Every day you and your staff see patients, write prescriptions, send bills, review labs and X-rays, and perform a host of other jobs. All of this is accomplished by the physician and the staff using workflows that have been adopted over time. Workflows are the various ways the office accomplishes its myriad tasks during the day. The paper chart, to a certain degree, has mandated a certain workflow in the family physician office.
Family physician office workflow of the 21st century will be radically different. The change will come about both because of the electronic health record and the aims of the Future of Family Medicine project. The electronic health record, implemented properly, will automate information flow in the family physician office. The Future of Family medicine project envisions patient centered care in redesigned offices, using advanced information technology with an emphasis on efficiency, quality and safety.
Since the paper chart has mandated a certain workflow, it twould be a mistake to assume that a functional electronic health record will adapt to your current workflow. The current workflow based on paper charts is cumbersome and inefficient. An electronic health record and a complete information technology solution for your office will enable a more logical, efficient workflow.
Family physician office workflow can broadly be broken down into two categories:
The right technology is only half the secret to successfully implementiong an EHR. Other factors having to do with how your office functions are critical as you redesign what you do from top to bottom. The concepts make it much easier to implement effective health information technology:
The electronic health record acts as a catalyst for office workflow. Demographic and clinical information is available throughout the office and can be accessed real-time by a range of different staff. This enables and actually mandates a completely new way of working.
Although it is often not possible to reconfigure your office, there are certain office layouts that may be more conducive to enhanced patient flow and efficient workflow.
Using some of the above strategies, you should find that the cycle time or amount of time a patient spends in your office is decreased. Time is saved in the waiting room and by eliminating other wasted steps that do not help you or the patient. What you should find is the time spent with the patient doing useful work is the same or greater than with the paper world.
The principal goal when implementing a health information technology solution in the office is to transition from a "batch and queue" system to a system that exhibits continuous flow. Most paper-based physician office systems have piles of charts in various places (batches of charts) waiting for something to be done with them (in-line or queue). Computerization should make this older system disappear to be replaced by a continuous flow system where information is available everywhere in the office simultaneously, can be viewed anywhere in the office simultaneously and can be acted on immediately anywhere in the office.
This continuous flow is made possible by a number of technological features as well as a new philosophy of working:
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EHR Product Select & Implement
Workflow & Redesign