Why does the HIT industry lag behind in terms of supporting workflow-friendly technology & process awareness? How do we fix?

Tuesday during HIMSS15 (great conference!) a special #HITsm tweetchat occurred during a live panel. I’d submitted a question about workflow, but didn’t think it had been accepted. Only Thursday did I realize the question had indeed been tweeted and discussed. Better late than never! Here are my tweeted responses to panelist answers to my question. I may write a complete blog post later, with links to my many other posts about healthcare workflow technology.

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HIMSS15 Top Ten List Of Healthcare Workflow Movers & Shakers

Wow! Been a great HIMSS15 show. Prior to HIMSS I announced an intention to create my HIMSS15 Top Ten List Of Healthcare Workflow Movers & Shakers. I’d hoped to have individual rationales to tweet out one at a time during HIMSS. But I’ve written a couple and realize I can’t do justice t to every one of the ten “POWHIT”ers. I will circle back after HIMSS with ten rationales. BTW I intend no order, and in fact Twitter doesn’t allow Twitter lists to be sorted by users. I look forward to writing about each POWHITer. I hope some of you might look forward to reading about them. At least I hope the POWHITers themselves will! :)


POWHIT stands for People and Organizations improving Workflow with Health Information Technology. Over the years I’ve often used the #POWHIT Twitter hashtag.

Here’s link to the Twitter list itself: HIMSS15 Top Workflowistas! If you have any questions or quibbles, you may wish to read my rules! Or just wait until I explain why I selected the individuals and organization that I did.


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Appian Inside? Consider Building Your Next Great Health IT Application on The Best Work Platform

As the leading proponent of process-aware technology in healthcare, I am especially excited to announce I’m working with Appian, the market leader in modern Business Process Management (BPM) software. I’ve enlisted Appian’s expertise and help to even more systematically spread the message of how modern workflow technology can make a significant impact for the healthcare industry.


If you follow me on Twitter or read my blog, you may know my personal workflow “Triple Aim”:

  • Engage health IT leaders, professionals, and users about workflow and workflow tech.
  • Highlight health IT vendors using workflow technology.
  • Recruit into healthcare the very best workflow tech from the workflow industry.

Over the past five years, I’ve energetically engaged and highlighted, if growing ranks of healthcare ‘workflowistas’ is any indication. There’s been a remarkable surge in workflow tech mentions on HIMSS conference exhibitor websites: 2%, 4%, 8%, 16% and this year, 25%+ (may be higher than 25+, but there is so much activity in this area at HIMSS15, I ran out of time to compile the data this year!). If you follow me on Twitter or monitor the #HIMSS15 hashtag, you have seen the numerous kudos I’ve handed out.

What about the third component of my workflow triple aim: Recruiting? I spend a lot of time networking and attending conferences in the workflow tech industry. Mostly I learn, but I also present to workflow tech professionals, explaining healthcare and health IT unique needs. And I encourage workflow tech companies to aim high in healthcare.

During this same five period I attended the yearly Appian World conference in (or near) Washington, DC. I wasn’t a user, reseller, or a partner, in any sense. I was a fan. It was my good luck to live in in the same home metro region with the current leader in modern BPM technology. And every time I went Appian World, I talked about healthcare workflow. Appian World is coming up — April 27-29 — I’d love to see you there. Here is one of my early trip reports.

Then, back in 2013, I took my new Google Glass to Appian. I wanted to see how easy it might be to integrate some cool new wearable with a cool leading BPM work platform. You can read about the result of that collaboration. It was easy. And it was easy because creating custom workflow applications on platforms evolved from process management discipline is completely different from how health IT has designed, built, sold, and bought health IT.

If you can’t find any health IT applications that fit your needs and workflows, and you don’t want to create such health IT applications from scratch (meaning hiring programmers to write code) consider a “low code” approach.

  • Design your app on a modern platform.
  • Draw workflows in a editor without coding.
  • Design forms with point-and clicks.
  • Use the completed application over the Web.

Then push a button to generate intelligent workflow apps natively running on multiple mobile devices without doing any additional building or testing. Oh, one more thing, Appian integrates both private and public social media-style activity streams into these intelligent workflow applications better than anyone else.

I’ll publish more details later. I just wanted to get this blog post up and out, on the first day of the biggest and most influential annual health IT meeting.

Have a great HIMSS15 conference. And watch this space! That is, this blog and my Twitter account, @wareFLO.

Viva la custom workflow applications on platforms evolved from modern process management ideas and technologies!

P.S. Of course, I will continue to search for and champion all people and organizations improving workflow with health information technology. Look for my HIMSS15 Top Ten List Of Healthcare Workflow Movers & Shakers later during the HIMSS15 conference.


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I’m A Cartoon Character On YouTube! Mr. Wearable Workflow, What A Hoot!

I (and my wife) laughed until we cried when we saw this. TX V!

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Wearable Workflow, the Internet Of Things, and the Maker Movement: Free Full Text Download of My New Book Chapter

[Here's a pdf of the chapter! Enjoy!]

Just in time for this year’s HIMSS15 conference in Chicago, I’ve published a chapter about an idea I call “Wearable Workflow.” The chapter appears in the new book “BPM Everywhere (Tagline: Internet of Things, Process of Everything). All attendees at my Friday, April 10, 1:00PM-1:30PM EST, Google Hangout about a new hashtag I’m promoting — #HIMSSmakers — will get a free copy of my chapter! Just tweet me after, at @wareFLO. I’ll send you the link.



Wearable technology and the Internet of Things have incredible potential for improving healthcare workflow. From the original calculator watch to today’s smart glasses and smart clothing accessories, wearable technology seeks to weave (sometimes literally!) information and communication technology into everyday life and work, making it pervasive, intimate, and, metaphorically, friction free. Especially promising are applications in healthcare. These, for example, include patient monitors for the well and unwell and wearable user interfaces to health information systems. However, wearable tech will not succeed unless we get the workflow right. Getting the workflow right means understanding the relationship of wearable tech to the Internet of Things, driving workflow at the point-of-care, and analyzing and optimizing this workflow. Inexpensive Maker-style prototyping of 3D-printed wearable and Internet of Things gadgetry is a great way to explore Wearable Workflow. This presentation is based on the Dr. Webster’s recent 2015 keynote at the Society for Health Systems, Institute of Industrial Engineering Healthcare Systems Process Improvement Conference.

Buy BPM Everywhere!



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Chuck @wareFLO’s 1st Google Hangout After 4/10 Friday’s #HITsm Tweetchat: #HIMSS15 #HIMSSmakers & Workflow

You missed it! Not to worry. Here it is.

Short version:

1:00PM-1:30PM Friday 4/10, G+ link, hashtag is #HIMSSmakers, but might as well add #HIMSS15 too!

What’s my Hangout about?

  • 3D Printing
  • Hacking Arduino Hardware
  • Drones
  • Wearables
  • Internet of Things
  • Healthcare workflow (of course)

Receive a free copy of my new book chapter about Wearable Workflow for attending!

Longer version:

You’ve put up with my incessant tweets. You may have read one of my interminable blog posts…

Now, found out what’s in the box!

Join me for my very first Google Hangout this Friday from 1PM EST to 1:30PM EST immediately after this week’s #HITsm HIMSS15 conference preview tweetchat.

This link will allow you RSVP and get reminded (I assume): http://bit.ly/1CbsFmr

I’ll post a link to the Hangout here, when it’s available. (I’ve not done a Google Hangout before. They use links, right?) I’ll also tweet the link just before hand. What an incredible excuse to follow me on Twitter!

My hangout is made possible by the generous support of @ClinicSpectrum (full description below), purveyors of a wide variety of fine workflow solutions for successful medical practices everywhere. (Love CS’s tagline: “Empowering Cost Effective Workflow!”) I will be in the capable interviewer hands of Steven Incontrera @Steven_Paul of @NextWaveConnect.

You could be excused to suspect all I want to do is all I apparently ever want to do, which is talk about healthcare workflow and workflow technology. I’ll certainly touch on that, but this Hangout actually germinated from this tweet about Makers at HIMSS15.

I’ll be answering questions from Steven about some or all of the following subjects. (Whatever we can get too, guided by Steven’s questions and your tweets.) Feel free to tweet me at @wareFLO on the #HIMSS15makers hashtag (though you might wish to also add #HIMSS15 for good measure). And use whatever native chat mechanism built into Google Hangouts of course, if that exists. Again, this is my first Google Hangout.

  • 3D Printing
  • Hacking Arduino Hardware
  • Drones
  • Wearables
  • Internet of Things
  • Healthcare workflow (of course)

With respect to the first three topics I can discuss the basics. What is X? How does X work? How can I, a complete noobie, get started with X? With respect to the last three topics, I draw on my recent My Keynote at the Healthcare Systems Process Improvement Conference.

Do come by and throw peanuts at me! (But no walnuts! They hurt!)

P.S. I’ll be hanging around the ClinicSpectrum booth during HIMSS15 (booth #5427 in the south hall, below’s a map). I someplace to store all my Maker stuff! And I’ll have my magic black and yellow STANLEY tool box with me. It’s full of drones and Arduino-compatible boards relevant to wearables and the Internet of Things. I might, might, even have my 3D printer on hand!

P.S.S. Clinicspectrum is a healthcare services company providing outsourcing/back office and technology solutions for 17+ medical billing companies, 600+ medical groups/healthcare facilities. Clinicspectrum is able to offer its customers Invoice, Credentialing, Messaging and Productivity Spectrum product suites. These patent pending product suites enable our clients to automate invoices, manage credentialing and re-credentialing activities for providers, monitor and enable employee productivity.


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Chuck Webster: Drone master, robot maker, man of many degrees (Healthcare IT News Profile)

I’m tweeting a lot before, during, and after the HIMSS15 conference in Chicago. Sometimes folks surf from my Twitter profile to my blog. So I’m reposting here Scott Tharler’s excellent profile, which appeared March 2 Healthcare IT News. If you’re interested in any of my passions — healthcare workflow, workflow tech, wearables, Internet Of Things, 3D-printing, robots, drones, Arduino, Twitter — I hope you’ll follow me on Twitter at @wareFLO!)


[Caption under the above photo of Mr. RIMP and me: Chuck Webster, MD holding a version of the robot he created, Mr. RIMP. "I am not above jumping on the latest gadget because it's a way to generate content.”]

If at HIMSS15 you spot a tall gentleman wearing Google Glass, with a robotic pocket protector and a 4.5 -inch drone hovering over him while taking HD video, you’ve just encountered Chuck Webster, MD.

Otherwise known on Twitter as @wareFLO, has in years past been spotted walking around toting a 3D printer in a small Lucite box. Before that, he was ‘The Hat Cam Guy.’ And this year Webster will serve among the credentialed HIMSS15 Social Media Ambassadors who attend the conference and essentially share what they find via social channels.

“I am not above jumping on the latest gadget because it’s a way to generate content,” Webster explains. Indeed, Webster currently owns three drones. But he doesn’t just adopt gadgets – he creates them.

A year and a half ago, Webster invested time in learning about 3D printing, open source hardware, the Internet of Things, Bluetooth and Wi-Fi; combined those technologies into an interactive wearable device; and the ‘Robot In My Pocket’ (a.k.a. Mr. RIMP, who has his own Twitter account) was born.

Designed for pediatricians and others who work in children’s hospitals, Mr. RIMP can be customized with clever sayings and amusing little animations to entertain children. “There is a serious side to Mr. RIMP,” Webster explains. “He’s my experimental wearable workflow platform.”

A member of the maker movement, Webster – who’s taking classes in injection molding – hints that future versions of the kid-friendly gadget may incorporate slicker design; contain custom electronics; and perhaps be controllable through a Pebble watch.

“I want him to be programmable by people who aren’t programmers,” Webster says. “That’s very consistent with what I would eventually want to see in the health IT world.”

His vision: Doctors, nurses and patients having the ability to adapt their health IT tools and ecosystem to fit their needs, rather than the other way around.

It all makes sense, based on his academic origins.

Back in his undergraduate days at the University of Chicago, Webster – perhaps the world’s only accountancy-pre-med dual major – became interested in healthcare costs. His advisor, president of healthcare operations research with a PhD in applied mathematics from Johns Hopkins, steered Webster toward an MD. His graduate work included programming and analyzing flight simulation emergencies and computerized manufacturing workflow simulations.

Fast forward a few decades and several earned degrees to the present wherein Webster obsessively scans the websites of all (roughly 1,200) vendors exhibiting at HIMSS each year. He’s on the lookout for companies that put an emphasis on workflow in their products, as it pertains to usability, patient safety and interoperability.

“Three or four years ago, I had trouble finding interesting stuff,” Webster admits. But by his estimates, the fraction of workflow-related vendors had doubled twice between 2012 and 2014, up to about 16 percent last year.

Now companies come to him, as they strategize on how best to make their products relevant to healthcare. Not surprising since this perpetual proponent of process-aware technologies lives by the mantra:

“Moderation in everything – except workflow.”

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Let’s Use Dell Business Process Management for End-to-End Healthcare Service Delivery and Transformation

Every year, since 2013, I participate in the Dell #DoMoreHIT Healthcare Think Tank online event. (My past tweets on #DoMoreHIT hashtag.) It’s a wonderful opportunity to push my monomaniacal agenda :) to raise awareness about the need to deploy more true workflow technology in healthcare. This year my angle is this: Let’s Use the Dell Business Process Management Suite In Healthcare! Your mission, should you decide, to accept it…. wait, I’m getting ahead of my self. Please read on.


PTBE: Photo To Be Explained

Part of my assumed role as a HIMSS Social Media Ambassador is to use whatever means necessary to accelerate diffusion of workflow tech into healthcare and health IT. Dell will be at the upcoming HIMSS15 conference in Chicago, booth 955. I hope you’ll inquire into their workflow solutions. Healthcare needs more workflow technology and you can help!


The theme of the #DoMoreHIT Think Tank is entrepreneurship, consumerism, and social media. There are lots of interesting connections from those topics to workflow platforms (see my The Intelligent Workflows Behind Engaging Patient Experiences). Look for my tweets on the #DoMoreHIT hashtag on Monday from 11AM to 2PM EST). In this post I’ll drill down into features and benefits of the Dell Business Process Management Suite. The following is a series of quotes I pulled from the Dell BPM brochure along with my amplifying comments.

Dell BPM Suite Relevance to Healthcare
“there’s a growing need to radically change the problem-solving mindset to reduce, streamline and eliminate repetitive process work” So true in healthcare!
“Dell Services has pioneered the concept of Automated Full-Time Employees (AFTEs). The Dell AFTE solution includes over 50 vertical specific and vertical-agnostic tools that reduce, if not completely eliminate, human effort by automating repetitive, high-volume and rules-based tasks.” Interesting! Automated Full-Time Employees. Everyone knows, or should know, that a majority of healthcare cost is expensive human labor. In fact, when setting up a budget one speaks of fully loaded FTEs — no, not inebriated, basically the total cost of an employee, not just compensation. So Dell’s AFTE potentially goes to the very heart of healthcare costs.
  • “Utilize a complex set of sequential process activities, logically broken down by business rules
  • Repeat specific steps without variation and with a high degree of accuracy
  • Enable a set of man-machine interactions that are designed to reduce effort by as much as 50 percent
  • Perform certain activities automatically”
So far, a classic description of business process management!
Benefits of Dell AFTE:

  • Reduce costs: AFTEs cost significantly lower than the price of an offshore full-time employee (FTE).
    Increase efficiency: AFTEs can potentially work 24×7 and each AFTE can replace approximately two to three FTEs.
  • Improve accuracy: AFTEs eliminate errors that humans make in high-volume processes such as missed process steps, inaccurate data entry or calculation errors. AFTEs do it the right way, every time.
  • Utilize in-depth industry knowledge: Using embedded industry knowledge, the AFTE solution is able to automate complex process such as medical coding, claims adjudication and accounts receivable management.
  • Improve speed to market: AFTEs give you the ability to ramp up your process volumes through an iterative implementation model.
  • Improve regulatory compliance: Through detailed audit trails and the assurance of programmatically delivered processes, AFTEs ensure compliance with industry regulations.”
Each and every one of these benefits is highly relevant to healthcare. My favorite? Utilize in-depth industry knowledge. Because this exactly what makes healthcare different. (In fact. it’s what makes every industry different!) Note the mention of medical coding. One of the great debates and push-backs regarding ICD-10 is the increase in the amount of work required by physicians. So, why not use BPM/AFTE’s help reduce cost, increase efficiency, improve accuracy, speed to market, and regulatory compliance of ICD-10 initiatives? (I’ve seen signs of some progress here, but not nearly enough, in my opinion.)
“So what does it take to replace human effort with AFTEs? The Dell AFTE model utilizes an iterative process to deconstruct work activities through identification of each micro step and reconstruction of the work activity by deploying a combination of automated techniques and manual effort.” Again, a classic workflow management/BPM approach. As I have said, over-and-over, we need to create models of work and workflow, and then execute and mechanically consult those models, to systematically improve usability, safety, productivity, interoperability, and even patient experience and engagement.
“we have been automating workflow and knowledge management tasks since 2001. The toolset’s evolution has absorbed thousands of ideas from business process practitioners, leading to the creation of a self-learning, seamlessly integrated suite of business process management applications.” Cool. Not a BPM noobie. Self-learning … can you spell learning health care systems?
“Workflow management portal:

  • Skills- and role-based routing logic is used to enable workforce specialization and collaboration across the process chain
  • Its rapid configuration capability enables automated access to files, work process flow design and efficient, granular measurement, as well as process productivity and quality reporting
  • Estimated 10–15 percent improvement of productivity and quality”
Again. Classic. Now think on this. Dell already supplies enormous amounts of tech products and services to the healthcare industry. Given the incredibly complementary fit between the long list of workflow related problems in healthcare, causing a long list of usability, safety, productivity, interoperability, and patient experience and engagement problems in healthcare, the following has just got be inevitable. Dell BPM tech in healthcare. In fact, it’s already here! (See next entry…)
“CodeFinder and ezyCode

  • International Classification of Diseases/Current Procedural Terminology (ICD/CPT) online code finder including cross-walk solution
  • Automated medical coding using natural language processing”
Nuff said! (well, at least here, in this particular table cell element… please read on…)

In addition to Dell’s foundational work Process Management Layer, Dell also describes its Process Transformation Layer (analytics for process health indicators and key performance indicators). And describes its Integration and Access Layer (accepts input variety of formats and from market leading integration tools, plus access via web, Android, and iOS). So you can see that Dell BPM tech is not just relevant to usability, productivity, consistency, agility, etc., but to workflow interoperability as well.

You Mission, Should You Decide To Accept It…

One of my many little projects, adding up to my very big main project (workflow-ization of healthcare?), is finding companies with both a health IT footprint and a workflow tech foot print, and trying to get those feet working together. So, when you get to HIMSS15, go the Dell booth #955, and ask them about using the Dell Business Process Management Suite to solve your healthcare workflow problems.

Tell them The Secretary sent you (who will, of course, disavow any knowledge of your mission).

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