School of Public Health, Department of Health Management and Policy, The University of Michigan, Ann Arbor, Michigan 48109-2029, USA.
J Am Med Inform Assoc. 2010 Jul-Aug;17(4):454-61. doi: 10.1136/jamia.2010.004440.
Health IT implementations often introduce radical changes to clinical work processes and workflow. Prior research investigating this effect has shown conflicting results. Recent time and motion studies have consistently found that this impact is negligible; whereas qualitative studies have repeatedly revealed negative end-user perceptions suggesting decreased efficiency and disrupted workflow. We speculate that this discrepancy may be due in part to the design of the time and motion studies, which is focused on measuring clinicians' 'time expenditures' among different clinical activities rather than inspecting clinical 'workflow' from the true 'flow of the work' perspective. In this paper, we present a set of new analytical methods consisting of workflow fragmentation assessments, pattern recognition, and data visualization, which are accordingly designed to uncover hidden regularities embedded in the flow of the work. Through an empirical study, we demonstrate the potential value of these new methods in enriching workflow analysis in clinical settings.
医疗信息技术的实施常常给临床工作流程和工作方式带来根本性的改变。先前研究这一影响的结果相互矛盾。最近的时间和动作研究一直发现这种影响可以忽略不计;而定性研究则反复揭示了负面的终端用户感知,表明效率降低和工作流程中断。我们推测,这种差异可能部分归因于时间和动作研究的设计,该研究侧重于衡量不同临床活动中临床医生的“时间支出”,而不是从真正的“工作流程”角度检查临床“工作流程”。在本文中,我们提出了一组新的分析方法,包括工作流程碎片化评估、模式识别和数据可视化,这些方法旨在揭示工作流程中嵌入的隐藏规律。通过实证研究,我们展示了这些新方法在丰富临床环境中的工作流程分析方面的潜在价值。