Description of Session
The introduction of digital health interventions requires re-examining existing workflows and operations in health facilities in order to ensure that interventions are used efficiently. Finding the optimal integration of an intervention into a facility workflow requires that an intervention is designed with existing workflows taken into account, but also with consideration for how existing workflows can be modified. This optimization helps to improve the efficiency and quality of work completed by healthcare workers when a digital intervention is in use. We studied the effects of modifying workflows within immunization clinics where an electronic immunization registry (EIR) had been introduced, in order to achieve efficient use of the EIR in collecting and reporting immunization data. Using time-motion study techniques, we studied immunization clinic workflow patterns at public health facilities in Kenya. By assessing immunization clinic workflows among facilities using the EIR, we identified bottlenecks, potential solutions, and tested strategies for redesigning an immunization session to increase time efficiencies when healthcare workers perform dual data entry (paper and electronic). We used an iterative approach to test different workflows, assessing how time use changed for each activity, and documenting needed EIR software updates to support healthcare workers using an improved workflow. Workflows were assessed across different sizes and types of facilities. We tested three workflow modifications: preparing records the day before, full paperless data entry, and the use of two tablets (versus one) in a single facility. This study quantified the improved accessibility of immunization information for healthcare workers, allowing them to perform new tasks that can help increase their facility’s vaccination coverage.
