I was just reading through Jamie’s post on EMR and EHR talking about showing EMR “meaningful use” and EMR reporting. She provides some really interesting examples about the challenges of reporting out of an EMR that wasn’t designed to report those various data elements.

This discussion caused me to think about the impact that having to report on meaningful use will have on an EMR implementation. An EMR implementation is hard enough as it is now. Now, not only will an EMR user have to focus on learning all the new EMR functionality and translating their various clinical workflows into an EMR workflow, but they’ll also have to take into consideration the reporting requirements that will be necessary to get access to the EMR stimulus money and show meaningful use.

Certainly some of this planning could be a good thing and probably should have been done regardless of whether a doctor wanted EMR stimulus money or not. However, anyone that’s had to deal with reporting knows that it takes a lot of work and planning to get it right.

It will be interesting to see how much of an impact these reporting requirements will have on the already abysmal successful EMR implementation success rates. Granted, most doctors implementing an EMR won’t properly address these requirements during implementation and will just suffer the consequences of not showing meaningful use when that time comes.

I read this nice post about an EMR system reporting “number of patients.” Here’s a quick snippet of the EMR reporting problem:

They considered a patient to be someone who had started a course of treatment. However, the clinical operations considered a patient to be someone who walked through the door.

Both of these are valid numbers, but when finance asked for ‘how many patients did you see,’ the two came up with wildly different numbers.

I can’t tell you how many times I’ve had discussions like this. For example, I’ve been asked the question, how many patients have we seen in the clinic? Do you mean people who have come to the clinic or total appointments for those people? Do you include nurse only visits for immunizations or do you just mean doctors’ visits? etc etc etc.

The cool part is now we’re past those basic EMR reporting and can now start looking at cool questions like, how many patients with a BMI in a specific range were properly diagnosed as obese? Was this addressed during the patient visit? That’s when the data in an EMR starts to be really cool.