DHHS Request for Information

Re: Department of Health and Human Services; Agency for Healthcare Research and Quality (AHRQ); Request for Tools and Methods Used by Small-and Medium-sized Practices for Analyzing and Redesigning Workflows Either Before or After Health Information Technology Implementation

In the June 25, 2009 Federal Register the AHRQ announced the intention to request information from

(1) small- and medium-sized practices about how they study or redesign their workflow, including information on the use of tools and methods for studying workflow

(2) others ( e.g., experts, vendors, professional associations) that have developed, implemented and used tools and methods for studying workflow in the context of health IT implementation and use

Workflow is defined as the way work is performed and patient-related information is communicated within small- and medium-sized practices and between those practices and external organizations such as community pharmacies and local hospitals.

It is our understanding that there is currently no standard description of workflows for care processes that can be used to guide decisions of where and how to incorporate health information technology. This Request for Information is part of a three-pronged effort to scan the environment, the literature and knowledgeable and interested parties to produce a useful list of resources that may assist small and medium-sized medical practices and clinics to consider the utility and potential effectiveness of incorporating health IT into the way they practice and communicate patient information.

The responses to this request for information will be considered for reference and possible incorporation into an electronic toolkit to be made available on the

Internet to assist small- and medium sized practices in analyzing or redesigning workflow either before or after implementation of one or more health IT applications.

Submission Criteria:

The agency is particularly interested in obtaining information and opinions from small- and medium-sized healthcare practices that have implemented or are considering implementing health information technology as well as information and opinions from workflow or health IT experts, vendors, professional associations, and others that have developed and/or used workflow analysis or redesign tools.

It would be useful to receive basic information about:

Number of physicians and providers in the practice or clinic
Total number of staff
Number of patient visits in 2008
The medical or surgical specialists within the practice or clinic
Any ancillary services located onsite at the practice or clinic
What specific health IT applications and software has been used

Include function regarding:

Functionality of each health IT application
How long each health IT application has been in us

With regard to workflow analysis and redesign tools, please tell us about any tools, methods, technologies, or data reports to analyze or redesign the way work is done and information flows in your practice or clinic before or after health IT implementation. Examples of tools include process analysis, flowcharting, task analysis and lean management. Other examples include using data reports from a health IT application to analyze or understand processes and workflow.

For each tool, method, technology or data report we would appreciate the following information:

Name and acronym of the tool, method, technology, or data report
Authors, sources and/or references
Background about the tool, method, technology, or data report
Intended purpose
How the tool, method, technology, or data report was used
Information about reliability and validity of the tool, method, technology, or data report
Advantages and disadvantages of the tool, method, technology, or data report
How useful, overall, the tool, method, technology, or data report is
How easy or difficult is it use the tool, method, technology, or data report

Additionally, please provide information that you think will assist our target audience to avoid pitfalls of complicated or inappropriate tools and software. If you are willing and authorized to share any referenced tools, please submit them with your response along with instructional documents related to the tool and its use, including any restrictions or prerequisite permissions necessary for use by others.

A discussion of the following would provide valuable information for small and medium sized practices or clinics:

Support that was available during the health IT implementation
Discussion of successful or unsuccessful interfacing of the health IT application (s) is/are interfaced with each other and/or other IT
Discussion of any formal evaluation of the health IT implementation was conducted and any measures used for the evaluation

Comments would be appreciated on how health IT has impacted or supports:

Communication among practice or clinic staff
Coordination of care among practice or clinic staff
Information flow between the practice or clinic and external healthcare organizations
Clinicians’ work during patient visit
Clinicians’ thought processes as they care for patients
Access to patient-related information

Submit comments on or before August 24, 2009 to:

Electronically (preferred): WorkflowRFI@ahrq.hhs.gov

Regular Mail:
Teresa Zayas-Caba´n, Senior Manager, Health IT
Agency for Healthcare Research and Quality

Attention: Workflow RFI Responses
540 Gaither Road, Room 6115
Rockville, MD 20850,

Phone: 301–427–1586

For further information contact:

Teresa Zayas-Caba´n

Teresa.ZayasCaban@AHRQ.hhs...gov

Web site of the project on ‘‘Incorporating Health Information Technology Into Workflow Redesign’’:

http://cqpi.engr.wisc.edu/withit_home

The June 25, 2009 Federal Register is available online at:

http://edocket.access.gpo.gov/2009/pdf/E9-14947.pdf