AHRQ zeroes in on health IT workflow

By Bernie Monegain
10:14 AM
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The Agency for Healthcare Research and Quality (AHRQ) plans to assess how health IT affects the quality of care. The agency is asking the Office of Management and Budget (OMB) to approve the information collection project: “Workflow Assessment for Health IT Toolkit Evaluation.”

The project willl focus on small- and medium-sized physician practices.

The estimated total cost of  the project is $793,456 over a 27-month period from Sept. 23, 2011 to December 22, 2013. The estimated average annual cost is $352,646.

The notice of the project, requesting public comment, was posted in the Federal Register March 9.

Quality and workflow
AHRQ notes that it is a lead federal agency in developing and disseminating evidence and evidence-based tools on how health IT can improve healthcare quality, safety, efficiency, and effectiveness.

“Understanding clinical work practices and how they will be affected by practice innovations such as implementing health IT has become a central focus of health IT research,” say AHRQ officials. “While much of the attention of health IT research and development had been directed at the technical issues of building and deploying health IT systems, there is growing consensus that deployment of health IT has often had disappointing results, and while technical challenges remain, there is a need for greater attention to sociotechnical issues and the problems of modeling workflow.”

The implementation of health IT in practice is costly in time and effort and less is known about these issues in small- and medium-sized practices where the impact of improved or disrupted workflows may have especially significant consequences because of limited resources.

“Practices would derive great benefit from effective tools for assessing workflow during many types of health IT implementation, such as creating disease registries, collecting quality measures, using patient portals, or implementing a new electronic health record system.

To that end, in 2008, AHRQ funded the development of the Workflow Assessment for Health IT toolkit. Through the toolkit, say officials, end-users should obtain a better understanding of the impact of health IT on workflow in ambulatory care for each of the following stages of health IT implementation:

  • determining system requirements,
  • selecting a vendor,
  • preparing for implementation, or
  • using the system post implementation.

They should also be able to effectively utilize the publicly available workflow tools and methods before, during and after health IT implementation. The agency is conducting an evaluation to ensure that the newly developed workflow toolkit is useful to small- and medium-sized ambulatory care clinic managers, clinicians and staff.

The evaluation will consist of field assessments of use of the workflow toolkit in 18 small- and medium-sized practices and gathering feedback from two Health IT Regional Extension Centers (RECs) that are providing support to some of these practices. The evaluation will address the issues of system validation as classically defined in software engineering: determining whether the software or system actually meets the requirements of the user to perform the relevant tasks.

The proposed evaluation will be conducted to examine usefulness of the workflow toolkit in small- and medium-sized practices.

The evaluation will be conducted with 18 practices affiliated with one of two practice-based research networks (PBRNs) in Oregon and Wisconsin, and with the Health IT Regional Extension Centers (RECs) in those states.