Importance of Workflow Analysis During Physician Office EMR Implementation

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Mapping the workflow processes is a very simple exercise, but frequently not taken seriously with a high enough level of detail. Every step, no matter how small, needs to be mapped out. The mapping can be sophisticated (using specialized software such as Visio) or very simple (table paper taped to the break room wall). The objective is to capture every step along the way: every decision point and every hand off between staff. It is not uncommon to uncover disparities between staff as to what actually is happening and who is doing what (or who is quietly following behind and fixing things that would have fallen through the cracks).


Electronic Medical Record (EMR) implementation is frequently considered an IT project: it is not.

EMR implementation is actually a clinical project with a strong IT component. Providers and staff with limited computer skills may experience high anxiety during the conversion to an electronic record.

Only basic computer skills are necessary for a successful implementation (if they can check their email they have the necessary skills). The real difficulty in EMR implementation is the total disruption and consequent redesign of office workflow. The first step in managing this process is workflow mapping of the current (paper) processes.

Workflow mapping also identifies visual cues that will go away with the advent of electronic records. The paper chart is a frequent indicator of which exam rooms have patients in them, which patients need a phone call, or what dictation needs to be done. Forms and papers serve similar functions. Identification of these cues helps to plan for how these processes will be managed in the new system.

Another benefit of workflow mapping is that it helps the EMR vendor implementation coordinator understand the practice. The vendor should be an expert in their system but a stranger to the practice. While there are general commonalities between practices each practice is unique in itself. The members of the practice are experts in their office but don’t have enough product knowledge to be able to make informed decisions about EMR processes. Workflows done in conjunction with the vendor are invaluable in successful implementation. The implementation coordinator should take the existing workflows and help guide the practice in effective product utilization. The process also serves to help the practice start to understand the product early in the implementation. The practice should bring in different users during the creation of new workflows. The more people involved the better the outcome.

In summary, workflow analysis of current processes is a valuable tool to be used in EMR implementation. No implementation is perfect, but careful analysis and planning help to minimize the possibility of major system oversights. Additionally it builds understanding between the EMR vendor’s implementation coordinator and practice staff and can also lessen the disruption felt during the conversion from paper to electronic records.