Abstract
ObjectiveTo establish an enterprise initiative for improving health and health care through interoperable electronic health record (EHR) innovations.Materials and MethodsWe 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.ResultsUniversity 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.DiscussionKey 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.ConclusionEHR-integrated digital innovation initiatives can be key assets for enhancing the EHR user experience, improving patient care, and reducing provider burnout.
Highlights
Given the information-intensive nature of clinical medicine, it was long hoped that electronic health record (EHR) systems could help optimize health and health care.[1]
While customization and training can improve the EHR user experience,[10,11] physicians spend as much as 2–5 h on the EHR for every hour spent in direct patient care,[12,13] and they can go through 4000 clicks per shift in the emergency department.[14]
Presented as a case study, we describe an enterprise initiative for EHR optimization at an academic health system leveraging SMART on FHIR and related interoperability standards
Summary
Given the information-intensive nature of clinical medicine, it was long hoped that electronic health record (EHR) systems could help optimize health and health care.[1]. Following over $30 billion of government investment,[7] the United States has achieved near-universal EHR adoption.[8] Despite such heavy investments, EHRs have often failed to achieve their promise.[9]. SMART on FHIR innovations can help meet clinician needs inadequately supported by the native EHR. Such needs can include support for high-level clinical reasoning, communicating and coordinating care, and complying with rules and regulations.[24]. These innovations allow for rapid continuous improvement often not possible in the EHR itself. By describing the initiative and lessons learned, we hope to catalyze a more rapid transformation of health care through this promising approach to digital medicine
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
