Regenstrief, VA Lead Journal on EHR Transitions Impact

Regenstrief Institute

INDIANAPOLIS -- Two Regenstrief Institute and U.S. Department of Veterans Affairs researchers are key leaders of a national journal's special supplement designed to help address the plethora of issues that can accompany a healthcare system's transition to a new electronic health record (EHR) system.

Regenstrief Institute's David Haggstrom, M.D., MAS, and Michael Weiner, M.D., MPH, are among four guest editors who have spent the last two years leading content development for a Journal of General Internal Medicine (JGIM) special supplement focusing on a range of EHR system topics including data integrity, security and patient care.

The goal of the JGIM special supplement is to assist with understanding the perplexity related to transitions to new EHR systems. The supplement presents a dozen research and five perspective articles that highlight "substantive new science, commentary and knowledge about EHR transitions and their impacts," according to authors Drs. Haggstrom and Weiner, along with special supplement co-editors Seppo T. Rinne, PhD, M.D., and Elizabeth M. Yano, PhD, MSPH, in the introductory editorial.

The content examines both VA, the largest integrated healthcare system in the U.S. and one of the largest in the world, and non-VA facilities across diverse organizational and geographic settings.

"The transition of the VA's EHR to a new platform is a generational experience given the nationwide size and scale of the VA healthcare system," said Dr. Haggstrom, who is the director of the Center for Health Services Research at Regenstrief. "Research will continue to play a critical role in generating data that evaluates the impact and implementation of changing technologies."

"Most medical institutions have significant experience with adopting EHR systems, due to factors such as institutional mergers, costs of system maintenance and needs for increased functionality. Transitions from one such system to another have become more common," said Dr. Weiner. "All medical institutions undergoing this type of transition will need to understand the difficulties, to inform decisions and maximize success.

"Financial costs for one institution are typically millions of dollars, if not billions. History and observation indicate that nearly all such transitions are difficult," said Dr. Weiner. "Challenges can include technical problems, culture change, proper training, access to legacy data, financial issues and accommodating emerging policies, technical needs and clinical practices and workflows."

Medical institutions have increasingly adopted and updated EHR systems, especially since passage of the Health Information Technology for Economic and Clinical Health Act in 2009.

The special supplement editors developed the goals, wrote the introductory editorial, established a guest editorial board, issued a call for submissions, oversaw the peer-review process, identified expert commentators, interacted with the journal staff and editorial board and made final decisions about content.

In addition to their Regenstrief affiliations, both Dr. Haggstrom and Dr. Weiner have appointments with the VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center in Indianapolis, and also are faculty at Indiana University School of Medicine. Dr. Haggstrom serves as an associate editor for JGIM.

Dr. Rinne is affiliated with the Center for Healthcare Organization and Implementation Research at the VA Bedford Healthcare System in Bedford, Massachusetts and the Department of Medicine at the Boston University Chobanian and Avedisian School of Medicine in Boston. Dr. Yano is affiliated with the VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy at the VA Greater Los Angeles Healthcare System in Los Angeles. She is also affiliated with the Department of Medicine at the David Geffen School of Medicine at UCLA and the Department of Health Policy and Management in the Fielding School of Public Health at UCLA.

JGIM is the official journal of the Society of General Internal Medicine. The journal promotes improved patient care, research and education in primary care, general internal medicine and hospital medicine. Its articles focus on topics such as clinical medicine, epidemiology, prevention, health care delivery, curriculum development and numerous other non-traditional themes, in addition to classic clinical research on problems in internal medicine.

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