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Comparative Study
. 2020 Mar 4:2019:1167-1176.
eCollection 2019.

Process Mining and Ethnography Study of Medication Reconciliation Tasks

Vaishak Ramesh Vellore  1 , M Adela Grando  2 , Benjamin Duncan  2 , David R Kaufman  2 , Stephanie K Furniss  2   3 , Bradley N Doebbeling  2   4 , Karl A Poterack  3   5 , Timothy Miksch  3 , Richard A Helmers  6
Affiliations
Comparative Study

Process Mining and Ethnography Study of Medication Reconciliation Tasks

Vaishak Ramesh Vellore et al. AMIA Annu Symp Proc. .

Abstract

We studied the medication reconciliation (MedRec) task through analysis of computer logs and ethnographic data. Time spent by healthcare providers performing MedRec was compared between two different EHR systems used at four different regional perioperative settings. Only one of the EHRs used at two settings generated computer logs that supported automatic discovery of the MedRec task. At those two settings, 53 providers generated 383 MedRec instances. Findings from the computer logs were validated with ethnographic data, leading to the identification and removal of 47 outliers. Without outliers, one of the settings had slightly smaller mean (SD) time in seconds 67.3 (40.2) compared with the other, 92.1 (25). The difference in time metrics was statistically significant (p<.001). Reusability of an existing task-based analytic method allowed for rapid study of EHR-based workflow and task.

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Figures

Figure 1:
Figure 1:
Schematic representations of the MedRec interfaces from EØ system 1 used at Florida and Arizona: A) “Document Medication by Hx” button can be clicked in the “Order-Charges” section, B) the last dose taken of a medication can be added through the “Compliance” section.
Figure 2:
Figure 2:
Schematic representations of the MedRec interfaces from EØ system 2 used at Rochester: A) the “Message” button can be clicked in the “Outpatient Order - Medication List” page, B) the buttons “Adm/Outpt Verify Message”, “Add Dose Last Taken” and “Clear Dose Last Taken” can be clicked to leave a message about a medication, reconcile the last dose taken or remove changes to doses, C) when the “Add Dose Last Taken” button is clicked it opens the “Dose Last Taken” window for adding the date and time; changes are saved by clicking “Continue”.
Figure 3:
Figure 3:
Histogram showing frequency of MedRec tasks at two Rochester sites
See this image and copyright information in PMC

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