The myth of standardized workflow in primary care

Journal of the American Medical Informatics Association : JAMIA
G Talley HolmanTosha B Wetterneck

Abstract

Primary care efficiency and quality are essential for the nation's health. The demands on primary care physicians (PCPs) are increasing as healthcare becomes more complex. A more complete understanding of PCP workflow variation is needed to guide future healthcare redesigns. This analysis evaluates workflow variation in terms of the sequence of tasks performed during patient visits. Two patient visits from 10 PCPs from 10 different United States Midwestern primary care clinics were analyzed to determine physician workflow. Tasks and the progressive sequence of those tasks were observed, documented, and coded by task category using a PCP task list. Variations in the sequence and prevalence of tasks at each stage of the primary care visit were assessed considering the physician, the patient, the visit's progression, and the presence of an electronic health record (EHR) at the clinic. PCP workflow during patient visits varies significantly, even for an individual physician, with no single or even common workflow pattern being present. The prevalence of specific tasks shifts significantly as primary care visits progress to their conclusion but, notably, PCPs collect patient information throughout the visit. PCP workflows were unpre...Continue Reading

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Citations

Feb 26, 2016·Journal of the American Medical Informatics Association : JAMIA·Charlotte TangYunan Chen
Jun 16, 2018·Health Informatics Journal·Michael W SmithHardeep Singh
Feb 8, 2020·JMIR Medical Informatics·Abdulrahman Mohammed Jabour
Sep 23, 2020·Health Care Management Science·Sujee LeeJingshan Li
Apr 16, 2019·JMIR Human Factors·Safiya RichardsonDevin Mann
Oct 13, 2018·Medwave·Alejandra Rodríguez TorresDonovan Casas Patiño
Dec 28, 2018·Journal of the American Medical Informatics Association : JAMIA·Jeffery L BeldenRichelle J Koopman
Jul 8, 2020·International Journal of Environmental Research and Public Health·Suvi VainiomäkiHannele Hyppönen
Sep 1, 2017·Current Diabetes Reports·Yao Liu, Rebecca Swearingen
Jan 19, 2021·Journal of Patient Experience·Jaya AysolaRachel M Werner
Feb 25, 2021·JMIR MHealth and UHealth·Stephanie StarasElizabeth A Shenkman
May 22, 2019·Applied Ergonomics·Scott R WalterJohanna I Westbrook
Dec 1, 2020·Applied Ergonomics·Rupa S ValdezPascale Carayon

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