As time goes on, paper-based patient records are swiftly becoming a thing of the past. The popularity of health information technology is rising at an ever-increasing rate, and EHR software adoption is no different. The use of ambulatory vs. inpatient electronic health records has been booming, but many need help understanding the difference between the two.

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What This Article Covers:

• Treatment Types
• What Is an Inpatient EHR?
• What Is an Ambulatory EHR?
• Certification Criteria
• Cost
• Which To Choose?

Digitization has created myriad opportunities for better patient record management across hospital EHR systems. New technology can streamline workflows by phasing out archaic, time-intensive and paper-based procedures. Inpatient and outpatient health care facilities run differently, and with various EHR software solutions available, choosing the correct one can be confusing and seem nearly impossible.

This has medical practices, hospitals and health care businesses alike asking: “What is the difference between ambulatory EHR and inpatient EHR software?” Knowing the differences between the two can help you choose the best EHR solution for your health care facility.

Treatment Types

Before learning about inpatient vs. ambulatory and choosing the right EHR for your practice, the first step is identifying the type of treatment your facility provides. Whether your facility provides inpatient or outpatient treatment will most likely determine which EHR to use.

Inpatient and outpatient facilities both have unique challenges when it comes to adopting electronic health records. With outpatient facilities, patients visit several clinics, labs, etc., so your EHR should be able to pull up all that information. In contrast, an inpatient facility must integrate with different departments within a single hospital.

Patients often choose their own treatment types, typically those related to rehabilitation. Outpatient tends to be more common and is usually the preferred treatment method among patients for several reasons, including comfort and lower costs.

When choosing your EHR software solution, it’s essential to keep in mind your treatment center’s specific needs, treatment type and government requirements for certification.

More often than not, an inpatient facility will have to use an inpatient EHR to function correctly; the same goes for ambulatory treatment centers. Below is an overview of these ambulatory and inpatient EHRs.

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What Is Inpatient EHR?

Inpatient EHR is a digital platform that helps hospitals streamline their daily workflows and gain operational efficiency using a variety of tools, including patient scheduling, medical billing, beds management, e-prescribing and more.

From an IT perspective, a hospital isn’t a single entity but a group of various departments and systems. Since inpatient EHR systems help manage inpatient data, most hospitals commonly use them to automate and supervise administrative tasks.

In the not-too-distant past, hospitals purchased and installed software designed for each specific department, e.g., the in-house lab department, the radiology department, medical billing systems and several others that perform various functions for the hospital.

These systems help in linking all the internal departments together. In the past, each department had to separately print out the results for all individual patients they collected. In addition, each department manually entered data, increasing the likelihood of duplicate or inaccurate data.

Electronically document patient visits, billing statements and health charts.

EHRs always capture and document medical records, but time has made them more sophisticated and systematic. This led to an integration increase between the EHR and the hospitals’ different departments, rather than them all operating separately. However, only departments within a single practice can use these integrations with limited help to new patient admissions.

Many hospitals still lie in this challenging stage where they can’t get their systems to communicate with each other. As EHRs have grown more refined, they’ve become the hub of linking each department.

The lab, pharmacy, x-ray and many other departments required customization and integration. An inpatient EHR integrates these systems, sharing patient information between each of the various hospital departments and ensuring consistent data throughout the hospital.

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What Is Ambulatory EHR?

Ambulatory EHR is a comprehensive toolkit enabling outpatient care facilities and smaller practices to document and store patient care information in electronic databases.

Medical professionals can access patients’ complete medical histories stored in electronic databases. These documents essentially include all surgery or treatment procedure records that don’t involve hospital admissions.

In general, ambulatory EHR solutions are simpler than inpatient EHRs, because they deal with a single practice and its patients rather than the complex web of hospital departments that any one patient may interact with.

Ambulatory EHR systems have the advantage of making it easier for physicians to track a patient’s medical records and long-term care. Physicians use these systems to collect detailed, specific information about each patient, providing complete documentation of their personal health records.

Documented histories include injuries, diagnoses, treatments, prescriptions, visits and more. Comprehensive databases help physicians see the bigger picture, streamlining future diagnoses.

For example, this capability makes patterns easier to recognize, which could help reveal anything from a seasonal allergy to a serious problem that has increased in frequency over time. Health care businesses have capitalized on this information by providing practices with patient portals.

Integrating an ambulatory EHR solution with a patient portal gives patients access to their up-to-date medical records. This has become more of a necessary EHR feature than a “nice-to-have” feature in recent years.

Practice EHR’s patient portal allows patients to view their history, schedule appointments and more.

When it comes to outpatient treatment, there are many advantages for the patient. For starters, rather than sitting in a bland hospital room and eating from the cafeteria while they recover, patients can instead relax in the comfort of their own home or bed, eating their own food.

Additionally, patients have more freedom to do what they want, whereas their entertainment options are very limited in a hospital.

With outpatient treatment being the preferred option for most patients, ambulatory EHR use has increased dramatically over the past few years. And this trend isn’t slowing down any time soon; the ambulatory EHR market share valuation may reach $6.6 billion in the next five years. Increased government efforts in promoting EHR systems project a massive ambulatory EHR growth by 2027.

Unlike hospital records all being on the same chart, a physician’s practice includes dealing with patient information from multiple clinics. Unlike inpatient treatment, outpatient facilities deal with many other pharmacies and external labs or clinics.

Contrary to hospitals with their own x-ray departments, imaging labs and pharmacies, external labs and clinics admit ambulatory health patients. More often than not, patients choose these facilities based on health care coverage as well as other factors such as cost and proximity.

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Certification Criteria

Because ambulatory EHRs and inpatient EHRs support two different types of health care practices, it’s only natural that the criteria needed for each to earn certification and incentives differ depending on the style of health care (inpatient/outpatient). Government EHR incentives to promote their use started in 2009.

A year later, the Office of the National Coordinator for Health IT initiated another program to expand the use of certified health IT to more health programs and promote greater interoperability and initiatives for care improvement. This laid out the unique requirements for each type of EHR.

Inpatient EHR certification focuses mostly on orders and medication management. The features that fulfill this need include electronic medication administration records and medication reconciliation. Ambulatory EHR certification, on the other hand, requires more patient-centric capabilities. For example, e-prescribing, patient reminders, clinical summaries and timely access are just a few ambulatory EHR certification requirements.

As we mentioned above, one example of how certification requirements vary by the EHR type is how physicians prescribe medications. An outpatient facility prescribes to outside pharmacies electronically — while an inpatient facility (such as a hospital) doesn’t because they typically handle medications themselves.

Automate appointment reminders to reduce last minute cancellations and no-shows.

There are, however, several similarities between the two types of certifications. As with most health care systems, security and note-taking are high priorities. This is also the case with drug-to-drug and drug-to-allergy interaction checks, privacy and security standards, medication lists, and allergy lists. Additionally, both certification types require clinical decision support and computerized provider entry (CPOE).

Ambulatory and inpatient facilities provide completely different treatment types, but at the same time, they both provide the same general service: health care. The same goes for EHR certification — sure, they both require some of the same criteria, but different certification requirements are, indeed, necessary.

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Cost

A lot of solo practices and clinics make use of ambulatory EHRs. This is possible because of the system’s simplicity, thereby providing users with affordable options to avail this solution. And even though these applications run on monthly subscriptions, they have relatively lower start-up costs than other server-based enterprise solutions.

Inpatient EHR, on the other hand, offers users a wide range of customization options to simplify daily workflows and reap plenty of benefits upon using the system. This makes this solution type costlier than ambulatory EHRs, with a design type enabling buyers to begin using them right off the bat.

Which To Choose?

So, after all this information regarding ambulatory vs. inpatient EHR, which system will work best for you? An ambulatory electronic health records system may be perfect if you’re a single practice. However, if you’re a part of a chain of practices, you could use either ambulatory or inpatient EHR. And if you’re a hospital or a chain of hospitals, you probably want to implement both.

As of now, an inpatient facility would not operate well using an ambulatory EHR and vice versa. Yes, you could access an ambulatory EHR through the cloud while in a hospital and copy that into inpatient documentation, but this still requires staff attention and manual work. Interoperability between the two isn’t fully there yet, but we can expect inpatient and outpatient EHRs to connect in this way moving forward.

When it comes to cost-effectiveness, your health care facility may choose to go with a smaller, specialized EHR to accomplish practice requirements. While some nearly-do-it-all systems are out there, small and specialty EHR vendors have become increasingly popular.

With that said, each health care provider is different, meaning different needs and requirements from your EHR software. The important thing isn’t whether you choose an ambulatory or inpatient EHR; it is essential to know what you’ll use it for.

Make sure whichever EHR you choose has proper capabilities and functionality to suit your facility. Take a look at our EHR software comparison report to find out which solution is best for you.

Do you use an EHR for your health care practice? Ambulatory software or inpatient? Let us know in the comments!