eBook Series: BPM in Healthcare

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eBook Series: BPM in Healthcare (First Edition)

Hospitals and pharmaceutical companies are embracing BPM as a means to improve operational efficiency, achieve patient safety goals and positively influence the quality of care. This eBook explores the opportunities BPM and workflow technology have to make a profound impact on patient care while examining the challenges that are present in the healthcare arena.

Other titles in the BPM and Workflow eBook Series...
* Introduction to BPM and Workflow (Size: 130 pages, 3MB)
* Financial Services (Size: 265 pages, 10 MB zipped file.)
* Healthcare (size 185 pages, 8MB zipped file)
* Utilities and Telecommunications (152 pages, 5MB)

BPM in Healthcare

Overview and Table of Contents

This new eBook presents the collection of best and most important chapters on this topic recently published in the annual BPM and Workflow Handbook series, and our other publications. BPM’s promises are real, but the path to success is littered with pitfalls and shortcuts to failure. Best practices can help you avoid them. If you are just embarking on using its methods and tools, these authors have a wealth of experience to learn from and build on. Whether you are a business manager or an Information Technology practitioner, this special collection of papers will provide valuable information about what BPM can do for you—and how to apply it.


This new eBook presents the collection of best and most important chapters on this topic recently published in the annual BPM and Workflow Handbook series and other publications. BPM’s promises are real, but the path to success is littered with pitfalls and shortcuts to failure. Best practices can help you avoid them. If you are just embarking on using its methods and tools, these authors have a wealth of experience to learn from and build on. Whether you are a business manager or an Information Technology practitioner, this special collection of papers will provide valuable information about what BPM can do for you—and how to apply it.

Workflow Opportunities and Challenges in Healthcare

Jonathan Emanuele and Laura Koetter, Siemens Medical Solutions USA, Inc., USA
Workflow technology has expanded substantially into the healthcare industry over the last year. Hospitals are embracing this technology as a means to improve operational efficiency, achieve patient safety goals and positively influence the quality of care. This paper will explore the opportunities BPM and workflow technology have to make a profound impact on patient care while examining the challenges that are present in the healthcare arena.

Transforming Healthcare through Enterprise Architecture and BPM

Christine Robinson, CSC, USA
Health Care is one of President Obama’s top priorities for the nation according to his 2009 State of the Union Speech and many other statements he and others have made. This area demands radical change to increase the accessibility and affordability of health care, find new cures for disease (especially a cure for cancer), assure privacy of patient data, lessen health care’s draining effects on our economy, cut waste and fraud in Medicaid and Medicare, have greater participation in global health initiatives, accelerate health care’s role in Emergency Preparedness and Disaster Recovery, and facilitate information sharing environments between organizations. These are some of the major objectives the United States must fulfil to improve our lives as individuals, as a nation, and as members of the global community. This calls for new ways of providing health care across the nation and beyond. With the frameworks and models already in place today, we can achieve profound improvements through adopting an Enterprise Architecture (EA) approach empowered by Business Process Management (BPM) and enabling technologies toward improving affordability and accessibility of health care while protecting the privacy of patient data.

Authenticated Document / Data Exchange in Healthcare

Dr. Mohammed Shaikh, Image X Inc., USA

Exchange of documents and data in commercial organizations is normally ac­complished using traditional workflow methodologies. Successful implementation of workflow in these organizations is encouraging agencies that did not look at these workflow methodologies favorably because data and documents exchanged were considered confidential and restricted and for use only by authorized users. The workflow in these organizations requires that user be authenticated before accessing the document/data as well as obtain their signatures at each step due to legal requirements associated with these processes. In addition retaining the confidentiality of the document/data based on user authentication is of utmost concern. Recent advances in digital signature technology and its use in replacing traditional signature have opened the possibility of creating a successful document/data exchange workflow for authenticated documents and data. Further this approach could be extended to authenticate each user and their role to meet confidentiality and security requirement.

Business Process Management in Pharmaceutical R&D

Dr. Kai A. Simon, ALTANA Pharma AG — a Nycomed company, Germany
Although highly profitable, the pharmaceutical industry has been facing increasing development cost, price pressure, and regulatory requirements. In this context, many companies have embarked on BPM initiatives to manage efficiency and compliance. This article provides an introduction to BPM in the pharmaceutical industry on the basis of a short case study in clinical Research and Development (R&D).

The Representation of Dynamic, Context-Informed Workflow

H. Dominic Covvey, Donald D. Cowan, Paulo Alencar, William Malyk, Joel So, David Henriques and Shirley L. Fenton, University of Waterloo, Canada 

In this chapter, we analyze the nature of dynamic workflow processes, show the limitations of classic techniques in representing these processes, and articulate a new model for representing and processing workflows and a framework for incorporating workflow context into the workflow representation. Although much has been done on the representation of workflow in business settings, two challenges are still the focus of current research: (1) the representation of workflow in highly variable (dynamic) settings, and (2) the incorporation of contextual knowledge into workflow representations in an explicit, declarative form. Properly addressing the latter challenge would enable the automated evaluation of workflows, i.e., the assessment of a workflow relative to objectives and constraints. Regarding the former, many processes in complex environments are dynamic, such as in healthcare, our focus. Dynamic environments typically involve considerable human interaction resulting in a high degree of variability in scenario outcome. In healthcare settings there are many decision makers (e.g., the patient, family, and physicians), kinds of decisions, events and a multitude of reactive, subsidiary workflows (e.g., those that deal with the occurrence of specific events) that often require a quick revision of the course of action.

Managing Change with Re-Usable Assets for Government Agencies

Dr. Setrag Khoshafian, Pegasystems Inc., USA 

Business Process Management (BPM) suites automate policies and procedures. The policies and procedures are captured in executable process flows, different types of business rules, case data, user interactions and service integration—all in the con-text of organizational access controls. These are the operational BPM assets of government agencies.  This chapter will show how BPM can realize change and agility through re-usable government BPM assets. Dynamic BPM repositories allow each government agency to use common practices, while specializing for their particular agency extensions and needs. Thus re-usable assets can be organized in different collections pertain-ing to shared as well as specialized solutions for various sectors such as healthcare, financial management, education, and national security. The chapter will discuss dynamic BPM repositories for the public sector. These repositories organize the re-usable assets for specific agency needs.

Using BPM to Drive Clinical Intelligence and Process Oversight in the Acute Healthcare Setting

Ray Hess, The Chester County Hospital, USA

The environment of the acute hospital setting is a complex compilation of intricate processes. The healthcare worker is challenged to manage and coordinate many diverse aspects of their patients’ care effectively. There is an ever-increasing bur-den of care options and requirements that need to be considered. The use of business process management to help automate and control patient care has been shown to be effective in improving this care burden. However, the healthcare sector has been very slow to adopt BPM. There are many reasons for this phenomenon. Clinical care processes are very complex and often do not have easily de-fined beginning and ending points. They tend to overlap and disrupt other workflows based on the details of the individual process. A complex matrix of conditions can change the logic for dealing with event-based data elements and the way a system should react to those events. The clinical users tend to be very mobile and are not electronically connected for extended periods of their day. These are just a few of the challenges facing healthcare process automation.

SECTION 2: Case Studies

The Chester County Hospital: Case Study

Ray Hess, The Chester County Hospital, USA

The healthcare industry has been slower to adopt Business Process Management (BPM) than other industries. However, The Chester County Hospital (CCH) has distinguished itself by not only implementing workflow management technology in a healthcare setting, but by customizing and supplementing that technology with its own home-grown applications. The result is a workflow system that integrates clinical, operational and financial processes to support patient-centered care. In addition to meeting the primary goal of providing safer, more efficient care to patients, BPM has enabled CCH to improve working conditions for employees, dramatically increase productivity, achieve higher levels of cost optimization, and become a competitive force to reckon with in the local healthcare community.

Geisinger Health System, USA

Gold Award, North America. Nominated by TIBCO, USA

In a move to improve document management and bring greater efficiency to clinical, business and financial processes across its organization, Geisinger Health System undertook a cross-enterprise BPM initiative that has resulted in significant productivity improvements, cost savings and improved customer service. Benefits have included automated document retrieval, faster response on billing and claims inquiries and greatly reduced turnaround time on accounts payable processes with resulting cost savings of $1.5 million+ annually.    

PruHealth, South Africa

Gold Award, Middle East and Africa. Nominated by TIBCO, France

PruHealth is a leading health insurance company which rewards members for adopting a healthy lifestyle. Launched in October 2004, PruHealth is a joint venture between Prudential and Discovery, the South African health insurance leader. Its model is based on a successful concept launched in South Africa.  Prudential is a leading financial services company founded in 1848 with over 21 million customers and 28,000 employees worldwide.
PruHealth is using a business process management approach on top of a service oriented architecture to create a more agile IT infrastructure – one that enables them to adapt their processes to business opportunities and bring products to market more quickly in the highly competitive health insurance market in the UK. PruHealth acquired the BPMS software in August 2007 and had already started to deploy processes on a service-oriented architecture by April 2008, a significant achievement in a short space of time. PruHealth’s IT team and back office and systems support is located in Johannesburg, South Africa. 

IMAN Australian Health Plans Australia

Silver Award, Pacific Rim. Nominated by Polonious Pty Ltd, Australia

Australian Health Plans, a division of IMAN International Pty Ltd is a specialist provider of health plans for temporary residents working in Australia. Since 1981, the IMAN group has specialized in this niche market for health plans.
In 2004 IMAN had a problem; as their sales grew, their costs grew in proportion. Considering this, they made a strategic decision to embark on an IT improvement strategy based on implementing Open Source technology via their IT software partners Polonious Pty Ltd. Their main objective was being to control operating costs and stop costs increasing with sales as far as possible. A side benefit of this approach has been to reduce the external systems to near zero and provide a single point of reference for all information pertaining to claims and plans within the core system. The approach has improved IMAN business processes so that their cost structure is now well below the industry average.

Chemcentral Corporation, USA

Finalist, North America

Acting on a newly implemented operating strategy designed to expand and enhance its customer and market focus, CHEMCENTRAL, a leading global chemical distributor, recently put into operation a new private network-based workflow solution to automate document distribution to and from its trading partners and customers. The service, offered by ADEXS Inc., is being utilized as a means to reduce internal document processing costs, enhance customer service and improve response time to customer requests for quality control/conformance documents such as Certificates of Analysis (COAs) and OSHA-regulated compliance documents such as Material Safety Data Sheets (MSDSs).

NAS Cheetah Project, USA

Finalist, North America; nominated by Green Square Inc., USA

Sometimes you need to run like a Cheetah. In 2003 Congress passed sweeping changes to the nation’s Medicare program. Noridian Administrative Services, LLC. (NAS), one of the largest Medicare contractors in the country had only a short time to prepare for these changes. One of their key Medicare contracts was the first selected for competitive bid. NAS executives challenged a number of areas within the company to offer innovative approaches that could better position NAS to win and execute future contracts. Business Process Management (BPM) and workflow were identified as critical technologies that could enable the innovation. A team was quickly formed to dramatically expand the existing workflow envi­ronment. In the spring of 2005, the Cheetah project was established to take on this challenge. Cheetah’s mission was to expand workflow/BPM into every operational team, a feat that would require the implementation of 20 workflows in 13 departments for over 350 users in just 20 weeks. This case study focuses on the possibility and reality of massively parallel workflow implementations. 

University Hospital Virgen Rocio, Spain

Finalist, Europe. Nominated by Andalusian Health Service, Spain

Document management is one of the major points of inefficiency in hospitals. Due to the great amount of medical reports that are generated for each patient, and the importance of said reports for the continuity of the patient's care, it’s indispensable for the improvement in the generation and management of clinical reports.
This work presents the introduction of speech recognition technology for clinical reports in a healthcare organization in Andalusia (Spain). This technology facilitates a quicker and more secure way for health care professionals to complete patient's reports. The new process reduces possible mistakes in the reports and offers better management of hospital resources. We have used methodology based on Business Process Management to guide the implementation of this speech recognition system.

Unimed Porto Alegre Medical Co-operative Ltd, Brazil

Gold Award, South America, Nominated by BPM Soluções, Brazil

Proper monitoring of the contractual instruments which govern relations between clients and providers is a prerequisite for the efficient management of an organization. Unimed Porto Alegre, the leading medical co-operative in the south of Brazil, recognizes the importance of optimizing the management of its contracts both with corporate clients and providers. Our priorities are standardization, monitoring, speed of response and risk reduction. Through the use of the BPM approach and the automation of processes we have been able not only to revolutionize the way in which we monitor and manage our contracts but also to open the way for a wide number of automation and optimization initiatives in other departments.

Velindre Hospital Integrated Care Pathway

Gold Award: Medical and Healthcare, Nominated by Cardiff School of Computer Science and Informatics, Cardiff University, UK

Teamwork, collaboration and coordination are key aspects of the patient-centric approach taken by modern healthcare. Although many projects have been and are currently being undertaken to improve support for health care professionals, adequate support for teamwork, communication and coordination has yet to be achieved. The delivery of the healthcare service is very challenging as it involves heterogeneous distributed systems, multi-professionals and dependent tasks among each. In addition, the treatment journey of each patient is unique, as decisions are usually made according to several constraints related to the patient, medical condition, patient’s choice, available resources and\or feedback from doctors’ consultation.