Introduction

The Regenstrief Institute is a 25-year old research foundation located on the Indiana University School of Medicine campus and is dedicated to the study and improvement of health and health care delivery.

The Regenstrief Institute, Inc is a joint enterprise of the Regenstrief Foundation, Inc., the Indiana University School of Medicine, and the Health and Hospital Corporation of Marion County.

Institute investigators include members of the faculty of Indiana University's School of Medicine, School of Liberal Arts, School of Informatics, and staff of the Richard L. Roudebush Veterans Administration Medical Center.

View the Regenstrief Institute Board of Directors.

Mission Statement

Regenstrief Institute, Inc., an internationally recognized informatics and healthcare research organization, is dedicated to the improvement of health through research that enhances the quality and cost-effectiveness of health care.

Overview

A Man with a Vision

The Institute was named for Sam Regenstrief, a visionary authority on industrial production techniques. He manufactured and popularized the low cost home dishwasher, at one time producing 40% of the world's dishwashers. He was a man who appreciated technology and what it could do to increase efficiency. It was his hope that evolving technological innovations could improve the quality and delivery of health care.

To further this goal the Regenstrief Institute has developed the Regenstrief Medical Records System. This innovative system is an electronic medical record that helps physicians manage health care information needed to care for their patients.

The Regenstrief Medical Record System (RMRS)

The Regenstrief Medical Records System (RMRS) is a physician-designed integrated inpatient and outpatient information system which contains 30 years of data. Physicians and other health care providers enter information from physical examination, diagnostic images, clinical laboratory tests, and other patient treatment data at terminals located at the point of care. The RMRS is unique in the standardized manner in which lab results, in addition to medical procedures, prescriptions, discharge summaries and other information, are coded and entered for rapid reference. Unlike paper hospital records which can be misplaced or read by nonauthorized individuals, the RMRS is always available and maintains confidentiality. All access to the record is password controlled and monitored, and transmitted data is encrypted. Regenstrief designed clinical workstations are user friendly and user smart. Physicians write all of their orders and increasingly, their notes at these workstations.

The RMRS has registered over 3 million patients since 1972 and contains more than 25 million prescriptions, 300 million numeric or coded patient observations, 5.5 million dictated reports and 400,000 EKG tracings. It is accessed more than 400,000 times a month. The RMRS is used at more than 40 inpatient and outpatient facilities in Indianapolis and the surrounding counties and is the largest coded, continuously operated medical records system in the country. A commercial version of the system's software is being successfully marketed internationally. Medical facilities, which purchase the software, develop their own patient data bases using the RMRS established parameters.

In the field of health informatics standards, the Regenstrief Institute led in the creation of the first clinical message standards, and is a national leader in the development of coding standards for the laboratory data and clinical observations needed for clinical care and outcomes management.

Medical Care Delivery Studies

Scientists at the Regenstrief Institute for Health Care are also engaged in health services research, studies of physicians' practice patterns, studies related to aging, and studies to identify new biostatistical techniques.

The "laboratory" for many Regenstrief studies is the Primary Care Practice associated with Wishard Health Systems, the public health system serving Marion County, Indiana. This unique "laboratory" and the Regenstrief Medical Record System facilitate many large clinical studies ranging from studies of the success of various smoking cessation interventions to the effect of depression screening and reminders on the treatment of depression.

A recent Regenstrief study on the computerized order entry system showed a 13% reduction in costs and is now incorporated into the workstations at Wishard Hospital.

"This study proved the ability of the RMRS to assist us in delivering high quality, cost effective care. We are proud to be a part of this study and to have the benefits of the RMRS in our hospital and clinics."

-John Williams, M.D., Director of Wishard Memorial Hospital

A wide variety of specialists conduct Regenstrief research studies. Among the specialties represented at Regenstrief are general medicine, endocrinology, geriatrics, medical sociology, pharmacy, medical economics and biostatistics.

Medical Informatics

The Regenstrief Medical Record System (RMRS) has been in development and daily use for over a quarter century and has a tripartite mission of improving patient care, enabling research and fostering teaching.

A significant Regenstrief contribution to health informatics standards is the development of the LOINC terminology, a set of standardized names and codes for tests and clinical measurements. LOINC is distributed freely for public use at http://www.loinc.org. LOINC has been widely adopted by major health delivery systems and large national clinical laboratories for use in electronic medical records and outcomes research.

Health Care Delivery

A major emphasis of research in this field is the gathering of better information about the health care process and its outcomes. Regenstrief research scientists are working to develop improved statistical and epidemiological methods for analysis of complex, retrospective patient data bases. They are also developing new methods for organizing, comparing, and presenting information.

One recent Regenstrief study examined the implications of prompting health care providers regarding the need for advanced directives and their presence in medical decision-making. Another study looked at the effects of depression on health costs and the use of the health care system and concluded that those with symptoms of depression had higher levels of physical illnesses and substantially greater use of health services, than patients without depression.

Research Related to the Elderly

As the population ages, the elderly will have an increased impact on the health care system. Regenstrief research scientists are studying ways of improving the quality of health care for the elderly by improving the ability of patients and health care providers to access and manage medical information. The Regenstrief Institute is the home of the Indiana University Center for Aging Research, directed by Christopher Callahan, M.D. This center was founded by Indiana University and its Council of Health Deans to facilitate collaborative aging research.

Funding

The Regenstrief Institute is a medical research organization funded by the philanthropic Regenstrief Foundation, Inc. Sam Regenstrief, an Indiana industrialist, founded the Regenstrief Foundation to support investigations into health care delivery. Regenstrief Foundation resources have focused on medical informatics, geriatrics, and health services research. Since 1969 it has supported numerous investigators of the Regenstrief Institute for Health Care (now known as Regenstrief Institute, Inc.) Direct annual support from Regenstrief Foundation is $2.7 million, and is complimented by approximately $5 million in annual extramural support.

• Review Regenstrief Policy on Recovery of Space Costs

Regenstrief Fellowship Program

Annually, Regenstrief welcomes four new physicians with interest in health services research and informatics to its externally funded two-year fellowship programs. The Institute augments these grants by providing funds for enrichment of the fellows' experience including travel for research presentations, an MPH program and direct support of research conducted by the fellows. Current fellows have trained in general medicine, and other primary care specialties as well as numerous subspecialty areas. Inquires can be addressed to the Regenstrief fellowship program at .

Collaboration

The administrative offices and many of the research scientists of the Diabetes Research and Training Center (established 1977) and the Center for Aging Research (established 1997) are located in the Regenstrief Institute.

The editorial offices of two prominent journals, Diabetes Care (editor: Charles Clark, M.D.) and Medical Care (editors: William Tierney, M.D. and Morris Weinberger, Ph.D.) are housed at Regenstrief.

Biannual Conferences

Biannually, Regenstrief convenes a conference dedicated to sharing the knowledge among members of the community of scholars.