Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States.
Institute for Child Health Policy, University of Florida, Gainesville, FL, United States.
JMIR Mhealth Uhealth. 2021 Mar 31;9(3):e18534. doi: 10.2196/18534.
eHealth apps often fail to improve clinical outcomes due to poor integration with clinical workflow-the sequence and personnel needed to undertake a series of tasks for clinical care. Our central thesis is that eHealth interventions will be more effective if the clinical workflow is studied and taken into consideration for intervention implementation. This paper aims to provide an introductory tutorial on when and how to use a clinical workflow analysis to guide the implementation of eHealth interventions. The tutorial includes a step-by-step guide to conducting a clinical workflow analysis in planning for eHealth implementation. We began with a description of why a clinical workflow analysis is best completed before the implementation of eHealth interventions. Next, we described 4 steps needed to perform the clinical workflow analysis: the identification of discrete workflow components, workflow assessment, triangulation, and the stakeholder proposal of intervention implementation. Finally, we presented a case study of a clinical workflow analysis, which was conducted during patient visits of patients aged 11 or 12 years from 4 diverse pediatric or family medicine clinics to plan the implementation of a tablet-based app for adolescent vaccination. Investigators planning the implementation of new eHealth interventions in health care settings can use the presented steps to assess clinical workflow, thereby maximizing the match of their intervention with the clinical workflow. Conducting a prospective workflow study allows for evidence-based planning, identifying potential pitfalls, and increasing stakeholder buy-in and engagement. This tutorial should aid investigators in increasing the successful implementation of eHealth interventions.
电子健康应用程序由于与临床工作流程（为临床护理进行一系列任务所需的顺序和人员）整合不佳，往往无法改善临床结果。我们的核心论点是，如果研究临床工作流程并将其纳入干预措施的实施考虑，电子健康干预措施将更加有效。本文旨在提供一个关于何时以及如何使用临床工作流程分析来指导电子健康干预措施实施的入门教程。本教程包括在规划电子健康实施时进行临床工作流程分析的分步指南。我们首先描述了为什么在实施电子健康干预措施之前最好完成临床工作流程分析。接下来，我们描述了执行临床工作流程分析所需的 4 个步骤：离散工作流程组件的识别、工作流程评估、三角剖分以及利益相关者提出的干预实施建议。最后，我们展示了一个临床工作流程分析的案例研究，该研究在来自 4 个不同儿科或家庭医学诊所的 11 或 12 岁患者就诊期间进行，旨在规划为青少年接种疫苗的基于平板电脑的应用程序的实施。在医疗保健环境中计划实施新的电子健康干预措施的研究人员可以使用呈现的步骤来评估临床工作流程，从而最大程度地使干预措施与临床工作流程相匹配。进行前瞻性工作流程研究可以进行基于证据的规划，识别潜在的陷阱，并增加利益相关者的认同和参与。本教程应有助于研究人员提高电子健康干预措施的实施成功率。
