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Expanding Electronic Medical Records: Vanderbilt CIO and ICA President Talk Interoperability

by Kathy Mahdoubi , Senior Correspondent
As health care institutions continue to implement electronic medical records (EMR) across the country, finding out how to unite disparate information systems across a community is becoming increasingly more important in achieving the Obama administration's vision of health information technology in America. Vanderbilt University Medical Center CIO, Dr. William Stead, and Informatics Corporation of America CEO, Gary Zegiestowsky, spoke with DOTmed about interoperability and the universal health record.

Based on two national surveys supported by The Office of the National Coordinator for Health Information Technology (ONC), hospital adoption of full, application-rich EMR is at about 2 percent and ambulatory center adoption is at about 4 percent. Slightly more substantial are physicians' offices. About 17 percent of physicians have implemented some basic form of EMR, and approximately 8 percent of hospitals have a basic EMR that at the very least allows doctors to order medications and view laboratory and radiology reports electronically.

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For the few institutions that have implemented EMR, the next step is leveraging that technology to form larger networks that allow health care workers to pull patient information and review data about broader disease populations. This interoperability not only accelerates patient care by enabling detailed medical information to follow patients across community hospitals and clinics and can reduce redundant procedures, it also allows regional health care organizations the ability to better gauge, manage and treat specific disease states that are common within a community.

In 2000, a few Vanderbilt University Medical Center informatics programs began working on two complementary software applications dubbed StarChart and StarPanel, which aggregated and organized medical data, as well as improved communication and clinical decision-making within a single interface. Dr. Stead, Vanderbilt's chief information architect, has worked in biomedical informatics at Vanderbilt for well over a decade.

"The simple idea was to assemble information from any source and to use computational algorithms to turn it into something that can be used," says Dr. Stead. "It has no boundaries and it's analogous to what Google has done. Google answers questions by crawling over any number of sources of information -- each of which are used for a single purpose but none having the original purpose of answering your question."

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