Workflow for Health Information Management. What is Workflow? Workflow Definition: Two Contexts. Workflow for HIM - OHIMA 2010
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1 Workflow for Health Information Management Why you need to analyze before you automate Ohio HIM Association (OHIMA) 2010 Barbara Hinkle-Azzara, RHIA What is Workflow? Workflow Definition: Two Contexts 1. Business Process Re-engineering (BPR) aka: TQM, Six Sigma, Lean The fundamental rethinking and radical redesign of business processes to achieve dramatic improvement in critical, contemporary measures of performance such as cost, quality, service and speed. Hammer, M., Champy, J.,(1993). Reengineering the Corporation: A Manifesto for Business Revolution., Harper Collins, London. 2010, Meta Health Technology Inc 1
2 Workflow Definition: Two Contexts 2. Software Automation an approach to analyzing and managing a business process that can be combined with an object-oriented programming approach, which tends to focus on documents and data. Search CIO.com powered by WhatIs.com an online computer dictionary Learning Goals 1. Where workflow concept started 2. Why workflow is so important to HIM 3. How to analyze your workflow 3Ts: techniques, tools, technology 4. Why you need to analyze workflow before you automate #1 Mantra Don t computerize a manual process that doesn t work! > 80% of EHRs fail because workflow analysis was not done well AHIMA Advanced Workflow Seminar- 12/2009 Most facilities only utilize 25% capacity of EHR Electronic Health Records: Where Do We Go From Here?, The New York Academy of Sciences Symposium- 2/5/ , Meta Health Technology Inc 2
3 What is Workflow? Literally: WORK FLOW History of Workflow 1940s 1980s Management Engineering (time & motion studies) Total Quality Management Vendor Perspective Automation 1990s Lean Methodology Benefits of Workflow Analysis Identify obstacles & gaps Improve utilization of resources Implement best practices Define roadmap for computerization ease transition from manual promote successful implementation 2010, Meta Health Technology Inc 3
4 Importance for HIM Improve HIM efficiencies Incentives from ARRA define roadmap for EHR achieve Meaningful Use Criteria accomplish 2014 implementation goal How to Analyze Your Workflow Three Ts Techniques Tools Technology T1: Techniques Identify opportunity & scope Identify key processes Select project team & sponsor Select analysis tool 2010, Meta Health Technology Inc 4
5 T1: Techniques Map current flow Obtain baseline data Map future flow Test future flow T1: Techniques Measure & evaluate outcomes Review & adjust flows as needed Apply mapping to automation T2. Analysis Tools Flow charts Swim lane diagrams Use cases Value stream mapping 2010, Meta Health Technology Inc 5
6 Current Flow Chart T2. Analysis Tools Review Chart Documentation clear? Yes Complete CDI Review Need clarification or specificity No Query necessary? No Yes Formulate query/ Complete query form Sufficient query content? No Clarify with specialist/ supervisor Yes Query the physician Routing mechanism? Phone Fax Current Flow Chart T2. Analysis Tools Future Flow Chart T2. Analysis Tools 2010, Meta Health Technology Inc 6
7 Swim Lane Diagram T2. Analysis Tools What is Workflow? T3. Technology The automation of a business process, in whole or part, during which documents, information or tasks are passed from one participant to another for action, according to a set of procedural rules. Workflow Management Coalition HIM Workflow Software Adoption AHIMA Survey Hybrid Record Survey 2009 Convention Summary Report, October , Meta Health Technology Inc 7
8 Workflow for HIM - OHIMA 2010 HIM Workflow Software Adoption AHIMA Survey Hybrid Record Survey 2009 Convention Summary Report, October HIM Workflow Software Adoption AHIMA Survey Hybrid Record Survey 2009 Convention Summary Report, October Benefits of Applying Automated Workflow Efficiency Effectiveness Customer satisfaction Employee motivation 2010, Meta Health Technology Inc 8
9 Efficiency Reduce waste due to manual effort/analysis Eliminate manual handoffs Achieve concurrent processing Get clear picture of productivity See lower costs/fewer FTEs Effectiveness Handle exceptions better/faster Make better decisions More control and accountability who s doing what, when where each item is in process Effectiveness Increase compliance Increase revenues Reduce errors Ensure tasks don't get lost 2010, Meta Health Technology Inc 9
10 Customer Satisfaction Administrators Doctors Patients Requestors Employee Motivation People take more pride in their work if they are part of a team, doing quality work. Automated Workflow Development Utilize process analysis Specify who does what, when Translate to workflow rules 2010, Meta Health Technology Inc 10
11 Automated Workflow Workflow Components Events Rules Queues Queue items Tasks Event a condition that can trigger automatic processing eg patient discharge financial class change nursing unit transfer 2010, Meta Health Technology Inc 11
12 Rule determines how an item is added to a queue is triggered by an event criteria can be simple complex Queue a list of items to be worked on eg inpatient coding queue outpatient abstract/coding queue release of info initial review queue Task a logical step or process eg scan/index coding analysis 2010, Meta Health Technology Inc 12
13 Workflow Engine Build it Once rules are defined, setup is complete Run it When triggered by events, workflow engine examines rules to determine which queues to populate Workflow Features Web-based Easy to use Flexible Integrated Workflow Features Document access Messaging Alerts Security 2010, Meta Health Technology Inc 13
14 Automated Workflow 1. Prioritize efforts! Summary 2. Take time to define current & future processes 3. Ensure necessary stakeholders involved 4. Monitor & report outcomes Most importantly Don t computerize a manual process that doesn t work! 2010, Meta Health Technology Inc 14
15 Recommended Review AHIMA E-LEARNING Health IT: Preparing for Implementation through Workflow Analysis X4434 OHIP (Ohio) Regional Extension Center Overview: Practice & Workflow Redesign HIMSS ME-PI Toolkit: Process Management & Mapping Questions? Contact Information Barbara Hinkle-Azzara, RHIA 2010, Meta Health Technology Inc 15
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