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

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


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 languageEnglish (US)
Article numberooab041
JournalJAMIA Open
Issue number3
StatePublished - Jul 1 2021


  • CDS Hooks
  • FHIR
  • clinical decision support
  • electronic health record
  • interoperability standards

ASJC Scopus subject areas

  • Health Informatics


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