The final report for the 1115 Waiver extension year is to update the three disparities identified in the past five years, report the new activities accomplished in the last year (10/01/2016~09/30/2017), and summarize the lessons learned from this project. The report focuses on how a project is carried out to make positive impacts on the health system (i.e. building electronic health records) which allows for academic research, clinical decision making, and institutional strategic planning.