Redesigning the Workflow Process to Upload Paper Consents into the Electronic Health Record

ABSTRACT

Background: Before starting cellular therapy treatment, patients and their physicians must sign consent forms for Standard of Care (SoC) treatment plans as well as ancillary protocols. To avoid delay in patient care, signed SoC consents are scanned into the Electronic Health Record (EHR) in a timely manner, and protocol consents are handed off to the research team to manage as needed. The COVID-19 pandemic forced our large academic center to adapt this consent management workflow to function with fewer onsite staff, which resulted in prolonged turnaround time for consents to be uploaded into the patient's EHR, and operational inefficiencies (e.g. lost consents requiring re-signing, increase workload for staff, etc.). The process involved 4 cross-functional teams, and handoffs spanning multiple physical locations. Combined with the increasing patient volume of our center, the consents process was unsus-tainable and inadequate. Method(s) Our first redesigned process involved physicians dropping off signed consents directly in the clinic workroom.A Research Coordinator would then sort out the protocol consents and hand off SoC consents to the Health Information Systems (HIS) team for EHR scanning. This new process reduced the number of stakeholders handling the consents and consolidated the handoff location to one location. While this allowed for marked improvement in turnaround times for SoC consent scanning, there were additional opportunities to integrate the workflow with the HIS team's existing processes to allow for further efficiencies. After 4 months, we implemented our second redesigned process after drop-off in the clinic workroom by physicians, the HIS team would collect all consents three times per day and scan SoC consents while setting aside protocol consents for the Research team to pick up. This allowed for SoC consents to be scanned without delay and reduced workload for the Research team all while streamlining our workflow into existing HIS processes. See Figure 1 for workflow iteration details. Result(s) The new processes reduced the average turnaround time for SoC consents scanned into the EHR from 8 to 2 busi-ness days. Furthermore, we have increased the number of consents scanned same day into the EHR from 18% under the 1st redesign, to 52% with the 2nd redesign (see Figure 2). We have also diminished the error rate (including lost consents) to 1% of consents processed. (Figure Presented)(Figure Presented) Conclusion(s) The redesigned consents workflow resulted in quicker uploads into the EHR, increased same day uploads and has made lost consents statistically insignificant. Timely uploads of consents into EHRs have also allowed us to flag and resolve any issues earlierCopyright © 2023 American Society for Transplantation and Cellular Therapy