Dallas Hospital Blames Flaw In Workflow For Release of Ebola Patient, Then Retracts

(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!)

slide04
On October 3rd, I woke up and I had hundreds of mentions and people emailing me, including health IT journalists, contacting me through contact forms of one of my blogs asking me about this headline which is “Dallas hospital blames ‘flaw’ in ‘workflow’ for release of Ebola patients.” I actually end up quoted in quite a few health IT publications and was exciting moment for me to see workflow up there in lights.

  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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Ebola Workflow, Nurse Workflow, Physician Workflow, EHR Workflow: Part 1

(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!)

slide05
Interestingly enough, the next day, the hospital retracted the statement that there was a flaw in the HRE workflow. The other half of the health IT community went ‘aha’, it was a human or user error. We’ll talk about that at the end of this presentation. On the second one, a PR release came out, which I read on the third, it talked about visibility of workflow. The nurse collected the information supposedly about travel from Africa and somehow, the result of this wasn’t part of the physician workflow, it wasn’t visible. All of this is going to a build-up to what does it mean, to have visible workflow, but I’m using a lot of analogy and metaphor.

  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
Posted in ebola | Leave a comment

EHR Workflow Is A Series Of Steps, Consuming Resources, Achieving Goals

(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!)

slide06
Let’s start with the basics. I have looked at literally hundreds of definitions of workflow, some of which would fill multiple PowerPoint slides. This is my favorite definition, because I made it up: “A series of steps, consuming resources, achieving a goal.” If you’ve ever written out a workflow on a napkin, labeled boxes with little arrows to explain workflow to someone else, I’m sure you’re familiar with that. Consuming resources; each workflow step requires a widget from inventory or the time of some user or some access to some other system that’s talking to and it consumes these resources; it can’t perceive without those resources, but it also costs something. The amount of time the user spends interacting with, say a data entry screen is part of that. Finally, the workflow achieves a goal. That goal is the benefit of the workflow.

What we’ve connected up here is a series of steps to cost and benefit. If the cost and the benefit change, if the economics of the workflow change, you should be able to change the workflow. Unfortunately, many workflows and health IT and many EHRs are relatively frozen and that’s one of the sterling qualities that workflow technology brings to EHRs and health IT. It makes it easy to change the workflow when contexts change in order to make the users happier and more effective and efficient.

  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
Posted in ebola | Leave a comment

EHR Workflow Engine Executes EHR Workflow Definition, Performing Work For EHR Users

(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!)

slide08
Here we have a very basic workflow. Let’s say the patient’s been taken to the exam room and the nurse asks about allergies, medications, take some vitals, information and initial chief complaint, reason for visit. Then, another person or role takes over; the physician conducts a physical exam, makes an assessment, prescribes something, okay some codes to go off to the billing system. That’s a very, very basic ambulatory workflow. Instead of the user having to drive the screens from screen to screen and find the right screen or find the right person or figure out that they are the right person, the workflow engine is putting up the right screen at the right moment for the right person. That is part of the magic or the intelligence of the workflow.

  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
Posted in ebola | Leave a comment