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Mapping Multi-Site Clinic Workflows to Design Systems-Enabled Interventions.

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Workflow diagrams streamline colorectal cancer screening implementation across multiple clinics. Documenting variations using these diagrams improves electronic health record (EHR) tool integration and data feedback for better patient care.

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Area of Science:

  • Health Services Research
  • Clinical Informatics
  • Preventive Medicine

Background:

  • Clinical processes for preventive interventions vary significantly across different health systems.
  • Implementing standardized interventions, like colorectal cancer screening, is challenging due to these variations.
  • Electronic Health Records (EHR) offer potential but require careful integration with existing workflows.

Purpose of the Study:

  • To present a method for documenting clinical process variations using workflow diagrams.
  • To demonstrate how understanding workflow variations aids the implementation of EHR-embedded interventions.
  • To improve the effectiveness of colorectal cancer screening interventions across multiple sites.

Main Methods:

  • Mapped variations in ordering/documenting fecal testing, colonoscopies, and pathology results across 26 safety net clinics.
  • Developed clinic-specific workflow diagrams.
  • Distilled clinic-specific diagrams into consolidated versions capturing key variations.

Main Results:

  • Identified significant variations in how clinics store and use colorectal cancer screening information.
  • Workflow diagrams facilitated the optimization of fecal test kit distribution to patients.
  • Informed the rollout of new EHR tools and identified best practices for data capture.

Conclusions:

  • Workflow diagramming is highly valuable for implementing and refining EHR tools in multi-site clinical settings.
  • The process revealed successful practice recommendations and potential limitations of research interventions.
  • This documentation method can enhance other EHR-powered multi-site research and improve EHR data feedback to clinicians.