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Current State and Future Vision:
Making EHRs Work for You

EHR Optimization to Advance Learning Health Systems

On October 18, 2017 the Association of American Medical Colleges (AAMC) and the Donaghue Foundation hosted the Current State and Future Vision: Making EHRs Work for You summit at the AAMC Learning Center in Washington, DC. The summit brought together approximately 80 participants—among them chief medical officers, chief information officers, chief quality officers and leading researchers from health systems, along with representatives from government agencies, nonprofits, and foundations—to identify opportunities for improving EHR function to support the advancement of learning health systems.

Successful Application of EHR Data

The summit opened with researchers from three different health systems sharing their experience using health informatics to conduct innovative and interdisciplinary studies. Jeffrey A. Gold, MD , highlighted the value of adopting an EHR simulation tool to evaluate and train health care professionals while identifying safety and processing errors in EHR use. Jeffrey T. Kullgren, MD, MS, MPH , presented how analyzing EHR orders can help identify where low-value services are ordered and provide opportunities in facilitating high-value health care decision-making. Simon A. Mahler, MD, MS , introduced an EHR tool, the HEART Pathway, which identifies patients eligible for early discharge. He also described an app that offers a scalable solution and EHR integration.

Next, participants heard from Christopher J. Alban, MD, MBA , who shared Epic’s perspective on the goals of future systems. Vivian Singletary, MBA , provided an overview of Digital Bridge, a partnership among health care and public health organizations that isimplementing electronic case reporting across the country. David C. Grabowski, PhD , then discussed the importance of EHR linkage to post-acute care and long-term care systems. He identified the barriers to achieving interoperability, and discussed policy options moving forward. The agenda  provides more details of the day.

Priority Areas Identified

Summit attendees had the opportunity to discuss and debate what issues related to EHR research and analysis they found most relevant to advancing learning health systems. After working in small-groups, attendees posed questions to an expert panel. The following key themes emerged as areas of focus moving forward as AAMC works with health systems to identify best practices related to EHR implementation and using EHR data for research:

  • Adopting and optimizing clinical decision support systems;
  • Engaging clinician and others in optimization and identifying data needs;
  • Incorporating additional data into EHRs such as social determinants of health and patient-reported data;
  • Transferring knowledge across institutions about effective EHR-tools, resources, governance structures, and data models;
  • Standardizing outcome measures in EHRs to support interoperability.

EHR Optimization Discussion Group

Following the summit, AAMC launched the EHR Optimization Discussion Group, which is composed of leaders from academic health systems, the research community, and EHR vendors, who are dedicated to identifying best practices in EHR implementation and performance improvement. AAMC will lead this group when gathering best practices related to the themes that emerged from the summit, and when developing policy papers and advocating for issues related to EHR optimization within learning health systems.

For more information, please contact Anne Berry, MPP, Lead Specialist, Implementation Research & Policy: aberry@aamc.org.

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