7 things you didn’t know about your EMR (and the information missing from it)

doctor utilizing enterprise imaging

Every day, technology influences the way doctors treat patients and how patients connect with doctors. From innovative portal technology that encourages patients to own more of their health journeys, to tech-assisted diagnostics, it seems as though better healthcare is always a click or two away.

The challenge, however, is ensuring that we are giving the technology the information it needs to help make healthcare better.

“With all the great work we’re doing and all the great technology available, we’re still not gathering all the content that’s out there and making it available to the provider team in real time at the point of care,” said Colleen Sirhal RN, BSN, CPHIMS, chief clinical officer, Hyland Healthcare.

Sirhal, along with Cheryl Petersilge MD, CEO, Vidagos Enterprise Imaging, shared their thoughts during a recent webinar, The information missing from your EMR — How to find it and what to do with it. The duo shared their philosophies on technology and how you can best use it to empower physicians, as well as tips and techniques attendees can use to uncover hidden information and connect disparate systems to gain a complete view of their patients.

The big 7

Here are seven of the best:

1. The EHR and EMR are not the same

Many people use the terms EHR and EMR interchangeably, but they are not the same. The electronic health record (EHR) contains all of the information involved in a patient’s care, encompassing all medical information within the patient’s health journey.

The electronic medical record (EMR) is the digital representation of a patient’s chart. A subset of the EHR, the EMR includes all interactions between the patient and care provider. The EMR is where providers work, serving as the gateway to all those different archives, which should include your enterprise-imaging ecosystem. This ecosystem is not limited to radiology and cardiology; it also includes pathology, ophthalmology and nearly every other sub-specialty.

The challenge, said Petersilge, is that a lot of unstructured information lives outside the EMR and should be connected to the EMR to create a comprehensive EHR.

2. What is the role of unstructured data?Doctor examining x-rays on digital tablet

Petersilge defines unstructured data as information that does not fit nicely into an Excel sheet’s rows and columns, like documents and imaging data. More than 20 percent of patient information is unstructured, she added, though she suspects this number is an underestimation.

“And we have lots of it. DICOM, radiology, audio files, videos, photographs. Making decisions with a 20 percent gap in data is something our patients wouldn’t want to know,” she said. “And as clinicians, it’s a challenge because we want to make sure we’re making the best, most-informed decisions.”

The goal, then, is to build a system that includes unstructured data and provides medical staff with that information. Access to that information should be easy and intuitive, as well.

“Remember, our goal is to keep clinicians in our EMR workflow,” said Sirhal. She emphasized clinicians’ desire to do more than read imaging reports. They want to review the images, as well. “And we want to present those images to them in their EMR workflow and where they are.”

The goal, she added, is to ensure clinicians’ access to data is streamlined and that they don’t have to jump through hoops to get information.

3. Your mantra should be simplify, standardize, automate

“In 2020, our ability to integrate is key – and frankly, a key expectation,” said Sirhal. “There are so many ways to use technology to integrate. Sometimes it just takes a little thoughtfulness and a conversation with your vendor. We want everyone to recognize electronic capture of this information will improve quality and make everyone’s lives easier.”

Your mantra should be simplify, standardize, automate. By removing the human factor, you help eliminate errors, make things go faster and give staff more time to do higher-value work.Senior female surgeon in hospital

4. Partner with departments, connect with clinicians and walk the floors

One of the best ways to find where information is hiding in your organization is to go looking for it. Walk the floors, talk to clinicians and get involved with how your departments handle information. Understand where departments generate information and figure out how to get it integrated into the EMR.

Knowing where data is hidden will help you build a stronger roadmap and help you get out from under all the paper chaos.

5. Let’s get on the same terminology page

It’s important to treat medical images and documents like every other asset in the organization. To do that, you have to label them. And the only way to do that is through centralized, agreed-upon terminology, definitions and categorization.

Unfortunately, the healthcare industry is woefully behind with regard to common terminology.

“Even radiology, which is highly structured, still falls down on not having standardized study descriptors between organizations,” said Petersilge. “Without this common terminology, our data is not as searchable or serviceable as we’d like, and that contributes to that snarly mess of information. When we have good standardization, we straighten that line out between A and B.”

6. The CIO and CMIO should be bosom buddies

While the CIO drives both document management and imaging management strategies at attendee healthcare organizations, according to a real-time poll, Petersilge and Sirhal agreed the CMIO should play a bigger role in tech strategy.

“We have found that the CIO and CMIO working closely together leads to greater success among our customers,” said Sirhal.


“Because the CMIO is very focused on the structured data in the EMR and the data that’s driving the medical practice,” she said. “And bringing structure to unstructured data is tied so tightly to the strategies the CIO is leading.”

Also, when looking at the HIMSS adoption model, knowing that CMIOs typically lead outcomes and manage data makes it even more important to have that leader involved in the conversation.

“My perception of the CMIO is that they are the clinical voice of how information will be used by and presented to the clinicians,” said Petersilge. “If this can all be integrated, and the EMR is the gateway, then the CMIO is the master of that gateway.”

7. Patients want to see medical images, too

Make sure patients can also access medical images. Recent research shows that patients are more engaged in their healthcare plans when they have the ability to access information and look at images, too. It improves trust and strengthens the patient/doctor relationship.

The easier it is for a doctor to share that imagery in real time with the patient, whether that’s sharing the information on a computer monitor in an office setting or on the hospital floor via an iPad after pulling it up via the EMR, the better it is for patient education and engagement.



In the end, it’s all about that mantra: simplify, standardize, automate.

“If I was met with a pit of information every morning, it would be a really tough work day,” said Sirhal. “That’s not what we want. We want providers to have a simple, beautiful experience where they see order and can leverage patient information to improve outcomes and drive patient health.”

Ready to learn more? View the entire webinar.

Tom Tennant has expertise in content creation and content services and has been a contributor to the Hyland blog.
Tom Tennant

Tom Tennant

Tom Tennant has expertise in content creation and content services and has been a contributor to the Hyland blog.

... read more about: Tom Tennant