Workflow Analysis

Andrew Sharpin 

Deloitte Consulting 

"Reviewed November 2014"
Pre-Pilot Analysis 

April-2012 

End-Pilot Analysis 

Feb-2013 

13 Sites Evaluated 10 Sites Evaluated
 

Workflow Analysis Overview
 

Workflow
 

Analysis
 

Process Mapping 

Time Measurements 

Staff Interviews 

2D Barcode Scanning Impact 
8 

2 

Private 

Public 

9 

1 

Pediatrics 

Family 

Practice 

5 

2 

3 1 - 5
 

6 - 10
 

11 +
 

5 

2 

1 

1 

1 Office Practicum 

eClinicalworks 

Allscripts 

Epic 

Practice Partner 

Immunizer Demographics
 

Practice Type 

Practice Size 

Specialty 

EMR Vendor 
 

 

 

 

 

 

 

Process Observations 

1. There is limited supply of 2D barcoded vaccines in the practices 

2. Single doses are given less frequently than combination vaccines 

3. The location of EMR data entry can impact user adoption 

4. Delaying EMR data entry increases the possibility of entering incorrect
 

information
 

5. EMR integration with 2D barcode scanning improves usability, which increases 

adoption 

6. Adding NDC documentation when scanning can incentivize use 

7. Adding 2D barcodes to the vaccine package/box allows for a more seamless
 

transition
 

8. User product preference may influence technology acceptance 
4 

1 

3 

2 Vaccine Prep Station 

Nursing Station 

Mobile Laptops 

Exam Room 

 

Before Admin 

After Admin 

Mix 

3 

3 

4 

Vaccine Documentation Location & Timing
 

EMR Data Entry Location 

EMR Data Entry Timing 

Vaccine Prep Station 

 Proximity to inventory fridge has 

minimal disruption on workflow 

 Document during vaccine prep 

Nursing Station 

 Data entry hub 

Mobile Laptops 

 Plug/ unplug scanner 

 Scanner location dictates data entry 

location 

Exam Room 

 Physician practices 

 Multi-dose vials returned to fridge 

 Document after patient has left room 
Clinician Feedback
 

Lot number and expiration 

date stamped on M-M-R 

package 

“The lot number and expiration date are hard to read on 

some of the vaccines we get. When those vaccines get 

barcodes we can scan, it will be a huge help.” 

“I often see transcription errors where eight (8) and “B” or zero (0) and 

“O” have been mixed up. Scanning will fix these issues and reduce the 

number of times I can’t find the lot I’m looking for in our inventory.” 
Clinician Feedback
 

“Some of the vaccines are easier to scan than others... I
 

think it might have to do with size or darkness of the 2D 

barcode” 

“Right now, I can only scan one out of 

the five vaccines I’m entering. It’s a pain 

and hard to always remember. Once I can 

scan all five, it will save me a lot of 

time.” 
 

 

Summary Results of Efficiency Findings
 

 Inventory is initial point of vaccine data 

entry 

 Lot number and expiration date manual 

transcription eliminated 

 Experienced user maximized baseline 

process efficiencies 

 Scanning efficiency will improve as the 

number of vaccines scanned per patient 

increases 

* Overall average based on 10 sites with data from pre-pilot and end-state workflow analysis; NYS-2 excluded due inconsistent data from new staff 

Preliminary results 

t n
 

Inventory Management Efficiency Findings
 

Practices using their EMR system for inventory management all saw efficiency 

improvements when scanning 2D barcodes 

* Overall and EMR averages based on 10 sites with data from pre-pilot and end-state workflow analysis; NYS-2 excluded due inconsistent data from new staff 

Preliminary results 

e

R
 

Vaccine Administration Efficiency Findings
 

Improvements in vaccine administration efficiency were closely tied to a practice’s 

experience scanning 2D barcoded vaccines 

* Overall and EMR averages based on 10 sites with data from pre-pilot and end-state workflow analysis; NYS-2 excluded due inconsistent data from new staff 

Preliminary results 

e

R
Enhancement Opportunities
 

EMRs 

 Product identifying 

information 

 Alerts 

 Vaccine 

administration 

recognition 

 Multi-level 

packaging barcode 

 Data entry 

requirements 

Scanners 

 Scanner technology 

Manufacturers 

 Multi-level 

packaging barcode 

 Label direction 

Providers 

 Data entry location 

 Data entry timing 
 

 

 

 

Key Study Findings 

1. Increase industry adoption 

• Number of 2D barcoded vaccines 

• Practice awareness of vaccines with 2D barcodes 

2. Increase data entry efficiency 

• Quicker data entry 

• Reduced error correction 

3. Optimize practice workflow 

• Office layout and scanner locations 

• EMR software functionality 
Questions? uestions?