The Value of Research Participation for Practices: A Case Study

1. The Value of ResearchParticipation for Practices:A Case Study Erin Leege, MPH Amy Irwin, MS Paul Smith, MD Wisconsin Research and Education Network (WREN), UW School of Medicine Department of Family Medicine

2. The Study: “The Toolkit” • Agency for Healthcare Research and Quality (AHRQ) developed “The Toolkit” • Workflow Assessment for Health IT Toolkit • Purpose • Provide tools and resources to better integrate technology into clinical care through workflow assessment • Audience • Small- and medium-sized primary care clinics

3. The Toolkit • http://healthit.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit

4. Project Objective • Evaluate the usability and suitability of AHRQ’s Toolkit

5. Partners • Oregon Rural Practice-Based Research Network (ORPRN) • Wisconsin Health Information Technology Extension Center (WHITEC)

6. Methods • Eight Wisconsin clinics met regularly for about 10 weeks to discuss the Toolkit • Usually every other week • Research coordinators had observational role • Clinics self-identified workflow process needing improvement

7. Results: Clinic Demographics

8. Results: Electronic Health Records

9. Results: Self-Identified Projects • Most (n=6) focused on lab workflows • Ordering (future), processing, billing, notifying • Wide range of lab-related processes • 2 clinics worked on prescription refill processes • 1 clinic began EHR vendor switch process

10. Results: Clinic 1 Changes • Initial focus: Future labs (ensure follow up) • Before: • Complex • Inefficient • Missed opportunities

11. Results: Clinic 1 Workflow – PRE Current Process for Scheduling Future Orders – Urgent Visits (continued on next slide)

12. Results: Clinic 1 PRE, continued Current Process for Scheduling Future Orders – Planned Visits

13. Results: Clinic 1 Workflow – POST

14. Results: Clinic 1 Changes • After: • Streamlined • Standardized • Solving larger problem than initially planned • Final product: all labs and visits

15. Results: Clinic 2 Changes • Planned implementation of a new process (see next slide) • Identified other areas needing improvement • Vaccine inventory and administration • Created manual for new employees describing workflow processes • Incoming phone calls (how to funnel) • Patient check-in • Other administrative processes

16. Results: Clinic 2 Workflow – NEW

17. Results: Clinic 2 Changes • Planned implementation of a new process (see next slide) • Identified other areas needing improvement • Vaccine inventory and administration • Created manual for new employees describing workflow processes • Incoming phone calls (how to funnel) • Patient check-in • Other administrative processes

18. Results: Clinic 3 Changes

19. Results: Clinic 3 Changes • Discussed future model of care: • Clinic – preventive care • Planned Parenthood – contraception • Telemedicine

20. Lessons Learned • Drivers of successful change • Dedicated (paid) time • Someone serving as a reminder • Research Coordinator • Small, diverse team • Project champion

21. Conclusion • In addition to completing the primary aim of this project, most clinics developed new workflow processes in their clinical practice. • These results suggest that participation in practice-based research network (PBRN) projects may benefit clinical care in unanticipated ways.

22. Partner with WREN! • Upcoming studies (clinics) • Influenza Surveillance • Join WREN (individuals) • Listserv – participate in surveys impacting primary care, discuss “Hot Topics” • Check out our website: wren.wisc.edu

23. Questions?

24. Thank you! Erin Leege, MPH, erin.leege@fammed.wisc.edu Milwaukee Research Coordinator Amy Irwin, MS, amy.irwin@fammed.wisc.edu Northern and Western Research Coordinator Paul Smith, MD, paul.smith@fammed.wisc.edu Associate WREN Director