Incorporating Health Information Technology Into Workflow Redesign

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Summary

Health information technologies (HIT), which provide computerized clinical information to clinicians and/or patients, have been heralded as the saviors of healthcare quality and patient safety. Evaluations of the impact of HIT on quality and safety show mixed results, however. The main reason for those mixed results seems to be a lack of integration of HIT into clinical workflow in a way that supports the workflows among organizations (e.g. between a clinic and community pharmacy), within a clinic and within a visit, as well as the cognitive work of the clinician. HIT must be designed to fit the specific contexts - practice and patient types - if they are to work. Unfortunately, we do not currently have standard descriptions of workflow for care processes that can be used to guide decisions about where and how to integrate HIT.
The purpose of this contract is to develop a toolkit that healthcare organizations and decision makers can use to easily assess their workflows and determine when and how health IT may be used. The contract involves the following activities within ambulatory care settings:

• Assessing existing research and evidence in the area of the impacts of HIT on workflow, its linkage to clinician adoption, and its links to the safety, quality, efficiency, and effectiveness of care delivery,
• Identifying currently available resources for workflow assessment in healthcare as well as proven workflow analysis methods and instruments used in the field of human factors and ergonomics that could be applied in healthcare settings, and
• Synthesizing the information gained into a toolkit that summarizes commonly used methods for workflow assessment, explains the purpose of each method, describes how to implement them and the resources needed to do so, explains the advantages and disadvantages of each approach, cites available resources for more in-depth information on each tool, and provides a decision guide for how and when health IT can be used in practice redesign efforts.

The project led by Pascale Carayon and Bentzi Karsh involves a multidisciplinary team of researchers in human factors and ergonomics, industrial and systems engineering, sociology, psychology, health informatics and medicine.

Funding

Funding for the research project is provided by the Agency for Healthcare Research; contract # HHSA290-2008-10036C.

The research project is conducted by the Center for Quality and Productivity Improvement (CQPI) at the University of Wisconsin–Madison.