Clinic Workflow Analysis Paper

Workflow is defined as the interacting processes seen in a facility as they provide patient care and its analysis is the recommended starting point for organizations that are considering EHR implementation. This may be a difficulty endeavor since many facilities lack the awareness to conduct workflow documentation and analysis. Several techniques for workflow analysis have been suggested: formation of a multi-disciplinary team; review of the process analysis by the staff performing the work; analysis to be conducted by the clinic staff, and not the vendor; and lastly, assigning a team leader to the workflow analysis project. [1] Benefits can be obtained when workflows are analyzed: a detailed understanding of the interacting clinic processes

wherein the workflow in fifteen ambulatory clinics providing chronic disease care was evaluated. 157 patient-provider encounters were reviewed, with the focus on the interactions among people, processes and technology. Over a 10-month period, direct observation, semi-structures interviews, analysis of artifacts and development of workflow models were done. Each clinic’s ability to meet study goals using Strengths, Weakness, Opportunities and Threats (SWOT) was also analyzed. With each clinic dealing with a different chronic disease, differences such as visit structure, type of information transferred and allocation of physical space differed. The study concluded that the primary care orientation of existing EHRs was not meeting the needs for most chronic care clinics, thus the following recommendations were given: supplementing the core HIT functionality with disease-specific modules, development of specialized templates such as self-reports or nutritional templates, user-responsive HIT development, better input modalities such as speech recognition software, unified data entry to minimize data coming from multiple sources and formats, and better EHR training of the end users. The study presented several limitations: the ambulatory clinics used the same EHR, thus the workflow might be affected again should a different EHR be used and the chronic disease clinics were disease-specific clinics, excluding the primary care

Health care facilities are complex creatures – numerous players, varying protocols, different diseases. This was addressed by Ramaiah et. al. when evaluating small clinic practices, which was misleadingly complicated. The analysis of the workflow for chronic disease clinics presented its own difficulties since these diseases may almost need an entirely different EHR approach when compared with primary care diseases or preventive care. The weaknesses of the studies were based on the observation technique that most of them used, leading to possible observer bias or the Hawthorne effect, as noted in the Australian ED study by Walter, et.al. Their strengths were on the intensive number of hours dedicated to the observations and the temporal factors that they considered in their data analysis. The most important strengths of the studies were the recommendations that they made, many of which were practical and detailed for health facilities that are considering EHR adoption or