the power of process: workflow, bpm, and healthcare

With CompleteSpeaker’s

Notes!

The Power of Process

Workflow Automation, BPM* and Healthcare

*Business Process Management

v.12

http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow

http://www.youtube.com/watch?v=KiCglcaS4rY

http://ChuckWebster.com/

http://EHRworkflow.com/

http://hcBPM.com/

http://twitter.com/EHRworkflow

Outline

• BPM Background• Healthcare needs BPM• Other industries• Point-of-care• Non-point-of-care• Next steps

2

http://hcBPM.com/

Charles Webster,MD, MSIE, MSIS

• Accy, Industrial Engineer, AI, Medicine

• Hospital MIS, Professor, EHR vendor• Designed first undergrad medical

informatics program• Workflow: 200+ blogs, 20,000 tweets• Adaptive Case Management Global

Excellence Awards• IEEE Task Force on Process Mining 3

http://hcBPM.com/

Borin

g!

http://hcBPM.com/

Charles Webster,MD1, MSIE2, MSIS3,

BSA4

5

Pre-medAccountancy4

ArtificialIntelligence3

IndustrialEngineering2

Medicine1

Cost Workflow

Computers Healthcare

HCBPM

http://hcBPM.com/

@EHRworkflow #ThePowerOfProcess

My Online Resources

6

http://hcBPM.com/

Big Data

Big Workflow

http://hcBPM.com/

8

#1!

In G

oogle

for a

decad

e

(mos

tly)

http://hcBPM.com/

My Definition of Workflow

Series of steps,consuming resources,achieving a goal.

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http://hcBPM.com/

Workflow of Workflow

Workflow

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http://hcBPM.com/

Workflow

Even BetterWorkflow

BetterWorkflow

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http://hcBPM.com/

Cat. Dog. Tree.

12

???

http://hcBPM.com/

Cat. Dog. Tree.

13

http://hcBPM.com/

Engine.

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http://hcBPM.com/

Engine. Definition.

15

http://hcBPM.com/

Engine. Definition. Editor.

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http://hcBPM.com/

The Power of (executable) Process

(models)

17

Executed By Create

Workflow DefinitionProcess Definition

http://hcBPM.com/

18

UnderstoodBy

The Power of (executable) Process

(models)

Create

Workflow MapProcess Map

http://hcBPM.com/

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Business Process Management

???

http://hcBPM.com/

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Business Process Management

http://hcBPM.com/

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"process optimization

process”

http://hcBPM.com/

http://en.wikipedia.org/wiki/File:Business_Process_Management_Life-Cycle.svg 22

process”

http://hcBPM.com/

http://en.wikipedia.org/wiki/File:Business_Process_Management_Life-Cycle.svg 23

Software-based

PDCA (plan–do–check–act/adjust)

process”

http://hcBPM.com/

EstimatedGlobal BPM Market

Size

24

Annual Growth Rate ≈ 18%

http://hcBPM.com/

EstimatedGlobal BPM Market

Size

25

Annual Growth Rate ≈ 18%

Health IT (magnitude larger): Annual Growth Rate ≈ 7%

http://hcBPM.com/

Healthcare

Needs

BPM26

http://hcBPM.com/

US is estimated to waste more than $765

billion/year on healthcare spending, one third of the total

$2.5 trillion dollar healthcare industry

27

http://hcBPM.com/

Why Does Healthcare Cost So Much?

• Unnecessary services• Defensive medicine• Unnecessary use of high-

cost services• Administrative waste• Duplicative costs of

administering different plans

• Unproductive documentation

• Inefficiently delivered services

• Medical errors• Uncoordinated care 28

• Inefficient operations• Too-high prices• Prices higher than

competitive levels• Excessive variation in

service prices• Medicare/Medicaid fraud• Insufficient investment to

detect fraud• Missed prevention

opportunities• Poor delivery of clinical

prevention services

http://hcBPM.com/

29

“We have a particular interest in healthcare because processes are much more chaotic than in many other industries, and potential savings are enormous…. healthcare is a very challenging, and therefore interesting, application domain for BPM.”

http://hcBPM.com/

Torn From The Headlines!

30

http://hcBPM.com/

Usability Issues Tip of Iceberg

EHR

31

http://hcBPM.com/

EHREHR & non-EHR ITEffectivenes

s, Efficiency,User

Satisfaction,Issues

32

http://hcBPM.com/

s, Efficiency,User

Satisfaction,Issues

33

Defi

nition

ISO

http://hcBPM.com/

s, Efficiency,User

Satisfaction,Issues

“BPM is a systematic approach to making an organizations workflow more effective, more efficient, and more capable of adapting to an ever-changing environment.”

34

Defi

nition

ISO

http://hcBPM.com/

s, Efficiency,User

Satisfaction,Issues

“BPM is a systematic approach to making an organizations workflow more effective, more efficient, and more capable of adapting to an ever-changing environment.”

35

Defi

nition

ISO

http://hcBPM.com/

BPM and Healthcare Process Improvement

36

My MSIE

http://hcBPM.com/

37

EHRsHealth IT

MedicalInformatics

TQM

SixSigma

Lean

My MSIE

http://hcBPM.com/

38

EHRsHealth IT

MedicalInformatics

TQM

SixSigma

Lean

Healthcare BPM

My MSIE

http://hcBPM.com/

Where’s Healthcare?

39

Insurance

Manufacturing

Association

Hospitality

Transportation

Energy

Banking

http://hcBPM.com/

Healthcare’s Catching Up!

40

Insurance

Manufacturing

Banking

Associations

Hospitality

TransportationHealthcare

Energy

http://hcBPM.com/

41

Healthcare’s Catching Up!

http://hcBPM.com/

Social

Analytics

Mobile

Cloud

42

Healthcare

http://hcBPM.com/

Social

Analytics

Mobile

Cloud

43

Healthcare

http://hcBPM.com/

Point-of-Care Workflow

Automation

44

http://hcBPM.com/

Use Case ≈???

A use case is a list of steps … defining interactions between a role … and a system to achieve a goal. (Wikipedia, 2013)

45

http://hcBPM.com/

Use Case ≈???

A workflow is a series of steps, consuming resources, achieving a goal. (Webster, 2013)

46

http://hcBPM.com/

Use Case ≈Workflow Definition

A workflow is a series of steps, consuming resources, achieving a goal. (Webster, 2013)

47

≈ +A definition is a short description of a thing by its properties. (Johnson, 1755)

http://hcBPM.com/

Classic Workflow Editor

1. Triage Patient2. New neuro check?3. Nurse TPA

assessment4. Thrombolysis

candidate?

5. STAT CVA Eval6. CVA Confirmed?7. CT Head r/o CVA8. Hemorrhage absent?9. Physician TPA

decision

1

2 3 4 5 6

78

9

48

http://hcBPM.com/

EHR Data Review & Entry & Order Entry Screens

Screenless Tasks: Check for Labs, Print Ed. Materials, Send Reminders

Non-Point-of-Care Workflow

Automation

62

http://hcBPM.com/

Drag and Drop

Hospital WorkflowDefinition

Editor

63

http://hcBPM.com/

64

Create Step

Drag and Drop

Editor

http://hcBPM.com/

65

Create StepDrag and

Drop Hospital WorkflowDefinition

Editor

http://hcBPM.com/

66

Create Step

Drag and Drop

Editor

http://hcBPM.com/

67

Create Step

Drag and Drop

Editor

http://hcBPM.com/

68

Drag and Drop Options and Actions to Individual

Workflow Steps

http://hcBPM.com/

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Workflow Steps

Customize Step

http://hcBPM.com/

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Workflow Steps

Add Action

http://hcBPM.com/

Workflow Engine Executes Workflow Definition

71

http://hcBPM.com/

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Execute Step

http://hcBPM.com/

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Execute Step

http://hcBPM.com/

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Execute Step

http://hcBPM.com/

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Execute Step

http://hcBPM.com/

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Execute Step

http://hcBPM.com/

Cost per Patient Admissions Packet

Manual Paper Process Workflow Automated Process$0.00

$0.50

$1.00

$1.50

$2.00

$2.50

$3.00

$2.40

$0.45

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http://hcBPM.com/

Next Steps

78

Learn (doing that now!)

Compare WorkflowProducts

List HighValue Workflows

http://hcBPM.com/

Workflow Value

# of Users

Financial Impact Current

Pain

Execution Frequency

79

http://hcBPM.com/

First Steps

80

List LowComplexityWorkflows

http://hcBPM.com/

Workflow Complexity

# of Steps LogicalComplexity

# of Interfaces

81

# of Users

http://hcBPM.com/

High Value Low Complexity,Workflows First

Value

Complexity 82

X

XX

X X

X

XX

X X

http://hcBPM.com/

High Value Low Complexity,Workflows First

Value

Complexity 83

X

XX

X X

X

XX

X XSooner Later

http://hcBPM.com/

First Steps

84

List LowComplexityWorkflows

Tackle High Value,Low Complexity

Workflow

Vendor-SpecificBest Practices

http://hcBPM.com/

Vendor-Specific Best Practices

Your workflow vendor knows best.

85

http://hcBPM.com/

Big Data

Big Workflow

http://hcBPM.com/

The Future is Bright!

87

HCBPM

http://HCBPM.COM

HealthcareBusinessProcess

Management

HealthcareProcess

ManagementCareProcess

Management

http://hcBPM.com/

88

What’s Your Story?

http://ehrworkflow.com/powhit

http://hcBPM.com/

http://ehrworkflow.com/powhit

Thank You!*Questions & Discussion

ChuckWebster.com @EHRworkflow

EHRworkflow.com hcBPM.com

*Thanks to @BrownSelasie @ProfBPM @dz45tr @mloxton @iHT2 @FormFast @KittermanMG @janicemccallum @MightyCasey @INFORMS

@jeanmariegrange @BPMbooks for tweets re this presentation!

89

http://hcBPM.com/

http://twitter.com/BrownSelasie

http://twitter.com/ProfBPM

http://twitter.com/dz45tr

http://twitter.com/mloxton

http://twitter.com/iHT2

http://twitter.com/FormFast

http://twitter.com/KittermanMG

http://twitter.com/janicemccallum

http://twitter.com/MightyCasey

https://twitter.com/informs

http://twitter.com/jeanmariegrange

http://twitter.com/BPMbooks

Question #1

Who needs to be the champion of workflow? Is it the physician, the nurse, administration, IT, what’s your thought?

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http://hcBPM.com/

Question #2

Are there specific examples of high value, low complexity workflows that you can think of as low-hanging fruits?

91

http://hcBPM.com/

Question #3

How would you manage the ‘But we’re special,’ pushback,” most BPM theory gets from clinical care teams?

92

http://hcBPM.com/

Question #4

Could you comment on the similarities and differences at BPM within organizations versus across organizations?

94

http://hcBPM.com/

Question #5

How do we use [BPM] in inpatient flow management when the applications like ER systems, bed management systems and utilization management systems are all un-integrated?

95

http://hcBPM.com/

Question #6

Is Lean as a good first pass for healthcare entities looking to explore BPM?

96

http://hcBPM.com/

the power of process: workflow, bpm, and healthcare

ehrworkf webster

ehrworkf dog

ehrworkf of workflowworkflow10

ehrworkf online resources6

ehr vendor

industrial engineer

medicine hospital mis

msis accy

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