Monday, March 5, 2012

Connecting devices to your EMR-Part 2


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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