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A simulation framework for evaluating electronic order workflows in integrated health records
Yang Chen1, Haoran Niu2, Olufemi A Omitaomu2
1Computational Sciences and Engineering Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA. cheny4@ornl.gov.
Npj Health Systems
|July 29, 2026
Summary
Electronic health record (EHR) systems require workflow optimization. A simulation framework using real-world data identified critical bottlenecks and resource constraints impacting order processing efficiency in healthcare.
Area of Science:
- Health Informatics
- Operations Research
- Healthcare Systems Engineering
Background:
- Electronic health record (EHR) systems are vital for healthcare, but their order processing workflows are not well understood.
- Inefficiencies in EHR order processing can lead to care delays, increased workload, and patient harm.
Purpose of the Study:
- To develop and apply a discrete-event simulation framework to model and analyze EHR order processing workflows.
- To identify bottlenecks and evaluate the impact of workflow changes and resource constraints on healthcare system performance.
Main Methods:
- Utilized real-world data from the Veterans Health Administration's Corporate Data Warehouse.
- Developed a discrete-event simulation model mapping order events to state transitions across various facilities.
- Calibrated and validated the simulation model using empirical data and observed performance metrics.
Main Results:
- The simulation accurately reflected historical EHR order processing performance.
- Resource capacity constraints were found to significantly worsen the impact of order surges, leading to delays and backlogs.
- Network analysis identified critical workflow states and transitions acting as bottlenecks, particularly 'Reserved', 'InProgress', and 'Completed' states.
Conclusions:
- Simulation-based approaches are effective for monitoring EHR order processing and assessing workflow impacts.
- The developed framework offers a scalable, data-driven tool for operational decision-making in complex healthcare environments.
- Optimizing EHR order management is crucial for improving healthcare efficiency and patient care.
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