Inferring EHR Utilization Workflows through Audit Logs

Abstract

Electronic health records (EHRs) usage and clinical workflows are intrinsically linked. To accommodate the complex care settings (e.g., emergency departments), EHR utilization workflows dynamically change in clinical practice, which in turn shapes the clinical workflows. Learning EHR workflows would provide an opportunity for healthcare organizations to enhance clinical workflows in the context of EHRs. However, very few studies investigated HER utilization workflows executed in clinical practice. We develop a network analysis framework and apply it to EHR audit logs to infer EHR workflows. We then measure the differences in the workflows between patient subgroups divided by races via differential network analysis. We apply our framework to trauma patients admitted to the emergency department, which is one of the clinical settings that need timely support from EHR utilizations. Our results show five core EHR workflows related to Narrator, Navigator, SmartTools, Chart Review, and ED workup activities in the ED. We find EHR workflows involving Narrator, SmartTools, and BPA are different when comparing patient subgroups.