The regenstrief medical record system 2000:Expanding the breadth and depth of a community wide EMR.

The Regenstrief Medical Record System (RMRS) continues to grow in breadth and depth. As we expand its breadth -- the system links 5 health care systems, 11 acute care hospitals, 13 homeless care sites, nearly 100 clinics/offices and the county and state health departments -- we have had to overcome critical problems inherent to creating a community wide electronic medical record (EMR). Data for more than 2 million patients consisting of 300 million coded observations, 5.8 million text reports, 300,000 electrocardiogram tracings and 700,000 images. We are now processing almost 8 million observations monthly. In order to accommodate this expansion, significant we have made extended the system architecture over the last several years. These improvements include enhanced message routing, extended message processing, a multiple entity database, a master patient index, master provider index, and methods for displaying and attributing data from multiple entities.