This paper researches Electronic Medical Records Systems also known as Electronic Health records systems (EMRs/EHRs). An overview of what emrs are, how they are used, who uses them and why and when they should be used will be provided. It compares 3 well known emr systems Cerner, Agility and eClinicalworks. There will be an evaluation of the 3 emrs on a variety of criteria including but not limited to document management, patient portal if one is offered, analytics and reporting, interoperability with other systems already in place and user friendliness. A determination of which system rates highest for cost, interoperability and reporting and analytics will be given. This paper will also discuss the ethical issues may that arise when using emrs. (Barsley & Chet, 2017) noted that emrs have complicated some processes such as the signed consent and steps must be taken to ensure changes to the records remain detectable. Electronic Medical RecordsA comparison of Cerner, Agility and eClinicalworksTwenty years ago, if you visited your doctor, dentist or another medical professional the details of your visit were documented in a paper chart. Today, your visit is most likely documented electronically into a system known as an electronic medical record or electronic health record (emr/her). This is the electronic version of your medical history (Y Quintana, 2017). EMRs enable a medical practice or hospital to chart data from an office visit like going in to get your flu shot. Some EMRs have a patient portal so that you would then be able to go online and print out a copy of your flu vaccine for your employer if needed. I work at Children’s National Hospital and the employee patient portal allowed me to print out a copy of my flu vaccine to give to my primary care doctor for my records.DisadvantagesThe use of EMRs increases ethical concerns for medical practices and hospitals. HIPPA Health Insurance Portability and Accountability Act covers safety and privacy of patient. data. Laws cover patient confidentiality and include an emr is designed to have many different types of users access the data. The front desk employee may access the calendar to check the patient in and out. The nurse may access the section with immunizations and visit notes to document the reason for the visit, the doctor or nurse practitioner may access prescriptions and labs. The billing department may access the system to send out bills and manage patient payments. Medical practices and hospitals must ensure that only those authorized to view data have access to data. This can be managed with permission level security in the system. The front desk employee would only have access to the calendar. The employees from the billing department would only have access to the billing information. (Barsley & Chet, 2017) note that emrs have also complicated some relatively simple processes like consents for vaccines. In the paper record the patient would simply sign the document and it would be placed in the chart. Now it must be signed electronically using a signature pad or the paper must be signed and then scanned into the system. You must ensure that the date of the original document is recorded and archived. This may be ensured by audit functionality in the system tracking and time stamping each time a chart is opened and manipulated and by whom. A log would be created showing which users last accessed the chart and what action was taken by that user and include the data and time. This functionality is also helpful for system data integrity.(Ozair, 2015) Notes that unintended consequences of transition to emr from paper records could also be caused by poorly designed systems, users that are not properly trained or who are unwilling to learn the new system due to strong emotional responses. These issues can cause medical errors and an overdependence on technology. A back up plan must be in place to ensure that providers can provide care during the case of a power failure, natural disaster or system crash.AdvantagesEvaluation Criteria I will be comparing 3 emrs Cerner, Agility and eClinicalWorks. They will be evaluated based on criteria and a determination will be made as to which one excels in 3 categories cost, interoperability and reporting and analytics. User friendliness refers to whether the system is easy for the user to use and learn how to use. Does it make it easier to do the job or more difficult? How do the screens look? Can the user easily determine where things are on the screen? These are all questions to be asked to determine if the system is user friendly.Interoperablility refers to how well the system works with existing systems. Most emrs will need to be fed data from other systems. Can it connect and work with the existing softwareReporting and analyticsDocument management refers to how the system manages documentation.A Patient portal allows a patient to access their records by logging into the portal. It allows you to print immunization records, review lab results and make appointments. Depending on the system it may allow you to make appointments, request prescriptions, have a virtual visit or ask you provider a question as well.