UConn Health’s CMIO discusses the challenging task of clinical workflow redesign

Chief Medical Information Officer for UConn Health, a five-hospital health system based in Farmington, Connecticut, Dr. R.J. Dirk Stanley isn’t the only physician complaining about workflow problems. But he is one of the few who is doing something about it.

In his role as CMIO, Stanley and his team have redesigned UConn’s clinical workflow to better serve its physicians and their patients. And they’ve worked to re-imagine electronic health records and deploy artificial intelligence and automation to ensure mission-critical IT is best supporting those new workflows.

We interviewed Stanley to understand the main problems of clinical workflow as he sees them. He offered his advice for clinical workflow design and perspective on how AI and automation can help streamline efficiency and improve the provider experience.

Q. What are the problems with clinical workflow today? And what role does Health IT play?

One. The biggest challenge is that clinical workflow is complex, requires a great deal of attention to detail, and is often interdependent on the who, what, when, where, and why of other workflows. Therefore, fixing them usually takes more time and effort than most people plan for.

Fortunately, the national health IT community is responding by increasing support for practical clinical informatics, and recognizing the importance that these “clinical architects” have in designing and securing best practice workflows for frontline clinical staff. and play a role in working with other billing and HIM stakeholders. Staff alignment and buy-in before starting configuration or construction.

Q. What are your personal thoughts on clinical workflow design? Where does one start? What are the best approaches?

One. Good design starts with good blueprints (#BlueprintsBeforeBuild), so clinical architects (Applied Clinical Informatics) are needed to truly understand the current situation and needs of all stakeholders, and then build a solid, efficient and user-friendly Future-proof workflow design has to be done. Meets all the clinical, legal and financial requirements of the organization.

It begins with understanding the current state of affairs, and learning how to document it quickly so that a beautiful future-state becomes clear and tangible before it is created.

Q. How do you fit health care information technology like EHR and AI into the workflow design you create?

One. Workflow drives everything, so I always start with workflow. Once I know the current-state and future-state workflow, I know the tools needed to support it, both inside and outside the EHR. This is a common source of confusion, thinking it is only about the tools inside the EHR.

Tools outside the EHR are just as important, so it’s about keeping them all in alignment and pointing them all towards good patient care. AI is a new development that fits well into the general analysis and change management paradigms I use to investigate technology and develop solutions, so AI is a part of the processes and swim lane-type diagrams of my workflow. And becomes the “role”.

Q. Please give an example of some clinical workflow design you have done at UConn Health and how it has helped physicians. What has been the result of your work?

One. At UConn Health, I have helped streamline workflow throughout the organization, from our ED to the ICU and other inpatient areas, perioperative areas, and ambulatory clinics. Admission, rounding, discharge, visits, pre-process, post-process – I work on all of these, using my blueprints to translate end users’ needs into concrete deliverables, so they can plan for the future before they even start. Can imagine the situation and agree with it. to make it. It is a very satisfying job.

Some of my favorites are complex, high-risk workflows. With a previous employer, I once completely streamlined unfractionated heparin titration from scratch. Unfractionated heparin titration is a very complex workflow, to say the least, so I was very satisfied when it was created and implemented and adopted throughout the health system as best practice.

Ultimately, this design (clinical informatics) task helps reduce clicks, reduce frustration, reduce variation, improve safety, and improve patient care.

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