Electronic Medical Records Companies: A Guide for Legal Teams

The electronic medical records companies legal teams meet most on record requests are Epic, Oracle Health (formerly Cerner), MEDITECH, eClinicalWorks, NextGen, Veradigm, Practice Fusion, ModMed and TruBridge. Over 99% of US non-federal acute care hospitals and 91% of office-based physicians use a certified EHR [1]. Tavrn is the retrieval and chronology layer that plugs into these.

This guide covers each company and what its system name tells you about how to shape the request.

EMR or EHR: what the terms mean

People use the two terms as if they mean the same thing. ONC draws a line between them. In its words, "EMRs are digital versions of the paper charts in clinician offices, clinics, and hospitals" [2]. EHRs are broader: they hold information from all the clinicians involved in a patient's care and share it with other providers [2].

For a legal team, the label matters less than one fact. Each company's software holds the chart for that one provider. A patient seen by a hospital, a clinic and a physical therapist may have records in three different systems. Each one needs its own request.

The companies at a glance

Notes on each company

Epic

Epic was founded in 1979 [3]. The company says more than 325 million patients have a current electronic record in Epic [3]. When a health system uses Epic across many sites, ask the records team whether one request can cover every site in the system.

Oracle Health (Cerner)

Oracle agreed to buy Cerner in December 2021 [4]. Oracle described Cerner as a provider of digital information systems used in hospitals and health systems [4]. Records printed before the change may still carry the Cerner name, so list both names when you ask about older dates.

MEDITECH

MEDITECH sells Expanse, its EHR for hospitals and other care settings [5]. Hospitals that have used MEDITECH for many years may keep older charts in a prior version. Ask whether the date range you need lives in the current system or in an archive.

eClinicalWorks and NextGen

eClinicalWorks was founded in 1999 and sells cloud-based software to medical practices [6]. NextGen Healthcare serves ambulatory practices across more than 40 specialties [7]. Both are common on the clinic side of a case, so expect separate requests for each office a patient visited.

Veradigm and Practice Fusion

Allscripts moved its solutions, including its electronic health records, to the Veradigm brand [8]. Practice Fusion is a cloud-based EHR, and its parent company is Veradigm [9]. If a bill or older record says Allscripts, the provider may now use a Veradigm product.

ModMed

ModMed was founded in 2010 and is based in Boca Raton, Florida [10]. It builds software for specialty practices [10]. Expect it from specialty offices a patient sees after the hospital visit.

TruBridge (CPSI)

CPSI started in 1979 to build software for hospitals in rural communities [11]. The company now operates as TruBridge after a 2024 brand change [11]. Rural hospital records may show either name.

What the system name changes about a request

The software company does not answer record requests. The provider's own records team does. Still, the system tells you where the pages live and what to ask for.

• Name billing records. HIPAA's designated record set includes "the medical records and billing records about individuals maintained by or for a covered health care provider" [12]. Billing often sits in a separate module, so ask for it by name.
• Ask for the format you need. When a patient requests their own records, the provider must give them "in the form and format requested by the individual, if it is readily producible" [13].
• Know that an electronic export exists. ONC's certification criteria require certified health IT to let a user create an export of all of a single patient's electronic health information the product can store [14].
• Ask about archives. When a provider changed systems or a vendor changed names, older dates may sit in a legacy archive. Give the dates and any old system names you have.
• Ask for the audit trail separately. If the case turns on when a note was written or changed, list the audit trail as its own item.

How Tavrn fits

Tavrn retrieves medical records from any US provider: one authorization in, complete record out, via platform, integration or API. One authorization covers every US provider the patient has seen. Tavrn requests records from each provider by fax, mail, email and phone. Every open request is followed up automatically every 48 hours, and records arrive as each provider responds.

What to do next

If your team sends requests to many providers on different systems, see how Tavrn works for law firms.

Sources

1. National Trends in Hospital and Physician Adoption of Electronic Health Records (Health IT Quick-Stat #61) — ASTP/ONC
2. Health IT and HIE Frequently Asked Questions — ASTP/ONC
3. About Epic — Epic Systems
4. Oracle Buys Cerner — Oracle, 2021-12-20
5. MEDITECH Expanse EHR — MEDITECH
6. About eClinicalWorks — eClinicalWorks
7. About NextGen Healthcare — NextGen Healthcare
8. About Veradigm — Veradigm
9. About Practice Fusion — Practice Fusion
10. About ModMed — ModMed
11. About TruBridge — TruBridge
12. 45 CFR 164.501 Definitions — eCFR
13. 45 CFR 164.524 Access of individuals to protected health information — eCFR
14. 45 CFR 170.315 2015 Edition health IT certification criteria — eCFR