Recent statistics from the Office of the National Coordinator for Health Information Technology (ONC) show that over 78% of office-based physicians and 96% of hospitals in the U.S. have adopted electronic health record (EHR) systems. Despite this widespread adoption, many healthcare facilities still struggle to choose the right EHR/ EMR for their specific healthcare setting.
Ambulatory EHRs are designed primarily for outpatient settings like private practices and clinics, while inpatient EHR solutions cater to the specific clinical and administrative needs of hospitals. This piece provides a clear overview of the core functions of both EHRs, discusses recent developments in the field, and highlights top vendors in each category to help you make an informed choice between ambulatory EHR vs inpatient EHR.
Both outpatient and inpatient healthcare settings have unique requirements and challenges when implementing EHR software. It is important to keep in mind your facility’s workflows, the type of care you deliver, and regulatory compliance requirements.
As already established, an outpatient care center requires an ambulatory EHR to operate effectively, while an inpatient facility needs an inpatient EHR to meet the specific needs of hospitalized patients. Below we provide a concise overview of these two types of EMR software.
Ambulatory EHR – An Overview
Ambulatory EHR offers a comprehensive suite of solutions to help outpatient care facilities streamline their day-to-day workflows. These systems are specifically designed to manage patient records, clinical documentation, and other practice tasks efficiently in a fast-paced outpatient environment. Ambulatory EHRs are ideal for a single practice and help providers collect detailed, specific information about each patient.
As of 2021, nearly 9 in 10 of U.S. office-based physicians had adopted any electronic health record and nearly 4 in 5 had adopted a certified EHR. This widespread adoption highlights the growing importance of EHRs in enhancing the quality of care within ambulatory settings.
Inpatient EHR – An Overview
Inpatient EHRs, also known as acute care EHRs, provide an all-in-one digital solution to meet the complex needs of hospital settings, where patient care involves multiple departments, extensive data integration, and continuous monitoring. These systems link various departments and systems (e.g., lab, pharmacy, imaging) within a hospital to ensure that all relevant information is centralized and accessible.
Data from 2019 and 2021 shows that that 86% of non-Federal general acute care hospitals had adopted a 2015 Edition certified EHR, while only 40% of rehabilitation hospitals and 23% of specialty hospitals had done the same.
EHR software designed for inpatient and outpatient settings differ in various aspects and functionalities. Below is a simple table comparison followed by a more comprehensive analysis of the differences between ambulatory vs inpatient EHRs.
| Ambulatory EHR | Inpatient EHR |
Focus | Primarily focuses on clinics and doctor's offices | Designed for hospitals and emergency services |
Cost | Less expensive | More expensive |
Complexity | Easier to implement in outpatient settings | Requires extensive integration with hospital workflows |
1. Clinical Workflow And Usage
Inpatient EHRs are inherently more complex than those designed for outpatient facilities due to the extensive data storage requirements and the technical expertise needed for immediate data transfers.
Additionally, the type of data managed by inpatient EHRs differs from that of ambulatory EHRs. Hospitals are required to share electronic admission, discharge, and transfer (ADT) data with each patient's care team, as mandated by the US Department of Health and Human Services.
Inpatient EHRs, such as Epic, also support complex workflows with functionalities designed to automate pharmacy communication and inventory management, monitor hospitalized patients for infections, and manage critical care. In contrast, electronic health records in ambulatory care focus on automating administrative workflows and providing a comprehensive view of patient health within a single practice.
2. Patient Encounter Documentation
Inpatient EHRs manage extensive documentation across various departments and care units, covering treatments, tests, and procedures performed in both general and intensive care settings. Ambulatory EHRs simply focus on documentation for a single practice, including office visits, prescriptions, and outpatient procedures.
Many vendors are now embedding AI-powered technologies into their software to streamline the clinical documentation process in both healthcare settings.
3. Integration And Interoperability
Inpatient EHRs are designed to create a comprehensive network of shared health data, allowing providers to access complete and accurate patient information, regardless of where the patient has previously received care. However, ambulatory EHR systems are primarily required to share data and connect with the existing systems within a doctor’s office.
4. Regulatory And Compliance Requirements
Both inpatient and ambulatory EHR systems must adhere to stringent regulations to protect patient data, ensure data security, and maintain high-quality care. However, the specific compliance requirements differ based on the healthcare setting.
Inpatient EHRs are required to adhere to HIPAA requirements to protect patient data. Hospitals also need to meet the Joint Commission standards, which ensure EHR systems support accurate documentation and communication to maintain patient safety and care quality. Additionally, hospitals must follow the Promoting Interoperability Programs (formerly known as the Meaningful Use program), which mandate the effective use of certified EHR technology that meets the standards set by the Office of the National Coordinator for Health Information Technology (ONC).
You can also use our regulatory compliance checklist for new healthcare practices to ensure that your EHR system meets all necessary standards and regulations.
5. Customization And Scalability
Inpatient EHR systems are often highly customized to accommodate a wide range of specialties, departments, and workflows within hospital environments. Scalability is also important, as hospitals require EHR systems that can manage large volumes of data and adapt to evolving requirements.
In outpatient settings, customization is particularly important as specialty practices require EHR systems tailored to their specific needs and workflows. A 2023 physician sentiment survey by athenahealth and Harris Poll revealed that 93% of physicians feel regularly burned out. This is often due to EHRs that lack customization and force them to search extensively for relevant information within patient charts.
This highlights the need for ambulatory EHR systems to be flexible enough to accommodate the unique clinical complexities of various specialty practices.
The EHR industry has seen significant advancements in recent years, with both inpatient and outpatient EHR vendors introducing innovative solutions. In this section, we will explore these recent developments and examine the emerging trends shaping the future of electronic health records.
Integration Of AI Technology
The benefits of implementing AI in EHR software can have far-reaching consequences for the quality of patient care and overall operational efficiency within practices.
Many EHR vendors are incorporating AI into their systems to enhance functionality. For example, Epic uses AI to help hospitals automatically draft responses to patient inquiries, generate progress notes, and speed up the medical coding process. It has also introduced GPT-4-powered ambient documentation, which helps hospitals reduce the clinical documentation time.
In the ambulatory care sector, Oracle (previously Cerner EMR), has introduced the AI-powered Oracle Clinical Digital Assistant. This tool uses voice technology and generative AI to reduce the number of EHR clicks required, which helps lower provider burnout and improves patient interactions.
Enhanced Interoperability
Epic and Oracle, two major players in the hospital EHR industry, have a strong commitment to enhancing interoperability. Oracle is building an open healthcare platform with intelligent tools designed to connect healthcare providers, customers, payers, and public health organizations.
Meanwhile, Epic has introduced a feature that allows patients to easily share their medical records with third-party health apps through TEFCA's record location services.
Telemedicine Evolution
Virtual care and remote patient monitoring technologies are revolutionizing how practices and providers reach more patients. Many ambulatory and inpatient EHR vendors have now integrated telemedicine into their broader suite of solutions.
An emerging trend in this space is the use of AI-powered telemedicine solutions. AI is becoming essential in guiding patients through the telemedicine process, advising them on when a virtual visit is appropriate, and suggesting alternative care options when needed.
Blockchain For Data Security
Blockchain, originally developed for Bitcoin, is a distributed database that enables secure, transparent, and tamper-proof transactions. Its potential in electronic health records is increasingly recognized due to its ability to provide greater control over patient data and who can access it.
One of the key benefits of blockchain in healthcare is its capacity to prove that medical records are complete and unmodified. It can precisely document actions taken and when they occurred, ensuring the integrity of patient data.
While blockchain technology offers significant potential for improving data security and patient autonomy in EHR systems, its adoption in the EHR industry is still in the early stages.
Patient Engagement Tools
Both inpatient and ambulatory EMR vendors are taking significant measures to enhance patient engagement by integrating advanced tools into their systems. These solutions are designed to empower patients to take an active role in their healthcare journey. Some examples of these tools include remote patient monitoring, medication adherence reminders, automated appointment reminders, and patient education resources.
Ambulatory EHR vendors like athenahealth, Tebra, NextGen EHR software, and AdvancedMD EHR offer comprehensive patient engagement solutions tailored to outpatient care. On the inpatient side, vendors such as Epic, Cerner, and Meditech EMR provide robust patient engagement features that support coordinated care across different departments.
Choosing the right EHR software for your practice is a major decision that can impact your operations and patient care. You should consider your practice size, budget, specific feature requirements, and integration needs to choose the right software. Whether you're in an ambulatory or inpatient setting, selecting an EHR that aligns with your workflow and objectives will ensure a smoother transition and long-term success.
For personalized guidance on choosing the right EHR software for your healthcare setting, contact us at (661) 384-7070, and we will be happy to assist you in making the best decision for your practice.