Table 2:

Dimensions of workflow integration

Dimensions of workflow integration	Sub-dimensions	Description
Time The technology is integrated with the temporal nautre of work. The technology fits in the workflow, which unfolds over time.	Sequential	The technology fits with the sequential flow of tasks/people/information/tools one after the other (occurring in a sequence)
	In parallel	The technology fits with the flow of multiple tasks/people/information/tools at the same time; the technology supports the flow of tasks/people/information/tools concurrently.
	Discontinuous	The technology fits with the flow of tasks/people/information/tools that is interrupted throughout time. The flow of tasks/people/information/tools is discontinuous; for example, a task may start, then be interrupted and stop, and then resume at a later point in time. Does the technology support this, i.e. going back to the original task/tools-technologies/information after interruption?
	Timing	The technology fits in the flow of tasks/people/information/tools at a specific point in time (e.g. when is it used? when does the technology show up?). The technology is available at the point in time in which it is needed by the physician.
	Extended time	The technology is integrated in the workflow as it occurs over an extended period of time, such as days, weeks, or months. For example, residents in the ED rotate to other services such as cardiology. When the residents rotate to these other services, they adapt to a new workflow during that time (e.g. over months of time) that may differ than the workflow used in the ED. Does the technology fit the workflow over this extended period of time?
Flow The technology is integrated in the flow of tasks, people, information, and other tools/technologies	Tasks	The technology is integrated in the flow of tasks, which occurs over space and time. In order for a technology to integrate in the workflow according to the flow of tasks, the technology should be available/accessible in a location near the preceding and succeeding tasks (e.g. reviewing vitals, completing documentation) and support next steps (e.g. placing an order).
	People	The technology is integrated in the flow of people including the physical environment in which people flow through. The flow of people occurs over space and time.
	Information	The technology is integrated in the flow of information. For instance, if the technology relies on lab results or information from another clinic, this information is available and integrates with the technology. Triggers represent one type of the flow of information. There are two specific considerations for triggers: • Trigger versus no trigger: Whether or not a trigger is used as a reminder to use the technology • Point in time for trigger: The point in time in the workflow for the trigger to occur
	Other tools/technologies	The technology is integrated in the flow of other tools and technologies; this includes the technology’s integration with other CDS that are used by the physician for other diagnoses. It also includes integration of the CDS with other parts of the EHR and other tools such as MDCalc.
Scope of patient journey The scope of the patient journey (i.e. part of the process) in which the technology is integrated within	Within patient interaction	The technology is integrated in the workflow during a patient interaction (e.g. with a clinician, staff); the technology is integrated with a small portion of the patient journey.
	Within patient visit	The technology is integrated in the workflow within the patient (e.g. ED) visit; this is a larger part of the patient journey.
	Before, within, and after patient visit	The technology is integrated in the workflow before (e.g. urgent care visit), within, and after (e.g. hospital stay) the ED visit; the technology is integrated in a large part of the patient journey. For example, the technology is integrated in the workflow as a patient moves from the ED to the hospital by facilitating the transfer of information between the ED attending and the hospitalist.
Level The technology is integrated into the different levels of workflow including the individual workflow, the workflow of a team, and the organizational workflow. The dimension, LEVEL, relates to how many people are involved in the workflow in which the technology is integrated	Individual	The technology is integrated in the workflow of an individual.
	Team	The technology is integrated in the workfolw of a team working together.
	Organization	The technology is integrated in the workflow of the organization.