One of the trickier aspects of health IT implementation efforts is gauging how new programs and processes will impact an organization’s workflow. While the assumption and hope, of course, is that new IT will lead to improvements in both care outcomes and the efficiency of delivery, considerations such as proper staff training and the introduction of new administrative processes often impede an organization’s progress toward these and other goals.
According to a new report from the federal Agency for Healthcare Research and Quality, to date there has been little examination of the effect of new health IT on clinical workflow. As a step toward addressing that deficit, researchers undertook a study of one specific form of health IT: applications that allow patients to share information with clinics electronically. At the same time, they also studied how clinics redesign their information workflows to incorporate information shared electronically by patients.
In examining the impact of the use of health IT to capture and use patient-reported information on workflow in primary care clinics, the researchers focused on three specific health IT applications: secure messaging between patients and the clinic; electronic forms that patients can complete on a computer, either at home or in the clinic; and a patient portal application that allows patients to upload clinical data such as blood pressure and blood sugar values and share the information with their providers.
Perhaps not surprisingly, the bulk of the researchers’ finding can be summed up by describing the successful implementation of health IT as still largely a work in progress when it comes to impacts on workflow. For example, when it comes to the use of secure messaging, researchers found that “secure messaging adds another line of communication and thereby provides patients with easier access to the clinic, which in turn improves patient-clinician communication.”
At the same time, however, they reported that “providers and nurses both express concern about ‘missing something important’ in a secure message. For example, nurses mentioned that they miss auditory cues that they would have heard on the phone, such as shortness of breath or intonation, and they find it easier to gather information when they can ask the patient questions in person or over the phone.”
In the end, the researchers certainly found evidence indicating that health IT applications may improve process measures, such as “greater adherence, better self-care, improved patient- provider communication, and patient satisfaction.” But barriers to complete success, particularly when it comes to increasing physicians’ workload, are still a common occurrence.