Summary
Background: Discovery of clinical workflows to target for redesign using methods such as Lean
and Six Sigma is difficult. VoIP telephone call pattern analysis may complement direct
observation and EMR-based tools in understanding clinical workflows at the enterprise
level by allowing visualization of institutional telecommunications activity.
Objective: To build an analytic framework mapping repetitive and high-volume telephone call
patterns in a large medical center to their associated clinical units using an enterprise
unified communications server log file and to support visualization of specific call
patterns using graphical networks.
Methods: Consecutive call detail records from the medical center’s unified communications
server were parsed to cross-correlate telephone call patterns and map associated phone
numbers to a cost center dictionary. Hashed data structures were built to allow construction
of edge and node files representing high volume call patterns for display with an
open source graph network tool.
Results: Summary statistics for an analysis of exactly one week’s call detail records at a
large academic medical center showed that 912,386 calls were placed with a total duration
of 23,186 hours. Approximately half of all calling called number pairs had an average
call duration under 60 seconds and of these the average call duration was 27 seconds.
Conclusions: Cross-correlation of phone calls identified by clinical cost center can be used to
generate graphical displays of clinical enterprise communications. Many calls are
short. The compact data transfers within short calls may serve as automation or re-design
targets. The large absolute amount of time medical center employees were engaged in
VoIP telecommunications suggests that analysis of telephone call patterns may offer
additional insights into core clinical workflows.
Citation: Rucker DW. Using telephony data to facilitate discovery of clinical workflows. Appl
Clin Inform 2017; 8: 381–395 https://doi.org/10.4338/ACI-2016-11-RA-0191
Keywords
Telephone - workflow - communication - organizational efficiency - VoIP