(Drawn from Refs A6,A7 and http:// www.regenstrief.org The Regenstrief Institute (directed by Dr. Clement McDonald) was founded in 1969. The Regenstrief EHR effort began in 1972 on the site of the Marion County General Hospital (renamed in 1975 as Wishard Memorial Hospital) and was directed first at diabetes patient records but with the goal of capturing patient care data in order to make that data generally and easily available as well as reliable so that important implications for patient care were not missed. Such captured data would also then be available for later practice analysis. Later, the work was expanded to include the hospitals that were centralized on the Indiana Univ. Campus in Indianapolis and contained several teaching hospitals (Long Hospital, Riley Hospital for Children, Indiana University Hospital and the Roudebush Veterans Administration Medical Center) as well as the University instructional facilities and the Institute itself. It was this Regenstrief Medical Records System (RMRS) configuration that was identified and recognized in the 1975 National Center for Health Services Research and Development report (Ref A13). In 1984 the Outpatient test ordering capability was incorporated into the functions already directed at Registration, Visit Scheduling, Outpatient Prescriptions and Diagnostic Test Result Reporting (including imaging procedures) and in 1990 that for inpatient ordering was added. The RMRS serves 70 local clinics as well as seven hospitals. In 1997 Indiana Univ Hospital, Riley Hospital for Children and Methodist Hospital of Indianapolis combined to form Clarian Health Partners. 1.5 million patient records are now served by the RMRS. This EHR model development site has therefore had a major influence on the evolution of a national EHR environment.

Wishard Memorial Hospital and Regenstrief Institute, Indianapolis IN

Courtesy of  Regenstrief Institute

The capabilities of the RMRS environment evolved to include electronic capture of clinical laboratory data, pharmacy prescription data and other clinical observations. Its overall objectives were to eliminate the logistical access problems to patient data, to manage the data capture book-keeping processes so that key data are not overlooked and to have the captured data exist in data structures that facilitate analysis in clinical, management and epidemiologic questions. The evolving architecture incorporated rule-based reminders for practitioners and early on demonstrated the reduction in practice errors that resulted from the use of this feature in the participating hospital settings. This underlined the benefits of these capabilities, which were also found in the MGH setting in Boston, as noted in the 1975 NCHSRD report. The Regenstrief Institute has continued to be the focus of the investigations into needed new capabilities, the common conventions needed to implement these capabilities and the benefits to the health of patients resulting from availability of such new capabilities. The development of helpful new capabilities has thus been, and will continue to be, the catalyst at this model development site. Individuals from the Institute have participated in all of the important Health Informatics Standards activities that are noted in the EHR Status segment of this web site, particularly those involving messaging functions.