Wednesday, February 29, 2012

Connecting devices to your EMR-Part1


[This is the first of a three post series.  The first post will discuss components.  The second post will discuss data.  The third post will discuss buying strategies]

One of the trends for 2012 is connecting devices to electronic medical record (EMR) software.  The ability to connect devices such as EKG machines and vital sign machines to EMRs is nothing new.  But the compatibility between devices and EMRs has been limited.  Now thanks to the increasing EMR installation base, increased reporting requirements, and technical improvements, the market is primed for this next technical uplift in the medical practice.

To help shed some light on what it takes to connect and share data between a device and EMR, we’ll focus on three aspects.  First we’ll look at the component parts we’re working with.  Second, we’ll discuss the data itself.  Finally, we’ll look at some purchasing strategies.

Component parts
Three main components are: 1. the device providing the data; 2. the software into which you want the data transferred; and 3. the interface between the device and the software

The device
This can be any number of devices; blood pressure monitor, EKG, radiology.  The device will need to have a means of exporting data.  This is typically through a port (think USB or serial port like on your computer), or wireless transmission such as Bluetooth. 

If the device can export data, the manufacture will typically include in the technical specification the words USB, Serial port, Bluetooth, or that ever the format is.  These specs are usually available on the box the device came in, its user manual, or the manufacture’s website.   Not all devices have this capability, so be sure to check the tech specs.

The interface
The interface is simply a translator between the sending device and the receiving software.  The two parts to an interface are: 1. the physical or wireless interface; and 2. the software interface.

The physical interface is the conduit which allows data to exit the device and be received by the computer.  It may be as simple as a USB cable, or it may require a special proprietary cable or dongle from the device manufacturer.  If the connection is wireless, such as Bluetooth, the device will have that capability build in.  Note that the computer to which the device is attached also needs the same type of port or Bluetooth capability.  Be sure to check the specs of your computer to make sure it’s compatible.

The software interface is what allows the EMR software to interpret the data sent by the device.  The best case scenario is that your EMR software has a built in interface for your device.  If that’s not the case, then you’ll need to acquire or purchase the software interface from either the device vendor, EMR vendor, or a third party vendor.

Why all the variation with interfaces?  Because even though all vendors talk about standards, there are still gaps between vendors.  Interfaces require lots of cooperation and coordination among device manufactures and EMR companies.  Add to that the multitude of device platforms (EKG, vitals, radiology et al), different EMR platforms (client/server, thin client, cloud), and shifting computing device platforms (computer, laptop, tablet, iPad, iPhone, Android et al).  There are lots of moving parts.

Finally, some devices simply are incompatible with certain EMR software, meaning they don’t have a viable interface.  Even within the product line of a device vendor, different devices may require different interfaces or be incompatible.  That is why it’s important to check the compatibility of the specific device you want to use with the specific software you will send data to.  This includes confirming the specific device version, interface version, and EMR software version or build.

The software
In our context of a medical practice, we’ll focus on receiving information from a device into our electronic medical record (EMR).  EMRs are being improved so they can receive data from a wider array of devices and vendors.  Most of the focus from the device vendor side has been on the acute care setting, with scant attention paid the ambulatory side.  But buyer options are improving all the time. 

This is the part where I need to help you be a better EMR owner.  If you ask your EMR vendor, “can I interface my EMR with XYZ Company’s blood pressure machines?”, you’re asking the wrong question.  The correct question should be, “Can I interface my model A, version B, XYZ Company blood pressure machine with your current software?  Will the next version of your software continue to support my device?”  And finally, “Is support of this interface included in my existing maintenance and support contract, or is there an extra cost?  Is support provided by your company, or an outside vendor?”

Don’t be surprised if you get different answers from different people at your EMR vender.  Interfaces have typically been a victim of lost ownership within EMR companies.  The Support teams don’t typically work with them much, implementation teams don’t do much with them, sales typically has an outdated list of available interfaces, and communication between EMR and device venders is often strained.  If you can’t get satisfaction from the sales, implementation and support teams, request that they get an answer from an interface analyst working with your software or device.  And don’t be put off if they won’t share that person’s contact information with you, most software companies don’t want customers in direct, uncontrolled contact with analysts and programmers.  If they did, analysts and programmers would have customers contacting them all the time with suggestions, complaints and break/fix issues.

Now that we have looked at the component parts involved with connecting a device to an EMR, next time we’ll look at the data that is received in the EMR.

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