Developing a Workflow Composite Score to Measure Clinical Information Logistics. A Top-down Approach

Area of Science:

• Health Informatics
• Information Systems in Healthcare
• Clinical Workflow Analysis

Background:

• IT application usage is well-studied, but IT support for clinical processes, termed clinical information logistics, requires further understanding and measurement.
• Operationalizing and measuring clinical information logistics is crucial for optimizing healthcare IT systems.

Purpose of the Study:

• To propose and develop a workflow composite score (WCS) for quantifying clinical information logistics.
• To assess the quality of the WCS through reliability and validity analyses.

Main Methods:

• Followed a procedural model for construct conceptualization, instrument development, and validity assessment.
• Defined clinical information logistics using descriptors: data/information, function, integration, and distribution.
• Selected and measured representative clinical processes (ward rounds, pre/post-surgery, discharge) across 183 diverse hospitals.

Main Results:

• The WCS framework was validated against international literature and refined with sample clinical processes.
• High reliability (r=0.89) and good validity were demonstrated through group discrimination and correlation with EHR models.
• Chief Information Officers provided positive evaluations of the WCS.

Conclusions:

• The WCS is a reliable and valid measure for clinical information logistics.
• Its design, not assuming ideal workflows, suggests high portability across international healthcare settings.
• The WCS will enhance the understanding and measurement of clinical information logistics.