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

Population Health Management and Business Process Management (part 1)

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Population health management. Looked at about 2 or 3 dozen definitions, and this is the one I came up with that's a synthesis. Proactive management of clinical and financial risks of a defined patient group to improve clinical outcomes and reduce cost via targeted, coordinated engagement of providers and patients across all care settings.

Think about SMACs: Social, Mobile, Analytics, and Cloud. There's obvious relevance. Social: the patient, wherever they are. Mobile: out and about. Physician, too. Analytics: relevant to improving outcome or reducing cost. And then across all care settings: Cloud. You've got something in a virtual way.

But what I want to focus on is targeted and coordinated. Targeted means you need to find the patients at risk and intervene quickly enough to be of benefit. That's complex event processing. So, you have patients who are not enrolled in a chronic management program but should. They should have been enrolled, but are not measuring the right things that they should. Or, they are those numbers, glucose level, is out of balance.

You could have someone who is perfectly healthy, and then all of a sudden they need to be admitted to a chronic management program. You could be in a chronic management program. The numbers are being measured on the right schedule, but then they move out. So, a change in the patient's status needs to trigger a workflow to intervene and stop that trend, that bad trend.

Coordinated, once you kick off that workflow, that's the automated workflow that you don't want to be extra workload for someone. You want it to be transparent. If a task languishes someplace, you want to be able to have it pop up and say, "Hey wait a minute, what about me?"

There's this great fit between the complex event processing and the business process management, which is a fit which other people in BPM and other industries have noted. It's very relevant to healthcare.

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