Curbside Consult with Dr. Jayne 2/16/26

I met up with some clinical informatics friends over the weekend. Our conversations focused on a few key themes. One was how much time we’ve spent in the field, as we realized that the most junior member of the group just hit the 20-year mark.

None of us set out to specifically look for technology-related roles, but each of us found our way to the field as we identified gaps in what was happening around us and stepped in. The most senior of the group got involved because he had an engineering background and saw what was going on elsewhere in the country with respect to electronic charting. He wanted to see his institution be a leader in the field rather than a follower, and worked with a big tech company to build a clinical repository for the organization.

It initially compiled data from just one hospital, but as more hospitals joined the system through mergers and acquisitions, the repository became more complex. The team that supported it needed clinical expertise to handle issues like normalization of laboratory values and standardization of test orders. He had some great stories about how the repository grew and became integrated with electronic medical records. It lasted for more than two decades before being retired in favor of a half-billion-dollar investment to move everyone to a single platform.

My colleague still refers to the systems clinicians use as EMRs. That led to a discussion of EMR versus EHR. One member admitted that he uses the terms EMR and EHR interchangeably because he keeps getting loaner computers from his IT department and hates having to go into all the different dictionaries to prevent the system from autocorrecting EHR to HER.

That admission led to a discussion about how the Microsoft Office suite and Office 365 applications handle such things, which bafflingly makes the setting device-specific rather than defaulting from the user profile. I’m no expert, but I know that it’s annoying every time I get a new laptop. I usually end up consulting Google because finding it in the application settings isn’t intuitive.

Quite a bit of back and forth ensued around the merits of EMR versus EHR. I was surprised by how passionate some of the people are about one or the other. We all agreed that “health record” is more comprehensive than “medical record.” One of the group felt that the latter sounded more serious since “health” is often linked with “wellness,” which often includes non-evidence-based and consumer-oriented services.

People pulled out their phones to look for articles for and against each term. I was surprised that the first response that popped up in my EMR versus EHR query was that “EMRs are mainly used by clinicians for diagnosis and treatment, while EHRs are designed to be shared and accessed by the patient. EMRs are less susceptible to cybersecurity issues, since they are not being shared with patients, but are securely managed by the practice.”

That got us rolling, since none of us has encountered a cybersecurity issue related to patient use, but we’ve seen plenty of times where trained employees and hospital medical staff fell victim to phishing schemes. An ASTP/ONC blog addresses the topic, but it’s from 2011. Some of its language is identical to what I found in that first response, which leads me to suspect that the vendor had done some copying and paraphrasing from ASTP.

Most of us agreed that now it’s kind of a stylistic thing and we aren’t bothered when vendor folks use the words interchangeably. I’ve worked with vendor organizations whose style guide spells out which term to use when referring to their products, but not everyone has one of those. I remember reaching out to Epic a few years ago to ask if it had an official position one way or the other and was told that it doesn’t. If that has changed, feel free to drop a comment and let me know the current state.

That conversation led us into a whole “words have meaning” discussion. That immediately drew me in because the industry is plagued by people who use words that don’t make sense. Maybe it’s a phrase they learned during a corporate training class, or perhaps they saw it in an article. When they come to me as a CMIO and start spouting words that don’t completely work together, it makes my attention go zinging off elsewhere.

One colleague, who is a doctor of osteopathic medicine, noted that nothing turns him off more than using “MD” as shorthand for “doctor.” Both have the same number of syllables, so it’s not like saying MD is faster or easier. It’s not worth it to use it in a way that alienates a subset of physicians.

One of the group brought up a recent position paper in Annals of Internal Medicine that addresses “The Ethical Significance of Names in Health Care.” It’s an analysis of the physician versus provider debate, referring to the latter term as contributing to “deprofessionalization.” The authors felt that their examination was unique because it looks at the situation from an ethics perspective.

I popped up the article while we were talking and was excited to see a Shakespeare quote in the first screenful of text. The article includes a review of the origins of care-related words, including patient, physician, doctor, and compassion.

One might have expected that the article would recommend simply not lumping physicians in with other kinds of heath care providers, but it went further to suggest that we get rid of the word “provider” entirely: “Language in health care has ethical and practical implications. Physicians should be referred to as physicians, not providers. Also, when describing professionals with varied credentials who care for patients, the terms clinicians or health care professionals, should be used.”

I’ve been a fan of the word clinician for a long time. It’s shorter than the recommended alternative. I plan to stick with it.

Not surprisingly, we stumbled into a discussion of clinical informatics versus medical informatics, and even a debate about informaticist versus informatician. There’s actually a paper from 2024 called “Informaticist or Informatician? A Literary Perspective”  that goes deep into the history of the two. My colleague quickly sent me a link.

It is a fascinating read. The authors close with a clinical informatics spin on a classic Shakespeare quote, which made me smile. They also received a chuckle with their line, “Whether you are an informaticist or an informatician, may you collaborate better than the Montagues and Capulets.”

Even though the conversation was all over the place, it’s always good to catch up with colleagues who have fought the same battles and who have made it through the same topsy-turvy changes within the industry. They are not only knowledgeable, but are generally a fun bunch. I feel privileged to have them on my phone-a-friend list when times get tough.

Is your company in EMR or EHR mode? What phrases, taglines, or buzzwords make you cringe? Leave a comment or email me.

Email Dr. Jayne.