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

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. Establishing a multidisciplinary initiative for interoperable electronic health record innovations at an academic medical center. JAMIA open. 2021 Jul 1; 4(3):ooab041.

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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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