Last week the census reached 330 at St. Joseph’s Hospital in Marshfield, WI. It is the second largest hospital in WI. That is amazing given Marshfield has a population of less than 20,000 and it is in the middle of nowhere (sorry Marshfield). There isn’t even a a highway within 30 miles of the city.
But, Marshfield is the home of the Marshfield Clinic, a highly regarded multi-specialty clinic with 750 physicians. If you need tertiary care in Northern Wisconsin you make the track to Marshfield.
Marshfield is also the home of a remarkable healthcare IT story. The Marshfield Clinic has been developing its own clinical IT systems since 1984 (or so). In 1995 they had an electronic medical record that rivals the most advanced systems you would find anywhere today.
Other large clinics have tried to write their own clinical applications. There have been some spectacular failures. John Deere Clinics wrote-off tens of millions of dollars in their attempt. Kaiser Permanente wrote-off hundreds of millions of dollars when they abandoned their internally developed EMR. But somehow the Marshfield clinic has succeeded where others have failed. Carl Christensen is the CIO there. He leads a team of 280 IT professionals.
Candid CIO 
Marshfield Clinic deserves credit for developing an EMR system in house that meets their needs. Since it was developed over, a long period is it able to be packaged up and delivered as a product. On the other hand, is it a mash of legacy and current technology limited in use to only their organization?
The Marshfield Clinic EHR product is not able to be packaged and deliverd. In fact they have weekly updates to the product which are all installed via script created by someone who does not even work for their organization.
While they have a great product (yes I do have first hand use & knowledge of it), it is a mesh of old and new technology dating back to the mid 80’s. They are currently in the process of re-coding many of the old portions of the program that are limiting them, but as anyone who has programmed knows that is a huge undertaking.
It will definately be interesting to see where Ministry/Affinity Health go with their EHR decision. If they do go with the clinic’s EHR they definately have their work cut out for them, both the Marshfield clinic, and Ministry/Affinity.
This description of the the clinic’s system also accurately describes most vendors (a mix of old and new technology). The comment of frequent updates is interesting. I have to think about that a little bit more. I am not sure if it is good or bad.
Whichever direction we head, we have our work cut out for us.
Thanks for posting.
280 IT profssionals on staff? What a huge expense for a hospital with a census of 330? How is this a good thing again?
Actually, the Marshfield Clinic does not own the hospital. My organization does (Ministry Health Care). They own the practices of 750 doctors across Wisconsin. It is a large organization.
from Kaiser (mentioned above: Kaiser Permanente wrote-off hundreds of millions of dollars when they abandoned their internally developed EMR)- just for the record…we’re still using that legacy system even as HealthConnect (EPIC) continues it’s inexorable multi billion dollar march.