Redesigning clinic workflows for electronic medical record integration

Electronic medical records (EMR) play a critical role in modern healthcare infrastructure, serving as the fundamental source of patient medical data. These medical records can function variously as a comprehensive record of past visits, a tool to aid physicians' diagnoses, a system to manage operational details during a patient visit, and an effective and accurate billing mechanism for insurance plans. In 2010, the University of Virginia (U.Va.) Medical Center adopted EpicCare EMR across its hospital and one-hundred and seventy-two ambulatory clinics to deliver higher quality patient care. With a focus on three U.Va. Orthopedics division clinics, this project seeks to characterize the current workflows involving EpicCare, identify opportunities for improvement, and evaluate and recommend a strategy for improving clinic operations. The iterative approach encompassed observations in each target clinic, discussions with employees and administration, and visualizations of the workflows for each clinic. Observation results were synthesized into findings, and related back to defined core objectives. Workflow variance, both within and among clinics, was analyzed to ultimately determine the best method to complete tasks common to all clinics. These tasks were further examined to determine if variability could be changed, whether this change could be beneficial, and the root cause of the variability. Alternatives for mitigating variability and improving the employee workflow across all clinics within U.Va. Orthopedics were generated, addressing each task with specific, tailored solutions. These alternatives can be evaluated according to identified metrics, based on feasibility and projected benefit.