Over the last seven years, with funding from the National Institutes of Health, National Library of Medicine, we have extended the RMRS to the Indianapolis Network for Patient Care (INPC), a city-wide clinical informatics network.  Indianapolis is served by five major hospital systems – Community Hospitals Indianapolis, St. Vincent Hospitals and Health Services, St. Francis Hospital and Health Centers, Clarian Health, and Wishard Health Services. These five INPC hospital systems operate a total of 11 different hospital facilities and more than 100 geographically distributed clinics and day surgery facilities. Collectively these systems admit 165,878 patients, and serve more than 390,000 emergency room visits and 2.7 million clinic visits per years. Clarian is a recent merger of Indiana University/Riley Hospital with Methodist Hospital. The ancillary services within the two parts of the merged entity, including surgical pathology, still use different computer systems and have different histories.

All INPC participants now deliver registration records, all laboratory tests, and all UB92 records (diagnosis, length of stay, and procedure codes) for hospital admissions and emergency room visits to separate electronic medical record vaults in a central INPC server located at Wishard Hospital. The computer system standardizes all clinical data as it arrives at the INPC vault, laboratory test results are mapped to a set of common test codes with standard units of measure, and patients with multiple medical record numbers are linked.  Each institution has the same file structure and shares the same term dictionary, which contains the codes, names (and other attributes) for tests, drugs, coded answers, etc. When a patient is seen in any of the 11 emergency rooms operated by the consortium hospitals, and the patient consents, the information from all of these institutions about one patient can be presented as one virtual medical record.

By weaving ubiquitous clinical data access into the fabric of the healthcare in the region, creating a model for clinical data exchange for other regions and building a unique laboratory for informatics research, this sustainable I3 realizes the IAIMS vision.