Multi-Method Study of Electronic Health Records Workflows

Maria Grando, Areti Manataki, Stephanie K. Furniss, Benjamin Duncan, Andrew Solomon, David Kaufman, Sarah Hirn, Robert Sunday, Joanne Bouchereau, Bradley Doebbeling, Matthew Burton, Karl A. Poterack, Tim Miksch, Richard A. Helmers

    Research output: Contribution to journalArticlepeer-review

    8 Scopus citations


    EHRs transform work practices in ways that enhance or impede the quality of care. There is a need for in-depth analysis of EHR workflows, particularly in complex clinical environments. We investigated EHR-basedpre-operative workflows by combining findings from 18 interviews, 7 days of observations, and process mining of EHR interactions from 31 personnel caring for 375 patients at one tertiary referral center. We provided high-definition descriptions of workflows and personnel roles. One third (32.2%) of the time with each patient was spent interacting with the EHR and 4.2% using paper-based artifacts. We also mined personnel social networks validating observed personnel's EHR-interactions. When comparing workflows between two similar pre-operative settings at different hospitals, we found significant differences in physical organization, patient workflow, roles, use of EHR, social networks and time efficiency. This study informs Mayo Clinic's enterprise-wide conversion to a single EHR and will guide before and after workflow comparisons.

    Original languageEnglish (US)
    Pages (from-to)498-507
    Number of pages10
    JournalAMIA ... Annual Symposium proceedings. AMIA Symposium
    StatePublished - Jan 1 2018

    ASJC Scopus subject areas

    • General Medicine


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