Answer #1: 
           To avoid pain and suffering
    • Many clinics have implemented health IT 
      only to find that they did not anticipate how 
      much health IT can change clinical and 
      administrative workflows. 
    • The unanticipated changes cause 
      considerable pain during and after 
      implementation for the clinic staff because 
      suddenly the way things have to get done 
      becomes very different.
                              
              Answer #1 (continued)
    • The pain and suffering caused by workflow 
       problems is not just emotional.  There can be 
       significant disruption in
        – Patient care
        – Billing
        – Communication
    • So if you don’t pay attention to workflow 
       when implementing health IT, your patients, 
       your staff, and your finances all may suffer.
                                   
            Some experiences…
    Electronic Health Records: Just around the Corner? Or over the 
      Cliff?
    “We recently implemented a full-featured electronic health record in our 
      independent, 4-internist, community-based practice of general internal 
      medicine. 
    We encountered various challenges, some unexpected, in moving from paper to 
      computer. Its financial impact is not clearly positive; work flows were 
      substantially disrupted; and the quality of the office environment initially 
      deteriorated greatly for staff, physicians, and patients. 
    That said, none of us would go back to paper health records, and all of us find 
      that the technology helps us to better meet patient expectations, expedites 
      many tedious work processes (such as prescription writing and creation of 
      chart notes), and creates new ways in which we can improve the health of 
      our patients.” 
    Baron et al. (2005). Annals of Internal Medicine, 143 (3), pp.222-226
                            
            Some more experiences
    How the Electronic Health Record Did not Measure Up 
      to the Demands of Our Medical Home Practice
    “One of our primary reasons for using an electronic health record 
      initially was to receive lab results electronically. That way, we 
      would be able to use clinical data to track treatment 
      outcomes, target interventions to our needier patients, and 
      facilitate our own quality improvement…. Instead, we continue 
      to receive lab data on paper documents that we scan and 
      store as portable document format, or PDF, files, which means 
      that we cannot trend them, search them, or use them as data 
      elements.” 
    Fernandopulle & Patel (2010). Health Affairs 29 (4), pp. 622-628.
                                 
                        Answer #2: 
          It will assist in vendor selection
    • By studying your workflows before choosing a 
       vendor, you can 
        – Identify efficient and productive workflows that you would 
          like to keep and inefficient ones that you would like to 
          change.
        – Determine how your workflows are likely to change after 
          implementing the technology.
    • With that information, you can ask each potential 
       vendor about how their technology will affect 
       different workflows.
    • This way, you can select the vendor that best fits 
       your practice.