How Measura Integrates With an EMR

For physicians

Getting results into the record

A diagnostic that lands in the chart as a scanned image satisfies a documentation requirement and answers no population question. It is worth deciding this before the first patient is tested, not after the hundredth.

Three levels of integration, in order of usefulness

1. Document delivery

The report arrives as a PDF and is filed to the chart. It is visible to a clinician reading that patient’s record and invisible to anything else. Fast to implement, and the level most practices stop at.

2. Discrete result capture

Key values — ankle-brachial index, conductance values, heart rate variability indices, resting energy expenditure, lean mass, cognitive score — are entered as structured observations. Now they can be trended, graphed and queried.

3. Interface-level exchange

Results flow as structured messages into the record without manual entry. Highest effort, and the only level that scales to a whole panel without adding staff time.

Why level two is usually the right target

Level one is not enough, because the entire clinical argument for this testing rests on comparison over time, and a PDF cannot be compared with anything by a computer. Level three is the correct destination and is a project with its own timeline. Level two — a short, fixed set of discrete values entered at the point the report is reviewed — captures most of the value for a fraction of the effort.

Choose the fields once and never change them. A trend is only a trend if the same field was populated the same way every time.

A minimum discrete field set

FieldWhy it earns a slot
Ankle-brachial index, left and rightThe primary vascular screening value; asymmetry matters
Toe-brachial index, left and rightRemains valid where the ankle index is falsely elevated
Sudomotor conductance, hands and feetThe small-fiber signal; feet are the clinically important side
Heart rate variability summary indexThe autonomic trend value
Orthostatic blood pressure changeDirectly actionable, and drives medication decisions
Resting energy expenditureThe denominator for any nutrition plan
Lean body mass and fat massWhat BMI cannot separate
Cognitive screening scoreMeaningless without a prior value; invaluable with one
Conditions of measurementFasting state, caffeine, nicotine, time of day, medication timing
The last row is the one most often omitted and the one that makes the rest comparable.

Practical notes

  • Decide who enters the values. If it is the reviewing clinician it will happen inconsistently; if it is the person who performed the study it happens every time.
  • Use the record’s own units and never mix them. A field silently switched from one unit to another destroys the trend it was created for.
  • Keep the narrative report as well. Discrete values do not carry waveform morphology or the interpreting clinician’s reasoning.
  • Confirm the patient’s identifiers before filing. A correct result on the wrong chart is worse than no result.

For patients: the same subject written for the person having the assessment is at understanding your results.

Talk to someone about testing

Tell us what you are trying to find out and we will explain which Measura assessments answer that question, what each one involves, and how the results are reviewed with a clinician.

4477 Woodson Rd, Suite 201, St. Louis, MO 63134. Monday to Friday, 9:00 a.m. to 5:00 p.m. Please do not send symptoms, diagnoses or images through a web form — a website form is not a secure medical channel. Call us with clinical detail.

Common questions

Can results come in as structured data?

It depends on the record system and on what is built; the discrete field approach works everywhere in the meantime. Getting results into the chart.

What is the minimum we should capture discretely?

The nine fields in the table above, including the conditions of measurement. Read more.

Who should enter them?

Whoever performed the study, at the time of the study. What makes a good tester.

Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, medical director of Measura. Last reviewed .