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

3. The Spirometer Phone

4. Clinical Integration Model
GVA-AAA
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

5. Asthma Guideline

6. Asthma Pathway

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

8. 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. 

9. Evidence: Implementation Science

10. 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”

11. 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?