Raymond Simkus

The EHR vs EMR argument is much like the debate about the relative importance of systolic vs diastolic blood pressure. Why should we be constrained to choosing one or the other. It is like asking if the left arm is more important than the right arm. I was astounded that in the CMA's Future Practice issue that surveyed clinics across Canada using EMRs that so many clinics entered lab results manually. This was because of the lack of ability to exchange data electronically. Here in BC we have had the ability to get our lab results electronically for over 10 years. This is provides a fantastic resource. Even so there are labs in BC and EMRs in BC that cannot seem to provide or handle results in a standard format. It seems that there is no group that has been able to force the issue and data standards are incomplete. As a result my clinic lost the specific identifiers for 800,000 lab results when we switched from one EMR provider to another. Our blood hemoglobins get mixed up with the urine hemoglobins.

Typically at the EMR development level there are not the resources to fully specify all that is required. There is also the problem of deciding on one of several options when different parties have different vested interests. In Canada, at the present time these types of resources are only going to be available at the national level.

Having been involved in EMR development since 1979 I can say that both the EMR and the EHR are important. To have a high performance EMR you need an EHR.

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