Regenstrief Leads the Charge for Student EMR Training

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The Regenstrief Institute has the longest operating EMR system in the world. The Regenstrief Institute has the longest operating EMR system in the world.

Electronic medical records (EMRs) are now a centerpiece of a doctor’s daily life, yet local health IT leaders say most medical students aren’t receiving formal training on the technology. Additionally, legal red tape—among other issues—prevents students from having any interaction with EMRs. Indiana University School of Medicine (IUSM) Assistant Professor Dr. Blaine Takesue says not training students on a tool they’ll be expected to use every day screamed of irony, so he spearheaded the development of a training system recently launched to give medical students valuable EMR experience.

“All day, we’ll be using EMRs,” says Carole Kounga, a second year IUSM student. “Having this experience of using [EMRs] before going into rotations—it takes away a little of the fear. We know what it looks like and feels like.”

Regenstrief tEMR, short for teaching electronic medical record system, is designed to give IUSM students real-world experience with EMRs. The program was developed by clinicians and informatics experts at IUSM and the Regenstrief Institute in Indianapolis. The organization is an internationally respected informatics and health care research institute known for having the longest operating EMR system in the world.

Containing some 10,000 records of patients, Regenstrief tEMR is the same system used at Eskenazi Health with one key difference: patient identity is “scrubbed” and other identifying information is scrambled. Although anonymized, the use of actual patient data helps students learn how to care for patients with “real-life” problems.

“A textbook will talk about heart failure, but it won’t talk about heart failure and how to treat a patient who can’t afford their medicine,” says Takesue, also a Regenstrief investigator. “Or the patient with diabetes who has problems with transportation and calls the ambulance to go to the Emergency Room, because they don’t have transportation to see their regular doctor. A real EMR includes all those notes, so a student can read about a real-life patient and their struggles interacting with the medical system.”

Learning the system is currently a second-year course at IUSM, but the school plans to back that up to first-year students in 2016. While Kounga is very positive about the system, she believes the earlier students can get their hands on it, the better they can learn how to sift through the wealth of information it provides.

“For instance, if the patient has been in and out of the hospital 10 years, and you want to know something about their diabetes, you may have an overload of information,” says Kounga. “It’s not intimidating using the tEMR, but the amount of information you can retrieve from it can be overwhelming.”

In addition to tEMR alerting users to possible drug interactions or overdue checkups, Kounga says one of her favorite aspects of the system is using it for patient education.

“We might say, ‘We don’t want you to smoke, because it’s affecting your lungs.’ Just saying that might not be very meaningful,” says Kounga. “With the computer in the room, and having films or pictures of your lungs on-screen, we can show you this is what your lungs looked like last year, and the fact that you’ve been smoking, this is what they look like now. It might actually benefit the patient as well.”  

tEMR is currently being used at IUSM’s nine campuses throughout the state via the Internet, and the university says 70 other medical schools across the country are interested in subscribing to the system. An $11 million American Medical Association grant funded tEMR’s development, and supplemental funds will support an expansion, so more schools can use the program.

“If we can get this system at several medical schools, that’s going to increase our impact footprint, so to speak,” says Takesue. “We’re working hard to create a system where other schools can use this. We believe by improving education, we’re going to indirectly improve care—and that’s what Regenstrief is all about.”

Takesue says medical students across the country need more access to EMR training.
Kounga says tEMR is helping teach her how to work within a team of doctors in different specialties.
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