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DOI: 10.4338/ACI-2015-07-CR-0082
Managing and Communicating Operational Workflow
Designing and Implementing an Electronic Outpatient WhiteboardCorrespondence to:
Publication History
received:
09 July 2015
accepted:
06 February 2015
Publication Date:
16 December 2017 (online)
Summary
Background
Healthcare team members in emergency department contexts have used electronic whiteboard solutions to help manage operational workflow for many years. Ambulatory clinic settings have highly complex operational workflow, but are still limited in electronic assistance to communicate and coordinate work activities.
Objective
To describe and discuss the design, implementation, use, and ongoing evolution of a coordination and collaboration tool supporting ambulatory clinic operational workflow at Vanderbilt University Medical Center (VUMC).
Methods
The outpatient whiteboard tool was initially designed to support healthcare work related to an electronic chemotherapy order-entry application. After a highly successful initial implementation in an oncology context, a high demand emerged across the organization for the outpatient whiteboard implementation. Over the past 10 years, developers have followed an iterative usercentered design process to evolve the tool.
Results
The electronic outpatient whiteboard system supports 194 separate whiteboards and is accessed by over 2800 distinct users on a typical day. Clinics can configure their whiteboards to support unique workflow elements. Since initial release, features such as immunization clinical decision support have been integrated into the system, based on requests from end users.
Conclusions
The success of the electronic outpatient whiteboard demonstrates the usefulness of an operational workflow tool within the ambulatory clinic setting. Operational workflow tools can play a significant role in supporting coordination, collaboration, and teamwork in ambulatory healthcare settings.
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Conflicts of Interest
The authors have no conflicts of interest to report.
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References
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Correspondence to:
-
References
- 1 Brownstein JN, Hirsch GR, Rosenthal EL, Rush CH. Community Health Workers “101” for Primary Care Providers and Other Stakeholders in Health Care Systems: Journal of Ambulatory Care Management. 2011; 34 (03) 210-220.
- 2 Issom D-Z, Hagry C, Wodia LMendo, Seng H, Ehrler F, Lovis C. Challenges and issues of geolocation in clinical environment. Stud Health Technol Inform 2012; 180: 447-451.
- 3 Doebbeling BN, Burton MM, Wiebke EA, Miller S, Baxter L, Miller D, Alvarez J, Pekny J. Optimizing perioperative decision making: improved information for clinical workflow planning. AMIA Annu Symp Proc 2012; 2012: 154-163.
- 4 Reddy MC, Dourish P, Pratt W. Coordinating Heterogeneous Work: Information and Representation in Medical Care. In: Prinz W, Jarke M, Rogers Y, Schmidt K, Wulf V. editors. ECSCW 2001 [Internet]. Dordrecht: Kluwer Academic Publishers; 2002. [cited 2015 Jun 23]. 239-58. Available from: http://link.springer.com/10.1007/0-306-48019-0_13.
- 5 Pratt W, Reddy MC, McDonald DW, Tarczy-Hornoch P, Gennari JH. Incorporating ideas from computersupported cooperative work. Journal of Biomedical Informatics 2004; 37 (02) 128-137.
- 6 Rasmussen R. Electronic whiteboards in emergency medicine: a systematic review. ACM Press: 2012. [cited 2015 Jun 16]. p. 483. Available from: http://dl.acm.org/citation.cfm?doid=2110363.2110418.
- 7 Mainthia R, Lockney T, Zotov A, France DJ, Bennett M, St Jacques PJ, Furman W, Randa S, Feistritzer N, Eavey R, Leming-Lee S, Anders S. Novel use of electronic whiteboard in the operating room increases surgical team compliance with pre-incision safety practices. Surgery 2012; 151 (05) 660-666.
- 8 Bardram JE, Hansen TR, Soegaard M. AwareMedia: a shared interactive display supporting social, temporal, and spatial awareness in surgery. ACM Press; 2006. [cited 2015 Jun 16]. p. 109. Available from: http://portal.acm.org/citation.cfm?doid=1180875.1180892.
- 9 Wong HJ, Caesar M, Bandali S, Agnew J, Abrams H. Electronic inpatient whiteboards: improving multidisciplinary communication and coordination of care. Int J Med Inform 2009; 78 (04) 239-247.
- 10 Keep SL, Locker TE. The impact of a computerised whiteboard system on digit preference bias in the recording of emergency department process times. Eur J Emerg Med 2012; 19 (03) 177-180.
- 11 Hertzum M, Simonsen J. Work-practice changes associated with an electronic emergency department whiteboard. Health Informatics J 2013; 19 (01) 46-60.
- 12 Jensen J. United hospital increases capacity usage, efficiency with patient-flow management system. J Healthc Inf Manag 2004; 18 (03) 26-31.
- 13 Unertl KM, Weinger MB, Johnson KB, Lorenzi NM. Describing and modeling workflow and information flow in chronic disease care. J Am Med Inform Assoc 2009; 16 (06) 826-836.
- 14 Brindisi M, Bui R, Mazo J, Ong ZYM, Van Vleet S, Bailey R. Redesigning clinic workflows for electronic medical record integration. IEEE 2013; [cited 2015 Jun 16]. 133-8 Available from: http://ieeex- plore.ieee.org/lpdocs/epic03/wrapper.htm?arnumber=6549507
- 15 MySQL: The world’s most popular open source database [Internet]. MySQL: The world’s most popular open source database. [cited 2015 Jun 23]. Available from: www.mysql.com.
- 16 Health Level Seven International [Internet]. Health Level Seven International. 2015 Available from: www.hl7.org.
- 17 Weinberg ST. Optimizing an Electronic Outpatient Whiteboard Through Analysis of Incoming HL7 Scheduling Messages. American Medical Informatics Association Annual Symposium. 2009. Nov; San Francisco: CA.;
- 18 Aronsky D, Jones I, Lanaghan K, Slovis CM. Supporting Patient Care in the Emergency Department with a Computerized Whiteboard System. J Am Med Inform Assoc 2008; 15 (02) 184-194.
- 19 Karsh BT. Beyond usability: designing effective technology implementation systems to promote patient safety. Quality and Safety in Health Care 2004; 13 (05) 388-394.
- 20 Weinberg ST, Patterson BL. Embedding Real-Time Clinical Decision Support in An Electronic Whiteboard to Reduce Missed Opportunities for Influenza Vaccination. American Academy of Pediatrics’ Council on Clinical Information Technology. 2010. Oct; San Francisco: CA.;
- 21 PHP: Hypertext Preprocessor [Internet]. PHP: Hypertext Preprocessor. 2015 Available from: www.php.net.