Hospital provides update on open-source move

IDG News Service - Midland Memorial Hospital hopes to have the bulk of its electronic health record (EHR) system up and running on open-source software by late spring or early summer, according to David Whiles, the Midland, Texas, facility's information systems director.

Operating across three campuses five miles from each other and linked by high-speed networks, Midland Memorial is a 371-bed county hospital run as a single organization. Midland Memorial is also the first facility on track to fully implement OpenVista software and services from Medsphere Systems Corp.

The Medsphere software is based on the open-source Vista EHR system developed by the U.S. Department of Veterans Affairs and in use at VA hospitals. Funded by U.S. taxpayer money and thus in the public domain, Vista (Veteran Health Information Systems and Technology Architecture) was developed to unify all the different departments within a hospital. Medsphere ported Vista to Linux and removed some of the system's specifications that related solely to veterans' health care.

Migrating to open-source software has been a long process for Midland Memorial, Whiles said in a recent phone interview. The hospital first started evaluating a move back in 2003 to update, better integrate and improve the efficiency of its systems in a cost-effective manner. In the same year, Midland Memorial begun working with Medsphere.

From the start, the hospital put together an executive team from different hospital departments, including laboratory, pharmacy, radiology and nursing services to "self-educate ourselves on the new system" while working in conjunction with Medsphere, Whiles said. The software evaluation continued into 2004 and involved a couple of site visits to VA hospitals, he added. In June 2004, Midland Memorial brought together 150 hospital staff and about 20 physicians for a software demonstration and to let them try out the system.

The cost of fully implementing OpenVista will be $7.1 million, as opposed to more than double that figure if the hospital had gone with commercial software, according to Whiles.

Implementing OpenVista required six months of initial development work starting in March 2005 before the first hospital application, a pharmacy application, went live in late October. The laboratory application went live in early December. With those applications up and running, "we were back to where we started with the legacy system," Whiles said, duplicating with open-source software the hospital's previous system based on proprietary applications.

Over the past two weeks, the hospital has taken other applications live, including its first clinical unit EHR software, as well as EHR capabilities for a nursing unit and its same-day surgery unit. Midland Memorial also has a small computerized physician order entry application running. "We'll let that percolate for the next 30 days," Whiles said.