Post on 16-Nov-2014
description
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 @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Outline
• BPM Background• Healthcare needs BPM• Other industries• Point-of-care• Non-point-of-care• Next steps
2
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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 4
Borin
g!
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Charles Webster,MD1, MSIE2, MSIS3,
BSA4
5
Pre-medAccountancy4
ArtificialIntelligence3
IndustrialEngineering2
Medicine1
Cost Workflow
Computers Healthcare
HCBPM
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
@EHRworkflow #ThePowerOfProcess
My Online Resources
6
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Big Data
Big Workflow
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
8
#1!
In G
oogle
for a
decad
e
(mos
tly)
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
My Definition of Workflow
Series of steps,consuming resources,achieving a goal.
9
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow of Workflow
Workflow
10
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow of Workflow
Workflow
Even BetterWorkflow
Workflow of Workflow
BetterWorkflow
Workflow of Workflow
11
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Cat. Dog. Tree.
12
???
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Cat. Dog. Tree.
13
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Engine.
14
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Engine. Definition.
15
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Engine. Definition. Editor.
16
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
The Power of (executable) Process
(models)
17
Executed By Create
Workflow DefinitionProcess Definition
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
18
UnderstoodBy
The Power of (executable) Process
(models)
Create
Workflow MapProcess Map
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
19
Business Process Management
???
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
20
Business Process Management
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
21
Workflow of Workflow
"process optimization
process”
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
http://en.wikipedia.org/wiki/File:Business_Process_Management_Life-Cycle.svg 22
Workflow of Workflow
"process optimization
process”
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
http://en.wikipedia.org/wiki/File:Business_Process_Management_Life-Cycle.svg 23
Software-based
PDCA (plan–do–check–act/adjust)
Workflow of Workflow
"process optimization
process”
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
EstimatedGlobal BPM Market
Size
24
Annual Growth Rate ≈ 18%
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
EstimatedGlobal BPM Market
Size
25
Annual Growth Rate ≈ 18%
Health IT (magnitude larger): Annual Growth Rate ≈ 7%
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Healthcare
Needs
BPM26
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Torn From The Headlines!
30
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Usability Issues Tip of Iceberg
EHR
31
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Usability Issues Tip of Iceberg
EHREHR & non-EHR ITEffectivenes
s, Efficiency,User
Satisfaction,Issues
32
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Usability Issues Tip of Iceberg
EHREHR & non-EHR ITEffectivenes
s, Efficiency,User
Satisfaction,Issues
33
Defi
nition
ISO
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Usability Issues Tip of Iceberg
EHREHR & non-EHR ITEffectivenes
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Usability Issues Tip of Iceberg
EHREHR & non-EHR ITEffectivenes
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
BPM and Healthcare Process Improvement
36
My MSIE
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
BPM and Healthcare Process Improvement
37
EHRsHealth IT
MedicalInformatics
TQM
SixSigma
Lean
My MSIE
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
BPM and Healthcare Process Improvement
38
EHRsHealth IT
MedicalInformatics
TQM
SixSigma
Lean
Healthcare BPM
My MSIE
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Where’s Healthcare?
39
Insurance
Manufacturing
Association
Hospitality
Transportation
Energy
Banking
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Healthcare’s Catching Up!
40
Insurance
Manufacturing
Banking
Associations
Hospitality
TransportationHealthcare
Energy
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
41
Healthcare’s Catching Up!
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Social
Analytics
Mobile
Cloud
42
Healthcare
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Social
Analytics
Mobile
Cloud
43
Healthcare
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Point-of-Care Workflow
Automation
44
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Use Case ≈???
A use case is a list of steps … defining interactions between a role … and a system to achieve a goal. (Wikipedia, 2013)
A workflow is a series of steps, consuming resources, achieving a goal. (Webster, 2013)
46
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Use Case ≈Workflow Definition
A use case is a list of steps … defining interactions between a role … and a system to achieve a goal. (Wikipedia, 2013)
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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
EHR Data Review & Entry & Order Entry Screens
Screenless Tasks: Check for Labs, Print Ed. Materials, Send Reminders
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Non-Point-of-Care Workflow
Automation
62
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Drag and Drop
Hospital WorkflowDefinition
Editor
63
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
64
Create Step
Drag and Drop
Hospital WorkflowDefinition
Editor
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
65
Create StepDrag and
Drop Hospital WorkflowDefinition
Editor
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
66
Create Step
Drag and Drop
Hospital WorkflowDefinition
Editor
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
67
Create Step
Drag and Drop
Hospital WorkflowDefinition
Editor
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
68
Drag and Drop Options and Actions to Individual
Workflow Steps
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
69
Drag and Drop Options and Actions to Individual
Workflow Steps
Customize Step
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
70
Drag and Drop Options and Actions to Individual
Workflow Steps
Add Action
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Engine Executes Workflow Definition
71
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Engine Executes Workflow Definition
72
Execute Step
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Engine Executes Workflow Definition
73
Execute Step
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Engine Executes Workflow Definition
74
Execute Step
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Engine Executes Workflow Definition
75
Execute Step
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Engine Executes Workflow Definition
76
Execute Step
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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
77
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Next Steps
78
Learn (doing that now!)
Compare WorkflowProducts
List HighValue Workflows
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Value
# of Users
Financial Impact Current
Pain
Execution Frequency
79
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
First Steps
80
Learn (doing that now!)
Compare WorkflowProducts
List HighValue Workflows
List LowComplexityWorkflows
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Workflow Complexity
# of Steps LogicalComplexity
# of Interfaces
81
# of Users
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
High Value Low Complexity,Workflows First
Value
Complexity 82
X
X
X
X
X
X
X
X
XX
X X
X
XX
X X
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
High Value Low Complexity,Workflows First
Value
Complexity 83
X
X
X
X
X
X
X
X
XX
X X
X
XX
X XSooner Later
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
First Steps
84
Learn (doing that now!)
Compare WorkflowProducts
List HighValue Workflows
List LowComplexityWorkflows
Tackle High Value,Low Complexity
Workflow
Vendor-SpecificBest Practices
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Vendor-Specific Best Practices
Your workflow vendor knows best.
85
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Big Data
Big Workflow
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
The Future is Bright!
87
HCBPM
http://HCBPM.COM
HealthcareBusinessProcess
Management
HealthcareProcess
ManagementCareProcess
Management
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
88
What’s Your Story?
http://ehrworkflow.com/powhit
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Question #1
Who needs to be the champion of workflow? Is it the physician, the nurse, administration, IT, what’s your thought?
90
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Question #2
Are there specific examples of high value, low complexity workflows that you can think of as low-hanging fruits?
91
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Question #3
How would you manage the ‘But we’re special,’ pushback,” most BPM theory gets from clinical care teams?
92
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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 93
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Question #4
Could you comment on the similarities and differences at BPM within organizations versus across organizations?
94
http://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
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://ChuckWebster.com http://EHRworkflow.com http://hcBPM.com @EHRworkflow
http://www.youtube.com/watch?v=KiCglcaS4rY
Question #6
Is Lean as a good first pass for healthcare entities looking to explore BPM?
96