AHRQ Workflow Assessment for Health IT Toolkit Eval 2012_SummaryPartARevisions

Workflow Assessment for Health IT Toolkit Evaluation 2012: Summary of Revisions to Part A and Attachments

Based on your feedback, we have revised Supporting Statement Part A, along with Attachments A, B, E, and F. These revisions are listed below, along with a summary of what changes were made.

1. Supporting Statement Part A:

As discussed, we removed three of the original four questions so that only the agreed upon question, “Does knowledge change?” remains. We also revised the description of the Pre-Workflow Toolkit Interview Guides (Attachments A and B) and the Post-Workflow Toolkit interview Guides (Attachments E and F) to reflect the questions that will be asked. Considering the interview questions were reduced in number, we changed the estimated length of each interview (Pre- and Post-Workflow Toolkit Interviews) from 1 hour to 30 minutes, and adjusted the burden hours (Exhibit 1) and the cost burden (Exhibit 2) to reflect this change. Lastly, we revised the topics the analysis will attempt to identify to directly reflect the more narrow focus of the evaluation.

2. Attachment A: Pre-Workflow Toolkit Interview Guide – Practice:

We changed the anticipated length of the interview from one hour to 30 minutes.

As discussed, we reduced the questions in the guide to include:

1. What does workflow mean to you?

[Wait]

If you can’t define it, can you give me an example of a workflow in your practice?

2. Can you tell me how is understanding workflow important in your practice?

   1. Can you give me an example of when understanding practice workflow was important in your practice?

   2. How is workflow important in practice change?

   3. How is workflow important in health information technology implementation? (health information technology includes new electronic health records, changing your electronic health record, or adding new functionality such as e-prescribing or a patient portal)

3. Describe a workflow in your practice.

Prompt: Describe how a new laboratory report is processed when it is received, or how prescription refill requests are handled.

4. Please think about a time when you implemented a health information technology system in your practice. Health IT systems include new electronic health records, changing your electronic health record, or adding new functionality such as e-prescribing or a patient portal. Can you walk me through the steps that were taken to implement this health information technology system in your practice?
   
   

   1. What happened first?

   2. What happened next?

   3. Next?

   4. How did you know when implementation was complete?

5. Do you have any final comments or questions?

3. Attachment B: Pre-Workflow Toolkit Interview Guide – REC:

We changed the anticipated length of the interview from one hour to 30 minutes.

As discussed we reduced the questions in the guide to include:

1. What does workflow mean to you?

[Wait]

If you can’t define it, can you give me an example of a workflow in clinical practice?

2. Can you tell me how understanding workflow is important to the work of the REC?

   1. Can you give me an example of when understanding practice workflow was important to the work of the REC?

   2. How is workflow important in practice change?

   3. How is workflow important in health information technology implementation? (health information technology includes new electronic health records, changing the electronic health record, or adding new functionality such as e-prescribing or a patient portal)

3. Describe a workflow in clinical practice.

Prompt: Describe how a new laboratory report is processed when it is received, or how prescription refill requests are handled.

4. Please think about a time when a practice worked with the REC to implement a health information technology system. Can you walk me through the steps that were taken to implement this health information technology system in the practice?
   
   

   1. What happened first?

   2. What happened next?

   3. Next?

   4. How did you know when implementation was complete?

5. Do you have any final comments or questions?

4. Attachment E: Post-Workflow Toolkit Interview Guide – Practice:

We changed the anticipated length of the interview from one hour to 30 minutes.

As discussed, we reduced the number of questions in the guide to include:

1. What does workflow mean to you?

2. Thinking of your use of the Workflow toolkit, how has your understanding of workflow changed during this project?

Prompt: For example, the importance of workflow for practice change or innovation?

Prompt: For example, the importance of workflow for implementing computer technology?

3. How has your understanding of the importance of assessing workflow changed?

Prompt: In practice change or innovation?

Prompt: In health information technology implementation?

4. Describe a workflow in your practice?

Prompt: For example how a new laboratory report is handled when it is received, or how prescription refill requests are handled.

5. Walk me through how you used the Workflow toolkit.

6. What changes would you suggest to improve the Workflow toolkit?

   1. What changes to the tools in the toolkit?

   2. What changes to the toolkit itself?

7. What final comments or questions do you have about the workflow toolkit?

5. Attachment F: Post-Workflow Toolkit Interview Guide – REC:

We changed the anticipated length of the interview from one hour to 30 minutes.

As discussed, we reduced the number of questions in the guide to include:

1. What does workflow mean to you?

2. Thinking of your use of the Workflow toolkit, how has your understanding of workflow changed during this project?

Prompt: For example, the importance of workflow for practice change or innovation?

Prompt: For example, the importance of workflow for implementing computer technology?

3. How has your understanding of the importance of assessing workflow changed?

Prompt: In practice change or innovation?

Prompt: In health information technology implementation?

4. Describe workflows the practice(s) talked about.

Prompt: For example how a new lab report is handled when it is received, or how prescription refill requests are handled.

5. Walk me through how you used the Workflow toolkit with the practice(s).

6. What changes would you suggest to improve the Workflow toolkit?

1. What changes to the tools in the toolkit?

2. What changes to the toolkit itself?

7. What final comments or questions do you have about the workflow toolkit?

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