sequentially or simultaneously.” 10
Managing workflow processes in the healthcare setting requires documentation of each step, task, stakeholder, and expected outcome. Any time a new system or change in process
is planned, careful consideration should be taken to assess and
detail the current state of the environment, followed by the future state. There are various tools available for assessing, mapping, and documenting processes. These tools have an application in clinical and non-clinical processes.
Some tools endorsed by AHRQ are:
Flowchart: Flowcharts visually convey the steps in a process. This is one of the most commonly used tools.
Workflow Diagram: A workflow diagram demonstrates
movement through a process. The diagram is comprised
of a map (such as a floor plan) of the area where the process occurs and uses lines to show movement of people,
materials, and information. The diagram demonstrates
where redundant motion and inefficiency is present.
Cycle Time Chart: A cycle time chart portrays, in a graph,
the amount of time spent at each step in a process. In addition, it may demonstrate the costs associated with each
step as well as whether the steps add value.
Decision Tree: Decision trees are tools that can be utilized to navigate several courses of action to arrive at one
choice. Their structure allows one to evaluate multiple options and explore what the potential outcomes are from
choosing a particular option. Decision trees are useful for
comparing strategies, projects, and potential investments
because they provide a view of each of the decisions, risks,
Challenges to Health Informatics
Critical challenges in health informatics are evolving today in
the United States. Challenges reside in different aspects of the
health informatics enterprise, such as:
Ensuring quality of data management and data use
Establishing and strengthening standards and regulation
in response to rapidly growing technologies and devices
Increasing qualified staffing resources
Increasing financial support
Improving system integration, interoperability, and infor-
These challenges must be overcome to successfully achieve
healthcare reform and patient safety initiatives, and to dem-
onstrate improved quality of care with reduced cost in the
The modern healthcare industry struggles to manage data.
In the quest for data, EHRs have been created to import large
amounts of data, storing every keystroke and data point. In fact,
in today’s era of Big Data, frivolous, meaningless, and unstruc-
tured data is collected and stored next to meaningful data. While
computers and hard drives are exceptional at sorting through
mounds of structured data, humans are not. Health data gener-
ated in EHRs and other electronic sources create data complex-
ity with large amounts of unstructured data and different types
and formats of data. Computers cannot distinguish good data
from bad data and unstructured data is more difficult to parse.
Human interaction is required to interpret the data. It is essen-
tial to balance usability with functionality.
With advanced and rapidly growing information technologies and mobile devices, privacy and security are rising, critical health informatics concerns. Patient-centered healthcare
and personalized medicine permit patients to engage in more
of their care decisions and have better access to and control
over their health data. Meanwhile, other stakeholders such as
researchers, business associates, system designers, and analysts
are seeking more data control and access. Healthcare professionals constantly learn of and experience illegitimate external forces working diligently to violate informatics systems for
criminal or malicious purposes. Protection of patient privacy
and system security is especially complex and important, requiring eternal vigilance to stay ahead of external forces working against healthcare information professionals. More effective
security strategies and tools are always needed to prevent security issues. It should also be noted that regulation and policies
are needed for informatics and mobile health devices.
Emerging Technology Brightens the Future of
Technology continues to change the healthcare landscape and
brings with it the opportunity for HIM professionals to transition into new and exciting careers in informatics. As traditional
non-healthcare corporations enter the market and new applications are developed to manage healthcare as well as the EHR,
HIM professionals can bring unique skills and knowledge to assist with these efforts. Below are a few examples depicting the
transformation of health informatics in the marketplace today:
Artificial intelligence (AI) is being developed in many
healthcare products, such as coding systems, radiology,
oncology, and payer systems, just to name a few. AI voice
assistants are being used in healthcare to schedule appointments, search wait times, and perform other tasks.
Voice assistants can be used in patients’ homes to allow
the patient to live at home.
While AI programs can assist the user in searching
through volumes of data, it will not replace the user. The
user plays an important role in providing feedback for the
machine learning required for AI. 11
Genomics and precision medicine will have an impact on
the treatment patients receive based on their individual response to the treatment, which will have an impact on the
structure of the EHR and how information is managed.
Amazon, Berkshire Hathaway, and JP Morgan Chase
are entering the healthcare market to create a non-profit
The explosion of the DNA testing market has raised serious questions regarding the privacy of DNA. One example
of how the DNA data collected by various companies can
be used to track and identify individuals—even if the individual in question has not submitted their own DNA, but
a relative has done so—is the recent investigation that un-