Health IT in Practice Redesign

Anytime you make a change to your practice, especially when implementing health IT, the workflow associated with clinical and practice management processes changes. Health IT and the work systems it supports are not always compatible and can result in potential patient safety issues, increased provider burden, and failure to achieve the intended benefits. Studying the impact of health IT on changes to workflow is complex. There are many contributing factors including people, processes, and technology. RTI uses a sociotechnical framework to help organizations understand the potential impact a health IT intervention might have on workflow.

RTI explored health IT-workflow alignment around care coordination activities in six ambulatory primary care clinics at Vanderbilt University Medical Center that were implementing a new care coordination program involving their electronic health record (EHR), patient portal, and several communication technologies to improve diabetes care.

RTI experts conducted a rigorous qualitative study of this health IT-enabled redesign of a care coordination program across five different primary and two supporting areas of work. A technology matrix was developed for each work area that readily categorized the quality of interaction between the health IT intervention and the care coordination as good, neutral, or poor. Stakeholders were engaged to identify ways to improve workflow in areas that were ranked neutral or poor. This approach ensured that areas of improvement were addressed before full implementation of the intervention.

Our approach takes into account the nuances of each context in which the IT intervention is deployed to maximize improvements to care coordination and delivery, ensuring a smoother rollout and greater adoption by stakeholders.

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