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

2. 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

3. 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

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

5. Workflow Analysis Tools Task Lists Flowcharts Swimlane Diagram / Process Map

6. Process Map Front Office Staff MA Provider Time

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

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

9. 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

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

11. Labs Work blocks

12. Triggers, Conditions, Colors

13. Branching

14. Patient Visit: Bird’s-eye View

15. Labs

16. ROI: Rx Refills

17. ROI: Paperless Savings

18. Highlight EHR Features

19. Workflow Tool Available at http://www.healthinsight.org/hcp/doqit/workflow.html

20. Workflow Tool UI

21. Questions?