Quantifying the impact of health IT implementations on clinical workflow: a new methodological perspective

Abstract

Health IT implementations often introduce radical changes to clinical work processes and workflow. Prior research investigating this effect has shown conflicting results. Recent time and motion studies have consistently found that this impact is negligible; whereas qualitative studies have repeatedly revealed negative end-user perceptions suggesting decreased efficiency and disrupted workflow. We speculate that this discrepancy may be due in part to the design of the time and motion studies, which is focused on measuring clinicians' 'time expenditures' among different clinical activities rather than inspecting clinical 'workflow' from the true 'flow of the work' perspective. In this paper, we present a set of new analytical methods consisting of workflow fragmentation assessments, pattern recognition, and data visualization, which are accordingly designed to uncover hidden regularities embedded in the flow of the work. Through an empirical study, we demonstrate the potential value of these new methods in enriching workflow analysis in clinical settings.

Development of a primary care physician task list to evaluate clinic visit workflow: Table 1

“…19e22 Zheng et al developed a task list and performed a time motion study to analyse physician workflow and use of health IT in paediatric intensive care units. 21 Battisto et al used a task list to describe nursing work in the hospital setting to inform the redesign of inpatient rooms and care areas to improve nursing productivity. 19 Our task list, similarly, should be useful in similar ways.…”

Temporal Analysis of Physicians' EHR Workflow during Outpatient Visits

“…Summative usability analysis should take into account the workflow in real clinical settings [1]. Our analysis methods are similar to those developed by Zheng but consider multiple channels [2] of temporal data that, when joined, overlap rather than merely partition the time axis. We exploit this overlap to control potential confounders and biases in profiling EHR workflow.…”

Measuring the Implementation of Behavioral Intervention Technologies: Recharacterization of Established Outcomes (Preprint)

“…Assessing the existing health information technology infrastructure, workflow, and use as well as the potential interoperability of the BIT at a site, are key factors later in the process. [45,46] For instance, Lyon and colleagues (2016) evaluated school-based practitioner workflows and current technology use practices to determine the appropriateness of a digital measurement feedback system prior to its implementation. [36] …”