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. 2021 Jul 31;4(3):ooab041.
doi: 10.1093/jamiaopen/ooab041. eCollection 2021 Jul.

Establishing a multidisciplinary initiative for interoperable electronic health record innovations at an academic medical center

Kensaku Kawamoto  1   2 , Polina V Kukhareva  1   2 , Charlene Weir  1 , Michael C Flynn  2   3   4 , Claude J Nanjo  1   2 , Douglas K Martin  1   2 , Phillip B Warner  1   2 , David E Shields  1   2 , Salvador Rodriguez-Loya  1   2 , Richard L Bradshaw  1   2 , Ryan C Cornia  1   2 , Thomas J Reese  1 , Heidi S Kramer  1 , Teresa Taft  1 , Rebecca L Curran  1   5 , Keaton L Morgan  1   2   6 , Damian Borbolla  1 , Maia Hightower  2   4 , William J Turnbull  2 , Michael B Strong  2   4 , Wendy W Chapman  1 , Travis Gregory  2 , Carole H Stipelman  2   7 , Julie H Shakib  2   7 , Rachel Hess  2   4   8 , Jonathan P Boltax  9 , Joseph P Habboushe  10   11 , Farrant Sakaguchi  2   3   5 , Kyle M Turner  2   3   12 , Scott P Narus  1   13 , Shinji Tarumi  14 , Wataru Takeuchi  14 , Hideyuki Ban  14 , David W Wetter  8   15 , Cho Lam  8   15 , Tanner J Caverly  16   17 , Angela Fagerlin  8   18 , Chuck Norlin  2   7 , Daniel C Malone  12 , Kimberly A Kaphingst  15   19 , Wendy K Kohlmann  2   15 , Benjamin S Brooke  1   6 , Guilherme Del Fiol  1
Affiliations

Establishing a multidisciplinary initiative for interoperable electronic health record innovations at an academic medical center

Kensaku Kawamoto et al. JAMIA Open. .

Abstract

Objective: To establish an enterprise initiative for improving health and health care through interoperable electronic health record (EHR) innovations.

Materials and methods: We developed a unifying mission and vision, established multidisciplinary governance, and formulated a strategic plan. Key elements of our strategy include establishing a world-class team; creating shared infrastructure to support individual innovations; developing and implementing innovations with high anticipated impact and a clear path to adoption; incorporating best practices such as the use of Fast Healthcare Interoperability Resources (FHIR) and related interoperability standards; and maximizing synergies across research and operations and with partner organizations.

Results: University of Utah Health launched the ReImagine EHR initiative in 2016. Supportive infrastructure developed by the initiative include various FHIR-related tooling and a systematic evaluation framework. More than 10 EHR-integrated digital innovations have been implemented to support preventive care, shared decision-making, chronic disease management, and acute clinical care. Initial evaluations of these innovations have demonstrated positive impact on user satisfaction, provider efficiency, and compliance with evidence-based guidelines. Return on investment has included improvements in care; over $35 million in external grant funding; commercial opportunities; and increased ability to adapt to a changing healthcare landscape.

Discussion: Key lessons learned include the value of investing in digital innovation initiatives leveraging FHIR; the importance of supportive infrastructure for accelerating innovation; and the critical role of user-centered design, implementation science, and evaluation.

Conclusion: EHR-integrated digital innovation initiatives can be key assets for enhancing the EHR user experience, improving patient care, and reducing provider burnout.

Keywords: CDS Hooks; FHIR; SMART on FHIR; clinical decision support; electronic health record; interoperability standards.

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Figures

Figure 1.
Figure 1.
Architectural overview.
Figure 2.
Figure 2.
Bilirubin app.
Figure 3.
Figure 3.
MDCalc connect.
Figure 4.
Figure 4.
AI-facilitated diabetes decision support system.
Figure 5.
Figure 5.
Lung cancer screening shared decision-making app.
Figure 6.
Figure 6.
Disease manager.
See this image and copyright information in PMC

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