Healthcare Business Process Management, Adaptive Case Management & Process-Aware EHR & Health IT Systems

Health IT

Workflow Complexity: Complicated data and simple workflow is complicated. Simple data and complicated workflow is complicated. Healthcare's complicated data and complicated workflow is hypercomplicated.

No Cost Competition: In other industries, companies are forced to adopt technology to optimize workflow to minimize cost while maximizing flexibility.

Regulatory Environment: EHR and HIT vendors are stretched thin addressing Meaningful Use requirements.

Screens vs. Workflow: It’s easier to appreciate EHR screens (layout of data and controls over space) than workflow functionality (sequences of events over time).

Threat to Revenue Streams: Switching to new platforms is risky and threatens current revenue streams.

Billing Over Clinical Emphasis: As long as the right codes are generated to maximize revenue, nothing else matters.

Skeuomorphism: Misguided attempts to model EHR user interfaces on paper medical record forms.

Workflow Stereotypes: Workflow management systems and business process management once emphasized automating human users out of processes. Not true now!

Not Invented Here-ism: Most academic and commercial BPM activity occurs outside the US.

Paradigm Shifts: You stick with a paradigm unless you’re forced to change. Health IT picked a document-based, instead of workflow-based, paradigm.

*Top Ten Reasons EHR-BPM Tech Is Not (Yet) Widely Deployed in Healthcare

Blog Posts

Process Support and Knowledge Representation in Health Care

Short Link: http://ehr.bz/pskr (from Process Support and Knowledge Representation) As you can tell from this blog's title (EHR Workflow Management Systems) and my Twitter account (@EHRworkflow), I think health IT and workflow technology is a great match. Many EHR (and related HIT) weaknesses are mirrored by business process management (BPM and related tech) strengths (for example, see Figure 3). Therefore I was excited to see this tweet from @manfredreichert:

The following (my emphasis) describes the contents of this proceedings of a workshop attended by both medical informatics and business process management researchers.

"Healthcare organizations are facing the challenge of delivering high quality services to their patients at affordable costs. These challenges become more prominent with the growth in the aging population with chronic diseases and the rise of healthcare costs. High degree of specialization of medical disciplines, huge amounts of medical knowledge and patient data to be consulted in order to provide evidence-based recommendations, and the need for personalized healthcare are prevalent trends in this information-intensive domain. The emerging situation necessitates computer-based support of healthcare process & knowledge management as well as clinical decision-making.
The ProHealth'12 / KR4HC'12 workshop brought together researchers from two communities who have been addressing these challenges from two different perspectives. The knowledge-representation for healthcare community, which is part of the larger medical informatics community, has been focusing on knowledge representation and reasoning to support knowledge management and clinical decision-making. In turn, the process-oriented information systems in healthcare community, which is part of the larger business process management (BPM) community, has been studying ways to adopt BPM technology in order to provide effective solutions for healthcare process management. Adopting BPM technology in the healthcare sector is starting to address some of the unique characteristics of healthcare processes, including their high degree of flexibility, the integration with EMRs and shared semantics of healthcare domain concepts, and the need for tight cooperation and communication among medical care teams."

Using the published Table of Contents I tracked down preprints for most of the papers. Keep in mind they were likely edited and polished after the workshop. Nonetheless, they show important connections between healthcare information and healthcare processes. And they show the motivation of respective academic communities to understand and exploit these connections.

I hope these papers, and their authors, inspire US EHR, health IT and business process management professionals, organizations, and vendors to benefit from similar concerted effort.

Table of Contents Plus Links to Papers

Where I know of a Twitter account for an author (or relevant associated vendor or organization) I added it.

Let me know if you track down any of the missing papers or know the Twitter accounts of additional authors.

 

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BPM Solutions

Process Orchestration Engine (AKA workflow engine) to drive the progression of work in structured and unstructured processes or cases

Model-Driven Composition environment for designing processes and their supporting activities and process artifacts

Content Interaction Management supporting e progression of work, especially cases, based on changes in the content itself (documents, images and audio)

Human Interaction Management enables people to naturally interact with processes they're involved in

Connected Processes and Resources they control, such as people, systems, data, event streams, goals and key performance indicators (KPIs)

Continuous Analytics monitor activity progress, and analyze activities and changes in and around processes

On-Demand Analytics to provide decision support using predictive analytics and optimization

Business Rule Management systems guide and implement process agility and ensure compliance

Management and Administration monitor and adjust technical aspects of BPM platform

Process Component Registry/Repository for process component leverage and reuse

Cloud-Based Deployment of about features and functions across desktop platforms and mobile devices

Social Media Compatible external and/or similar internal activity streams integrated with workflows

*Adapted from Gartner

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