1. Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b This material Comp10_Unit4b was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.

2. Acquiring Clinical Process Knowledge Learning Objectives 2 1.Identify how the strategic goals and stakeholders for a given health care facility can influence workflow processes in that facility (Lecture a) 2.Create an agenda for an opening meeting to discuss workflow processes in a health care facility (Lecture b) 3.Compare and contrast different types of knowledge and their impact on organizations (Lecture a) 4.Analyze a health care scenario according to CMMI levels (Lecture a) 5.Identify the workflow processes that are likely to be used by a healthcare facility (Lecture b) 6.Identify the workflow processes that are essential to document and analyze in order to determine how best to streamline the operations in a given health care facility (Lecture b) 7.Identify key individuals with whom the analyst should meet or observe in order to gain an understanding of the nature and complexity of their work (Lecture b) Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

3. Acquiring Clinical Process Knowledge Learning Objectives - Continued 8.Given a process observation scenario, formulate the questions that would facilitate a productive discussion of the workflow of information, activities and roles within that facility (Lecture c) 9.Suggest ways to successfully respond to common challenges encountered in knowledge acquisition (Lecture c) 10.Given a practice scenario, choose an appropriate knowledge acquisition method (Lecture c) 11.Given a process analysis scenario including a list of observations, create agenda for visit closing meeting and an initial meeting report (Lecture c) 12.Given a set of diagrams and observations from an information gathering meeting draft a summary report (Lecture c) 3 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

4. Topics - Lecture b Clinic information Common clinic processes Creating a process inventory 4 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

5. Acquiring Knowledge About the Practice Mission, Vision Stakeholders Publicly available or easily provided Do your homework! 5 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

6. Stakeholders Individual or group that participates in a process or organization –Or is impacted by it Examples of organizational stakeholders include: –Patients –Owners or shareholders –Suppliers –Payers –Employees –Regulators 6 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

7. Practice Functions 7 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b Office visits Lab tests Other Diagnostic tests (depends on specialty) New patientExisting patient Billing Procedures Write prescriptions Disease management Medical Practice Referrals / consults

8. Process Inventory Identification of main clinic processes Analyst works with clinic leadership to identify high priority processes Select processes are analyzed –Some can’t be improved –Some the gain is too small –Some can be improved, but by means other than use of health IT 8 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

9. Process Value Some processes are very important and if the process is not doing what it is supposed to do, the organizational mission and certainly productivity may suffer Some are less significant in terms of the operations 9 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

10. Common Clinic Processes Patient check-in Patient visit Prescriptions Assimilating received documentation Labs Other diagnostic tests Referral/consult Disease management Billing 10 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

11. Identifying Practice Processes Example By Phone Appointment Scheduling New Patient Intake and Registration –Using paper charts Receiving and Communicating Lab Results –Using a paper chart Routine Prescription Refill –No EMR 11 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

12. Identifying Practice Processes Example: Answers and Discussion Appointment Scheduling Patient check-in Patient visit Prescriptions Assimilating received documentation Labs 12 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

13. For each process Process variations used by the clinic For each of these –Main activities –Roles –Locations –Flow –Information needs –Likely exceptions 13 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

14. The Act of Acquiring Knowledge The act of acquiring the knowledge is just as important as the resulting diagrams. 14 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

15. Where to get the information Process participants Facility procedure manual Information used and produced in the process 15 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

16. Acquiring Clinical Process Knowled ge Summary - Lecture b Clinic information Common clinic processes, and Creating a process inventory 16 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b

17. Acquiring Clinical Process Knowledge References – Lecture b 17 Health IT Workforce Curriculum Version 3.0/Spring 2012 Fundamentals of Health Workflow Process Analysis and Redesign Acquiring Clinical Process Knowledge Lecture b References Acknowledgement: Material used in this lecture comes from the following sources Gaines, Brian R. (n.d.) Organizational Knowledge Acquisition. Accessed August 1, 2010. Available free from http://pages.cpsc.ucalgary.ca/~gaines/reports/KM/OKA/index.html http://pages.cpsc.ucalgary.ca/~gaines/reports/KM/OKA/index.html Milton, N. R. (2007). Knowledge Acquisition in Practice: A Step-by-step Guide (Decision Engineering). London: Springer-Verlag. Passive Knowledge Versus Active Knowledge, March 4, 2010. Accessed on August 2, 2010, available from http://www.beyonduni.com/2010/03/passive-knowledge-versus-active-knowledge/ http://www.beyonduni.com/2010/03/passive-knowledge-versus-active-knowledge/ Images Slide 7: Source: Meredith Nahm, PhD.