Johnson K et al. 2006 "Case report: activity diagrams for integrating electronic prescribing tools into clinical workflow."
Reference
Johnson K, FitzHenry F. Case report: activity diagrams for integrating electronic prescribing tools into clinical workflow. J Am Med Inform Assoc 2006;13(4):391-395.
Abstract
"To facilitate the future implementation of an electronic prescribing system, this case study modeled prescription management processes in various primary care settings. The Vanderbilt e-prescribing design team conducted initial interviews with clinic managers, physicians and nurses, and then represented the sequence of steps carried out to complete prescriptions in activity diagrams. The diagrams covered outpatient prescribing for patients during a clinic visit and between clinic visits. Practice size, practice setting, and practice specialty type influenced the prescribing processes used. The model developed may be useful to others engaged in building or tailoring an e-prescribing system to meet the specific workflows of various clinic settings."
Objective
"To facilitate the future implementation of an electronic prescribing system [by modeling] prescription management processes in various primary care settings" and share the model developed with "others engaged in building or tailoring an e-prescribing system to meet the specific workflows of various clinic settings."
Type Clinic
Primary care
Type Specific
Internal medicine, pediatrics, and family practice
Size
Large
Geography
Urban
Other Information
Research was performed at Vanderbilt University Medical Center, a large hospital and clinic-based faculty practice in Nashville, Tennessee.
Type of Health IT
Electronic prescribing (e-Rx)
Workflow-Related Findings
Two distinct workflows were found, one for prescription writing when the patient was not in the clinic and one for prescribing during a clinic visit. Workflows also varied for new prescriptions and renewals.
The authors were surprised by the range of tasks performed by staff other than the authorized prescriber, and this realization required making several important changes to their planned e-prescribing system.
Study Design
Story
Study Participants
A convenience sample of physicians and nurses at specialty clinics participated.