Lest anyone forget, there's a huge organization right here in the good old U.S. of A. that has been quite successful with an enterprise-wide EMR implementation for several years: the Department of Veterans Affairs. That EMR, the Veterans Health Information Systems and Technology Architecture--better known as VistA--is the subject of a major feature in the Wall Street Journal, intended as a lesson for the thousands of other hospitals that are moving to digitize their medical records.
VA clinicians can pull up and share patient data from any the 1,400 hospitals and clinics nationwide--and even a few outside the U.S.--as well as monitor patients with chronic diseases from home. The EMR is backed with clinical decision support and CPOE, among other features, allowing the VA to improve quality while holding costs down. Levels of preventive care have soared in the last decade and a half, and medication errors have plummeted since 1999, VA officials report.
VistA isn't for everyone, since the VA is a closed system that employs all of its physicians and nurses. It's also effectively a single-payer organization, with all the pros and cons associated with that model. Of course, some private firms have been successful commercializing VistA and scaling it down for use in a multi-payer environment. And, as a story in E-Health Europe about a VistA implementation in Amman, Jordan, demonstrates, other countries have taken advantage of the open-source software to bring EMRs to their own hospitals.