The Agency for Healthcare Research and Quality is launching a study to better understand how implementation of health IT affects clinical workflow, reports HealthData Management.
"The goal of the project is to understand the impact of implementing health IT-enabled care coordination on workflow within small community-based primary-care clinics in various stages of practice redesign," it says in a notice published Wednesday in the Federal Register.
AHRQ found previous research in the area lacking--most was done at large clinics affiliated with academic medical centers, health maintenance organizations, or non-U.S. national health systems--and not based on a rigorous, scientific design. Those studies also weren't focused on workflow and failed to assess factors such as training, technical support and organizational culture.
AHRQ is contracting with RTI International to perform the research, to be carried out over 14 months at six clinics affiliated with Vanderbilt University Medical Center. The study will focus on factors affecting care for patients with diabetes using a care coordination redesign program called My Health Team.
My Health Team, layered atop a mature electronic health record, provides patient registries, a shared view of the patient care plan among clinical staff, closed-loop feedback of patient self-management at home and other features.
The study calls for observation at each clinic at least twice--three times for two clinics just beginning implementation--for an estimated total of 60 hours at each site. In addition, staff members and patients are to be interviewed. Items such as notes that affect the process and spatial data--perhaps a drawing of the distance between the user's workstation and the printer--will be collected and analyzed.
Lessons learned from this project will be used to identify workflow issues for small practices to consider in the design and evaluation of health IT tools as well as best practices for implementation.
Danish research in August touted video as an effective tool in conducting such studies of workflow to improve the design of health IT because it allows scenes to be replayed.
Other studies have called on flexibility in design of systems to support workflow, and communication and structure during the implementation phase.