FLOW System (formerly FLOW3)
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The original design team, included physicians, prosthetists, purchasing, contracting, and administrative staff, who worked together to design a novel workflow to optimize the prosthetic limb care process, improve timeliness in care, employee satisfaction, and Veteran customer experience.
The FLOW system was designed to work alongside CPRS using custom software, including the FLOW Consult Comment© application and a web-based application. With support from Diffusion of Excellence as a 2017 VHA Shark Tank Competition winner, the FLOW team, expanded the practice to VISN 12 and started their journey to implement on a national scale. By 2021, the third version of the FLOW system, FLOW3, was an enterprise-wide solution; implemented in 142 facilities and benefiting over 15,300 Veterans.
In September 2023, the team launched FLOW4—an updated version designed to seamlessly integrate into the rollout of VA’s new electronic health record (EHR) system. FLOW4 is the culmination of years of Veteran and clinician feedback and provides greater transparency and access to prosthetic limb care.
Origin:
January 2013, Seattle VA Medical Center
Adoptions:
157 successful
Awards and Recognition:
FedHealth IT Award, Gears of Government Winner, Igniting Innovation Award, QUERI Partnered Evaluation Initiative, VHA Shark Tank Winner
Partners:
Diffusion of Excellence, Quality Enhancement Research Initiative, VHA Innovators Network
Recent Updates
Overview
The problem
The solution
The results
Metrics
- By January 2024, the FLOW system had impacted the lives of over 28,000 Veterans with limb loss who were prescribed prosthetic limb care.
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
Above:
The FLOW system, formerly FLOW3, creates excellent results for Veterans with limb loss. It has been implemented at 157 VA facilities, improved the lives over 28,000 patients, and continues to grow. This practice generates a 50% increase in productivity, from initial prescription to final prosthetic limb delivery and continues to contribute to the medical performance goal of “spreading innovation and best practices to modernize systems and optimize market area health systems.”
Above:
The story of the FLOW system begins and ends with the Veteran/ Provider relationship. Prosthesis prescription is entered through an easy-to-use template, with standard format and built-in codes, results in a consistent, clear, and thorough prescription.
Above:
The Prosthetist uses the Consult Comment Tool for Prescription coding. Easy application of codes eliminates need for back-and-forth with physician, outside vendors, and purchasing agents. It's easier to document the fabrication activity!
Above:
The web-based app is used by all staff involved with managing prosthetic limb care. Dashboards provide improved visibility and transparency and facilitate communication and workflow.
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The FLOW system, formerly FLOW3, provides a faster process from prescription (Rx) to purchase order (PO) to limb delivery:• Rx to PO authorization reduced from 21.3 to 10.3 days (non-VA providers)• Variability in timeliness reduced 57%• Rx to limb delivery reduced 39-50%FLOW3 provides greater data transparency and accuracy with data mining related to:• Prosthetics• Veterans with limb loss• Current VA services and need for new services
Above:
The FLOW system, formerly FLOW3, improves communication, patient engagement, and continuity of care:• More Veterans returning to clinic, excited to receive their prosthetic limbs
Videos
Above:
Dr. Jeffrey Heckman speaks about the collaborative origins of the FLOW system, formerly FLOW3, and how it uses three custom-designed features to address issues with artificial limb authorizations.
Implementation
Timeline
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Month 1
Locate installed tools and familiarize yourself. Participate in training modules appropriate for your role -
Months 2-12
Early adoption of the system. Socialize with staff and communicate with FLOW3 team at FLOW3@va.gov with any questions
Departments
- Administration
- Purchasing and supplies
- Education and training
- Patient services
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
Files
- n/a FLOW3 Vignette
Risks and mitigations
| Risk | Mitigation | |
|---|---|---|
| Poor adoption may result from ineffective communication amongst team members | Empower and support Practice Champions with official training materials. | Support Practice Champions with a pre-implementation readiness checklist to help identify pitfalls in their planning. |
About
Origin story
Original team
Dr. Jeffrey T. Heckman
Clinical Lead (Gold Status Fellow)
Jeff Bott
Technical Lead (Developer)
Wayne Biggs
Prosthetist (Coding and Template Lead)
Brian Stevenson
Diffusion of Excellence (Project Manager)
Carl McCoy
Diffusion Specialist
Comment
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