%0 Journal Article %T Multi-Method Study of Electronic Health Records Workflows %A Adela Grando %A Andrew Solomon %A Areti Manataki %A Benjamin Duncan %A Brad Doebbeling %A David Kaufman %A Joanne Bouchereau %A Karl A. Poterack %A Matthew M. Burton %A Richard A. Helmers %A Robert Sunday %A Sarah Hirn %A Stephanie K. Furniss %A Tim Miksch %J Archive of "AMIA Annual Symposium Proceedings". %D 2018 %X EHRs transform work practices in ways that enhance or impede the quality of care. There is a need for in-depth analysis of EHR workflows, particularly in complex clinical environments. We investigated EHR-basedpre-operative workflows by combining findings from 18 interviews, 7 days of observations, and process mining of EHR interactions from 31 personnel caring for 375 patients at one tertiary referral center. We provided high-definition descriptions of workflows and personnel roles. One third (32.2%) of the time with each patient was spent interacting with the EHR and 4.2% using paper-based artifacts. We also mined personnel social networks validating observed personnel¡¯s EHR-interactions. When comparing workflows between two similar pre-operative settings at different hospitals, we found significant differences in physical organization, patient workflow, roles, use of EHR, social networks and time efficiency. This study informs Mayo Clinic¡¯s enterprise-wide conversion to a single EHR and will guide before and after workflow comparisons %U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371265/