Health Informatics: Project Management Case Study A major focus area, for several years now, in healthcare settings has been the support of data collection and transmission of information on patients through computer-based workflow systems deployed in such institutions. This case study is an analysis of the deployment of a healthcare workflow system (commercially available) in a hospital setting. Research findings show workflow organizational support as a strategic solution and making use of an implementation team with members having varying functional roles were critical elements not just for success, but also for creating a comprehension of data flow into and via the system due to the complex and challenging work processes. It is important to comprehend the workflow management system maturity, organizational effect of workflow, and human participation and interaction specific to workflow. With the successful deployment of workflow in the healthcare organization, the benefits and applicability of technology provides greater insight. This paper will look at the current workflow state in the institution, system issues or problems, the proposed innovation, and proposed system implementation, proposed training plan and strategy for user acceptance, proposed go-live strategy and support and the proposed on-going maintenance and support strategy.

Introduction

Workflow entails the automation of business processes. It is designed to offer support for business activity coordination to attain business goals. An integral element of workflow is collaboration. Workflow entails people and computer-based processes' interaction to facilitate the flow of work from user to user or department to department within the healthcare setting. Workflow systems ensure that work is routed in the right sequence, offers document and data access to workers and even track the execution of work processes. Workflow systems offer information flow support for health information management based on business processes like deficiency processing and management, analysis of patient charts, patient admission, patient discharge, utilization review, patient billing and record completion. The health information management department is where most workflow bits begin. The flow of patient billing, medical records and other uses of hospital resources, among other processes in need of detailed information on patients are automated through workflow systems. Collaborated computing efforts have been attributed to the workflow technology. However, the emergence of workflow and collaborative computing has been slow. Despite the essence of workflow systems in hospital settings, their development is not just sensitive to the particular development tools utilized, but also unstructured. Workflow systems are ineffective in attaining optimal productivity when their development and implementation challenges are not completely analyzed and addressed. Lack of access to workflow systems in real world settings has been defined as one of the challenges that hinder analysis of such systems. Although healthcare institutions that have implemented workflow systems have experienced tremendous growth or are expected to grow in the next decade, they still have evolving experience, expertise and knowledge in the use of this technology as their major challenges. Healthcare institutions do not share their workflow system designs, whether they consider them a success or failure. Workflow technology implementations are time-consuming and complex. As a result, data collection processes become complicated. AVENUE HEALTHCARE is having problems mapping dataflow between its two facilities and the data center facility, as well as other industries. This paper studies a workflow management system that can help overcome certain workflow issues such as mapping information flow between different facilities owned by a single institution with their main data center facility, and also how to implement it. As the Informatics Project manager, I will propose a workflow management software, specifically TAG DOC, to help solve these issues. The manager's main role will entail overseeing the new software implementation and maintenance through project management (Aalst & Hee, 2004).

The Current State

Avenue is a healthcare clinic located in the north-eastern part of the U.S. The institution is an advanced acute care facility that operates on two independent campuses, with each situated on a separate area of the city. The total number of patient beds in use in both facility campuses is 800. The average inpatient admission on a yearly basis number 42,000; outpatient diagnostic processes total 400,000; and 73,000 visits to the emergency department. The healthcare facility is a regional resource for cardiovascular medicine, cancer treatment, surgery services, burn treatment, and kidney transplantation. The facility also runs a regional trauma center. HIM (Health Information Management) resources are accessible on both the facility's campuses. However, the major department of HIM is based in a different facility that hosts the IS (Information System) and the data center. The three facilities are linked using a high speed network. The main workflow challenge experienced by Avenue is mapping information...

Basically, the main information used is patient data with regards to diagnosis, prescriptions, admission, discharge, etc. The main system users include nurses, system administrators, pharmacists and physicians. The doctors are responsible for treating patients; nurses offer healthcare to patients undergoing treatment, such as drug administration; pharmacists provide drug prescriptions at the healthcare pharmacy; and the administrators are responsible for system management and monitoring, ensuring that it is up and running as expected, at all times (eHealth Conference et al., 2011).
Figure 1: See APPENDIX A

System Issues or Problems

Avenue has workflow issues mapping information transfer between its two facilities and the data center facility, in addition to other industries. As a result, the hospital experiences delays, interruptions, pauses, reworks, established workarounds, gaps due to omission of critical steps, and physicians perceiving processes as illogical. This leads to slower progress, decreased job satisfaction and thus lower quality care. Since the hospital handles large volumes of patient data, poor workflows lead to loss of valuable information, which in turn impedes coordination and communication between nurses and doctors, further increasing interruptions in the workflow system. The poor workflow system also leads to decreased ability to deviate from routine sequences and nurses dropping activities during busy periods. The large amounts of patient data being transferred and handoffs lead to information degradation. Interruptions break the workflow system cycle, determining what information is recorded and passed on to the next user. Due to all these system issues, it is important that Avenue healthcare institution adopts a new workflow management system that can help overcome these issues (In Berner, 2013).

Proposed Innovation

The workflow innovation proposed for Avenue healthcare is a product that is commercially available and created by a vendor of the Fortune 100 Healthcare Information Systems. It is an imaging and information management system based on a client/server technology (TAG DOC), integrating and supplementing healthcare applications. The system basis of this technology allows electronic capture, indexing, storage and retrieval of processed data (information) kept in various media and other electronic platforms from a centralized location. An online patient chart is created through the consolidation of primary or centralized patient information systems data with the information. An EPRS database also interfaces the workflow system to help track document routing, patient data query and real-time capture of patient information feeds. The innovation's workflow features allow for automation and customization of information flow within the system. Work objects, connected to each other to develop information flow via the work process, are used to construct workflow threads. 14 workflow objects are offered, as indicated in the figure 2 below.

Figure 2: See APPENDIX B

Deficiency processing and management, analysis of patient charts, utilization review, record completion, patient admission, and patient discharge are business processes that can be supported by developing threads. Release of information requests and patient accounting for billing are other processes that can be supported by the proposed innovation. The workflow map processing is controlled by a build-time agent. The processing of the workflow map occurs in a cyclical manner. The execution of the work objects by the workflow agent takes place in a pre-determined order by object type, processing the object links defined in work threads. The execution cycle starts after processing of all the links, proceeding till the termination of the workflow agent, which is scheduled to operate continuously; it is only stopped when system backups need to be performed. Generally, all system users have access to information stored in a centralized system through the internet, with system protection offered through an SSL protocol. This simplifies the workflow process, eliminating mapping issues that initially existed between the two campus facilities owned by the health institution, as well as the data center facility (Trotter & Uhlman, 2011).

Figure 3: See APPENDIX C

Proposed Implementation

The project management theory helps breakdown the implementation workload into smaller components, rendering it easier to accomplish and monitor. The whole project will take 720 hours and cost Avenue healthcare 38500 Euros. The implementation of the proposed innovation to help counteract workflow issues in Avenue hospital will undergo the following phases:

1. Initiation Phase

In this phase, the software implementation project begins. The innovation will be explored and elaborated if fit for the healthcare facility. The project feasibility will be determined and a suitable person with relevant skills and expertise assigned the role of an informatics project manager to oversee the general implementation of the workflow management software. Other parties expected to take part in the project…