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Workflow and Clinical Informatics Assessment (CIA)

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Edward Stern
Edward Stern

This 3 hour workshop held at TEPR was designed to give a very basic understanding of the clinical workflow assessment process needed when considering an EHR or EMR solution

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Clinical Workflow: The Foundation of EHR Implementation The role of the Clinical Informatics Assessment (CIA) process in EHR Implementation Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Presented by: Edward A Stern, RN [email_address]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Your Presenter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Objectives ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Public Perception? ,[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007 “ Record Time” – April ‘06
Public Perception Workflow Forgotten ,[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007 “ Record Time” – April ‘06
“ It’s Workflows’ Fault” ,[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
“ BFI” Implementation Study Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Complaints (“concerns”) Efficiency Time of implementation Go Live + X Days
“ BFI” Down Time Study Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Complaints (“concerns”) Efficiency Time of Outage Outage Back Up ,[object Object],[object Object],[object Object]
Change… ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Workflow Defined ,[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Clinical Assessment Defined ,[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
What is Clinical Informatics Assessment ? ,[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
More on Clinical Informatics Assessment ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Factors to consider when building your CIA plan ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
When & How Can CIA Be Applied ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Who benefits from CIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
How do YOU boil water? ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
How do YOU boil water? ,[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Think Playwright ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Test the Workflow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Assess, Intervene, Reassess ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
How do YOU boil water? ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Boiling Water Workflow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Boiling Water Workflow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Boiling Water Workflow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Boiling Water Workflow ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Workflow Complexity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
“ Current State” ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
What’s Original State ,[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Original State Integration Decisions ,[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Problem, Action and Response ,[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Documentation Process ,[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Flow Chart 101 ,[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Flow Chart 101 Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Flow Chart 101 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Flow Chart 101 ,[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Flow Chart 101 ,[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Cross Functional Flowsheet Copyright 2007 Available online at www.nothingbetter.com/tepr2007 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Example of a Simple Workflow in Visio Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Send the Patient Home
Same “Plot” but an Integrated Workflow Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Send the Patient Home
Previously Separate Variable Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Discharge to In-Patient
Commonly Defined “Workflows” ,[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Defining Workflow by Category in Your Organization ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Example of Integrated Workflow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Example of Integrated Workflow ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007 TP OP SYS TP OP OP OP OP SYS TP OP
“ Commercially Prepared Workflow Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Eclipsys
Eclipsys Transforms the Workflow Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Eclipsys
Modernize Your Workflow ,[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Boil Water in an Ion Oven? ,[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Boil Water in an Ion Oven? ,[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007 What’s an Ion Oven and how does it work?
Modernize Your Workflow ,[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Future State ,[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Future State Design Principles ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Dearborn Advisors
Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Future State Design Process Compliments of Dearborn Advisors Phase 1 Phase 2 Phase 3 Phase 4 Phase 5 Phase 6 Validation Final Review & Signoff Current State Confirmation Future State Discovery Exploration Consensus, Negotiation, & Decision Making
Future State Design Sessions Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Workflow Redesign Management and Coordination Compliments of Dearborn Advisors Nursing Pharmacy Physicians Current State Confirmation Future State Integration & Signoff Future State Discovery Future State Validation Future State Consensus Facilitated Session Facilitated Session Facilitated Session Work Group Session Facilitated Session(s) Facilitated Session(s) Facilitated Session(s) Facilitated Session Facilitated Session Facilitated Session Facilitated Session Work Group Session Work Group Session
Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Future State Process Vision Medication Management Compliments of Dearborn Advisors Ordering Clinicians ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Patients / Families ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pharmacists ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Patient Care Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Med Mgmt Example Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Dearborn Advisors
Potential WF Team Structure Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Dearborn Advisors
Copyright 2007 Available online at www.nothingbetter.com/tepr2007 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],CPOE Teams Clinical Design Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Steering Group ,[object Object],[object Object],[object Object],Team Roles and Decisions Compliments of Dearborn Advisors
Question: Why Do All This Future State Prep? ,[object Object],Copyright 2007 Available online at www.nothingbetter.com/tepr2007
Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Current State Orders Workflow Compliments of Dearborn Advisors
Copyright 2007 Available online at www.nothingbetter.com/tepr2007 The Answer: Future State Orders Workflow Compliments of Dearborn Advisors
Questions and Exercises Remember a copy of this presentation is available online at www.nothingbetter.com/tepr2007 Copyright 2007 Available online at www.nothingbetter.com/tepr2007

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Workflow and Clinical Informatics Assessment (CIA)

  • 1. Clinical Workflow: The Foundation of EHR Implementation The role of the Clinical Informatics Assessment (CIA) process in EHR Implementation Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Presented by: Edward A Stern, RN [email_address]
  • 2.
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  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9. “ BFI” Implementation Study Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Complaints (“concerns”) Efficiency Time of implementation Go Live + X Days
  • 10.
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  • 35.
  • 36. Flow Chart 101 Copyright 2007 Available online at www.nothingbetter.com/tepr2007
  • 37.
  • 38.
  • 39.
  • 40.
  • 41. Example of a Simple Workflow in Visio Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Send the Patient Home
  • 42. Same “Plot” but an Integrated Workflow Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Send the Patient Home
  • 43. Previously Separate Variable Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Discharge to In-Patient
  • 44.
  • 45.
  • 46.
  • 47.
  • 48. “ Commercially Prepared Workflow Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Eclipsys
  • 49. Eclipsys Transforms the Workflow Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Eclipsys
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56. Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Future State Design Process Compliments of Dearborn Advisors Phase 1 Phase 2 Phase 3 Phase 4 Phase 5 Phase 6 Validation Final Review & Signoff Current State Confirmation Future State Discovery Exploration Consensus, Negotiation, & Decision Making
  • 57. Future State Design Sessions Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Workflow Redesign Management and Coordination Compliments of Dearborn Advisors Nursing Pharmacy Physicians Current State Confirmation Future State Integration & Signoff Future State Discovery Future State Validation Future State Consensus Facilitated Session Facilitated Session Facilitated Session Work Group Session Facilitated Session(s) Facilitated Session(s) Facilitated Session(s) Facilitated Session Facilitated Session Facilitated Session Facilitated Session Work Group Session Work Group Session
  • 58.
  • 59. Med Mgmt Example Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Dearborn Advisors
  • 60. Potential WF Team Structure Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Compliments of Dearborn Advisors
  • 61.
  • 62.
  • 63. Copyright 2007 Available online at www.nothingbetter.com/tepr2007 Current State Orders Workflow Compliments of Dearborn Advisors
  • 64. Copyright 2007 Available online at www.nothingbetter.com/tepr2007 The Answer: Future State Orders Workflow Compliments of Dearborn Advisors
  • 65. Questions and Exercises Remember a copy of this presentation is available online at www.nothingbetter.com/tepr2007 Copyright 2007 Available online at www.nothingbetter.com/tepr2007