With Complete
Speaker’s Notes!
With Complete
Speaker’s Notes!
The Power ofProcessThe Power ofProcess
Workflow Automation,
BPM* and Healthcare
*Business Process Management
v.12
OutlineOutline
BPM Background
Healthcare needs BPM
Other industries
Point-of-care
Non-point-of-care
Next steps
2
Charles Webster,MD, MSIE, MSISCharles Webster,MD, MSIE, MSIS
Accy, Industrial Engineer, AI, Medicine
Hospital MIS, Professor, EHR vendor
Designed first undergrad medicalinformatics program
Workflow: 200+ blogs, 20,000 tweets
Adaptive Case Management GlobalExcellence Awards
IEEE Task Force on Process Mining
3
Charles Webster,MD, MSIE, MSISCharles Webster,MD, MSIE, MSIS
Accy, Industrial Engineer, AI, Medicine
Hospital MIS, Professor, EHR vendor
Designed first undergrad medicalinformatics program
Workflow: 200+ blogs, 20,000 tweets
Adaptive Case Management GlobalExcellence Awards
IEEE Task Force on Process Mining
4
Boring!
Charles Webster,MD1, MSIE2, MSIS3, BSA4Charles Webster,MD1, MSIE2, MSIS3, BSA4
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Pre-med
Accountancy4
Artificial
Intelligence3
Industrial
Engineering2
Medicine1
Cost
Workflow
Computers
Healthcare
HC
BPM
@EHRworkflow#ThePowerOfProcess
My Online ResourcesMy Online Resources
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7
Big Data
Big Workflow
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#1!
In Googlefor a decade
(mostly)
My Definition of WorkflowMy Definition of Workflow
Series of steps,
consuming resources,
achieving a goal.
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Workflow of WorkflowWorkflow of Workflow
Workflow
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Workflow of WorkflowWorkflow of Workflow
Workflow
Even Better
Workflow
Workflow of Workflow
Better
Workflow
Workflow of Workflow
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Cat. Dog. Tree.Cat. Dog. Tree.
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???
Cat. Dog. Tree.Cat. Dog. Tree.
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Engine.Engine.
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Engine. Definition.Engine. Definition.
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Engine. Definition. Editor.Engine. Definition. Editor.
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The Power of (executable)Process (models)The Power of (executable)Process (models)
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Editor.gif
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Executed By
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Create
Workflow Definition
Process Definition
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Editor.gif
Understood
By
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The Power of (executable)Process (models)The Power of (executable)Process (models)
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Create
Workflow Map
Process Map
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Business Process ManagementBusiness Process Management
???
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Business Process ManagementBusiness Process Management
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Workflow of WorkflowWorkflow of Workflow
"processoptimizationprocess”
http://en.wikipedia.org/wiki/File:Business_Process_Management_Life-Cycle.svg
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Workflow of WorkflowWorkflow of Workflow
"processoptimizationprocess”
http://en.wikipedia.org/wiki/File:Business_Process_Management_Life-Cycle.svg
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Software-based
PDCA (plan–do–check–act/adjust)
Workflow of WorkflowWorkflow of Workflow
"processoptimizationprocess”
EstimatedGlobal BPM Market SizeEstimatedGlobal BPM Market Size
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Annual Growth Rate ≈ 18%
EstimatedGlobal BPM Market SizeEstimatedGlobal BPM Market Size
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Annual Growth Rate ≈ 18%
Health IT (magnitude larger): Annual Growth Rate ≈   7%
HealthcareNeedsBPMHealthcareNeedsBPM
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US is estimated to wastemore than $765billion/year on healthcarespending, one third of thetotal $2.5 trillion dollarhealthcare industryUS is estimated to wastemore than $765billion/year on healthcarespending, one third of thetotal $2.5 trillion dollarhealthcare industry
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Why Does HealthcareCost So Much?Why Does HealthcareCost So Much?
Unnecessary services
Defensive medicine
Unnecessary use of high-cost services
Administrative waste
Duplicative costs ofadministering differentplans
Unproductivedocumentation
Inefficiently deliveredservices
Medical errors
Uncoordinated care
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Inefficient operations
Too-high prices
Prices higher thancompetitive levels
Excessive variation inservice prices
Medicare/Medicaid fraud
Insufficient investment todetect fraud
Missed preventionopportunities
Poor delivery of clinicalprevention services
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“We have a particularinterest in healthcarebecause processes aremuch more chaoticthan in many otherindustries, andpotential savings areenormous….healthcare is a verychallenging, andtherefore interesting,application domainfor BPM.”
Torn From The Headlines!Torn From The Headlines!
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Usability IssuesTip of IcebergUsability IssuesTip of Iceberg
EHR
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Usability IssuesTip of IcebergUsability IssuesTip of Iceberg
EHR
EHR & non-EHR IT
Effectiveness,
Efficiency,
UserSatisfaction,
Issues
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Usability IssuesTip of IcebergUsability IssuesTip of Iceberg
EHR
EHR & non-EHR IT
Effectiveness,
Efficiency,
UserSatisfaction,
Issues
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Definition
ISO
Usability IssuesTip of IcebergUsability IssuesTip of Iceberg
EHR
EHR & non-EHR IT
Effectiveness,
Efficiency,
UserSatisfaction,
Issues
“BPM is a systematicapproach to making anorganizations workflowmore effective,more efficient, andmore capable ofadapting to an ever-changingenvironment.”
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Definition
ISO
Usability IssuesTip of IcebergUsability IssuesTip of Iceberg
EHR
EHR & non-EHR IT
Effectiveness,
Efficiency,
UserSatisfaction,
Issues
“BPM is a systematicapproach to making anorganizations workflowmore effective,more efficient, andmore capable ofadapting to an ever-changingenvironment.”
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Definition
ISO
BPM and HealthcareProcess ImprovementBPM and HealthcareProcess Improvement
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My MSIE
BPM and HealthcareProcess ImprovementBPM and HealthcareProcess Improvement
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EHRs
Health IT
Medical
Informatics
TQM
Six
Sigma
Lean
My MSIE
BPM and HealthcareProcess ImprovementBPM and HealthcareProcess Improvement
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river.png
EHRs
Health IT
Medical
Informatics
TQM
Six
Sigma
Lean
Healthcare BPM
My MSIE
Where’s Healthcare?Where’s Healthcare?
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Insurance
Manufacturing
Association
Hospitality
Transportation
Energy
Banking
Healthcare’s Catching Up!Healthcare’s Catching Up!
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Insurance
Manufacturing
Banking
Associations
Hospitality
Transportation
Healthcare
Energy
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Healthcare’s Catching Up!Healthcare’s Catching Up!
Social
Analytics
Mobile
Cloud
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Healthcare
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Social
Analytics
Mobile
Cloud
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Healthcare
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Point-of-CareWorkflowAutomationPoint-of-CareWorkflowAutomation
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Use Case ≈???Use Case ≈???
use case is a listof steps … defininginteractionsbetween a role …and a system toachieve a goal.(Wikipedia, 2013)
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Use Case ≈???Use Case ≈???
use case is a listof steps … defininginteractionsbetween a role …and a system toachieve a goal.(Wikipedia, 2013)
workflow is a seriesof steps, consumingresources, achievinga goal. (Webster,2013)
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Use Case ≈Workflow DefinitionUse Case ≈Workflow Definition
use case is a listof steps … defininginteractionsbetween a role …and a system toachieve a goal.(Wikipedia, 2013)
workflow is a seriesof steps, consumingresources, achievinga goal. (Webster,2013)
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++
definition is a shortdescription of a thingby its properties.(Johnson, 1755)
Classic Workflow EditorClassic Workflow Editor
1.Triage Patient
2.New neuro check?
3.Nurse TPAassessment
4.Thrombolysiscandidate?
5.STAT CVA Eval
6.CVA Confirmed?
7.CT Head r/o CVA
8.Hemorrhage absent?
9.Physician TPAdecision
1
2
3
4
5
6
7
8
9
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Screen Shot 2013-05-21 at 4.10.55 PM.png
EHR DataReview &Entry &Order EntryScreens
Screen Shot 2013-05-21 at 4.10.55 PM.png
ScreenlessTasks: Checkfor Labs,Print Ed.Materials,SendReminders
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Non-Point-of-CareWorkflowAutomationNon-Point-of-CareWorkflowAutomation
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Drag and DropHospitalWorkflowDefinitionEditorDrag and DropHospitalWorkflowDefinitionEditor
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visual-designer.psd
Create Step
Drag and DropHospitalWorkflowDefinitionEditorDrag and DropHospitalWorkflowDefinitionEditor
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visual-designer.psd
Create Step
Drag and DropHospitalWorkflowDefinitionEditorDrag and DropHospitalWorkflowDefinitionEditor
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visual-designer.psd
Create Step
Drag and DropHospitalWorkflowDefinitionEditorDrag and DropHospitalWorkflowDefinitionEditor
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visual-designer.psd
Create Step
Drag and DropHospitalWorkflowDefinitionEditorDrag and DropHospitalWorkflowDefinitionEditor
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visual-designer.psd
Drag and DropOptions andActions toIndividualWorkflowStepsDrag and DropOptions andActions toIndividualWorkflowSteps
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visual-designer.psd
Drag and DropOptions andActions toIndividualWorkflowStepsDrag and DropOptions andActions toIndividualWorkflowSteps
Customize Step
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visual-designer.psd
Drag and DropOptions andActions toIndividualWorkflowStepsDrag and DropOptions andActions toIndividualWorkflowSteps
Add Action
Workflow EngineExecutes WorkflowDefinitionWorkflow EngineExecutes WorkflowDefinition
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visual-designer.psd
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Workflow EngineExecutes WorkflowDefinitionWorkflow EngineExecutes WorkflowDefinition
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Execute Step
Workflow EngineExecutes WorkflowDefinitionWorkflow EngineExecutes WorkflowDefinition
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Execute Step
Workflow EngineExecutes WorkflowDefinitionWorkflow EngineExecutes WorkflowDefinition
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Execute Step
Workflow EngineExecutes WorkflowDefinitionWorkflow EngineExecutes WorkflowDefinition
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Execute Step
Workflow EngineExecutes WorkflowDefinitionWorkflow EngineExecutes WorkflowDefinition
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Execute Step
Cost per PatientAdmissions PacketCost per PatientAdmissions Packet
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Next StepsNext Steps
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Learn (doing that now!)
Compare
Workflow
Products
List High
Value Workflows
Workflow ValueWorkflow Value
# of Users
Financial
Impact
Current
Pain
Execution
Frequency
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First StepsFirst Steps
80
Learn (doing that now!)
Compare
Workflow
Products
List High
Value Workflows
List Low
Complexity
Workflows
Workflow ComplexityWorkflow Complexity
# of Steps
Logical
Complexity
# of Interfaces
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# of Users
High ValueLow Complexity,Workflows FirstHigh ValueLow Complexity,Workflows First
Value
Complexity
82
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
High ValueLow Complexity,Workflows FirstHigh ValueLow Complexity,Workflows First
Value
Complexity
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X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Sooner
Later
First StepsFirst Steps
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Learn (doing that now!)
Compare
Workflow
Products
List High
Value Workflows
List Low
Complexity
Workflows
Tackle High Value,
Low Complexity
Workflow
Vendor-Specific
Best Practices
Vendor-SpecificBest PracticesVendor-SpecificBest Practices
Your workflow vendor knows best.
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Big Data
Big Workflow
The Future is Bright!The Future is Bright!
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baby.png
HC
BPM
http://HCBPM.COM
Healthcare
Business
Process
Management
Healthcare
Process
Management
Care
Process
Management
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What’s Your Story?What’s Your Story?
Thank You!*Questions & DiscussionThank You!*Questions & Discussion
ChuckWebster.com
@EHRworkflow
EHRworkflow.com
hcBPM.com
tweets re this presentation!
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Question #1Question #1
Who needs to be the championof workflow? Is it the physician,the nurse, administration, IT,what’s your thought?
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Question #2Question #2
Are there specific examples ofhigh value, low complexityworkflows that you can think ofas low-hanging fruits?
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Question #3Question #3
How would you manage the‘But we’re special,’ pushback,”most BPM theory gets fromclinical care teams?
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Charles Webster,MD, MSIE, MSISCharles Webster,MD, MSIE, MSIS
Accy, Industrial Engineer, AI, Medicine
Hospital MIS, Professor, EHR vendor
Designed first undergrad medicalinformatics program
Workflow: 200+ blogs, 20,000 tweets
Adaptive Case Management GlobalExcellence Awards
IEEE Task Force on Process Mining
93
Question #4Question #4
Could you comment on thesimilarities and differences atBPM within organizations versusacross organizations?
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Question #5Question #5
How do we use [BPM] in inpatientflow management when theapplications like ER systems, bedmanagement systems andutilization management systemsare all un-integrated?
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Question #6Question #6
Is Lean as a good first pass forhealthcare entities looking toexplore BPM?
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