EHR and the Value of Workflow Analysis

Workflow analysis and redesign is an essential part of EHR planning and implementation. One link to poor adoption and poor satisfaction with EHR may be related to poor planning. Any EHR implementation requires change. Change is stressful and causes resistance. Without effective planning, changes may actually hinder workflow and create ineffective and time-consuming workarounds.

“One important lesson is that the planning stage is as critical as the implementation and launch,” says Frank X. Speidel, MD, Chief Medical Officer for Healthcare IT Leaders. Speidel points out that an effective planning strategy takes time to engage internal team, learn strengths and weaknesses, and develops effective workflow solutions. A thorough workflow analysis can help identify challenges that must be addressed during implementation. As Speidel points out, “Existing workflow patterns may have grown inefficiencies and workarounds.”

Conducting a solid workflow analysis will probably be more effective if you utilized someone from outside the department or facility. Some larger medical facilities have engineers on staff who can help analyze workflow processes and may recommendations for change. Smaller facilities may have to hire a consultant. While you can conduct a workflow analysis by yourself, it will most likely be more thorough and expose possible blindspots if you use someone that is not part of the system.

Documentation is a key step in workflow analysis. Initial steps include,

  1. Collect all paper forms used in practice
  2. Select a workflow guide to facilitate analysis (i.e. one of the three listed above)
  3. Identify major processes to map out (key processes vs. all processes)
  4. Gather information on each process by interviewing people involved in each process
  5. Write detailed descriptions of each process
  6. Create detailed work flow maps (at least for the major processes) [1]

HealthcareIT.gov offers some helpful tools for conducting your own workflow process mapping. This involves identifying processes and stakeholders that must be mapped. “Developing a process map, or a visual depiction of a process, can help clarify workflow, identify bottlenecks and outline dependencies. It also provides a starting point for stakeholders by establishing a common language and set of steps. Maps can be used as a blueprint to discuss changes for the future and to implement new processes.” [2]

[1] “What Physicians Need to Know about Work Flow Analysis Before Selecting and Implementing an Ambulatory EMR.” Digitized Medicine, April 1, 2010 <http://www.digitizedmedicine.com/2010/04/what-physicians-need-to-know-about-work-flow-analysis-before-selecting-and-implementing-an-ambulatory-emr.html>
[2] “What is workflow redesign? Why is it important?” HealthCareIt.gov <http://www.healthit.gov/providers-professionals/faqs/ehr-workflow-redesign>

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