Literature DB >> 20595314

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

Kai Zheng1, Hilary M Haftel, Ronald B Hirschl, Michael O'Reilly, David A Hanauer.   

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.

Mesh:

Year:  2010        PMID: 20595314      PMCID: PMC2995654          DOI: 10.1136/jamia.2010.004440

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN: 1067-5027            Impact factor:   4.497


  51 in total

1.  Controlled trial of direct physician order entry: effects on physicians' time utilization in ambulatory primary care internal medicine practices.

Authors:  J M Overhage; S Perkins; W M Tierney; C J McDonald
Journal:  J Am Med Inform Assoc       Date:  2001 Jul-Aug       Impact factor: 4.497

2.  Comparison of time spent writing orders on paper with computerized physician order entry.

Authors:  K Shu; D Boyle; C Spurr; J Horsky; H Heiman; P O'Connor; J Lepore; D W Bates
Journal:  Stud Health Technol Inform       Date:  2001

3.  Immediate benefits realized following implementation of physician order entry at an academic medical center.

Authors:  Hagop S Mekhjian; Rajee R Kumar; Lynn Kuehn; Thomas D Bentley; Phyllis Teater; Andrew Thomas; Beth Payne; Asif Ahmad
Journal:  J Am Med Inform Assoc       Date:  2002 Sep-Oct       Impact factor: 4.497

Review 4.  Incorporating ideas from computer-supported cooperative work.

Authors:  Wanda Pratt; Madhu C Reddy; David W McDonald; Peter Tarczy-Hornoch; John H Gennari
Journal:  J Biomed Inform       Date:  2004-04       Impact factor: 6.317

5.  A comparison of self-reported and observational work sampling techniques for measuring time in nursing tasks.

Authors:  Amanda Ampt; Johanna Westbrook; Nerida Creswick; Nadine Mallock
Journal:  J Health Serv Res Policy       Date:  2007-01

6.  Clinical information technologies and inpatient outcomes: a multiple hospital study.

Authors:  Ruben Amarasingham; Laura Plantinga; Marie Diener-West; Darrell J Gaskin; Neil R Powe
Journal:  Arch Intern Med       Date:  2009-01-26

7.  A comparison of work-sampling and time-and-motion techniques for studies in health services research.

Authors:  S A Finkler; J R Knickman; G Hendrickson; M Lipkin; W G Thompson
Journal:  Health Serv Res       Date:  1993-12       Impact factor: 3.402

8.  Medication administration variances before and after implementation of computerized physician order entry in a neonatal intensive care unit.

Authors:  James A Taylor; Lori A Loan; Judy Kamara; Susan Blackburn; Donna Whitney
Journal:  Pediatrics       Date:  2008-01       Impact factor: 7.124

9.  A comparison of handwritten and computer-assisted prescriptions in an intensive care unit.

Authors: 
Journal:  Crit Care       Date:  1998       Impact factor: 9.097

10.  botXminer: mining biomedical literature with a new web-based application.

Authors:  Uma Mudunuri; Robert Stephens; David Bruining; David Liu; Frank J Lebeda
Journal:  Nucleic Acids Res       Date:  2006-07-01       Impact factor: 16.971

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  52 in total

1.  Systematic refinement of a health information technology time and motion workflow instrument for inpatient nursing care using a standardized interface terminology.

Authors:  Yi Zhang; Karen A Monsen; Terrence J Adam; David S Pieczkiewicz; Megan Daman; Genevieve B Melton
Journal:  AMIA Annu Symp Proc       Date:  2011-10-22

2.  The myth of standardized workflow in primary care.

Authors:  G Talley Holman; John W Beasley; Ben-Tzion Karsh; Jamie A Stone; Paul D Smith; Tosha B Wetterneck
Journal:  J Am Med Inform Assoc       Date:  2015-09-02       Impact factor: 4.497

3.  Exploring Dental Providers' Workflow in an Electronic Dental Record Environment.

Authors:  Kelsey M Schwei; Ryan Cooper; Andrea N Mahnke; Zhan Ye; Amit Acharya
Journal:  Appl Clin Inform       Date:  2016-06-15       Impact factor: 2.342

4.  Quantitative ethnographic study of physician workflow and interactions with electronic health record systems.

Authors:  Onur Asan; Erin Chiou; Enid Montague
Journal:  Int J Ind Ergon       Date:  2015-09-01       Impact factor: 2.656

5.  From expert-derived user needs to user-perceived ease of use and usefulness: a two-phase mixed-methods evaluation framework.

Authors:  Mary Regina Boland; Alexander Rusanov; Yat So; Carlos Lopez-Jimenez; Linda Busacca; Richard C Steinman; Suzanne Bakken; J Thomas Bigger; Chunhua Weng
Journal:  J Biomed Inform       Date:  2013-12-12       Impact factor: 6.317

Review 6.  Studying Workflow and Workarounds in Electronic Health Record-Supported Work to Improve Health System Performance.

Authors:  Kai Zheng; Raj M Ratwani; Julia Adler-Milstein
Journal:  Ann Intern Med       Date:  2020-06-02       Impact factor: 25.391

7.  Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

Authors:  Kai Zheng; Michael H Guo; David A Hanauer
Journal:  J Am Med Inform Assoc       Date:  2011-04-27       Impact factor: 4.497

8.  Assessing Unwanted Variations in Rheumatology Clinic Previsit Rooming.

Authors:  Edmond Ramly; Brad Stroik; Diane R Lauver; Heather M Johnson; Patrick McBride; Kristin Steffen Lewicki; Jon Arnason; Christie M Bartels
Journal:  J Clin Rheumatol       Date:  2019-04       Impact factor: 3.517

9.  Impact of electronic health record technology on the work and workflow of physicians in the intensive care unit.

Authors:  Pascale Carayon; Tosha B Wetterneck; Bashar Alyousef; Roger L Brown; Randi S Cartmill; Kerry McGuire; Peter L T Hoonakker; Jason Slagle; Kara S Van Roy; James M Walker; Matthew B Weinger; Anping Xie; Kenneth E Wood
Journal:  Int J Med Inform       Date:  2015-04-15       Impact factor: 4.046

10.  Patient-centered care requires a patient-oriented workflow model.

Authors:  Mustafa Ozkaynak; Patricia Flatley Brennan; David A Hanauer; Sharon Johnson; Jos Aarts; Kai Zheng; Saira N Haque
Journal:  J Am Med Inform Assoc       Date:  2013-03-28       Impact factor: 4.497

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