In the prior two posts in this series, we looked at the parts
involved with connecting a device to your EMR, and how the data is presented in
your EMR. This post will examine things
to consider when you're in the market place looking at devices. Since I’m not a clinician, I’ll leave it to
the dear reader to ponder specific medical and diagnostic issues. In this article I’m focusing on the more technical
aspects of devices.
Let me assure you that if you get confused while shopping,
you’re not alone. There seems to be lots
of chatter and unsettled matters when it comes to making EMRs and devices play
nice in the same sandbox.
Start by defining what it is you are looking to accomplish by
connecting a device to your EMR. Do you
want to save time, improve accuracy, save money, improve processes, all of the
above? Put another way, what problem are you trying to solve? If you can’t define a real problem, then you probably
shouldn’t go any further.
Next, determine the format the data should take. Does it need to be discrete so you can sort
and report? Or can it be non-discrete,
as long as it’s placed in the EMR? Would
it be acceptable if the device manufacture’s software held the data on a
computer instead of in the EMR? This
issue is important because you may be presented with choices as you shop, and
those choices may have very different price tags. Typically, it is more complex and therefore
more costly to get discrete data into the EMR from a device.
Finally, determine how and where you would connect a new
device to your computer. For example, do
you have a computer, Mac, laptop, iPad, iPhone or something else available to
make the connection? Does your computer
have enough USB ports, or maybe Bluetooth if required? Are you planning to move the device to
different rooms? Make sure you know the operating
system spec (typically some flavor of Windows, with a service pack version) and
the computer hardware spec for each computer you plan to connect with. Don’t forget about memory (RAM) and hard
drive space.
Once you know the problem(s) you’re trying to solve, the
format you’d like the data to take, and how you’ll make the physical connections,
now you can start looking at your options.
Start with your EMR vender and ask them the following questions. I previously mentioned some of these in the
first post in this series.
- Ask for a list of the devices for which your EMR version and build will interface.
- Ask for a list of the data fields which interface, and which are discrete, and which are non-discrete.
- Ask if these devices will continue to be supported in te next version of the EMR.
- Does the EMR vender or a third-party vender provide the interface between the device and the EMR?
- Is there an upfront cost for the interface? Is there an annual cost?
- Who supports the interface, the EMR vender or a third party vender?
In most cases, EMR venders will just have a list of device
manufactures with which they interface and the cost (if any) of the interface.
You may have to dig to find out about a specific device, specific data fields, and
discrete vs. non-discrete data fields. Regarding
forward-looking compatibility, in some instances they may not be able tell you
because the vender simply may not know what will happen in future builds.
Some practices are upset if they are told they need to pay
separately for an interface, especially if there is an annual fee for it. You can try to negotiate, but interfaces are
a true cost for EMR venders due to the coordination they need with the device
manufacturers. And things do change, they
need to periodically do some programming and troubleshoot break/fix issues. My personal opinion is that I’m fine paying a
reasonable annual maintenance fee for an interface.
Once you know which device manufactures and their devices are
supported, you can shop for devices.
When shopping for devices, here are some questions and
considerations.
- Is this model going to be around and supported for a while?
- Confirm with the device manufacture that the model you are looking at is in fact able to interface with your EMR.
- How does the device connect to my computer?
- Is this device compatible with the hardware in my office?
- Does the operating system software on my computer (typically Windows) support this device?
- Can I move the device between computers? Or does its license restrict that?
- Is there a special connection, such as a dongle, which I need to purchase?
- Does the manufacturer have it’s own software which can store data? Is that software included in the purchase price of the device?
Once you decide on a device, you’ll likely may need to
coordinate things with your EMR vender in order to activate the interface. This may be a simple process, or a test of
patience. Which ever it is, be sure to
document who you have spoken with, any ticket or job numbers they give you, and
the timeframe they have committed to. If
you ever need to revisit issues with the interface, this will be handy
information.
So, here’s a quick recap of today’s post:
- Define the problem which an interfaced device will fix
- Define your existing computer hardware and operating systems
- Define the devices your EMR supports
- Shop for your device
- After the device purchase, document the interface activation process.
Straight ahead,
Bob
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