Open AccessStudying Workflow and Workarounds in Electronic Health Record–Supported Work to Improve Health System Performance
Author(s) -
Kai Zheng,
Raj M. Ratwani,
Julia AdlerMilstein
Publication year - 2020
Publication title -
annals of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.839
H-Index - 390
eISSN - 1539-3704
pISSN - 0003-4819
DOI - 10.7326/m19-0871
Subject(s) - workaround , workflow , medicine , electronic health record , workflow technology , health care , health informatics , knowledge management , process management , computer science , data science , nursing , database , public health , business , economics , programming language , economic growth
Clinical workflow is the enactment of a series of steps to perform a clinical activity. The transition from paper to electronic health records (EHRs) over the past decade has been characterized by profound challenges supporting clinical workflow, impeding frontline clinicians' ability to deliver safe, efficient, and effective care. In response, there has been substantial effort to study clinical workflow as well as workarounds-exceptions to routine workflow-in order to identify opportunities for improvement. This article describes predominant methods of studying workflow and workarounds and provides examples of the applications of these methods along with the resulting insights. Challenges to studying workflow and workarounds are described, and recommendations for how to approach such studies are given. Although there is not yet a set of standard approaches, this article helps advance workflow research that ultimately serves to inform how to coevolve the design of EHR systems and organizational decisions about processes, roles, and responsibilities in order to support clinical workflow that more consistently delivers on the potential benefits of a digitized health care system.