What Happens to Health IT When Necessity Is the Mother of Invention?

After two weeks on the road in Sweden and Norway, I’m back in my Microsoft Redmond office this week looking forward to at least a month without any business travel. I’m sure my wife is thrilled.

Whenever I travel outside the US, I’m frequently amazed by the Health IT innovation I see. I often come across EMR/EHR/HIS/HIE solutions that to me seem much better and often more intuitive to use than the bloated, aging, complicated and very expensive solutions so common among US healthcare organizations. The most surprising advances are often found in some of the least expected places. Perhaps this is because when people are challenged by difficult, constrained economic conditions they tend to develop what I call more “right-sized” solutions that better meet the unique requirements of the environment where they are needed.

One of those places is Portugal. Back in 2007, I came across a hospital information system solution at Hospital de São Sebastião, a public hospital about 30 miles outside of Porto, Portugal. Doctors and nurses seemingly adored using it. Out of need, it had been developed entirely by hospital IT staff using readily available software from Microsoft and other vendors. I watched doctors move from patient to patient doing all of their charting with mobile, slate tablet PCs. Keep in mind this was a half dozen years ago. The solution was well ahead of its time.

Spain is another country where I have followed the development of some truly amazing solutions over the years. Just today my Microsoft colleagues in Spain sent out an update on some of the latest advances there.

One of those is a solution called Casiopea 2.0 being used at IDC Salud, formerly known as Capio Sanidad. IDC Salud has become one of the largest healthcare institutions in Spain. The private hospital group comprised of 7,563 employees and1,856 beds operates in 30 centers in 8 different cities across the country. Within a timeframe of just three years, IDC Salud developed an important new EHR project to transform healthcare delivery by fully integrating patient data across multiple points of care. With Casiopea 2.0 patients themselves are able to input and manage some of their health record. The solution provides a fully integrated planning and scheduling process across the continuum of care, increasing productivity and streamlining processes. It is built on Microsoft .NET and SQL Server 2012 and will be gradually rolled out across all of IDC Salud’s facilities where patients, clinicians and staff will have a fully integrated system available 24 hours a day, 7 days a week.

Another electronic health record solution based on Microsoft technology that is making strides in Spain is called GreenCube. GreenCube was created byTichconsulting, an electronic health record vendor founded only three years ago by the former CEO ofTorrevieja Hospital. The solution was developed inC# and relies on SQL Server 2012. Designed very much with the Cloud in mind, it makes intensive use of a web services environment. This ensures interoperability and integration with other departmental clinic solutions using standards such as HL7, IHE, DICOM, LOINC, and SNOMED among others. GreenCube is being rapidly adopted in the 14 hospitals operated by ASISA, an prominent Spanish health payer organization.

It seems that when necessity becomes the mother of invention, great things tend to happen. It is a lesson plan that developers of IT solutions for US hospitals and clinics might be wise to follow.