Analyzing Workflow for a Health IT Implementation by Lydia Washington, is a short shifted scenario published January 1, 2008 The inability to integrate electronic health records (EHRs) into clinician workflow is a well-documented barrier to implementing EHR systems. To address this problem, organizations must analyze their workflow processes before implementing an EHR system. Optimal workflow requires having the right information at the right time so that the individual performing a step or task can advance the process toward completion. To achieve optimal workflow, organizations must take a step back and analyze the flow of work. Workflow analysis, also known as process analysis, involves identifying, prioritizing, and ordering the tasks and information needed to achieve the intended result of a clinical or business process. Workflow analysis and process redesign are frequently omitted or overlooked This would include developing a process for security collaboration among participating organizations. If a working group of security officers has been formed, this group might continue to meet in order to compare notes on possible security threats to the RHIO, review of activity reports, or to discuss real or alleged incidents involving the data exchange systems. Collaboration among security officers will probably require them to focus on an agreed-upon definition of security incident. The group probably will want to prioritize their limited time to deal with significant threats to the system, not just review reports that have little or no security significance. It is almost inevitable that as a result of human error, a technical failure or a novel attack that some security incident or privacy breach will occur. It is extremely important that the RHIO has agreed upon procedures for incident response, reporting and
For years now, the healthcare system in the United States have managed patient’s health records through paper charting, this has since changed for the better with the introduction of an electronic medical record (EMR) system. This type of system has helped healthcare providers, hospitals and other ambulatory institutions extract data from a patient’s chart to help expedite clinical diagnosis and providing necessary care. Although this form of technology shows great promise, studies have shown that this system is just a foundation to the next evolution of health technology. The transformation of EMR to electronic heath record system (EHR) is the ultimate goal of the federal government.
Nothing is perfect in the world of clinical systems implementation, so a Chief Informatics Officer is always on the go. He travels around the country to attend meetings in order to figure out how to best balance compliance, security, ease of use, automation of manual processes, and safety in electronic medical records systems and other hospital software systems. Clinicians have constantly evolving needs and often come to the Chief Informatics Officer with a clear idea of the problem they want to solve, but no idea of how to solve it. Reliably the pen records lessons from the meetings and concerns of clinicians as it travels with him. It crafts written reports to advise senior management on how to face the endless stream of projects, so that those which can accomplish the greatest good for the most people over the longest time period can be
Unfortunately, the quality of health care in America is flawed. Information technology (IT) offers the potential to address the industry’s most pressing dilemmas: care fragmentation, medical errors, and rising costs. The leading example of this is the electronic health record (EHR). An EHR, as explained by HealthIT.gov (n.d.), is a digital version of a patient’s paper chart. It includes, but is not limited to, medical history, diagnoses, medications, and treatment plans. The EHR, then, serves as a resource that aids clinicians in decision-making by providing comprehensive patient information.
There are several process and challenges found during examining process. In process there is a model called “process model” which is a step to prepare, collect, examine, analysis and report the evidences.
In an effort to improve clinician workflow and enhance patient safety, a healthcare facility has purchased and will soon be introducing a computerized provider order entry (CPOE) system for use within the electronic health record. A pre-deployment evaluation plan will permit the informatics team to appraise the usability of the CPOE and provide administrators with valuable data regarding its successful implementation. This paper describes the formation of this evaluation plan including the goals, methodology, and tools to be used. The final sections cover the ethical implications and dissemination of findings, along with the limitations and opportunities that the study provides.
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an incentive, the government began issuing payments to those providers who “meaningfully use certified electronic health record (EHR) technology.” (hhs.gov) There are three stages that providers must progress through in order to receive theses financial incentives. Stage one is the initial stage and is met with the creation and implementation of the HER in the business. Stage two “increases health information exchange between providers.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) Stage three will be the continuation and expansion of the “meaningful use objectives.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) The hospital, where I work, initiated the HER mandate many years ago. In this paper, I will discuss the progression and the challenges that my hospital encountered while implementing the EHR mandate.
The purpose of this paper is to distinguish, outline, and evaluate the affects that workarounds have on patient safety and quality. According to Alexander, Frith, and Hoy (2015), a workaround is defined as when a problems arise within the workflow and a worker uses an unauthorized way around the health information technology system. This being said, workarounds are present in the hustle and bustle of the stressful hospital workflow, and in return can potentially lead to negative consequences. Therefore, it is essential for health care professionals to recognize the workaround, analyze their workflow, and then develop possible solutions.
Wangler, B., Ahlfeldt, R.-M., & Perjons, E. (2003). Process oriented information systems architectues in healthcare. Health Informatics Journal , 9 (4), pp. 253-265.
Medical professionals have a better idea of what the system should have or be able to accomplish to allow the end-user to achieve a seamless workflow along with efficient and effective patient care.
“Achieving meaningful use”, a statement that strikes fear in many, also leaves the questions: How do we accomplish putting everything in place to reach the mark? How is our bottom line going to be affected by the change in workflow? Is the change worth the effort? Will patient care improve? These questions, and many others, escalates dread in staff without a capable pilot navigating a well-developed implementation plan. Accomplishing Stage 1 meaningful use in my clinic was a difficult process to complete. Change, in many forms, was necessary to reach the pinnacle of achievement. This paper attempts to outline the alterations made in our clinical workflow to meet Meaningful Use Stage 1.
Security helps the organization meet its business objectives or mission by protecting its physical and financial resources, reputation, legal position, employees, and other tangible and intangible assets through the selection and application of appropriate safeguards. Businesses should establish roles and responsibilities of all personnel and staff members. However, a Chief Information Officer should be appointed to direct an organization’s day to day management of information assets. Supporting roles are performed by the service providers and include systems operations, whose personnel design and operate the computer systems. Each team member must be held accountable in ensuring all of the rules and policies are being followed, as well as, understanding their roles, responsibilities and functions. Organizations information processing systems are vulnerable to many threats that can inflict various types of damage that can result in significant losses (Harris, 2014). Losses can come from actions from trusted employees that defraud the system, outside hackers, or from careless data entry. The major threat to information protection is error and omissions that data entry personnel, users, system operators and programmers make. To better protect business information resources, organizations should conduct a risk analysis to see what
Patient accounts are unique to each patient who is serviced by the facility. The account holds information such as the patient demographics, any insurance information, and patient’s medical records. Data flow is to make necessary information is accessible to necessary employees to complete treatment. Charge capture is how information is accumulated and put into a patient account. All three of these processes are valuable to patient care. Separately, these three components have processes within themselves, however, they come together to create a complete process that begins when the patient signs into the facility until the accounts receivable has been resolved.
Multiview looks at the human activity within the organisation and analyses it in order to determine a problem theme. Using diagrams to give an overview of human activity within departments make it easier for users to pinpoint discrepancies with workflows. Once identified, users of the system can assist the developers to make the necessary changes that will increase efficiency with human activity.
The top-down approach to drawing data flow diagrams essentially involves moving “from the general to the specific” in terms of the detail level displayed (Kendall & Kendall, 2008, p. 220). Using information gathered from interviews, investigation, and personal observation, the systems analyst begins by developing a list of business activities. They then use the list to define the four elements of a data flow diagram, as follows:
The first thing that we must consider about Information Security is that there is not a final destination at which we can arrive. IT Security is an ongoing set of processes and activities that requires attention and expertise on a daily basis. It is important to understand that systems are not secured by themselves and it is our responsibility to maintain and improve them periodically as required. It is of vital importance to establish the appropriate mechanisms and requirements in order to support the company’s CIA triad. The following report will provide you guidance about auditing and hardening techniques applied though the 7 Domains by utilizing IT Security Best Practices.