Comparative Analysis of Ambulatory EHR vs Inpatient EHR

EHR are now the backbone of every practice, as they reduce majority of administrative burden and ensure quality care. Adoption of EHR (Electronic Health Records) is improving patient satisfaction and healthcare treatment for both ambulatory and inpatient care.

These records ensure privacy and security of ePHI (Protected Health Information) storage and transfer, which makes it a reliable tool for inpatient and ambulatory services.

As per a research data, 96 percent of hospitals (i.e. inpatient) and 72 percent of office-based physicians (i.e. ambulatory or outpatient services) adopted EHR in 2019. Reasons for this massive surge was to reduce human errors, paperwork, and ameliorate healthcare quality.

However, what exactly are ambulatory EHRs and inpatient EHRs and how are they different from each other? Read this article to find out.

Inpatient EHR

An inpatient EHR development involves a software that is integrated across multiple hospital departments to support real-time patient care and streamline day-to-day workflows. Custom EHR development is beneficial to share and store ePHI for all departments, including data for readmissions.

Everyday, hospitals are engulfed in varied treatments and tests for patients, hence it is critical for healthcare providers to have access to latest medical records. An inpatient EHR integrated in all departments helps to gain access to all latest updates of patients’ conditions.

Additionally, it aids workflows in both on-site and intensive care units. EHR software facilitates sharing of data immediately across these units for emergency care.

Inpatient EHR is more complex as compared to ambulatory EHR development, as it needs extensive data storage capacity and technical expertise to carry out immediate data transfers.

Furthermore, this type of EHR provides its data to support hospital billing process, which differs from service to service. Cost for developing an inpatient EHR depends on aspects such as customization, development team, number of features, and third-party integrations.

Inpatient EHR and ambulatory EHR also differ in the type of data shared by both. As per the US Department of Health and Human Services, hospitals need to share electronic ADT (Admission, Discharge, and Transfer) data with each patients’ care team. Along with this, HIPAA (Health Insurance Portability and Accountability Act) compliance is ensured for all hospital EHRs for privacy and security.

Ambulatory EHR

Ambulatory medical records are the digitally stored file of the patient’s outpatient medical records which consists of all the details of the care the patients receives without being admitted into the hospital. Ambulatory electronic health records help smaller practices and outpatient care facilities.

Healthcare providers access complete medical records of patients through ambulatory EHR, however it doesn’t involve data on hospital readmissions, as in the case of inpatient EHR.

Overall, ambulatory EHR is simpler than inpatient EHR, as it deals with only single practice and patients, rather than handling myriad of medical departments that patients’ have interacted with. This type of EHR software development supports certain activities such as prescription, office visits, tests, and outpatient procedures.

Further, providers can keep a track of patients’ medical records and long-term care through ambulatory EHR, which also aids in planning future diagnosis in advance. Ambulatory EHRs can be integrated with patient portals and patients can gain access to their medical records easily.

The rise in preference for outpatient care is enhancing usage of ambulatory EHR in small clinics. Availability of services such as mammograms, bloodwork, X-rays, MRIs, etc. in outpatient care, along with its cost-effectiveness, is driving the demand for this type of care, which in turn is boosting the adoption of ambulatory EHR.

In terms of data sharing, both inpatient EHR and ambulatory EHR ensure compliance of the 21st Century Cures Act’s Information Blocking Rule, HIPAA, and any other data security protocols needed to protect ePHI. Since, an ambulatory EHR is less feature intensive, the cost of developing it is also lower as compared to an inpatient EHR.

Ambulatory EHR have low start-up costs, and can get practice started with data management and sharing quickly. Contrary, to inpatient EHR, where it has to be linked and integrated with all hospital departments before getting started.

Ambulatory EHR vs Inpatient EHR: Certification Criteria

Stage 2 of Meaningful Use specifies that developers of CEHRT (Certified Electronic Health Record Technology) adhere to criteria that specify they are meaningful users.

In 2014 Edition Standards and Certification Criteria, the Office of the National Coordinator for Health Information Technology published the essentials needed for EHR systems, which fall into three categories – revised, new, and unchanged.

Inpatient EHR and Ambulatory EHR must support different medical practices, hence criteria needed for them both to earn incentive and certificate depends on the style of care – inpatient or outpatient.

An inpatient EHR require different abilities for CPOE (Computerized Physician Order Entry). It focuses on medication management and orders, and the features needed to fulfill these are medication reconciliation and electronic medication administration.

On the other hand, ambulatory EHR needs patient-centric abilities such as e-prescriptions, reminders, access to medical records, etc. Criteria addressed by inpatient EHR consists of aspects such as acute stroke management, emergency department throughput times, and more of such.

Choosing Between Ambulatory EHR and Inpatient EHR Development

The decision regarding the type of EHR software that you should be looking to get developed depends on your unique requirements. If you are looking to streamline inpatient operations, with a focus on medication management, inpatient EHR development takes precedence. On the other hand if you are looking to streamline longitudinal patient care including chronic disease management.

Ambulatory EHR vs. inpatient EHR, both differ in terms of certification criteria, usage, and who can use them. From the above discussion it’s clear that ambulatory EHR is suitable for individual practices, whereas inpatient EHR works well in hospitals or large healthcare facilities.

Interoperability factor can be considered for both, especially for inpatient EHR as it is integrated with several in-house departments and is complicated to use. Further, assure to consider functionalities and features of ambulatory EHR and inpatient EHR before settling down with one.

Additionally, customized EHR helps in both types of care – inpatient and outpatient, as it augments the overall patient experience, and there’s an option to include features as per needs and type of practice (dental, orthopedic, general practice etc.).

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