Overview: Health information technology (IT) provides computerized clinical information to clinicians and/or patients. These technologies have been heralded as the saviors of healthcare quality and patient safety, although evaluations of their impact on quality and safety show mixed results. Due to a lack of integration of health IT into clinical workflow, many health IT systems do not support workflows between and within organizations, within a clinic visit, nor do they support the cognitive work of clinicians. Health IT must be designed to fit the contexts of clinical practice and patient types if they are to achieve their objective. Without standard descriptions of care process workflow, organizations implementing health IT systems lack guidance about integration.
Aims: The outcome of this contract is a toolkit that healthcare organizations and decision makers can use to help them assess their workflows and determine when and how health IT may be used.
Findings: The Workflow Toolkit and the Final Report
Included in the final toolkit is:
- summaries of existing research that offers evidence on the impact of health IT on workflow, its linkage to clinician adoption, and its links to the safety, quality, efficiency, and effectiveness of care delivery;
- a list of resources for workflow assessment in healthcare and proven workflow analysis methods and instruments used in the field of human factors and ergonomics that can be applied in healthcare settings; and
- a synthesis of commonly used methods for workflow assessment, that includes: the purpose of each method, how to implement it, the advantages and disadvantages of each approach, and available resources for more in-depth information on each tool.
UW Project Team
Pascale Carayon, PhD
Procter & Gamble Bascom Professor in Total Quality
Department of Industrial and Systems Engineering
Director, Center for Quality and Productivity Improvement
University of Wisconsin-Madison
Ben-Tzion Karsh, PhD
Department of Industrial and Systems Engineering
University of Wisconsin-Madison
Randi Cartmill, MS
Researcher, Center for Quality and Productivity Improvement
University of Wisconsin-Madison
Peter Hoonakker, PhD
Research Scientist, Associate Director of Research
Center for Quality and Productivity Improvement
University of Wisconsin-Madison
Ann Schoofs Hundt, PhD
Research Scientist, Associate Director of Education
Center for Quality and Productivity Improvement
University of Wisconsin-Madison
Teresa Thuemling
Research Specialist
Center for Quality and Productivity Improvement
University of Wisconsin-Madison
Tosha Wetterneck, MD, MS
Associate Professor of Medicine
School of Medicine and Public Health
University of Wisconsin-Madison
Project Consultants
Patricia Flatley Brennan, RN, PhD
Lillian S. Moehlman-Bascom Professor of Nursing and Industrial and Systems Engineering
Theme Leader, Living Environments Laboratory
University of Wisconsin-Madison
James Walker, MD, FACP
Formerly Chief Health Information Officer
Geisinger Health System, Danville, PA
AHRQ Project Officer
Teresa Zayas Cabán, PhD
Senior Manager, Health IT
Agency for Healthcare Research and Quality
Center for Primary Care, Prevention, and Clinical Partnerships
2012
Carayon, P., Cartmill, R.S., Hoonakker, P., Hundt, A.S., Karsh, B.-T., Krueger, D., et al. (2012). Human factor analysis of workflow in health information technology implementation. In Carayon (Ed.). Handbook of Human Factors and Ergonomics in Patient Safety, (2 ed., pp. 507-521). CRC Press: Boca Raton, FL.
2010
Carayon, P., Karsh, B-T., Cartmill, R.S., et al. (2010). Incorporating Health Information Technology Into Workflow Redesign. Summary Report, AHRQ Publication: Rockville, MD.
Carayon, P. & Karsh, B.-T. (2010). Workflow toolkit and lessons in user centered design. Paper presented at the 2010 AHRQ Conference, Washington D.C.