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CoxHealth clinicians enhance EHR capabilities, save time with SMART on FHIR

In early 2016, leaders at CoxHealth — based in Springfield, Missouri — looked to address usability concerns with their electronic health record (EHR). They wanted to enhance specialized EHR workflows and improve the point of care for patients, so they turned to SMART on FHIR technology to help address these specialized workflows.

SMART health information technology enables innovators to create applications that seamlessly and securely run across the health care system. The HL7® Fast Health Interoperability Resources (FHIR®) standard comprises modern web-based application program interface technology, making it easier for health care systems to exchange the granular data elements of a patient’s record rather than entire documents.

SMART on FHIR is a contextually aware platform that allows clinicians to enhance capabilities, address usability concerns and access point of care reference material. It is embedded directly within the EHR and can extract information from within the EHR, such as current medical problems, medications and allergies.

Since implementing SMART on FHIR in March 2016, clinicians at the Cerner ITWorks℠ client, which consists of five hospitals and more than 80 clinics, have noticed time savings when it comes to differential diagnosis while using embedded applications like VisualDx, a point of care dermatology reference tool.

“I feel that I save time per patient using SMART on FHIR applications embedded in our EHR,” said Louis Krenn, MD, medical director of ambulatory clinical practice efficiency, CoxHealth. “If I estimate that I save just 10 seconds per patient while using SMART on FHIR apps, times potentially 30 patients a day, then multiply that by the amount of days I see patients in a year, you start to see some serious time savings.”

With a shortage of dermatologists in southwest Missouri, CoxHealth’s primary care providers must offer more dermatological care for their patients. Using SMART on FHIR and VisualDx, clinicians have the tools and resources needed to manage those patients and feel confident in their diagnosis and treatment options.

“With SMART on FHIR applications being contextually aware within Cerner Millennium®, the provider gets to the answer they’re looking for a lot quicker. They don’t have to log into a separate application, making better use of their time and providing them with more time to care for the patient,” said Krenn.

Essentially, the SMART on FHIR platform provides the clinician with the tools to find a diagnosis within seconds of inputting a patient’s symptoms into an embedded application. CoxHealth clinicians can share diagnosis information with the patient at the point of care, allowing clinicians more time to interact with patients.

CoxHealth clinicians quickly adopted the VisualDx application, which was the first to be embedded into the EHR. Since its launch in March 2016, the application routinely averages 200–250 unique providers, for a total of 1,200–1,300 application launches per month. In addition to VisualDx, CoxHealth has deployed three additional SMART on FHIR applications.

“It’s not about just pushing out the newest bells and whistles; it’s really about what can we do to solve the problems our clinicians have,” said Krenn. “Since we enabled SMART on FHIR applications within Cerner Millennium, it has been very well-received by our clinicians.”

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.