JMIR Publications

ABSTRACT

Background:

To help guide implementation of eHealth interventions, we report a simple and easy-to-follow method to conduct a clinical workflow analysis before eHealth implementation including an example of our experience.

Objective:

This study aimed to analyze workflow before eHealth implementation to determine the best timing and personnel for implementation.

Methods:

Following an example from our own work, we describe the steps to create a planned implementation workflow of an eHealth application in primary care clinics. We describe and provide examples for four steps: a) identification of discrete workflow components, b) selection of appropriate measurement tools, c) direct observation of clinical workflow, and d) stakeholder engaged data analysis and synthesis.

Results:

Between August 2016 and March 2017, we observed 13 visits of 11- or 12-year-olds at four diverse Florida pediatric or family medicine clinics. We created a flowchart to display each clinic’s workflow. Across clinics, the general workflow process and patient flow was similar and allowed approximately 20-minutes for patients to complete intervention tasks prior to seeing their doctor. During semi-structured interviews, lead clinicians and medical staff at each clinic reviewed the flowchart and expressed that it accurately captured their work. Three of the four clinics suggested nearly identical implementation strategies for the eHealth application. By conducting workflow analysis prior to implementation of an eHealth intervention, we identified specific timing, staffing, and management processes for implementation, potential barriers, and increased stakeholder buy-in.

Conclusions:

The easy-to-follow steps presented will help investigators plan implementation of new eHealth interventions in primary healthcare settings. Conducting a prospective workflow study allows for observation-based planning, identifying potential pitfalls, and increasing stakeholder buy-in.