EHR Airport Control Towers, Automobile Engines, And Aviation Cockpits: Analogies & Metaphors

(This is a full-text transcription of one slide from my November 5th 42-minute webinar on Ebola and EHR Workflow Engines, Editors, and Visibility. Please excuse occasional “typos” as I’ve not proofed every word. Consider watching the Youtube video or going to first slide in this transcribed series. My original post announcing the webinar includes motivating context and an outline. Thank you!)

We’re going to talk about visibility. Before we talk about the relationship between customizable workflow, workflow engines and task visibility, we need to lay a little bit of groundwork. 15 years ago, at HIMSS in Atlanta. HIMSS00 at AT., this was one of my presentations and was called Workflow enabled CPRs. This is even before people called systems electronic health records or electronic medical records, these were computerized patient records. In the middle, you have that engine that I’m talking about, the engine that consumes instructions. Over on the right, you have the aviation cockpit. I spent a year in aviation human factors at the University of [inaudible 00:08:54] and I graduate a degree in Industrial Engineering, one of the top programs in the world.

I learned about Fitts’ law and Hick’s law. Fitts’ law is the larger the target is, the larger a button is, the easier it is to hit accurately and quickly. Hick’s law is the number of options on the screen. The fewer there are, the more likely you can select the right one. It’s the job of the workflow engine consulting the workflow model to put the right buttons on the right screens and to filter out all of the extraneous, irrelevant content. If you don’t have that workflow engine, you get an explosion of the space you have to search in order to figure out what to do next.

Even if you have a workflow engine and you have a user customizable and improvable workflow model that’s being executed, sometimes tasks still fall between the cracks. Over on the left is the control tower of an airport. In that tower, you have what the usability engineer calls a ‘radar view’. You can see all of the patients and all of the planes, how long has they been waiting in their exam rooms on the runways or stacked up. You know how many minutes of fuel they have left. You can note exceptional circumstances and jump in there and fix them so that maximized throughput, while preserving safety. That’s actually called BAM or business activity monitoring in the business process management world, which I’ll go talk about briefly at the end.

  1. Transcribed Slides For My 42-Minute Webinar on Ebola, EHR Workflow Engines, Editors, and Visibility
  2. Outline: Ebola, EHR Workflow, Workflow Tech, Workflow Engines, Editors, and Visibility
  3. “Poke the workflow bear” Refers To Mentioning Me On Twitter!
  4. Dallas Hospital Blames Flaw In Workflow For Release of Ebola Patient, Then Retracts
  5. Ebola Workflow, Nurse Workflow, Physician Workflow, EHR Workflow: Part 1
  6. EHR Workflow Is A Series Of Steps, Consuming Resources, Achieving Goals
  7. EHR Workflow System, Like OR Nurse, Hands Right Screen to Right Person At Right Time
  8. EHR Workflow Engine Executes EHR Workflow Definition, Performing Work For EHR Users
  9. EHR Workflow Driven By Workflow Engines Consulting Workflow Definitions Created By Non-Programmer EHR Users
  10. Not There Yet, But Physicians Will Design EHR Workflows Dragging And Dropping Tasks
  11. Classic EHR Workflow Definition Editor Looks Like Traditional Visio Flowchart
  12. EHR Airport Control Towers, Automobile Engines, And Aviation Cockpits: Analogies & Metaphors
  13. EHR Workflow Tech Enables Smart Sequences And Simultaneous Actions
  14. EHR Tasks Much More Visible Because Workflow Engine Tracks Task Status
  15. Staff Prepare For Procedures Without Being Told, EHR Workflow System Coordinates
  16. EHR Screen At A Time, Only Relevant Data, Tweakable Workflow, Key Tests Not Forgotten
  17. Healthcare Needs Executable Process Model Between Clinicians And Data
  18. Hospitals Need Executable Process Model Betweet Human Workflow And Computer Data
  19. Rebranding Business Process Management For Healthcare
  20. Ebola Workflow, Nurse Workflow, Physician Workflow, EHR Workflow: Part 2
  21. “It’s really made my life much easier and the staff love it!” 2004 HIMSS Davies EHR Winner
  22. Thank You! Questions About EHR Workflow Engines, Editors, and Visibility? Slide 22 and Notes
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