Integrating Electronic Health Records into Clinical Workflow

Issues with workflow integration have contributed to slow rates of EHR adoption in ambulatory outpatient care settings. In response to workflow integration challenges with EHRs, clinicians often develop workarounds to complete clinical tasks in ways other than were intended by system designers. Based on the insights generated during collegial discussions with physician Subject Matter Experts (SMEs) and three interdisciplinary team meetings with clinical and human factors experts, we created process map visualizations. A wide range of opportunities to improve workflow through enhanced functionality with the EHR were identified. Targeted recommendations for EHR developers and ambulatory (outpatient) care centers are proposed to increase efficiency, allow for better eye contact between the physician and patient, improve physician’s information workflow, and reduce alert fatigue. These recommendations provide a first step in moving from a billing-centered perspective to a clinician-centered perspective.