Health Informatics Project

Cardiology Visit Swimlane Diagram

This assignment uses a cardiology clinic visit as a case scenario to practice healthcare workflow mapping. The diagram represents the care process at a computation-independent level, focusing on workflow steps, stakeholder responsibilities, decisions, and information exchanges before introducing any specific system design or technical implementation. Building on this workflow, the following sections discuss key health informatics challenges and propose opportunities to improve communication, coordination, data flow, and patient experience.

Healthcare Process Mapping Service Design Systems Thinking

Key Health Informatics Challenges

Limited Interoperability

One challenge shown in the workflow is limited interoperability between care settings and information systems. When the patient does not already have an existing file, the nurse needs to create a new patient record rather than directly retrieving relevant information from another healthcare system. This may lead to repeated data collection, incomplete patient history, duplicated records, and delays in care coordination. From a health informatics perspective, stronger interoperability could allow patient information, referrals, and clinical history to move more smoothly across primary care, the cardiology clinic, and hospital systems.

Limited IT Workflow Integration

The workflow also suggests that several information exchanges are not fully integrated into the clinical process. After the cardiologist makes a decision, the nurse often becomes responsible for forwarding records, sending requests, or communicating the next step to other departments. These tasks are necessary, but they appear to rely heavily on manual routing. In a more integrated workflow, the decision maker could trigger electronic orders, referrals, or departmental notifications directly through the system, with automatic routing and status tracking. This could reduce unnecessary handoffs and make the care process more reliable.

Nursing Workload Concentration

The nurse lane contains a high concentration of tasks, including copying medical records, collecting demographic and financial information, creating or updating patient files, digitizing patient information, conducting ECGs, sending ECG records, receiving cardiologist notifications, and sending requests to associated departments. This suggests that nurses function not only as clinical caregivers, but also as documentation workers, information coordinators, and workflow routers. When too many administrative and coordination tasks are concentrated in one role, it may increase workload pressure and create bottlenecks in the care process.

Dual Record Maintenance

The workflow includes both digitized patient information and stored hard-copy records. Physical copies may serve as a safeguard or backup, especially when teams want to protect access to important patient information. However, maintaining both paper and digital records can create extra handling work, increase storage and retrieval effort, and raise questions about which version is the most current. As digital infrastructure becomes more reliable, this process could be optimized through secure digital backups, audit trails, access control, and disaster recovery planning, reducing the need for routine physical copies while still preserving safety and continuity.

Possible Improvement

Improve Interoperability Across Care Settings

A potential improvement would be to strengthen interoperability between primary care, the cardiology clinic, and hospital systems. Instead of creating a new patient file from scratch when no existing clinic file is found, the system could support secure retrieval of relevant patient information from connected healthcare systems. This may include patient demographics, referral details, previous medical history, diagnostic results, and medication information. Better interoperability could reduce repeated data collection, improve information completeness, and support smoother care coordination across the patient journey.

Integrate IT Functions Into the Workflow

The workflow could also be improved by integrating key IT functions directly into clinical decision-making and task routing. For example, when the cardiologist determines that further testing, departmental review, or admission planning is needed, the system could allow the decision maker to trigger electronic orders, referrals, and notifications directly. These actions could then be automatically routed to the appropriate team with status tracking. This would reduce the need for manual forwarding, lower the risk of missed communication, and make the workflow less dependent on one person acting as the information middleman.

Reduce Nursing Documentation and Coordination Burden

Because the nurse lane contains many clinical, administrative, documentation, and coordination tasks, future workflow design should consider how to reduce unnecessary workload concentration. Some tasks could be supported through automated data capture, structured electronic forms, pre-populated patient information, electronic order routing, and clearer role assignment. Administrative or system-driven tasks should not always fall to nurses by default. Reducing avoidable documentation and routing work could allow nurses to focus more on patient assessment, clinical care, and direct communication.

Optimize Dual Record Management

The workflow currently includes both digitized patient information and stored hard-copy records. While physical copies may serve as a backup or safeguard, this dual record process could be optimized as digital infrastructure becomes more reliable. A stronger digital record strategy could include secure digital backups, audit trails, access control, version control, retention policies, and disaster recovery planning. With these safeguards in place, the organization could gradually reduce routine dependence on physical copies while still protecting information access, continuity, and patient safety.

Explore by Stage

Use the stage tabs to inspect smaller portions of the wide process map and connect each segment to one risk and one improvement opportunity.

Design Value

The diagram turns a complex care journey into a shared visual system. It helps teams see not only what happens during a cardiology visit, but where coordination can break down and where targeted improvements may have the greatest impact.