While buying an off-the-shelf EMR solves many problems, it does require hospitals to invest large amounts of capital and spend a long time adjusting the system to clinicians’ needs. For that reason, a number of hospitals are building their own in-house EMR, according to a story in Information Week.
One example of such a buildout comes from Landmark Hospitals, which operates five long-term acute care hospitals. Landmark, which wanted both an EMR and an HIE backbone connecting its properties, wanted to shape the EMR itself. “We found the IT solutions in the open market were not going to meet our needs,” Landmark Hospitals CEO William Kapp told Information Week. “We couldn’t find a solution that made any sense for us and the existing options were prohibitively expensive.”
Kapp and Landmark CTO Joe Morris pulled together an in-house team to build their own EMR. The new product, a cloud-based system with mobile capabilities dubbed Chartpad, provides a real-time stream of vitals, nurse and physician documentation and voice dictation via speech recognition tool Nuance. Landmark used Iguana technology to knit Chartpad and the other EMR systems together, IW reports.
Another hospital which has gone with home-grown technology is Boston’s Brigham and Women’s Hospital, which built an emergency department EMR including CPOE and decision support. The hospital’s Web-based system uses Microsoft .NET on the front end and InterSystems’ Cache database for back end functions.
Yet another example of in-house EMR development comes from the William Lehman Injury Research Center at the University of Miami in Florida, where center director Carl Schulman managed a project which helped the U.S. Army trauma training center meet its needs. The U of Miami works with the Ryder Trauma Center, a part of Miami’s Jackson Memorial Hospital, to train Army physicians prior to deployment, Information Week notes.
Working in partnership with the Department of Defense, a team at the Center developed MobileCare, Web-based software which integrates documentation, education and telemedicine for Army physicians working in the field.
But what about Meaningful Use? Eventually, hospitals that build out their own EMRs have a shot at having EMRs certified. Back in 2011, Beth Israel Deaconess Medical Center became the first hospital to have its home-grown EMR certified as “complete” by the CCHIT. According to CIO John Halamka, the process requires preparation, but it’s doable.