Multi-Method Study of Electronic Health Records Workflows

EHRs transform work practices in ways that enhance or impede the quality of care. There is a need for in-depth analysis of EHR workflows, particularly in complex clinical environments. We investigated EHR-basedpre-operative workflows by combining findings from 18 interviews, 7 days of observations,...

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Bibliographic Details
Published in:AMIA ... Annual Symposium proceedings 2018, Vol.2018, p.498-507
Main Authors: Grando, Adela, Manataki, Areti, Furniss, Stephanie K, Duncan, Benjamin, Solomon, Andrew, Kaufman, David, Hirn, Sarah, Sunday, Robert, Bouchereau, Joanne, Doebbeling, Brad, Burton, Matthew M, Poterack, Karl A, Miksch, Tim, Helmers, Richard A
Format: Article
Language:English
Subjects:
Electronic Health Records - organization & administration
Humans
Interviews as Topic
Patient Care Team - organization & administration
Social Networking
Surgery Department, Hospital - organization & administration
Task Performance and Analysis
Workflow
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Summary:EHRs transform work practices in ways that enhance or impede the quality of care. There is a need for in-depth analysis of EHR workflows, particularly in complex clinical environments. We investigated EHR-basedpre-operative workflows by combining findings from 18 interviews, 7 days of observations, and process mining of EHR interactions from 31 personnel caring for 375 patients at one tertiary referral center. We provided high-definition descriptions of workflows and personnel roles. One third (32.2%) of the time with each patient was spent interacting with the EHR and 4.2% using paper-based artifacts. We also mined personnel social networks validating observed personnel's EHR-interactions. When comparing workflows between two similar pre-operative settings at different hospitals, we found significant differences in physical organization, patient workflow, roles, use of EHR, social networks and time efficiency. This study informs Mayo Clinic's enterprise-wide conversion to a single EHR and will guide before and after workflow comparisons.
ISSN:1942-597X
1559-4076