Why Activity-Based Design is the right approach to point-of-care clinical workflows, guidelines and pathways.
There is substantial literature supporting the concept that knowledge works "organize and think of their work in terms of activities that are carried out in pursuit of some overall objective, often in collaboration with others." However, this framework breaks down in the modern clinical workflow given the need for significant parallel cognitive work in the face of constant interruptions and context switching. To date, clinical workflows within the EHR have been classically designed to support very discrete individual tasks rather than the natural holistic needs of a clinical activity.
| Concept | Task-based design | Activity-based design |
| Features | Isolated, action-focused, concept agnostic | Hoslisted, interconnected, collaborative |
| Example | Place CBC order, place CRP order, place CT scan order, review labs, add allergy, consult surgery, write note... | ED workup for possible appendicitis |
A good metaphor for how activity-based design might translate into clinical workflows is the previous work done by architects and innovative companies in Activity-Based Working. In this concept, originally coined by the Dutch consultant Erik Veldhoen in his 1994 book The Demise of the Office (and earlier by architect Robert Luchetti), the physical workspace is designed specifically for the activity which will occur there (focus room, conference room, project room, etc.).
In the clinical realm, this manifests as specifically designing the point-of-care for precise clinical activities. Using our example of ED appendicitis workup it would include a single screen where the clinician can view relevant data (labs, vitals, etc.), interrogate possible risk/probabilities (decision rules/support), review related resources (evidence, media, antibiograms, etc.) and complete bundled talks (ordering, documentation, follow up). Chained togethers, these activities represent a complete workflow, breaking the complexity of clinical work into digestible and designable pieces.
In this spirit, we at Curbside Health have architected our technology as a platform to deliver precise activities for any clinical situation, from ambulatory, to inpatient, to post-op to extreme subspecialty. Dynamically chained together, these activities represent a new way to bring standardization to complex workflows without sacrificing clinician autonomy or historical behaviors.
Videos from Intermountain Healthcare and their experience with Activity-based design
For more information about how Curbside utilizes activity-based design to build modern health technology, contact us for a quick demo.