Physician advisory program at Rochester Regional Health: An exercise in participatory sociotechnical design

Electronic Health Records (EHR) systems have transformed and modernized healthcare processes. Yet, EHR systems are frequently criticized for complicating workflows and low usability. To overcome those impediments, many EHR vendors have provided tools that allow greater involvement of physicians in improving EHR workflows. However, those “physician builder” tools are often difficult for physicians to master. This case explores a participatory EHR-based business process redesign initiative at Rochester Regional Health, an integrated health system in New York State. Through close collaboration between the health system’s Health Informatics Department and its clinical care providers, the Physician Advisory (PAd) Program created standardized note templates, produced trackable data, and leveraged in-house expertise to significantly lower operational costs and empower providers. The case probes the costs and benefits of process standardization and participatory design in the dynamic environment of health information management. The experiences at Rochester Regional Health provide valuable insights for health care organizations seeking to transform EHR workflows for greater fit with their needs, highlighting the importance of data-driven workflow review, reducing process fragmentation, and measuring progress for continuous improvement.