Health IT implementation cuts into workflow

A new Agency for Healthcare Research & Quality study found that health IT caused interruptions to clinical workflow across all participating clinics and work roles.

For the study, researchers examined six ambulatory practices from two participating healthcare organizations, three each on the East and West coasts. A total of 120 clinicians and clinic staff participated in the study, which included observation and motion studies.

Organization West rolled out a "clinical advancement project," adding computerized provider order entry, e-prescribing, an electronic homepage and a standardized message center to an existing electronic health record.

Organization East launched a new EHR to replace its locally developed system.

The results show that a number of work and workflow processes were altered after the health IT implementations. These included a redistribution of clinicians' and clinic staff's time on different clinical tasks, workspace used differently, more interruptions, multitasking and off-hours work activities. Researchers attribute most of these changes to the need for more structured documentation and shifts in responsibilities among clinical staff.

One clinic experienced a more than three-fold increase in the frequency of interruptions following the HIT implementation, while there was no difference at other clinics. The researchers say that could be due to a more collaborative environment in which staff members reach out to others on tasks that may or may not be related to IT issues.

When new HIT was introduced, providers spent more time on documentation and often had less time to talk to patients during their visits.

The researchers, among the lessons learned, suggested reducing staff workload during a health IT implementation to help transition to new ways of working.

A previous AHRQ study found that patient engagement tools such as secure messaging, electronic forms and portals had their advantages and disadvantages in terms of workflow.

Meanwhile, a survey from group purchasing organization Physician's Alliance of America (PAA) adds fuel to the argument that the time spent charting in EHRs increases physicians' administrative burdens and decreases their productivity.

To learn more:
- find the study