Lessons from Implementing a Combined Workflow-Informatics System for Diabetes Management

Abstract

Shortcomings surrounding the care of patients with diabetes have been attributed largely to a fragmented, disorganized, and duplicative health care system that focuses more on acute conditions and complications than on managing chronic disease. To address these shortcomings, we developed a diabetes registry population management application to change the way our staff manages patients with diabetes. Use of this new application has helped us coordinate the responsibilities for intervening and monitoring patients in the registry among different users. Our experiences using this combined workflow-informatics intervention system suggest that integrating a chronic disease registry into clinical workflow for the treatment of chronic conditions creates a useful and efficient tool for managing disease.

Helping High-Risk Youth Move through High-Risk Periods: Personally Controlled Health Records for Improving Social and Health Care Transitions

“…1,53,59,60 These service factors and approaches have been integrated effectively with adults [61][62][63] and may be especially important for low-socioeconomic-status youth. 64 Bioinformatics tools that engage youth and young adults with their health information and that enable real-time reporting, assessment and layering of applications as part of information management may support comprehensive care and motivate engagement.…”

Non-Visit-Based Cancer Screening Using a Novel Population Management System

“…Redesigning workflow to better involve practice delegates may increase the effect of PCP involvement. 21,40 Third, it is possible that some patients who were not overdue for screening were sent reminders; however, we received no reports of such overtesting. Fourth, although similar percentages of intervention and comparison group PCPs completed surveys, low response rates could have led to biased results if reasons for not responding differed among groups.…”

“…18,19 This model of care emphasizes management outside of office visits and provides a framework to facilitate the efficient allocation of limited clinical resources. 20,21 Advances in IT and new payment models encourage greater population-level oversight for comprehensive cancer screening outside of the office visit, but the best ways to do this remain uncertain. 22 Therefore, we designed a visit-independent population management IT application to support preventive screening for breast, cervical, and colorectal cancer within a primary care practice network.…”

Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation: Table 1

“…9e14 Implementation research in healthcare informatics has produced valuable case studies that present lessons learned, 15 analyses producing classifications of unintended consequences, 16e18 explications of best practices, 19 20 and conceptual models of work, tools, and behavior. 10 21 This study adds to the research on health IT implementation by exploring the mediation of technology adoption and use.…”