In the first post of this series, we looked at the three
components involved with interfacing a device to your EMR: the device; the
interface; and the EMR software. In this
post, we’ll discuss the data received by the EMR.
When your EMR receives data from your device (EKG, blood
pressure cuff and so on), it will usually take one of two forms, discrete or
non-discrete. So what does that
mean?
Discrete data
Within the context of your EMR, discrete data is data
that will be placed alongside your manually entered data just as if you had
manually entered it. Take, for example, data
from a blood pressure cuff. If you
manually enter a blood pressure (BP), you enter the systolic reading, diastolic
reading, and time of day. In the future
if the need arises you can generate a report on the patient’s historical BP using
these figures, and generate a nice graph if the EMR has the capability. Likewise, if the data you receive into your
EMR from your device is discrete, you can also view, sort and report on it just
as you would manually entered data.
Non-discrete data
Non-discrete data, by contrast, is data which is not
sortable or reportable. In the EMR, the
format into which it is placed is static.
Conceptually, think of the non-discrete data as a PDF
document. You can view it, but you can’t
pull anything out of it. Continuing with
the BP example, if the data from the device is non-discrete you couldn’t
search, sort or report on the systolic or diastolic data points.
So what?
Given the choice between discrete and non-discrete data, discrete
data is preferable. Why do we care if
data is discrete or non-discrete? For
starters, the ability to search, sort and report data such as BP is a great
tool when tracking an individual patient’s health over time. Second, public and private payer reporting
requirements may require you to pull and report data out of your EMR, and the
more discrete data you have the easier it is to report. Third, quality initiatives will ask for
reporting of various data sets, and the ability to have your EMR pull out that
data instead of you having to manually type it is important. Finally, are you now or planning to receive CMS
EMR Incentive money? If so, at some point
you’ll need to sort and report data out of your EMR.
This need for discrete data is one of the primary reasons
why not all devices fully interface with all EMRs. So why don’t device manufacturers and EMR
companies always interface their products? Creating and maintaining interfaces can be expensive
and time consuming in today’s market. Venders
are dealing with rapid evolution in EMR software, devices, and regulatory
standards. Plus they are dealing with a
market which has exploded with implementations.
Let me make a final point on this in defense of the device manufactures and software companies. Manufactures know that their products must
have high reliability. Going back to our
blood pressure example, the systolic data point exported by the device must be
in a form and format readable by an interface.
That interface must know where to place that data point within the EMR. That means making sure it gets into the
correct patient record and the correct systolic field. And it must happen correctly every time, without
fail. If the device software changes, it
must still perform flawlessly. If the EMR
is upgraded, it must still perform flawlessly.
Next time
So we’ve looked at the components to interfacing a device to
an EMR, and the data received into the EMR.
In the next post in this series we’ll look at navigating the marketplace
when purchasing a device.
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