Hackensack University Medical Center: Putting an end to the clipboard with FHIR

Jerry Rankin, Industry Strategy Director for Clinical Interoperability Infor
Written by: Jerry Rankin

We’ve all experienced having to fill out pre-visit questionnaires and paper work at every doctor visit – only to have to repeat the same tedious task at a different location or during the next visit. This frustrating and time-consuming process is repeated at various medical centers across the country each day.

On a journey to revolutionize the way in which medical information is shared among healthcare providers, researchers and patients, Hackensack University Medical Center (UMC) leveraged the HL7 FHIR standard to remove clipboards from their waiting rooms. This resulted from a larger initiative made by Hackensack UMC to the White House to “provide individuals with access to their clinical data via open, standardized APIs, enabling connection with applications that allow patients to donate their data to support precision medicine research.”

To honor their pledge, Hackensack established a common Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) standard service layer. With this service, all systems can now interact with and share information among partners and clinical research teams quickly and efficiently. This is in conjunction with increasing the use of mobile applications throughout the facility – giving patients more power over their health information and data.

Paving the way for FHIR enablement

As the first step, Hackensack UMC created an easy-to-use, mobile system for patients to book appointments and provide personal information through one simple health questionnaire – ultimately decreasing wait time and boosting patient satisfaction.

To make this possible, Hackensack joined forces with a technology partner to build out a web service interface layer and streamline the questionnaire itself – customizing questions per patient. This step enables patients to simply confirm their information, and then deliver that information using FHIR and proprietary integration.

A small step with a great impact

In 2015, Hackensack had nearly 450,000 outpatient visits. With the use of both the mobile application and the web services foundation put in place by Hackensack’s technology partner, nearly 65,000 hours were saved in manual data entry through paper-based questionnaires. This innovation led to a reduction, on average, of three minutes in waiting room time, per patient – enabling physicians to see an additional patient per hour.

Brian Benson, manager of enterprise systems, and Modi Boutrs, team leader for enterprise development at Hackensack UMC said about their vision: “We took the pledge from the White House to help gear towards precision medicine and interoperability. We’ve taken a stand with to enable our environment and our EHR to help us meet the HL7®FHIR® standard. Our main goal was to empower the patient so that they can take care of their personal health data. We believe that the HL7® FHIR® will allow us to reach this goal faster than any other technology.” Hackensack has made, and will continue to make, great strides toward achieving their goal to deliver precision medicine.

Driving Innovation with FHIR

Hackensack is leveraging this web service interface layer to provide patients with a mobile scheduling application. With this application, appointments can be scheduled anytime – day or night, giving patients the ability to research doctors and make sure their insurance is accepted. This powerful tool enables patients to make appointments in one minute, 5-10 times faster than the previous phone-based system.

Hackensack’s journey to revolutionize the sharing of healthcare information is off to a strong start. With the help of a trusted technology partner, other healthcare providers can simplify the pre-visit process – ultimately reducing patient wait time, increasing physician-patient face time, and boosting patient satisfaction.

FHIR, Hackensack University Medical Center, Innovation with FHIR


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