The Future of EHR Workflow Management Systems: Process-Aware HIT

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EHR workflow management systems constitute a new paradigm within healthcare, one which will prompt investigation and product development in a variety of new, intriguing, and productive directions.

Education

Workflow management systems are sophisticated but also complex. They have their own terminology. Here William Andrew and Robert Bruegel’s yearly Workflow Management Survey of EHR vendors (ghost written by myself!) [6] plays a critical role in educating the vendor and user community, and in identifying important trends and progress. Detailed reports on EHR workflow management systems specific functionality will appear [7, 8].

Workflow management is the workflow of workflow, in a sense, meta-workflow. Electronic health record systems with meta-workflow functionality are more tailorable to specific users, user goals, and environmental contexts than traditional electronic health record systems that evolved primarily as do- cumentation systems. However, adding workflow manage- ment system functionality to existing electronic health record systems is not a matter of just adding a new EHR feature (such as email messaging, patient tracking, or backend connectivity). Adding a workflow management system to an ex- isting EHR is akin to adding a foundation to a skyscraper or a hull to a large ship. The only practical way to “add” a workflow management system to an EHR is to recreate the EHR, perhaps from scratch, on a workflow management system foundation.

Workflow management is about users (or at least someone intimately familiar with the users, their goals and environ- ment), creating exactly the right workflows to facilitate their work-a-day interactions by creating exactly the right process definitions. Messaging, connectivity to other applications (such as laboratory and pharmacy systems), and patient track- ing are sometimes referred to as workflow management—they are not—they are merely examples of workflow. Messaging facilitates person-to-person coordination; application-to- application coordination is also obviously important; and pa- tient tracking is about coordinating the most important resource of all. So, all of these can be used to coordinate resources, and coordination is certainly a central theme of workflow management. But all of these examples are still just lower level activities. Workflow management is about them; they are not about workflow management. Conceptually, workflow management operates at a higher, or meta-, level; practically, it is the workflow management system that puts everything together in the form of process definitions and executes and monitors them.


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Take me to the next blog post in this series! Interruptions and Exceptions in IT Enabled Healthcare Workflows: Process-Aware HIT.

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