Technology Consult

August 5, 2005

Does your thermometer talk to your EHR?

Delo's dedication is apparent when her nurse takes a patient's blood pressure and temperature with a digital vital-signs device. The nurse doesn't key the results into the patient's electronic health record program, a potential misstep since numbers can be transposed or omitted. Instead, they're downloaded automatically into Delo's EHR.

You've heard the buzz about electronic connectivity-information flowing freely between your computer and those of hospitals, patients, other doctors, labs, and pharmacies. What's seldom mentioned, though, is the possible linkage between your EHR and ubiquitous testing equipment like thermometers, blood pressure cuffs, ECG machines, spirometers, oximeters, blood glucose meters, Holter monitors, and even weight scales. In today's marketplace, you can find a version of each that feeds results into an EHR. Besides eliminating data-entry errors, these devices can save time (think more slots for patient visits) and money as well as help you better interpret the results.

Another hi-tech tool in her office is a Welch Allyn resting ECG machine that plugs into a tablet computer. While traditional ECG machines are big boxy things with a printer, internal software, and perhaps an LCD panel, Delo's device is roughly the size of a handheld CD player, although the attached cables make it hard to stuff in a lab coat pocket. The small size is possible because the tablet computer-loaded with the ECG software-functions as the device that processes and displays the results. Delo likes the portability.

"It beats wheeling an old-fashioned ECG machine on a table into the exam room," says Delo, who works with an associate physician, a physician assistant, and a nurse practitioner.

Portability goes up a notch when you couple a mini-ECG gizmo with a PDA instead of a full-fledged computer. This combination is available from Welch Allyn as well as from Midmark Diagnostics Group in Torrance, CA, another medical-device maker with a line of EHR-compatible products. Midmark's PDA software allows you to display resting ECG results in real time and then wirelessly zap them to an EHR program on a server.

Doctors gain a diagnostic edge when ECG software works in tandem with an EHR. Delo, for example, can overlay an image of a new ECG tracing on top of an older one stored in the electronic chart, allowing her to spot any changes in the waveform immediately.

The 19 doctors at Cardiology of Tulsa (OK) have reaped similar benefits from ECG and vital-sign equipment that interfaces with their EHR from NextGen Healthcare Information Systems in Horsham, PA. When the doctors interpreted results from stress or treadmill ECGs in the old days, they had to leaf through 30 or more pages of printouts. "Now we can scroll through those tracings on the screen," says cardiologist Michael Spain. "They flash by so fast that it's almost like animation, and the variations stand out more."

For a time, the doctors scanned ECG tracings into their electronic charts, which made the images fuzzier and harder to interpret. This chore also gobbled up staff minutes, and then the paper had to be shredded. Eliminating these steps through electronic connectivity gives staffers more time to talk to patients on the phone and refill prescriptions. And images of the ECG tracings remain sharp.