Getting clinicians and other end users involved in the selection, implementation and training of an EMR is a key component to successful provider adoption, but Oroville Hospital in northern California has taken clinician participation to a new level.
Oroville Hospital decided to download the software developed by the Veterans Affairs for its VistA EMR. The hospital chose the open-source software because it wanted to own its EMR. It didn’t want consultants or health IT vendor to control the code, leaving it at the mercy of others if it wanted to change or further customize its EMR. Clinicians worked with its IT staff to align the capabilities of the EMR system with their workflow.
Oroville Hospital’s CIO pointed out that many of the physicians and nurses graduating from medical and nursing schools have served their residencies at VA hospitals, which use the VistA EMR. So they already have knowledge of and more importantly hands-on experience with the software, which gives the hospital a terrific advantage in that the learning curve is not steep.
Going down this road probably saved the hospital a lot of money doing the development and implementation itself. It helps that it has a good working relationship with its IT staff. Actually, Oroville Hospital is lucky it has an IT staff, whereas other smaller hospitals may not have the resources and opportunity to be so independent. Another benefit is that in the long term the hospital will save even more money by upgrading the system itself, rather than pay consultants or vendor.
How will the EMR stack up in terms of certification and meaningful use? Hard to say at this point, with changes occurring as we speak with certification bodies and processes. HHS and ONC will need to figure out how to classify and treat customized EMRs, given that open source is becoming a viable alternative to licensed software products.
It will be interesting to see how Oroville Hospital fares as time goes on, and even more interesting if they are the trailblazers of a new trend.


