I’ve gotten addicted to Quora (www.quora.com) lately. For a site that seems to have started out as a forum for discussing issues of such gravity as “When will Brittany Spears remarry?” it’s developed some great health IT content.
One neat health IT discussion going on on Quora touches on which hospitals and health systems were early adopters of EMRs/EHRs. This is a very interesting question, as the early adopters in the field are very much worth watching but often not as well known as they should be.
Here’s a detailed piece of background from Brian Martin, a clinical informaticist:
In the 1970s, academic medical centers were the first adopters of electronic medical records. There was COSTAR at Harvard, HELP at Latter-Day Saints Hospital at the University of Utah, and TMR at Duke. El Camino in Mountain View, CA, pioneered the Lockheed TDS system, which was installed in the early 1980s at the NIH Clinical Center.
VA started with the DHCP (De-Centralized Hospital Computer Program), which was then replaced by VistA.
DoD started with the CHCS (Composite Health Care System), developed by SAIC. I understand DoD spent more than $2 billion on this project, and that DoD and VA have agreed to merge and “open-source” their respective EHR implementations.
Another poster suggested Palo Alto Medical Foundation (www.pamf.org) as a good example of early adoption.
As for myself, I’d add Intermountain Healthcare (www.ihc.com) and Geisinger Health System (www.geisinger.org) as health systems of interest; I don’t know when each adopted their systems but everything I’ve heard suggests that they’re doing intelligent things with them.
What’s interesting to note is that in addition to these, there are a surprisingly large number of smallish rural systems that also jumped on board with EMRs early and have used them well. (They’re all over the HIMSS Analytics list of most-advanced EMRs.) Obviously, having a ton of capital is an advantage, but those scrappy smaller systems remind us that initiative and foresight can be equally valuable.