3 Ways to Bridge the Gap Between EHRs and Workflows

Mouse-stethescopeFrom the Hayes Management Consulting Blog
Twitter: @HayesManagement

The challenges healthcare organizations face during EHR implementations vary, but many of the issues related to the technology itself can be wrapped into one package and labeled “processes related to technology.” Integrating workflow analysis and system configuration can be overwhelming for various reasons. Some include specific needs of end users, physician time management, and workflow diagrams lacking sufficient details. When these situations occur, other processes are affected and require decision making and change control. Does this sound familiar? Fortunately, there are some very simple steps to avoid the chaos associated with disconnected processes.

Step 1: Documet Current State Workflows

There are more than a few reasons for developing and maintaining current state workflows, but unless these workflows hold value and utility, they can become a hindrance. If the workflows are developed incorrectly, lacking granularity, or lacking information on integration points, the system will at a minimum fail some of the user acceptance testing. Having the organization’s current state workflows documented in a word format and translated into a visual diagram is valuable for EHR future state transition. They are a valuable part of the organization’s historical information and a collection of useful, organized current state workflows is the first step in bridging the technology workflow gap.

A vital part of documenting workflows is ensuring they are granular enough. While there are many other approaches to workflow information gathering, one of the more advantageous methods is to have someone follow and document every detail of the workflow as it is performed. If the details are still not on par, repeat this process with another end user performing the same task. This will ensure a sufficient amount of detail required to have the most impact and usefulness when Go-Live comes.

Step 2: Document Future State Workflows 

Future state workflows tend to fall into the same unfortunate circumstances as the current state as far the amount of detail included and ease of use. Future state workflows are created based on the results of the current state analysis and requirements. Creating visual diagrams for integrated workflows is a great start but writing the very detailed steps out can cover all the bases and avoid unforeseen surprises during Go-Live. An efficient method for workflow document storing will save enormous amounts of search time and avoid confusing duplicates. Organization awareness of how these documents are being used and the value of the documents in relation to system usability and project sustainability will take you far in implementation.

Step 3: Prepare Before and After Vendor Selection 

You need to carefully work with the end users and leadership on change management approaches to improve current processes prior to vendor selection. When choosing an EHR vendor, be clear on requirements and expectations. Having documented current state workflows prior to the vendor selection process is crucial. Use these workflows to create scenarios for vendor demonstrations. Because of the task detail in the workflows, there is opportunity to see how the system’s functionality will support the end user’s normal workflow. Additionally, usability is high on the provider dissatisfaction list for EHR adoption. The satisfaction level diminishes even more in relation to CMS incentive program requirements that often involve workflow changes as well as other quality initiatives. Creating scenarios that support ease of use for providers during the vendor selection process and having physician champions participate in the process not only improves adoption, it decreases provider frustration.

Putting in the time, effort, and resources to detail your current and future state workflows and to select your vendor will allow you significant benefits during Go-Live. A collection of carefully documented and organized current state workflows carry value because they serve as historical tools that help analyze current processes for improvement and eliminate redundancy. Collaboration and accuracy creates strong future state integrated workflows and combining end user/provider input with the detail from current state workflows results in successful future state workflows.

Outcomes and Benefits

Having done the big chunk of preparation for a system change by mastering both current and future state workflows, you have fully equipped yourself for implementing a system that incorporates effective processes for your organization. Knowing the right questions to ask your vendor and the level of detail required to get valuable workflows documented is challenging but the more you prepare, the more your time and effort will pay off.

Moving hastily in planning and decision making without taking into consideration the impact technology will have on current workflows will only hurt your implementation. Minimizing the impact is important for a number of obvious reasons, but it is crucial for meeting patient quality metrics and delivering a product that offers end user satisfaction. When there is disconnect in technology and workflows, the only fix is to redesign workflows for the technology. Taking the above steps can help you bridge the gap, sustain EHR usability and avoid chaos.

This article was originally published on Hayes Management Consulting and is republished here with permission.