{"id":"https://openalex.org/W3026045625","doi":"https://doi.org/10.1055/s-0040-1710310","title":"Twilighted Homegrown Systems: The Experience of Six Traditional Electronic Health Record Developers in the Post\u2013Meaningful Use Era","display_name":"Twilighted Homegrown Systems: The Experience of Six Traditional Electronic Health Record Developers in the Post\u2013Meaningful Use Era","publication_year":2020,"publication_date":"2020-03-01","ids":{"openalex":"https://openalex.org/W3026045625","doi":"https://doi.org/10.1055/s-0040-1710310","mag":"3026045625","pmid":"https://pubmed.ncbi.nlm.nih.gov/32434224"},"language":"en","primary_location":{"id":"doi:10.1055/s-0040-1710310","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0040-1710310","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0040-1710310.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0040-1710310.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5034186950","display_name":"Tiago K. Colicchio","orcid":"https://orcid.org/0000-0003-3405-1538"},"institutions":[{"id":"https://openalex.org/I32389192","display_name":"University of Alabama at Birmingham","ror":"https://ror.org/008s83205","country_code":"US","type":"education","lineage":["https://openalex.org/I32389192"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Tiago K. Colicchio","raw_affiliation_strings":["Informatics Institute, University of Alabama at Birmingham, Birmingham, Alabama, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Informatics Institute, University of Alabama at Birmingham, Birmingham, Alabama, United States","institution_ids":["https://openalex.org/I32389192"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5085160284","display_name":"James J. Cimino","orcid":"https://orcid.org/0000-0003-4101-1622"},"institutions":[{"id":"https://openalex.org/I32389192","display_name":"University of Alabama at Birmingham","ror":"https://ror.org/008s83205","country_code":"US","type":"education","lineage":["https://openalex.org/I32389192"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"James J. Cimino","raw_affiliation_strings":["Informatics Institute, University of Alabama at Birmingham, Birmingham, Alabama, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Informatics Institute, University of Alabama at Birmingham, Birmingham, Alabama, United States","institution_ids":["https://openalex.org/I32389192"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I32389192"],"apc_list":null,"apc_paid":null,"fwci":2.1632,"has_fulltext":true,"cited_by_count":11,"citation_normalized_percentile":{"value":0.90460761,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":95,"max":97},"biblio":{"volume":"11","issue":"02","first_page":"356","last_page":"365"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.8557000160217285,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.8557000160217285,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12790","display_name":"Nursing Diagnosis and Documentation","score":0.018699999898672104,"subfield":{"id":"https://openalex.org/subfields/2910","display_name":"Issues, ethics and legal aspects"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13248","display_name":"Healthcare Technology and Patient Monitoring","score":0.009399999864399433,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/electronic-health-record","display_name":"Electronic health record","score":0.6727840900421143},{"id":"https://openalex.org/keywords/meaningful-use","display_name":"Meaningful use","score":0.6368905305862427},{"id":"https://openalex.org/keywords/health-records","display_name":"Health records","score":0.5657509565353394},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.5587307214736938},{"id":"https://openalex.org/keywords/data-science","display_name":"Data science","score":0.45433691143989563},{"id":"https://openalex.org/keywords/world-wide-web","display_name":"World Wide Web","score":0.4354780614376068},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.25727200508117676},{"id":"https://openalex.org/keywords/political-science","display_name":"Political science","score":0.0994623601436615}],"concepts":[{"id":"https://openalex.org/C3020144179","wikidata":"https://www.wikidata.org/wiki/Q10871684","display_name":"Electronic health record","level":3,"score":0.6727840900421143},{"id":"https://openalex.org/C3019659195","wikidata":"https://www.wikidata.org/wiki/Q5690566","display_name":"Meaningful use","level":3,"score":0.6368905305862427},{"id":"https://openalex.org/C3019952477","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Health records","level":3,"score":0.5657509565353394},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.5587307214736938},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.45433691143989563},{"id":"https://openalex.org/C136764020","wikidata":"https://www.wikidata.org/wiki/Q466","display_name":"World Wide Web","level":1,"score":0.4354780614376068},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.25727200508117676},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.0994623601436615},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D062527","descriptor_name":"Meaningful Use","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D062527","descriptor_name":"Meaningful Use","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D062527","descriptor_name":"Meaningful Use","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1055/s-0040-1710310","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0040-1710310","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0040-1710310.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},{"id":"pmid:32434224","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/32434224","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied clinical informatics","raw_type":null},{"id":"pmh:oai:pubmedcentral.nih.gov:7239668","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/7239668","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Appl Clin Inform","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1055/s-0040-1710310","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0040-1710310","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0040-1710310.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320310431","display_name":"University of Alabama at Birmingham","ror":"https://ror.org/008s83205"},{"id":"https://openalex.org/F4320312852","display_name":"University of Alabama","ror":"https://ror.org/03xrrjk67"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W3026045625.pdf","grobid_xml":"https://content.openalex.org/works/W3026045625.grobid-xml"},"referenced_works_count":58,"referenced_works":["https://openalex.org/W64795801","https://openalex.org/W99733978","https://openalex.org/W131357257","https://openalex.org/W179654700","https://openalex.org/W1155385988","https://openalex.org/W1435719715","https://openalex.org/W1518399097","https://openalex.org/W1569362564","https://openalex.org/W1608737606","https://openalex.org/W1694903022","https://openalex.org/W1849251259","https://openalex.org/W1885791449","https://openalex.org/W1971040337","https://openalex.org/W1979794499","https://openalex.org/W1985103579","https://openalex.org/W2022365852","https://openalex.org/W2023174736","https://openalex.org/W2027851423","https://openalex.org/W2030410501","https://openalex.org/W2042029298","https://openalex.org/W2054831782","https://openalex.org/W2064581852","https://openalex.org/W2076056672","https://openalex.org/W2095818009","https://openalex.org/W2098595796","https://openalex.org/W2100711705","https://openalex.org/W2101692118","https://openalex.org/W2103267969","https://openalex.org/W2104026855","https://openalex.org/W2124899758","https://openalex.org/W2141847884","https://openalex.org/W2150217040","https://openalex.org/W2150290401","https://openalex.org/W2276530525","https://openalex.org/W2288101395","https://openalex.org/W2293363146","https://openalex.org/W2296048788","https://openalex.org/W2337338791","https://openalex.org/W2396703815","https://openalex.org/W2415143626","https://openalex.org/W2431750226","https://openalex.org/W2505807891","https://openalex.org/W2790706219","https://openalex.org/W2794457162","https://openalex.org/W2805116895","https://openalex.org/W2895025094","https://openalex.org/W2906081359","https://openalex.org/W2940854303","https://openalex.org/W2944107102","https://openalex.org/W2959243900","https://openalex.org/W2965564384","https://openalex.org/W2990695504","https://openalex.org/W3141512384","https://openalex.org/W4285719527","https://openalex.org/W6655985216","https://openalex.org/W6658026386","https://openalex.org/W6661130673","https://openalex.org/W6766993462"],"related_works":["https://openalex.org/W3143743825","https://openalex.org/W2289033807","https://openalex.org/W2049073175","https://openalex.org/W2386164369","https://openalex.org/W1641026212","https://openalex.org/W4394958857","https://openalex.org/W176477701","https://openalex.org/W2113832486","https://openalex.org/W2078646730","https://openalex.org/W4385295400"],"abstract_inverted_index":{"OBJECTIVES:":[0],"This":[1],"study":[2],"aimed":[3],"to":[4,24,61,70,93,117,127,180,189,191,223,230,242,249,267],"understand":[5],"if":[6,72],"and":[7,73,81,98,114,130,138,145,160,173,210,213,275,290],"how":[8,74],"homegrown":[9,53,76,154,236],"electronic":[10],"health":[11,43],"record":[12],"(EHR)":[13],"systems":[14,54,178,221,245],"are":[15,278],"used":[16,52,80,90,225],"in":[17,107],"the":[18,25,112,187,231],"post-Meaningful":[19],"Use":[20],"(MU)":[21],"era":[22],"according":[23,229],"experience":[26,232,255],"of":[27,41,85,147,233,256],"six":[28,42,104,234],"traditional":[29,235],"EHR":[30,220,237,291],"developers.":[31,238],"METHODS:":[32],"We":[33,89],"invited":[34],"informatics":[35],"leaders":[36],"from":[37,102,121,247],"a":[38,63,86,162,200],"convenience":[39],"sample":[40,110],"care":[44,159,274],"organizations":[45,105,142,166,185,258],"that":[46,260],"have":[47,263],"recently":[48],"replaced":[49,135],"their":[50,75,136,153,177],"long":[51],"with":[55,66],"commercial":[56,87,201,261],"EHRs.":[57],"Participants":[58,101],"were":[59,139],"asked":[60],"complete":[62],"written":[64],"questionnaire":[65,113],"open-ended":[67],"questions":[68],"designed":[69],"explore":[71],"system(s)":[77],"is":[78],"being":[79],"maintained":[82],"after":[83],"adoption":[84],"EHR.":[88,202],"snowball":[91],"sampling":[92],"identify":[94],"other":[95,119],"potential":[96],"respondents":[97],"institutions.":[99],"RESULTS:":[100],"all":[103,269],"included":[106],"our":[108,128],"initial":[109],"completed":[111],"provided":[115],"referrals":[116],"four":[118],"organizations;":[120],"these,":[122],"two":[123,131],"did":[124],"not":[125,133,264],"respond":[126],"invitations":[129],"had":[132],"yet":[134],"system":[137,155],"excluded.":[140],"Two":[141],"(Columbia":[143],"University":[144,146],"Alabama":[148],"at":[149],"Birmingham)":[150],"still":[151],"use":[152],"for":[156,226,272,281,287],"direct":[157],"patient":[158,273],"as":[161],"downtime":[163],"system.":[164],"Four":[165],"(Intermountain":[167],"Healthcare,":[168,170],"Partners":[169],"Regenstrief":[171],"Institute,":[172],"Vanderbilt":[174],"University)":[175],"kept":[176],"primarily":[179],"access":[181],"historical":[182],"data.":[183],"All":[184],"reported":[186],"need":[188],"continue":[190,222],"develop":[192],"or":[193],"maintain":[194,243],"local":[195,276],"applications":[196,206,277],"despite":[197],"having":[198],"adopted":[199],"The":[203,239,253],"most":[204],"common":[205],"developed":[207,280],"include":[208],"display":[209],"visualization":[211],"tools":[212],"clinical":[214],"decision":[215],"support":[216],"systems.":[217],"CONCLUSION:":[218],"Homegrown":[219],"be":[224],"different":[227],"purposes":[228],"annual":[240],"cost":[241],"these":[244,257],"varies":[246],"$21,000":[248],"over":[250],"1":[251],"million.":[252],"collective":[254],"indicates":[259],"EHRs":[262],"been":[265],"able":[266],"provide":[268],"functionality":[270],"needed":[271],"often":[279],"multiple":[282],"purposes,":[283],"which":[284],"presents":[285],"opportunities":[286],"future":[288],"research":[289],"development.":[292]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":3},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":4}],"updated_date":"2026-06-26T08:34:08.712188","created_date":"2025-10-10T00:00:00"}
