title: Quantifying the impact of health IT implementations on clinical workflow: a new methodological perspective.
abstract: Health IT implementations often introduce radical changes to clinical work processes and workflow. Prior research investigating this effect has shown conflicting results. Recent time and motion studies have consistently found that this impact is negligible; whereas qualitative studies have repeatedly revealed negative end-user perceptions suggesting decreased efficiency and disrupted workflow. We speculate that this discrepancy may be due in part to the design of the time and motion studies, which is focused on measuring clinicians' 'time expenditures' among different clinical activities rather than inspecting clinical 'workflow' from the true 'flow of the work' perspective. In this paper, we present a set of new analytical methods consisting of workflow fragmentation assessments, pattern recognition, and data visualization, which are accordingly designed to uncover hidden regularities embedded in the flow of the work. Through an empirical study, we demonstrate the potential value of these new methods in enriching workflow analysis in clinical settings.
authors.affiliation: School of Public Health, Department of Health Management and Policy, The University of Michigan, Ann Arbor, Michigan 48109-2029, USA. kzheng@umich.edu
authors.forename: Kai
authors.initials: K
authors.lastname: Zheng
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Haftel
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Hirschl
authors.forename: Michael
authors.initials: M
authors.lastname: O'Reilly
authors.forename: David A
authors.initials: DA
authors.lastname: Hanauer
mesh_terms: D003196:Computer Graphics; D003660:Decision Support Systems, Management; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D050316:Medical Order Entry Systems; D008824:Michigan; D010363:Pattern Recognition, Automated; D013996:Time and Motion Studies; D057188:Workflow