How Regenstrief Built an Emergency EHR System During COVID-19

To aid Indianapolis Emergency Medical Services (IEMS) with an influx of COVID-19 patients, researchers from Regenstrief Institute utilized a global open-source EHR, OpenMRS, to create an emergency EHR system.

In less than two weeks, the researchers developed the emergency EHR system to register patients, collect patient data, and forward patient data to the Indiana Health Information Exchange (IHIE).

When COVID-19 began to spread throughout Indiana, IEMS leaders realized a significant gap between Indianapolis health system capacity and its health IT system to support the overburdened healthcare system, Regenstrief said.

It is typical for health systems in metropolitan areas to have a specific process for capturing and exchanging patient data during healthcare emergencies, such as COVID-19. Some approaches vary from a full EHR system or a hybrid EHR-paper system, the authors explained.

“Given the projected volume of patients for the COVID-19 pandemic and the proposed multi-institutional team approach needed in case of significant provider illness, IEMS sought a simple, efficient, consolidated EMR solution to support planning for the potential capacity gap,” Regenstrief wrote.

Because IEMS did not have access to an EHR system, it asked Regenstrief to leverage its existing experience with OpenMRS to enhance patient data exchange during the crisis. IEMS planned to establish a pop-up triage center to treat COVID-19, but it needed a health IT system to collect and send patient data to the Indiana Network for Patient Care (INPC) and IHIE.

This EHR system could make patient records available to local providers for future visits.

Regenstrief said it utilized an “all hands on deck” approach by combining health IT and subject matter experts for a human-centered and iterative process to meet IEMS’ needs.

“Our entire team jumped into action, employing the open source system available in OpenMRS,” Jonathan J. Dick, MD, a project leader and member of Regenstrief’s Global Health Informatics program, said in a statement.

Within a week, Regenstrief researchers optimized and set up a customized version of OpenMRS to aid IEMS’ popup hospital facilities. Regenstrief equipped IEMS with an end user manual and a support plan for the installation-ready EHR system.

“We worked with IHIE and IEMS to create forms to enter relevant COVID-19 data into the INPC,” Dick continued. “Within one week, we were prepared to make the interface live. Thankfully, we never needed to break the glass because the healthcare systems in the state did not become overwhelmed.” 

Although the EHR system never launched, the two organizations said they shared this approach to show how quickly an EHR system could be built and deployed under emergency situations. It is possible to leverage existing solutions to boost crisis response, Regenstrief explained.

“We learned valuable lessons from this experience that can be applied to future emergencies. This system can be adapted to work in other states or even countries, and it can be done very quickly,” said Burke Mamlin, MD, a project leader and member of Regenstrief’s Global Health Informatics program.

“This shows the value of open source and how it can lead to global goods that can benefit us in the United States.” 

Regenstrief originally helped develop and launch OpenMRS to create a health IT infrastructure and to manage health systems in underserved countries around the world.

“Open source global goods can rapidly be adapted to meet local needs in an emergency,” Regenstrief concluded. “OpenMRS can be adapted to meet the needs of basic emergency medical services registration, triage, and basic data collection.”