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Efficient Workflow Analysis to Address Paper Persistence in Tuberculin Testing.

Sarah A Thompson¹, Eli Dawson¹, Swaminathan Kandswamy²

¹Children's Healthcare of Atlanta, Atlanta, GA.

Studies in Health Technology and Informatics

|July 25, 2024

Summary

This summary is machine-generated.

Replacing paper-based Latent Tuberculosis Infection (LTBI) testing with electronic health records significantly improved documentation completion. This human-centered approach optimized clinical workflows for better patient data management.

Keywords:

Electronic health records nurse documentation paper persistence redesign workflow evaluation

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Area of Science:

Health Informatics
Clinical Workflow Optimization
Infectious Disease Management

Background:

Paper persistence remains a challenge in Electronic Health Records (EHRs), especially for multi-step clinical workflows.
Latent Tuberculosis Infection (LTBI) testing, involving Tuberculin Skin Tests (TST), exemplifies a complex workflow often reliant on paper documentation.
Existing paper-based systems hinder efficient documentation and retrieval of critical patient data.

Purpose of the Study:

To analyze and redesign a paper-based LTBI testing workflow using a low-resource approach.
To implement clinical decision support within an EHR to improve TST documentation and data retrieval.
To leverage human-centered design principles for successful electronic workflow integration.

Main Methods:

Conducted a workflow analysis of the existing paper-based TST process.
Applied human-centered design, including formative usability testing, with limited resources.
Developed and implemented a clinical decision support tool within the EHR system.

Main Results:

Achieved a significant increase in completed TST documentation from 57% (24/42) to 95% (18/19).
Demonstrated the feasibility of human-centered design and workflow analysis in resource-limited settings.
Successfully integrated an electronic solution that automated processes and fit clinical workflows.

Conclusions:

Low-resource workflow analysis and clinical decision support can effectively replace paper-based processes in EHRs.
Human-centered design is crucial for the successful adoption of electronic workflows in healthcare.
Optimizing LTBI testing workflows enhances documentation accuracy and data retrieval within EHR systems.