EMR Workflow Systems vs. EHR Workflow Management Systems

Short Link: http://ehr.bz/la

I’ve added a new page to this website about “Pediatric EMR Workflow Systems” (”Pediatric EMR WfSs” to get it to fit on a WordPress navigational tab). A majority of EncounterPRO users are pediatricians. Technically, they are not using the EncounterPRO EHR Workflow Management System. They are using the product of it, which, using conventional terminology from the workflow management systems/business process management industry, is really a workflow system (not, a workflow *management* system). We don’t harp on this distinction in either marketing or educational materials, because it really doesn’t matter to the user. What matters is that the software makes their life easier and helps them help their patients get better. For instance, you don’t need an art appreciation class to appreciate great art. However, this blog is into making important fine distinctions. So here is one. There is an important conceptual (and practical) difference between an EHR Workflow Management System and an EMR Workflow System.

(By the way, if you noticed that I switched from “EHR” to “EMR” in mid-paragraph, sorry! To some people they mean different things. Others use the terms synonymously. I tend to switch back and forth as a sort of offering to the great search engine gods that rule the Web. However, I’m thinking of reserving “EHR” for “EHR Workflow Management System” and “EMR” for “EMR Workflow System.”)

Just as workflow management systems are used to create and manage workflow systems–as discussed in Prof. van der Aalst’s book on workflow management systems–EHR workflow management systems are used to create and manage specialty-specific EMR workflow systems, in this case pediatric EMR workflow systems. This is similar, by analogy, to the way in which database management systems are used to create and manage database systems. Your baseball card collection database is a database system; it was a database management system, such as MS Access, that created and manages it.

“A workflow management system is a software package for the implementation of a workflow system. The term refers to a universally applicable system; in other words, a workflow management system is not customized to a specific business situation. By configuring such a system, it is turned into one which supports specific workflows. Unlike a workflow system, a workflow management system is a generic application.” (Page 357, Wil van der Aalst, Kees Max van Hee, Workflow Management: Models, Methods, and Systems, MIT Press, 2004.)

“A workflow system is one that supports the workflows in a specific business situation. Unlike a workflow management system, a workflow system usually consists of a workflow management system plus process and resource classification definitions, applications, a database system, and so on. We can compare the difference between a workflow management system and workflow system to that between a database management system and a database system.” (Page 357, Wil van der Aalst, Kees Max van Hee, Workflow Management: Models, Methods, and Systems, MIT Press, 2004.)

When you fill an EHR workflow management system with pediatric-specific content (picklists for pediatric symptoms, physical findings, assessments, treatments and so on), add pediatric-specific screens for immunization management, growth tracking, developmental checklists, rely on pediatric-specific functionality such as pediatric dosing and data norms, *and* create the necessary pediatric-specific workflow definitions (also known as process definitions), the result is a pediatric EMR workflow system.

So far I think I’ve done a good job of posting about the general (that is, universal) characteristics of EHR workflow management systems (for example, “What’s So Special about EHR Workflow Management Systems?” and “Litmus Test for Detecting Frozen EHR Workflow”) while touching on EHR business process management as well. However, while EMR customizers (”customizers”, not “customers”)  interact directly with an EHR workflow management system (three words!), physicians, physician assistants, nurses, technicians, and administrative staff typically do not. They interact directly with the EMR workflow system (two words!) that pops out when you turn the crank on the EHR workflow management system.

I took a poetry class once in which the instructor said that universal truth is reflected in specific experience. This blog will continue to be about (universal) EHR workflow management systems ideas, technologies, and products. However I think it needs a good dose of specifics. So I’m planning a series of posts describing specific pediatric EMR workflow systems, functionality, and features.

(Although I’ll probably slip up once in a while and refer to pediatric EMR workflow management systems, pediatric EHR workflow management systems, pediatric EHR workflow systems, or plain ol’ pediatric EMRs, too. It’ll be good for the search engines.)