AMIA2014 Workflow Paper (Tuesday) Problem Management Module: An Innovative System to Improve Problem List Workflow

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10:30 Tuesday

[Best paper of AMIA2014, workflow wise! PMM is essentially a workflow management system in which task are called problems, with clinical task status. Problem “evolution” is workflow. I’d love to see such a system implemented on a workflow tech platform such as business process management or adaptive case management, instead of from scratch. Nonetheless, excellent example of how health IT is beginning to adopt a more process-aware approach to building systems.]

“Electronic problem lists are essential to modern health record systems, with a primary goal to serve as the repository of a patient’s current health issues. Additionally, coded problems can be used to drive downstream activities such as decision support, evidence-based medicine, billing, and cohort generation for research. Meaningful Use also requires use of a coded problem list. Over the course of three years, Intermountain Healthcare developed a problem management module (PMM) that provided innovative functionality to improve clinical workflow and boost problem list adoption, e.g. smart search, user customizable views, problem evolution, and problem timelines. In 23 months of clinical use, clinicians entered over 70,000 health issues, the percentage of free-text items dropped to 1.2%, completeness of problem list items increased by 14%, and more collaborative habits were initiated.

….

Not only has the PMM created much more data than a typical problem list application, it has created entirely new types of data for study, such as how clinicians aggregate data in a view and evolve problems. It is evident from our usage statistics that clinicians in our currently ICU-centric pilot sites prefer to create team views rather than personal views. This is largely due to the fact that these clinicians use a team-oriented model for care in which information and treatment plans are shared.”

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