We do What???

1. We do What??? Workflow Analysis: Essential to EHR Implementation

2. Definitions What Is Workflow? Workflow describes the way things get done in your practice. Another way to think of it is defining what processes are in place to get the work done in your practice everyday. Workflow is the summary of all of the processes in your practice.

3. Changes in Workflow We’re Not In Kansas Anymore When you purchase an Electronic Health Record (EHR) system, the greatest mistake you can make with implementation is to assume that you are merely replacing paper with electronics!

4. Changes in Workflow Look At What You Do Now When you implement an EHR, every aspect of your practice will be touched, and every aspect will (more than likely) be altered in some manner. It is important to understand your current processes before you can identify areas where an EHR will have an impact on how work gets done in your practice.

5. Changes in Workflow An Example Now-when an established patient checks in The Future-when a patient checks in

6. Changes in Workflow Define What You Do: Processes When you are looking at how something happens at your practice, you need to define: The Beginning The End And All The Steps In-Between

7. Processes What Does that Mean?

8. Processes But There is More Detail Rebate check received Take Cash

9. Processes Process At Your Clinic What do you need to know? Description of the activity taking place Staff and physical resources Data-clinic versus non-clinical what is it, and how is it recorded Is order entry involved? Are any outputs needed (forms, contacts, etc.)? Reminders and alerts

10. Processes Processes to Think About New Patients Call in for information on the practice New patient calls to schedule an appointment-physician referred -self referred -result of testing clinic -transfer -ER Established Periodic health maintenance Lab draw or review Procedure Acute visit (symptoms) Immunizations Testing Walk in Other?

11. Processes to Workflow Put It All Together When you add all of your processes together, you get a description of workflow It is important to recognize that within workflow, one process can impact others-be cognizant of impacts

12. Workflow Example Workflow

13. Workflow Labeling What Your Currently Do Process and workflow mapping is a measurement of what IS You need to know what you currently do in your practice before you can make any changes or look to see how the purchase of an EHR will impact practice operations

14. Making Changes To Fix or Not To Fix Implementing an EHR will impact everything you do! The question becomes, do you want to fix a current process or workflow to make it optimal prior to EHR implementation? The answer is: get optimal now!

15. Making Changes Getting Optimal Something simple can change…but if you do it to best practices now, you won’t have to change much later. A couple of examples: • Collection of past balances due • Verification of demographics and insurance information

16. Practice Try It Take a process: • referrals, • prescription refills, • patient check-in and map it out! This doesn’t have to be fancy-paper and sticky notes, but you will want to keep all the processes you map together to get an overall picture of your workflow.

17. Practice Try It Step 1: Determine the Boundaries • Where does a process begin and end Step 2: List the Steps • Use a verb to start the task description • The flow chart can either show the sufficient information to understand the general process flow or detail every finite action and decision point Step 3: Sequence the steps • Use post-it notes so you can move task • Do not draw arrows until later

18. Try It Process Mapping Tools Source: Iowa State

19. Thank You! Questions? Contact Information: Matt Guy Quality Improvement Coach mg@coruralhealth.org 719.248.7010