Multi-Method Study of Electronic Health Records Workflows

AMIA Annu Symp Proc. 2018 Dec 5:2018:498-507. eCollection 2018.

Abstract

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.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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*