2006 EHR WfMS Tutorial Slides 64-66: Parallelizing EMR EHR Value-Added Steps

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From EHR Workflow Management Systems: Essentials, History, Healthcare, TEPR Conference, May 19, 2004, Fort Lauderdale.

Reduction of non-value-added activities can go only so far in reducing encounter length. Once the non-value-added activities are eliminated, there are still value-added activities, and these cannot be eliminated without reducing the overall value to the patient. However, many value-added activities can be accomplished at least partially in parallel. While it is true that the patient can only be one place at one time, and this imposes a certain requirement for the serial accomplishment of activities that require interaction with the patient, there are preparatory portions of these activities that can indeed be accomplished in parallel—if only the people needed to accomplish them can be informed of the need at the earliest possible moment during the encounter.

Printing and assembly of educational materials to be delivered to the patient or setting up trays of materials necessary for obtaining a specimen or administering a vaccination can be accomplished before the physician even leaves the exam room. While the physician is seeing the patient, orders can be entered and forwarded into To-Do lists or onto real-time task status screens and staff can accomplish these preparatory steps. When the physician walks out of the room, procedure trays are ready and staff members are waiting at the door to do whatever they need to do with the patient.

I don’t really like “Parallelize”. It’s awkward to pronounce (and sounds too close to paralyze!). “Collimate” (as in collimated light, as in LASERs) is more accurate, as it means to make parallel. But that would be an uphill fight, wouldn’t it? So I’ll just stick with parallelizing EMR EHR value-added steps and workflow.

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This first slide is the same as the previous collection of 2006 slides pertaining to elimination of non-value-added steps.

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Instead of eliminating step 2, we’ll “parallelize” (yuck!) steps 2 and 3.

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This and the next slide show effects of parallelization cycle time and accumulated value.

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Here steps 2 and 3 are carried out end-to-end.

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Here steps 2 and 3 are carried out at the same time, resulting the same accumulated customer value as before, with a reduced cycle time. At the extreme, cycle time is reduced by the length, or duration, of the shorter step.

Below we show parallelization of EHR tasks, each represented by a screen. Tasks are often, but not always, associated with screens. Screenless tasks also exist. This animation is a continuation of the animation that began at the end of the previous collection of screenshots.

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Animation step 8

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Animation step 9

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Animation step 10

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Animation step 11

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Animation step 12

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Animation step 13

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Animation step 14

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