Understanding workflow and information flow in chronic disease care

Abstract

Chronic disease care is a significant and growing problem in healthcare today. Current healthcare processes are more focused on dealing with acute episodes of care rather than the longitudinal care requirements of chronic disease. The use of information technology is one tool that may assist in improving chronic disease care.

The goals of the study were to study workflow and information flow in three ambulatory chronic disease clinics to develop general models of workflow and information flow in chronic disease care. Over 150 hours of direct observation in the three clinics identified elements of the workflow and information flow, the features of existing informatics tools used, and gaps between user needs and existing functionality. Clinic-specific models of workflow, information flow, and temporal flow were developed. Semi-structured interviews were conducted to gather additional data and verify the models. Generalized models were developed that identified the common aspects of workflow and information flow across all three clinics. Aspects of chronic disease care workflow that are important to address in the design of informatics tools were identified. The study confirmed that there are core similarities between different chronic disease domains, although there are some crucial differences and suggested approaches to dealing with the unique needs of the chronic disease care environment.