Table 3. Summary of findings for each participating organization.
| Motivation to replace HS | Motivation to keep HS | Annual cost to maintain HS | Apps developed/maintained locally | Reason for developing/maintaining local apps | |
|---|---|---|---|---|---|
| Columbia university | Merger of two health systems | Continues to add value, Downtime system | Server cost: $120,000 |
• Results display • CDS applications to augment vendor's solutions |
Vendor solution considered inadequate or unavailable |
| Intermountain healthcare | Failed partnerships, Consolidate multiple systems, Cost to comply with MU | Historical data (read only) | Server cost: 1.6 M Personnel: 4 FTEs |
• Patient portal • Behavioral health application • CDS applications, examples include: □ Clinical protocol for Pulmonary Embolism □ Alerts for readmission risk □ Alerts for sepsis risk □ Alerts for low tidal volume ventilation |
Vendor solution considered inadequate or unavailable |
| Partners healthcare | Consolidate multiple systems, Cost to comply with MU | Historical data (read only) | Not available | • Patient safety dashboards • Patient safety reporting tools • Ordering tools • CDS applications to augment vendor's solutions • Messaging tools • Summarization/visualization tools |
Vendor solution considered inadequate or unavailable Intend to share with others |
| Regenstrief institute | Consolidate multiple systems, Cost to comply with MU | Historical data (read only), HIE | Not available | • Risk score app for social determinants of health | Vendor solution considered inadequate or unavailable |
| UAB | Cost to comply with MU | Continues to add value, Downtime system | Server cost: $21,000 Personnel: 3 FTEs |
• Results display • Workflow management applications • Immunization history • Decision support calculators • Insurer health record viewer • Mobile applications |
Vendor solution considered inadequate or unavailable |
| Vanderbilt university | Inpatient system being sunset, Adopt widely used system, Cost to comply with MU | Historical data (read only), Platform for local apps | Server cost: 1 M | • FHIR-based CDS applications to augment vendor's solutions • Voice-driven clinical Information retrieval system • Mobile applications |
Vendor solution considered inadequate or unavailable Intend to share with others |
Abbreviations: API, application programming interface; app(s), application(s); FHIR, fast healthcare interoperability recourses; EHR, electronic health record; HIE, health information exchange; HS, homegrown system; M, million; MU, meaningful use.