Kawamoto Kensaku, Kukhareva Polina V, Weir Charlene, Flynn Michael C, Nanjo Claude J, Martin Douglas K, Warner Phillip B, Shields David E, Rodriguez-Loya Salvador, Bradshaw Richard L, Cornia Ryan C, Reese Thomas J, Kramer Heidi S, Taft Teresa, Curran Rebecca L, Morgan Keaton L, Borbolla Damian, Hightower Maia, Turnbull William J, Strong Michael B, Chapman Wendy W, Gregory Travis, Stipelman Carole H, Shakib Julie H, Hess Rachel, Boltax Jonathan P, Habboushe Joseph P, Sakaguchi Farrant, Turner Kyle M, Narus Scott P, Tarumi Shinji, Takeuchi Wataru, Ban Hideyuki, Wetter David W, Lam Cho, Caverly Tanner J, Fagerlin Angela, Norlin Chuck, Malone Daniel C, Kaphingst Kimberly A, Kohlmann Wendy K, Brooke Benjamin S, Del Fiol Guilherme
Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
University of Utah Health, Salt Lake City, Utah, USA.
JAMIA Open. 2021 Jul 31;4(3):ooab041. doi: 10.1093/jamiaopen/ooab041. eCollection 2021 Jul.
To establish an enterprise initiative for improving health and health care through interoperable electronic health record (EHR) innovations.
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.
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.
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.
EHR-integrated digital innovation initiatives can be key assets for enhancing the EHR user experience, improving patient care, and reducing provider burnout.
通过可互操作的电子健康记录（EHR）创新建立一项企业倡议，以改善健康和医疗保健。
我们制定了统一的使命和愿景，建立了多学科治理，并制定了战略计划。我们战略的关键要素包括组建一支世界级团队；创建共享基础设施以支持个体创新；开发并实施具有高预期影响力且有明确采用路径的创新；纳入诸如使用快速医疗保健互操作性资源（FHIR）及相关互操作性标准等最佳实践；以及在研究与运营之间以及与合作伙伴组织之间实现协同效应最大化。
犹他大学健康系统于2016年启动了“重新构想EHR”倡议。该倡议所开发的支持性基础设施包括各种与FHIR相关的工具和一个系统评估框架。已实施了10多项集成EHR的数字创新，以支持预防保健、共同决策、慢性病管理和急性临床护理。对这些创新的初步评估已证明其对用户满意度、提供者效率以及遵循循证指南方面产生了积极影响。投资回报包括护理改善；超过3500万美元的外部资助资金；商业机会；以及增强适应不断变化的医疗保健格局的能力。
汲取的关键经验教训包括投资利用FHIR的数字创新倡议的价值；支持性基础设施对加速创新的重要性；以及以用户为中心的设计、实施科学和评估的关键作用。
集成EHR的数字创新倡议可以成为增强EHR用户体验、改善患者护理以及减轻提供者倦怠的关键资产。
