EMR Experiment

Capital Region Health Care was an innovator when it installed an ambulatory electronic medical system for its physicians in the mid-1990s. As a clinical documentation tool, the EMR worked well, but it had one major limitation for the Concord, N.H.-based health system: Exchanging information electronically in a secure fashion was cumbersome. Because secure messaging technology was in its infancy, Capital’s physicians would print and mail referral information to dispatch to other specialists.

So when Portland, Ore.-based Kryptiq Corp. in 2003 asked the health system, which includes Concord Hospital, to serve as a development site for its secure messaging software, Chief Information Officer Deane Morrison jumped at the chance. Kryptiq’s chief financial officer had worked for Capital Region’s EMR vendor, and Kryptiq wanted to build a secure messaging application into the EMR. In exchange for slightly more than $100,000 for licensing rights and software, Capital Region would serve as a guinea pig.

Morrison’s vision of an easy-to-use messaging system proved elusive. Early versions were unwieldy, requiring physicians to cut and paste documents, then create PDFs that were posted to a secure site. In turn, the recipient would be notified and sent a link to the site. It was a multistep process that turned physicians off, Morrison recalls.

But Capital Health Care stayed with Kryptiq for the next 2 1/2 years, and the third version of the software, released in March 2006, finally hit the mark, Morrison says. Now, physicians can point and click to any information they want to send, then pick the recipient physician’s name from a drop-down menu. The software does the rest, assembling the package, posting it to a secure Web site, then notifying the recipient. If the information is sent to one of the 125 Capital physicians using the GE software, it goes directly into their computer, generating a to-do notification.

About one-third of Capital’s physicians use the messaging application, Morrison estimates. He figures that if half the physicians use the tool, the health system will break even compared to the cost of mailing the information.

Morrison cautions other CIOs to take a balanced view of beta project participation. “If you want to be first, you need a compelling reason,” he says. “In our case, we knew the limits of the EMR and what needed to be fixed. But if somebody wanted us to beta (test) a $3 million hospital information system, it would be a difficult conversation.”

—Gary Baldwin