Far from being a minor issue, productivity loss can cripple the healthcare office operations.  It can cause a cash flow drain of thousands of dollars per month, embarrassing mistakes and result in poor staff morale.

It’s especially important when you are installing a new system like an EHR, to make sure the proper workflows and procedures are in place. It will be tough enough implementing an electronic medical records system without having to deal with any more productivity loss than absolutely necessary.

For example, some occurrences noted after EHR implementations have included:

• Physician complaints about too much time being used for a patient encounter.
• Not maximizing system use in financial transaction resulting in not being able to track hundreds of thousands of accounts receivable dollars in the system.
• Awkward use of system templates instead of customizing them for the practice.
• Lagging productivity from the way work was done in the paper environment.
• Too much time being taken to train physician and staff.

To effectively design an optimum workflow, you need to take the following two steps:

• Current Analysis: Begin with analyzing precisely how paper and information flows between departments now.  This is usually done by interviewing the staff and documenting via a workflow chart the steps necessary to do the work. The idea is not to find fault with the steps but to develop good documentation so that no vital steps are missed during the electronic implementation.

It can be a daunting task. For example, you might find there are up to 12 work steps used to refill a prescription or 10 steps to finding a lost chart. It takes time, dedication and expertise to thoroughly complete a current workflow analysis.

• Redesign: The idea is to automate as many mundane and repetitive steps as possible making sure that all of the crucial information flows smoothly.  To do this effectively, you must ask encompassing questions.

For example, if you were going to chart how to complete nursing intake, you might ask- what information needs be in the system for the nurse to efficiently complete the nursing intake process? This will help make sure that only the vital steps are noted and any redundancies or wasteful processes be eliminated.

The workflow redesign process is best completed prior to the EHR implementation. If you do it after the fact, productivity will take an even greater hit.