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

What's Your Story? People and Organizations improving Workflow with Health Information Tech



One more thing, I love hearing workflow success stories regardless of whether they involved workflow engines or not. I’ve created a directory on my kind of Twitter account website which is at, POWHIT, P-O-W-H-I-T, links on the next slide too. POWHIT, that stands for people and organizations improving workflow with health information technology. POWHIT is kind of like those call outs that you’d see during a fisticuffs scene in the old Batman series, just trying to give it a little zip.

Thank You!,, The Healthcare BPM Blog, and @EHRworkflow




Okay. Finally, we’ve come to the end here. I think we’ll probably be holding questions until after Shawn has his chance to present. I do want to mention again, my blog, my Twitter account at wareFLO. I think I’m pretty interactive and I want to thank the folks down here at the bottom, Brown Selasie, Professor BPM in the Netherlands, Ryan Lucas, Mike Luxton’s a great guy, you should follow him. They’ve been re-Tweeting links about this seminar and they have been Tweeting me and saying, “How are the slides coming along?” It’s a very jovial community. It’s a good community to join if you want to learn about this kind of stuff.

Who Needs To Be The Champion of Workflow? Physician? Nurse? Administration? IT?



[I answered each of these questions to the best of my ability, extemporaneously , with in extreme time constraints. Each deserves at least a complete blog post…what a great idea!]

Well, I’m not even sure that the idea of a workflow champion necessarily makes sense to me. I think that if you give people the tools to improve the workflow around them, they will tend to want to do it, especially if you can demonstrate to them.

I guess you do need a champion for that first workflow, whoever owns the high value, low complexity workflow, that’s the champion. In fact, I didn’t show all of the dimensions. There’s actually about three or four dimensions to both value and complexity and one of the values, one of the dimensions was … had to do with executive sponsorship and/or a champion.

It’s a little bit like looking for your keys under the lamp post because that’s where you can see, so as you look As you scan the environment, one of the three or four or five things that will determine whether a workflow is a high value workflow or not is whether there’s a natural champion who can help shepherd the project. So, the answer to who is going to be the champion has to be answered on a case by case basis.

[That said, I do think there is also the role of champion for workflow technology, for bringing business process management software into a healthcare or clinical environment. I’ve seen CIOs perform this function, but also management engineers and CMIOs (Chief Medical Informatics Officers).]

Are There Specific Examples of High Value, Low Complexity Workflows?



[I answered each of these questions to the best of my ability, extemporaneously , with in extreme time constraints. Each deserves at least a complete blog post…what a great idea!]

It tends to be very, very sort of domain-specific. Are we talking about the medical records department? Are we talking about the ambulatory? are we talking about managing some kind of process in the executive suite? Probably, for good, specific examples in this case, Shawn might be the best source.

Shawn Curtiss (of FormFast, who hit’s the ball out of the park!):

Yeah, we typically talk with our customers about their high volume forms, and there are a lot of things that aren’t that complex. A lot of them … a lot of the processes don’t have a definition around them today even so things like employee on-boarding and all the things that are spurred around that, requesting access to systems from IT, requesting security badges and clearances from the security department so as you on-board an employee, those are simple processes but maybe you don’t have full control over those.

Kind of the other side of this too is, what’s the impact of not having full control over these processes? When that employee terminates, do you know what systems they have access to? Do you know what security passes they have on them? Do you know what equipment has been issued to them?

Being able to take those processes from the simple aspect of, “Geez, we just hired somebody, they need these items,” and then turning that into, “Now we have an inventory of what every employee has,” and extending it because now we can leverage technology rather than crap knowledge to do that.

Another high volume application that a lot of our customers are using are employee change orders so when they transfer from department to department or change a rate or hours, those are very high volume transactions in those processes, especially in some of the larger organizations. There are a lot of employees to do deal with. There are all kinds of processes that can be automated and of course, the number one process would be admissions, generating the right content at the time of admissions and making sure you get that right so that patient care flows properly and so that billing flows properly. It affects a lot of things, getting that right, getting signatures in place. That’s one of the core processes of automation. That’s a low-hanging fruit as well.

How Do You Manage "But we're special" Pushback Most BPM Theory Get's From Clinical Care Teams



Another question that we got via the chat states, “How would you manage the ‘But we’re special,’ pushback,” most BPM theory gets from clinical care teams? Chuck, do you see that type of pushback?



[I answered each of these questions to the best of my ability, extemporaneously , with in extreme time constraints. Each deserves at least a complete blog post…what a great idea!]

Yeah. Yes, I do and I think … and again, you only have enough time to cover what you can cover and I think I was pretty organized and spoke pretty quickly but if you go back to … I think, can you put me back on the [third slide] slides?

Okay, the fifth one down, Adaptive Case Management Global Excellence Awards. I’m actually a judge on that. You saw the quote from Wil van der Aalst, in which he said that healthcare is more chaotic and more unstructured. Within the business process management community, there has been a similar reaction to overly rigid process models and part of the tribe of rebels, they’re into something they call adaptive case management.

These systems, they come out of the business process management community but they very much diminish emphasis on that network diagram that says this has to happen and this has to happen. In fact, what they do is they represent very high level goals, like this case is 25% done or we have obtained the signature. It doesn’t say how to get the signature. Anybody can get the signature but what they do emphasis is visibility.

Visibility: here are the set of goals. Anybody can accomplish it based on certain constraints. I mean you have to have the authority and so forth. Then everybody sees as the case moves along, what’s being accomplished and then people jump in more dynamically.

What these systems emphasize and represent is *what* needs to be done, not *how* it needs to be done. There are some very interesting adaptive case management systems that I think would be great to show to those folks who look at a traditional BPM system and look at that workflow and say, “Well, we can’t imagine ourselves fitting ourselves into such a rigid structured workflow.”

My Next Speaking Engagement!


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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