Guest Column: A White Paper About EMR Workflow, Usability, And Productivity In Pediatric And Primary Care

By Charles Webster, MD, MSIE, MSIS

"A high-volume, low-margin business like primary care medicine simply cannot support the costs. These include both the very high dollar cost of buying and maintaining a system and the huge drop in productivity that initially accompanies implementation."

However, EHR workflow management systems, EMR workflow systems, and business process management technologies are ideal for high-volume, low-margin businesses such as ambulatory pediatric, family medicine, and obstetrics and gynecology practices. They can be more quickly and inexpensively deployed than traditional EMRs and they dramatically increase, not decrease, productivity.

My 2003 white paper "Electronic Medical Record Workflow Management: The Workflow of Workflow," which includes results from a survey of primary care practices documenting a workflow automation-induced productivity surge, has garnered a lot of web traffic over the years. With all of the published news articles and conversations on the Web about productivity and usability and workflow being major obstacles to EMR adoption, I decided to update that 2003 white paper by adding a companion titled "Pediatric and Primary Care EMR Business Process Management: A Look Back, a Look Under the Hood, and a Look Forward," co-authored with Mark Copenhaver (CTO at EHRI). Everything in the original "Workflow of Workflow" paper is still true and even more relevant today. However EncounterPRO and the HIT industry have evolved a lot in the past six years. Portions of this twelve page white paper are unavoidably somewhat technical in places, so this post is a shorter and less technical summary of its major points.