In previous HealthBlog entries, I've told you about the growing trend of hospitals using commodity software to run the enterprise including electronic medical record systems based on Microsoft standard products. Most of these examples come from outside the United States where perhaps there's more emphasis on spending precious public funds wisely. Most recently I profiled Torrevieja Salud hospital in Spain as an example of this trend. You can read more about what they did by clicking here.
One of my colleagues sent information about a public hospital system in Switzerland that has taken a similar approach to implementing electronic patient records. The hospital system is Solothurner Spitäler AG, a consortium of canton Solothurn's six public hospitals that are located in different locations across the region and are now centrally managed.
The healthcare system had been relying on a rudimentary electronic patient record solution built with Filemaker. It had been developed by the hospital’s own enterprising doctors and programmers. After reaching a size of some 75,000 patient records, the homegrown solution was becoming unstable and programmers realized it wouldn't scale for the future. Working with a local IT consulting company, afca informatik, the hospital system settled on a centralized electronic patient record solution based on XML. It is accessed by web services and uses Microsoft Office InfoPath on the client side. The solution is called INFOPath-DOC.
Speaking about the solution, Dr. Pascal Walliser, CIO for Solothurner Spitäler AG said, “INFOpath-DOC gave us a new foundation for an electronic patient record solution based on Microsoft standard products. It is an effective, reliable tool that supports everyday administrative work in our hospitals. At the same time it has given us a platform to develop innovative solutions that will allow us to go even further in our efforts to deliver consistently patient-oriented medical services.”
As the world embraces open standards and the advantages of XML web services, could such solutions in hospitals and clinics become more common? When one considers the fiscal constraints of our healthcare institutions and their primary mission to deliver the highest quality of care at the lowest possible cost, it seems like a reasonable assumption. Why would you spend hundreds of millions of dollars on an IT system when much lower cost and frankly much more contemporary solutions can be built using commodity components? Food for thought!
Bill Crounse, MD Worldwide Health Director Microsoft Corporation
I know you work for Microsoft and so your blog will likely call out Microsoft solutions to medical/healthcare problems, but I wish perhaps that the healthcare system would have contacted a FileMaker Certified Developer to see what the latest and greatest FileMaker-based solution could have done for them. FileMaker Pro 8.5 used with FileMaker Server Advanced 8.0 provide a highly scaleable LAN and/or Web-based solution that could well have served their needs, be easily developed and maintained and work 100% cross-platform. Plus, the total cost of ownership would be much less than with using Microsoft products.
I surely hope that in fairness you will allow this non-Microsoft (but respectful) counterpoint on your blog.
Thanks for writing, Chris.
I have no problem with leaving your comment on my Blog. I'm far more interested in serving the greater good; encouraging the adoption and use of information technology in healthcare. I suspect the hospital system's decision was based on their need to move well beyond a documentation solution to one that would truly serve their present and future needs as a platform for enterprise search, collaboration, mobility, unified communications, data analysis, and much more. That's the value of the Microsoft Office System.
Bill Crounse, MD Worldwide Health Director Microsoft
Implementing Patient and Provider Registry, Clinical Documentation, Computerized Provider Order Entry, Medication Reconciliation, Interdisciplinary & HandOff communication, Pathology & Lab systems, Emergency Room and Operating Room systems, Continuity of Care record, Clinical Research Management Systems etc with INFOPATH. Now thats impressive!!! But couldnt you do that with Microsoft Access too.
.Net or JAVA is for kids who wanna to do hobby projects? I would just use Microsoft Office System for all my enterprise IT needs!!!
My appologies if this sounds sarcastic. But either you are just plain naive or trying to play down the complexity of a real electronic medical record in a enterprise, regional or national health setting on purpose.
Well, I like to be called naive when we try to make things simple … :-)
As a medical IT provider we know about the complexity of the hospital environment. So our focus is to make things easier for users. Therefore we have a simple frontend approach, mainly based on Microsoft Office and MSIE. In the background we use SQL, IIS, MOSS and Exchange servers ... and of course there is .Net
Filemaker was implemented years ago in a very stupid way. It was like an Access DB witch grew up without any concept. In lack of appropriate knowledge about filemaker, we switched to our “common tools” …
BTW: The “real thing” is not Infopath, but the SOAP approach …
Thanks for all of your comments. I agree with Pascal that the "real thing" is the SOAP approach. I would encourage healthcare solution developers to become familiar with Microsoft's guidance on the "Connected Health Framework".
See the link below for the whitepaper and other resources:
Bill Crounse, MD
my husband and me have written program about electronic patient record
i want to date for demo my program
this program is digital data bank have patient information and you can creat form for medical research .
this program connect to spss software and you can provide article for bisease evaluation
this program connect to digital pen and you can register any information about your pationt
for example (photo film graph,........)
i'm going to come dubai in 6 june if you have time i'm waiting for specify time
rita nourbakhsh(soft ware engineering) aliasghar mehrgan(general patient)
waiting for specify time
My name is Ali, and I represent Microsoft Health in the region.
I got to know from Bill about your EPR, and I would be happy to meet you while you're in Dubai to discuss it further.
Thursday the 7th would be a suitable day to meet; please feel free to email me on firstname.lastname@example.org to set up the meeting.
I am trying to come up with a pediatric health record usning InfoPath and am interested in looking what others may have done. Are there any sites with template parts or other health examples to look at? If there is a working framework I would prefer to use that as a launch point rather than reinventing the wheel.
Thanks for writing. Yes, there are a number of small vendors building EMR solutions that use Office as the foundation and many individual physicians have come up with their own solutions to meet their unique needs. You will find a number of forms available on the Microsoft Office site that can be used in health applications. Follow this link
http://office.microsoft.com/en-us/results.aspx?qu=health+forms or just do a search on the site using the keyword health or helathcare.