Last month Vanderbilt University Medical Center commemorated the 20th anniversary of StarPanel, the first fully integrated electronic health record (EHR) in use in a major health system and developed independent of a vendor. Created by Dario Giuse, Dr-Ing, MS, associate professor of Biomedical Informatics, StarPanel served as Vanderbilt’s EHR from 2001 until 2017, when the Epic-based eStar system became operational.
StarPanel started as a way to broaden the use of StarChart, an electronic patient record system designed to support the single task of reviewing patient charts. When development of StarPanel began in June 2001 the objective was to create a system capable of supporting multiple tasks while eliminating paper-based systems.
At the time, rooms across the Medical Center were filled with paper patient medical records, and providers relied heavily on their own individual charts, which were not included in a patient’s official medical record.
After StarPanel went live in October 2001, patient data was aggregated from across health care teams. The system brought new functionality to VUMC, including clinical communication, whiteboards that tracked patient results and patient movement, and the ability to communicate with patients via secure messaging.
By July 2003, more than 10,000 users throughout VUMC relied on StarPanel to care for patients.
“I think it’s been a very interesting journey to go from the beginning idea in 2001 to seeing it used in one clinic three months later and in multiple clinics within six months,” said Giuse. Prior to eStar, 320,000 charts were opened in StarPanel on an average weekday. New features were continually added to StarPanel throughout the 2000s, including the addition of My Health at Vanderbilt, which integrated Message Baskets and served as VUMC’s patient portal.
Though StarPanel served VUMC well for more than 16 years, multiple reasons drove the decision to move to a vendor-based EHR. Maintaining the system and upholding regulatory requirements, combined with difficulty in sharing information among other health systems that were not using it, led to Vanderbilt implementing an EHR supporting greater interoperability.
When eStar became operational in the fall of 2017, the new EHR did not mark the end of StarPanel at VUMC. Rather, StarPanel transitioned into a health data repository, which contains legacy data on patients as well as all new data.
Today, clinicians and researchers can use a tool known as StarPanel Viewer to easily access the patient data within the repository. The StarPanel Viewer is embedded within eStar for a one-click access and integration into clinical workflows.
Moreover, eStar contains some of the best functionalities of StarPanel, such as the outpatient whiteboard, and gives providers complete insight into a patient’s history.
Teams at VUMC are still discovering new ways to make use of StarPanel. Most recently, Giuse implemented WordCloud, which uses natural language processing to create a conceptual index of every single document that is in a patient chart. This allows clinicians to see a word-based graphical representation of a patient’s entire history, pulling from such diverse sources as formal lists of diagnoses as well as clinical notes.
“I was aware of the fact that we had millions and millions of documents that could only be read by humans but had no way to access that information via a computer,” said Giuse.
The WordCloud user interface was added in March 2019; data from the WordCloud was used in the Implanted Cardiac Devices best practice advisory just six months later.
Even though StarPanel is no longer used as the EHR for the Medical Center, it continues to serve as a foundation for innovation among IT teams.
Giuse and others are looking at future applications, such as integrating voice-activated commands to search historical patient information. StarPanel leaves a legacy of moving VUMC forward into new digital eras of health care.
View a video of some of the pioneers behind StarPanel speaking on their early experiences.
