Leading the Charge

Frustrations with automated processes in electronic health record (EHR) systems are one of many challenges faced in health care today—making them contributing factors to patients not receiving the care they should and clinicians inching toward burnout.

“Providers are frustrated. Patients are frustrated,” said Kensaku Kawamoto, MD, PhD, MHS, associate chief medical information officer at University of Utah Health and professor and vice chair for clinical informatics in the Department of Biomedical Informatics at the Spencer Fox Eccles School of Medicine. “This was our motivation for ReImagine EHR.”

Founded in 2016, ReImagine EHR addresses the need for more efficient health care systems that are easier for clinicians to use while leveraging technology to improve patient care. According to Guilherme Del Fiol, MD, PhD ’08, professor and vice chair for research in the Department of Biomedical Informatics, while clinician burnout was increasing, patient portals were becoming widely accessible, presenting an opportunity to ease clinician workloads.

Integrating emerging tools, ReImagine EHR is re-shaping how health care is delivered to better meet today’s demands. These digital innovations stream-line care coordination, reduce clinician workloads, and ultimately enhance patient outcomes.

Here’s a look at some of the tools already making an impact on patient care.

Neonatal Bilirubin App

The Neonatal Bilirubin app, an electronic health record add-on, helps clinicians efficiently assess and manage newborns at risk of high bilirubin levels by automatically retrieving and organizing key data like lab test results and risk indicators. And it reduces the time spent managing cases by three-fold, while increasing the use of clinically appropriate phototherapy—the treatment—by 84%. If left untreated, high bilirubin levels can lead to permanent brain damage.

The bilirubin app’s user-centered design, which was developed with extensive input from clinicians, and its seamless integration into existing systems have contributed to its high usability. “It’s been used over 60,000 times in the past year,” Kawamoto said, with plans to expand its use to other health systems.

GARDE

GARDE identifies individuals at risk for early-onset familial cancers and offers personalized genetic screening services. Deployed at University of Utah Health and NYU Langone Health, the tool has two main com-ponents: one operating silently in the background, with algorithms identifying patients who qualify for and benefit from genetic testing, and the other—a chatbot—reaching out to prospective patients offering pre-test education and access to testing.

“The GARDE algorithms have helped identify 5% of U of U Health and NYU Langone’s adult patients, respectively, who are at risk for familial cancers and could benefit from genetic testing,” Del Fiol said.

The program has completed a successful clinical trial, which was led by University of Utah faculty Kim Kaphingst, ScD.

Decision Precision+

Decision Precision+ is a shared decision-making tool designed to increase lung cancer screening in busy clinical settings. After implementation at U of U Health, primary-care lung cancer screening in-creased over threefold. This innovation has received praise for its ability to streamline the process, integrate risk assessments into the EHR, and provide clinicians with quick, personalized patient data in one to two minutes. The tool uses data including demographics, smoking history, family history of lung cancer, and various medical conditions.

MDCalc for EHR

MDCalc is one of the three most broadly used medical references—and the top medical calculator—in the United States. About two-thirds of physicians rely on it to streamline patient care. Integrated with EHR systems, MDCalc for EHR helps clinicians pull relevant patient data directly from their records, greatly reducing the need for manual data entry. MDCalc for EHR auto-populates or suggests inputs, allowing physicians to utilize complete patient information—and as a study led by U of U Health cardiologists showed, the tool can also improve data accuracy.