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

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

doi:10.1093/jamiaopen/ooab041

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

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

Pharmacy Practice and Science

Research output: Contribution to journal › Article › peer-review

32 Scopus citations

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.

Original language	English (US)
Article number	ooab041
Journal	JAMIA Open
Volume	4
Issue number	3
DOIs	https://doi.org/10.1093/jamiaopen/ooab041
State	Published - Jul 1 2021

Keywords

CDS Hooks
FHIR
SMART on FHIR
clinical decision support
electronic health record
interoperability standards

ASJC Scopus subject areas

Health Informatics

Access to Document

10.1093/jamiaopen/ooab041

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Kawamoto, K., Kukhareva, P. V., Weir, C., Flynn, M. C., Nanjo, C. J., Martin, D. K., Warner, P. B., Shields, D. E., Rodriguez-Loya, S., Bradshaw, R. L., Cornia, R. C., Reese, T. J., Kramer, H. S., Taft, T., Curran, R. L., Morgan, K. L., Borbolla, D., Hightower, M., Turnbull, W. J., ... Del Fiol, G. (2021). Establishing a multidisciplinary initiative for interoperable electronic health record innovations at an academic medical center. JAMIA Open, 4(3), Article ooab041. https://doi.org/10.1093/jamiaopen/ooab041

Kawamoto, K, Kukhareva, PV, Weir, C, Flynn, MC, Nanjo, CJ, Martin, DK, Warner, PB, Shields, DE, Rodriguez-Loya, S, Bradshaw, RL, Cornia, RC, Reese, TJ, Kramer, HS, Taft, T, Curran, RL, Morgan, KL, Borbolla, D, Hightower, M, Turnbull, WJ, Strong, MB, Chapman, WW, Gregory, T, Stipelman, CH, Shakib, JH, Hess, R, Boltax, JP, Habboushe, JP, Sakaguchi, F, Turner, KM, Narus, SP, Tarumi, S, Takeuchi, W, Ban, H, Wetter, DW, Lam, C, Caverly, TJ, Fagerlin, A, Norlin, C, Malone, DC, Kaphingst, KA, Kohlmann, WK, Brooke, BS & Del Fiol, G 2021, 'Establishing a multidisciplinary initiative for interoperable electronic health record innovations at an academic medical center', JAMIA Open, vol. 4, no. 3, ooab041. https://doi.org/10.1093/jamiaopen/ooab041

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title = "Establishing a multidisciplinary initiative for interoperable electronic health record innovations at an academic medical center",

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",

author = "Kensaku Kawamoto and Kukhareva, {Polina V.} and Charlene Weir and Flynn, {Michael C.} and Nanjo, {Claude J.} and Martin, {Douglas K.} and Warner, {Phillip B.} and Shields, {David E.} and Salvador Rodriguez-Loya and Bradshaw, {Richard L.} and Cornia, {Ryan C.} and Reese, {Thomas J.} and Kramer, {Heidi S.} and Teresa Taft and Curran, {Rebecca L.} and Morgan, {Keaton L.} and Damian Borbolla and Maia Hightower and Turnbull, {William J.} and Strong, {Michael B.} and Chapman, {Wendy W.} and Travis Gregory and Stipelman, {Carole H.} and Shakib, {Julie H.} and Rachel Hess and Boltax, {Jonathan P.} and Habboushe, {Joseph P.} and Farrant Sakaguchi and Turner, {Kyle M.} and Narus, {Scott P.} and Shinji Tarumi and Wataru Takeuchi and Hideyuki Ban and Wetter, {David W.} and Cho Lam and Caverly, {Tanner J.} and Angela Fagerlin and Chuck Norlin and Malone, {Daniel C.} and Kaphingst, {Kimberly A.} and Kohlmann, {Wendy K.} and Brooke, {Benjamin S.} and {Del Fiol}, Guilherme",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association.",

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doi = "10.1093/jamiaopen/ooab041",

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AU - Kawamoto, Kensaku

AU - Kukhareva, Polina V.

AU - Weir, Charlene

AU - Flynn, Michael C.

AU - Nanjo, Claude J.

AU - Martin, Douglas K.

AU - Warner, Phillip B.

AU - Shields, David E.

AU - Rodriguez-Loya, Salvador

AU - Bradshaw, Richard L.

AU - Cornia, Ryan C.

AU - Reese, Thomas J.

AU - Kramer, Heidi S.

AU - Taft, Teresa

AU - Curran, Rebecca L.

AU - Morgan, Keaton L.

AU - Borbolla, Damian

AU - Hightower, Maia

AU - Turnbull, William J.

AU - Strong, Michael B.

AU - Chapman, Wendy W.

AU - Gregory, Travis

AU - Stipelman, Carole H.

AU - Shakib, Julie H.

AU - Hess, Rachel

AU - Boltax, Jonathan P.

AU - Habboushe, Joseph P.

AU - Sakaguchi, Farrant

AU - Turner, Kyle M.

AU - Narus, Scott P.

AU - Tarumi, Shinji

AU - Takeuchi, Wataru

AU - Ban, Hideyuki

AU - Wetter, David W.

AU - Lam, Cho

AU - Caverly, Tanner J.

AU - Fagerlin, Angela

AU - Norlin, Chuck

AU - Malone, Daniel C.

AU - Kaphingst, Kimberly A.

AU - Kohlmann, Wendy K.

AU - Brooke, Benjamin S.

AU - Del Fiol, Guilherme

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AB - 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.

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KW - SMART on FHIR

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

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Keywords

ASJC Scopus subject areas

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