Work flow analysis for effective electronic health record adoption and use Gary Berg, MSHS, Health Care Analyst Health Informatics Brown Bag 9/22/2010

Why Improve Workflow? 83% of office administrators / financial staff responding to a survey indicated that the need to improve workflow was the #1 motivating factor for the adoption of an EHR (M. Amatayakul) Top workflow concerns (Lumetra survey) – 63% Results tracking – 61% Unable to keep up with the schedule – 56% Patient waits – 51% Chart chasing – 49% Refills

How it May be Useful Understanding current process Understanding what will change – In a paper world – paper triggers the staff do something – In an electronic world – staff members manage processes using electronic triggers Create efficiencies in redesign Promote staff involvement

How it May Not be Useful Deciding on EHR Goals Identifying Cultural Issues Addressing One Specific Problem / Task

Workflow Analysis Tools Task Lists Flowcharts Swimlane Diagram / Process Map

Process Map Front Office Staff MA Provider Time

Timing in EHR Implementation EHR Implementation Roadmap – Goal setting – Planning – Selection – Implementation (EHR installed) – Evaluation – Improvement

Workflow Analysis Steps – Consultative Model Prepare Interview staff Map processes Share maps Post-workflow

Clinic Processes Visit SchedulingCheck inMeets with MA Meets with MD Lab f/u Chart completion Referral Prescription written, filled, refilled Incoming phone call May start during visit Check out Billing

The Software One process per map Swim-lane diagram Work blocks Roles Triggers Colors Comments

Labs Work blocks

Triggers, Conditions, Colors

Branching

Patient Visit: Bird’s-eye View

Labs

ROI: Rx Refills

ROI: Paperless Savings

Highlight EHR Features

Workflow Tool Available at

Workflow Tool UI

Questions?