Survey: EHR Workflow Management System Features & Functions

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In 2003 and through 2005, I contributed to, and updated, the General Workflow Management Criteria portion of the “Workflow Management Survey: Ambulatory EHR Systems” survey, conducted by Andrew & Associates, which appeared in Advance for Health Information Executives. It’s been four years WfMS technology has been creeping into the EHR mainstream, so it’s worth an update and a raising of the bar, so to speak. 

Here are the originally described EHR WfMS features and functions:

  1. System displays selected worklists for active cases.
  2. System permits employees to view and complete work items that have been assigned to other employees.
  3. System creates reminders for work items that have not been completed when due.
  4. Users can selectively modify assigned work items.
  5. System maintains a record of various changes made to work items.
  6. System maintains various records of completed activities.
  7. Users can selectively correct or modify records of completed activities.
  8. System has a workflow engine that automatically creates work items based on a workflow definition using various defined criteria.
  9. Users can customize workflow definitions to match their internal processes using various defined criteria.
  10. Users can define roles and resources that will receive task assignments.
  11. Users can edit workflow definitions using a graphical user interface.
  12. Software vendor provides workflow definitions for individual medical specialties.

A good start six years ago, however they actually barely scratch the descriptive surface of a fully functional EHR WfMS. (Although, if one had to prioritize, criteria 8, 9, and 11 are arguably the most important and the basis for my Litmus Test for Detecting Frozen EHR Workflow post.)


I’ve tentatively expanded these 12 criteria almost fourfold on a special page I’ve added to this blog titled, Electronic Health Records Workflow Management Systems Features & Functions Survey. If you fill out the survey, whatever comes in over the transom I’ll summarize back to the blog. By “tentatively” I mean that this survey is more of a rough public draft intended to attract comment, critique, and suggestions for improvement than anything that could be considered a polished final product.  I’d rather put out something imperfect now so it can be improved by critique than hold onto it while making successive smaller and smaller improvements.

This EHR WfMS F&F Survey is *not* intended to be an exercise in systematically comparing EHR WfM and EHR WfM-like systems. It could be used that way, however my primary goal is to raise awareness about the details and importance of EHR WfMS features/functions, and to create and improve a conceptual framework for understanding EHR WfMS and EHR WfMS-like applications.

You are welcome to submit data anonymously or not, to complete all or only some items, or to only provide comments on specific items. I am particularly interested in comments from workflow management systems and business process management professionals who would like to see this technology and way of thinking brought to healthcare in general and electronic health records in particular.

I’ll make minor revisions to the page in place. However, for larger revisions I’ll release a new version of the survey and archive the old one.

Yes, I know my terminology may be somewhat at variance with that of the WfMS industry. And yes, I know that in some cases I essentially ask the same question more than once in different ways. This is partly due to the old survey stratagem of asking the same question in different ways as a form of validity check and partly due to my observation that, in the electronic health records industry, workflow management systems terminology is not yet, in fact, typically standard with that of the workflow management systems industry. In other words, an EHR professional may use (and therefore recognize) other words than that adopted by the WfMS industry and I am trying to be accessible to both EHR and WfMS professionals.

I eventually plan to add business process management oriented material, however while WfMS ideas and terminology have become relatively standard, BPM is a moving target, so I’ll focus first, here, on WfMS aspects of EHR functionality. That said, implications of BPM for electronic health records are fascinating and important, so I’ll certainly post on the topic.

My hope is that improving these survey criteria might eventually become a community effort. Perhaps some sort of open source model based on ideas from the creative commons might apply. I’m thinking of a downloadable version coded in XML to facilitate sharing and co-development. (Is there an XML questionnaire schema that might be appropriate here?) I’m open to suggestions.

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