October 26, 2023

Regenstrief, VA researchers co-edit journal special supplement addressing far-reaching impact of EHR transitions

David Haggstrom and Mike Weiner

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.

The special supplement is available here.

About David A. Haggstrom, M.D., MAS 
As the director of the William M. Tierney Center for Health Services Research, David A. Haggstrom, M.D., MAS, is the Sam Regenstrief Investigator in Health Services Research at Indiana University School of Medicine, where he is also an associate professor of medicine. In addition, he is a core investigator for the U.S. Department of Veterans Affairs Health Services Research and Development Center for Health Information and Communication at Richard L. Roudebush VA Medical Center and a researcher with the Indiana University Melvin and Bren Simon Comprehensive Cancer Center.

About Michael Weiner, M.D., MPH 
In addition to his role as a research scientist with the William M. Tierney Center for Health Services Research at Regenstrief Institute, Michael Weiner, M.D., MPH, is an investigator at the VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, and a professor of medicine at Indiana University School of Medicine.

About Regenstrief Institute
Founded in 1969 in Indianapolis, the Regenstrief Institute is a local, national and global leader dedicated to a world where better information empowers people to end disease and realize true health. A key research partner to Indiana University, Regenstrief and its research scientists are responsible for a growing number of major healthcare innovations and studies. Examples range from the development of global health information technology standards that enable the use and interoperability of electronic health records to improving patient-physician communications, to creating models of care that inform clinical practice and improve the lives of patients around the globe.

Sam Regenstrief, a nationally successful entrepreneur from Connersville, Indiana, founded the institute with the goal of making healthcare more efficient and accessible for everyone. His vision continues to guide the institute’s research mission.

About Veteran Health Indiana and CHIC
The Richard L. Roudebush VA Medical Center is the flagship medical center for Veteran Health Indiana, the VA’s healthcare system in central and southern Indiana. The medical center is located in downtown Indianapolis and is collocated with three large community hospitals and the campus of the Indiana University Schools of Medicine and Nursing. The health system has been serving Hoosier Veterans since 1932. As Indiana’s Level 1a, tertiary care Veteran facility, the medical center serves as home base for a system of inpatient and outpatient care locations serving more than 62,000 Veterans.

The VA Health Services Research and Development (HSR&D) Center for Health Information and Communication (CHIC) group is a diverse cadre of researchers based at Roudebush VA Medical Center who work together to transform the healthcare system, both within and outside the VA so every patient receives consistent, high-quality care.

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