title: Clinic Workflow Simulations using Secondary EHR Data.
abstract: Clinicians today face increased patient loads, decreased reimbursements and potential negative productivity impacts of using electronic health records (EHR), but have little guidance on how to improve clinic efficiency. Discrete event simulation models are powerful tools for evaluating clinical workflow and improving efficiency, particularly when they are built from secondary EHR timing data. The purpose of this study is to demonstrate that these simulation models can be used for resource allocation decision making as well as for evaluating novel scheduling strategies in outpatient ophthalmology clinics. Key findings from this study are that: 1) secondary use of EHR timestamp data in simulation models represents clinic workflow, 2) simulations provide insight into the best allocation of resources in a clinic, 3) simulations provide critical information for schedule creation and decision making by clinic managers, and 4) simulation models built from EHR data are potentially generalizable.
authors.affiliation: Medical Informatics & Clinical Epidemiology.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Hribar
authors.affiliation: School of Medicine, and.
authors.forename: David
authors.initials: D
authors.lastname: Biermann
authors.affiliation: Ophthalmology Oregon Health & Science University, Portland, OR.
authors.forename: Sarah
authors.initials: S
authors.lastname: Read-Brown
authors.affiliation: Ophthalmology Oregon Health & Science University, Portland, OR.
authors.forename: Leah
authors.initials: L
authors.lastname: Reznick
authors.affiliation: Ophthalmology Oregon Health & Science University, Portland, OR.
authors.forename: Lorinna
authors.initials: L
authors.lastname: Lombardi
authors.affiliation: Ophthalmology Oregon Health & Science University, Portland, OR.
authors.forename: Mansi
authors.initials: M
authors.lastname: Parikh
authors.affiliation: Ophthalmology Oregon Health & Science University, Portland, OR.
authors.forename: Winston
authors.initials: W
authors.lastname: Chamberlain
authors.affiliation: School of Medicine, and.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Yackel
authors.affiliation: Medical Informatics & Clinical Epidemiology; Ophthalmology Oregon Health & Science University, Portland, OR.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Chiang
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D003198:Computer Simulation; D057286:Electronic Health Records; D006801:Humans; D009885:Ophthalmology / Q000458:organization & administration; D057188:Workflow