Why is it Hard to Get Quality Clinical Data From an EHR?

Transcript

Why is integration such a challenge in health care? For those familiar with Meaningful Use, Meaningful Use did a really good job of constraining the conversation between points A and point B. You need to be able to produce a document called a CCDA, and you need to be able to produce it in a in a way that is consumable by an endpoint. Meaning, you have a certification process around what that document looks like. And it as rules.

The challenge is that the rules are open to interpretation. And when you think about it, you’ve got to take a vendor specific interpretation of those standards.  And then to that, you kind of add the complication of humans, clinical workflows, specialties.  “I’m not going to put the data where you expect me to put in an order for this EMR to produce the data that it’s supposed to produce” even in a perfect scenario. And then you kind of add a third layer of integration technologies in between points A and points B, getting the data out of whatever databases are there, getting it out of whatever network is there, getting it through some threshold on the internet and into a secure system, the other side. Layers of an onion on both sides, if you will.  You take those three things and lay them together and the quality of the data is the product of those three, but that’s only if you can get your hands on the data.

So how do you get your hands on the data?  If you think about an EMR like a house the old school ways equivalent to kind of digging a hole next to the foundation of the house and hammering through the walls of the foundation and coming up through the floorboards – that would be kind of an adapter, that database concept.  API’s, messaging, IT profiles, web services, FHIR. Look at that like a backdoor. It’s friendly. It doesn’t tear the house to pieces, but it’s gonna fumble your way through the house, bump into furniture to eventually get to where you want to go.

What’s different about what we do, we come right through the front door. We at SmartLink just use the user interface as a common sense factor to go in and literally see the data. The user interface is arguably the most mature; it’s been there the longest, it is highly tested, has to be secure. And in the healthcare world is highly audited, meaning when you’re in the user interface, the system knows exactly where you go and what you do. For a while, you had no other options than old school HL7 or some of the newer variants that exists now. And even moving into FHIR and smart services and things like that. But the truth of the matter is, the user interface has been there all the while. It is an interface and we would say, “why not use it?”