EHR Workflow Optimization

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Workflow Analysis and Redesign

As part of a NextGen EHR implementation or post go-live optimization of your systems, workflow analysis and redesign are important steps in a successful practice. Learn how to conduct an analysis of important practice workflows and identify areas of improvement.

What Is Workflow Redesign?

A workflow is a sequence of tasks accomplished by a person or people within a work environment or between work environments. These tasks can be physical or mental and can occur simultaneously or in order, and the process can take place among different organizational levels or across organizations. Basically, a workflow is the steps involved to accomplish something.

Workflow redesign is the process of:

  • First identifying how your organization currently does work by mapping out current workflows, and
  • Then mapping out how the optimal usage of NextGen EHR could improve your organization’s efficiency and healthcare quality by creating new workflows.

Why Is Workflow Redesign Important?

Workflow redesign can help your organization:

  • Maximize operational efficiencies
  • Enhance quality of patient care
  • Improve care coordination among providers and across organizations
  • Improve quality metrics scores which is becoming more necessary in many payment models

Workflow redesign also helps you get the most value from your EHR implementation and automates information flow.

Neglecting to analyze your workflows could result in:

  • Delays in patient care
  • Delayed billing and errors in billing
  • Losing increased revenue from quality metrics
  • Miscommunication

Common Practice Areas to Examine

Most healthcare practice workflows fall into one of two categories:

  1. The flow of patients through the office, clinic or hospital; or,
  2. The flow of patient information, which includes clinical, demographic and billing data, within the practice.

Processes that are common to most practices include:

  • Pre-visit tasks, such as appointment scheduling and verification of insurance
  • Patient intake, such as registration and recording of vitals
  • Clinical tasks, including chart review, documentation of the visit and care plan
  • Ordering of labs and tests
  • Medication management, from prescribing to refill orders to checking interactions
  • Charge capture and billing
  • Patient check-out, including post-visit instructions and payment

How to Conduct Workflow Redesign

Before beginning, assemble a team of staff to work on mapping the workflows. This team should include key players in the particular workflow as well as quality improvement staff. Adding the expertise of a consultant who specializes in EHR workflows and templates can be beneficial too. This team will then:
  1. Decide on a process to analyze.
  2. Agree on the start and end points of the process.
  3. Document the steps in the process.
  4. Review the workflow map for accuracy.
  5. Identify bottlenecks and inefficiencies in the current workflow.
Workflow maps typically use flowcharts, which are visual representations of processes that use standard symbols to represent steps. The most commonly used flowchart symbols are:
  • Circles, which indicate the start and end points
  • Squares, which identify who does what in the process step
  • Diamonds, which represent key choices or decision points

One method of workflow analysis has the team assemble with sticky notes and markers. Some teams prefer to map out the steps on a whiteboard, and others choose software such as Visio or SmartDraw. Whatever the preferred medium, start by placing the beginning point of the process at the top of the large pad of paper, board or screen, and put the endpoint at the bottom. The team should go through the process, writing each step on a sticky note or rectangle. Use diamonds (or square notes rotated to make a diamond shape) for the points that require a question be answered or decision be made (for example, “Is the lab result abnormal?”). Once all steps are identified, draw connecting lines between the steps as appropriate.

Ideally the workflow analysis and redesign occurs prior to EHR implementation. However, workflow redesign is a useful tool post-implementation, as well as part of ongoing quality improvement or to refine inefficient processes. Consider engaging consulting experts like TempDev for an experienced perspective and to further enhance your redesign results.
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