To prep for an influx of COVID-19 patients at the height of the pandemic, researchers at Regenstrief Institute, a collaborative reserch and learning organization in Indiana, developed an emergency EMR — within the span of one week.

The aim was to provide the Indianapolis Emergency Medical Services with a resource that it could use to register patients, collect basic clinical data and transmit interactions to the Indiana Network for Patient Care (INPC), which is managed by the Indiana Health Information Exchange (IHIE), a crucial component in Indiana’s response to the pandemic.

To do this in such a short period of time, the team leveraged OpenMRS, a global open-source platform used to create customized EMRs. "This was more about using existing tools to be able to gather data in a mostly structured format electronically instead of using paper. Our wish list for an EMR for emergency situations would be a more functional EMR (which the global OpenMRS community is working toward). That said, it was a better option than paper," Dr. Burke Mamlin, a project leader and research scientist in Regenstrief's Global Health Informatics program, told HCB News.

The customized EMR was designed to support the creation of a triage center by IEMS to treat patients in case the Indianapolis health system became overwhelmed with COVID-19 patients. With it, gathering and communicating information would be faster and easier and patient records would be accessible to health systems and doctors during future visits.

Among the data it could collect were basic demographics, COVID-19 testing/exposure, smoking status, medical history, symptoms, basic physical exam, diagnoses, and disposition such as discharge or transfer to hospital. It could also discern different types of patients from one another, including healthcare workers, homeless people and nursing home residents.

While the state did not become overwhelmed with COVID-19 cases and the solution did not have to be implemented, its creation makes clear that it is possible to utilize existing resources like OpenMRS to create EMRs for emergency situations on short notice, according to Mamlin, a project leader and member of Regenstrief's Global Health Informatics program. He says the system can be adapted to work in other states or countries very quickly.

The process behind the development was written down in the peer-reviewed paper, OpenMRS as an Emergency EMR — How we Used a Global Good to Create an Emergency EMR in a Week. The paper was published in the International Journal of Medical Informatics online ahead of print.

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