The Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted in 2009 to address certain shortcomings in protections for and security of electronic medical records (EMR). For lawyers litigating personal injury claims, HITECH created the right for patients to receive electronic copies of their personally identifiable health information (PIHI) in an electronic format, including metadata which contains information about how the data was entered, accessed and if it was changed. When medical records are needed to prove liability or when the veracity of medical entries is at issue, the EMR provides information that simply does not transfer to the printed form.

The EMR information displayed on a computer screen for a nurse is often different than what is displayed for a physician, and differing by the particular EMR system being used. The forms and dropdowns can differ by user level. Accessible information may differ depending on the user’s authorization credentials. It is this inability to see these other dimensions in the printed copy of the EMR that makes the paper record only “two-dimensional.” In its electronic form, the EMR provides an additional dimension of information creating a “three-dimensional” record that can be viewed from varying user perspectives.

HITECH and EMR Access Requirements

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