IT Tools: Their Usability and Clinical Effectiveness Len Fromer, M.D., FAAFP

The Spirometer Phone

Clinical Integration Model GVA-AAA123-20090708- Clinical Integration Model Clinical Integration Model Disease-Specific Clinical Protocols Physician Led Team Based Care Clinical Integration Processes Patient/Provider Support Tools Clinical and Cost Metrics How do we address the gap between knowledge and action? Adapted from Winkler, Ambler; Preconference Presentation at the National Medical Home Summit West, PCMH, ACO, and Clinical Integraton, Sept. 20, 2011 SF, CA, Accessed on May 13, 2013. 4 4

Asthma Guideline

Asthma Pathway

This is where the idea for the new technology starts getting a little complicated.

What is Workflow? Workflow is the sequence of physical and mental tasks performed by various people within and between work environments. It can occur at several levels (one person, between people, across organizations) and can occur sequentially or simultaneously. 

Evidence: Implementation Science

Conceptual Frameworks for Better Technology& Workflow Integration Human-Automation Interaction Distributed Cognition (Hutchins) Sociotechnical Systems Theory Systems Engineering Initiative for Patient Safety (SEIPS) (Carayon et al., 2008) Systems Ambiguity Framework (Gurses et al, 2008) Trajectory framework (Corbin and Strauss, 1991) HIT should facilitate communication and coordination among clinicians and families/patients Each team member has different mental models, situational awareness, needs, preferences. (Need for establishing a common ground) HIT must fit with the multiple levels of workflow The fit between HIT and workflow should be measured (multidimensional) Need to manage HIT as both a technology and organizational/social intervention HIT needs/implementations context dependent- need for “flexibility in design and implementation”

Two Key Questions Does this sound like it will improve the clinical care of my patients at a reasonable cost? What would it take for a healthcare professional such as myself to integrate using this tool into my workflow?