My Foreword and Chapter in Business Process Management in Healthcare, Second Edition

(Excuse my mug! It’s my current @wareFLO Twitter avatar.)


I am delighted to write the foreword to BPM in Healthcare. Forewords traditionally deal with genesis and scope. I’ll tell you why I, an emissary from the medical informatics and health IT community, traveled to another land, that of Business Process Management (BPM). I hope to convince you that the sky is the limit when it comes to the potential scope of BPM in healthcare. And, finally, I assure you this is the right book to start you on your own exciting path to healthcare workflow technology self-discovery.

I first wrote about “Business Process Management” (BPM) in a 2004 health IT conference proceedings paper entitled EHR Workflow Management Systems: Essentials, History, Healthcare. But I’d been writing about workflow systems in healthcare since 1995. From the Journal of Subacute Care:


In 2004 I applied the Workflow Management Coalition’s ( Workflow Reference Model terminology to an Electronic Health Record (EHR) ambulatory patient encounter. (The Workflow Reference Model itself dates from 1994.)


I attended my first BPM conference in 2010 (BPM in Government, which had a healthcare track). At that and many subsequent BPM (and Case Management) conferences I met many of the BPM experts and workflow professionals who co-authored many of the Future Strategies’ publications currently sitting on my own bookshelf. In particular, I’d like to thank Keith Swenson, (My Sandbox, Your Sandbox, in this volume) for answering my incessant questions and welcoming health IT colleagues to BPM venues over the years. Eventually I even became a judge in the annual BPM and Case Management excellence awards.

That’s where BPM in Healthcare comes from in my personal journey. But where is BPM in Healthcare going? The biggest big picture within which to appraise the potential for BPM to transform healthcare is The Fourth Industrial Revolution2. The Fourth Industrial Revolution (also known as Industry 4.0) is not about any individual technology, such as steam power, electrification, or computing (the first three industrial revolutions). The Fourth Industrial Revolution is not even about the Internet of Things (IoT), 3D printing, self-driving cars, artificial intelligence, or big data. It is about the interaction among all these technologies. In other words, The Fourth Industrial Revolution is not about innovative technologies, but innovative systems of technologies. It is about multiple, different, complementary, interlocking, and rapidly evolving technology sub-systems becoming part of an even larger, and way more complex, super-system, a system of systems. Wearing my systems engineering hat, I will argue that the Fourth Industrial Revolution is therefore about processes and workflows.

How do systems engineers manage system complexity? With models. Systems engineers gather data and optimize these models. These optimized models then drive system behavior. Then more data is used to optimize, and so on. In the old days, systems engineers sometimes gathered data with stopwatches and clipboards. I did exactly this, when I built simulation models of patient flow. Today, the Internet of Things and Machine Learning are reducing time scales to collect and process data down to mere seconds. And today, process-aware systems, such as BPM suites, orchestrate and choreograph system processes and workflows, potentially in seconds.

What are “process-aware” systems? These are information systems that explicitly represent, in database format, models of processes and workflows. The models are continually informed by data. The models are continually consulted when deciding what to do, say, or steer next. While process-aware systems “introspect,” they are not “aware” in a conscious sense, but rather in the sense that they can reason with these models; in real-time, in response to their environment and to exhibit intelligent behaviors that would not otherwise be possible.

Currently the industry most adept at representing work, workflow, and process explicitly, in a database, and using this data to drive, monitor, and improve process and workflow is called the Business Process Management industry. Why is BPM so relevant to creating and managing effective, efficient, flexible, and satisfying systems or systems? Because, as Wil van der Aalst, a leading BPM researcher writes, “WFM/BPM systems are often the ’spider in the web’ connecting different technologies” (and therefore different technology systems).

BPM, while not a direct descendent of early artificial intelligence research, inherits important similar characteristics. First, both distinguish between domain knowledge that is acted upon and various kinds of engines that act on, and are driven by, changing domain knowledge. Workflow engines are like expert systems specializing in workflow (warning, a very loose analogy!). Just as expert systems have reasoning engines, workflow systems have workflow engines.

Second, artificial intelligence (AI) and machine learning (ML) are critically about knowledge representation. Early AI used logic; current ML uses neural network connection strengths.

Finally, many AI systems, especially in the areas of natural language processing and computational linguistics, communicate with human users. When I say “communicate” I don’t just mean data goes in and comes out. I mean they communicate in a psychological and cognitive sense. Just as humans use language to achieve goals, so do some AI systems. Communication between humans and workflow systems is rudimentary, but real. Workflow systems represent the same kinds of things human leverage during communication: goals, intentions, plans, workflows, tasks and actions. These representations are, essentially, the user interface in many workflow systems.

To sum up, The Fourth Industrial Revolution is not about any one product, technology, or even system. It is about innovation in how multiple systems of technology come together. Process-aware technology, such as business process management, will play a key role in gluing together these systems, so they can be fast, accurate, and flexible, at scale.

You could go off and read a bunch of books about BPM. There are many excellent tomes. Then figure out how BPM and healthcare fit together. Or just keep reading this Second Edition of BPM in Healthcare.

If you are a healthcare or health IT professional interesting in healthcare workflow and BPM/workflow technology, you could start here:


Aalst, W. Business Process Management: A Comprehensive Survey, ISRN Software Engineering, Volume 2013 (2013), Article ID 507984, 37 pages.

Webster, C. Prepare for a Computer-Based Patient Record That Makes a Difference, Journal of Subacute Care, Vol. 1(3), 12-15, 1995. (

Webster, C. EHR Workflow Management Systems: Essentials, History, Healthcare, TEPR Conference, May 19, 2004, Fort Lauderdale. (

Terminology and Glossary. Winchester (UK): Workflow Management Coalition; 1994 Feb. Document No. WFMC-TC- 1011. BPM in Healthcare (2012) Future Strategies Inc., Lighthouse Point, FL.

Case Management in Industry 4.0: ACM and IoT – see chapter by Nathaniel Palmer” “

Free! My Book Chapter:

Marketing Intelligent BPM to Healthcare Intelligently!

@wareFLO On Periscope!


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Actuarial Science, Accountable Care Organizations, and Workflow

Today’s Actuarial Challenge tweetchat is a welcome opportunity to ponder the future of actuarial science, health IT, and accountable care organizations, in a single blog post.

For background, see:

How will Accountable Care Organization (ACO) IT look in 10 years? How will Actuarial Science fit into that infrastructure? How can workflow technology get us there?

I am not an actuary, but I did get Accountancy and Industrial Engineering degrees (on the way to med school!). In doing so I studied fundamental Actuarial Science concepts: economic risk, random variables, time value of money, and modeling and optimizing stochastic processes (stock and trade for actuaries). Eventually I designed and deployed health IT software. But I’ve kept an interest in financial security systems. From Wikipedia:

“A financial security system finances unknown future obligations. Such a system involves an arrangement between a provider, who agrees to pay the future obligations, often in return for payments from a person or institution who wish to avoid undesirable economic consequences of uncertain future obligations.[1] Financial security systems include insurance products as well as retirement plans and warranties.[2]“

Here are my ten-year “What Will ACO IT” Look Like” predictions:

1. ACO enterprise SW will be ‘process-aware’ (workflow engines executing declarative process models). It will be essential for turning actuarial insight into automated ACO workflows, in almost real-time.

2. Stochastic simulation will literally be built into ACO enterprise software. Simulation is already built into many Business Process Management (BPM) workflow platforms. Actuarial simulation and workflow simulation will increasingly complement and even merge.

3. Virtual ACO enterprises will be built across workflow interoperable healthcare subsystem organizations. For extended discussion of task, workflow, and pragmatic interoperability, see my five-part series

4. ACOs will know exactly how much each service line (chronic Dx, procedure, etc) costs. Comprehensive ACO workflow IT platforms will seamlessly drive sophisticated event-driven activity-based cost management systems. Other industries know exactly what their smartphones and vehicles cost. Healthcare needs to do so too.

5. Virtual ACO enterprises will systematically optimize ROI on collections of targeted workflows. If each of predictions 1-4 become true (workflow tech infrastructure, embedded stochastic simulation, pragmatic workflow interoperability, and virtual ACOs), ACO will become truly intelligent learning healthcare systems.

Relative to intelligent learning systems, I should mention another of my degrees, an MS in Artificial Intelligence. Artificial intelligence, machine learning, workflow technology, business process management, and data pipeline management systems are increasingly leveraging each other’s strengths, and in some cases, even merging. While process-aware workflow technologies will increasingly form virtual ACO IT infrastructure, these workflows will be highly “tunable.” The additional data made possibly by workflow technology about what happened when will increasingly feed into stochastic models, which, in turn, will be essential for systematic improvement of workflows both driven by, and generating the data. This is the “intelligent learning” to which I am specifically referring.

I also have a whole bunch of questions! For example, what, exactly, does “stability” mean? (Probability that premiums will be sufficient to claims cash flows?) What is the current state-of-the-art for actuarial simulation? Are “state models” (as in, Markov models of disease progression) routinely used in ACO actuarial calculations? And so on.

For now, I’ll just close with some thoughts on the intersection among actuarial science, accountable care, and my favorite topics: healthcare workflow and workflow technology!

What is the connection between workflow, workflow technology, actuarial science, and accountable care?

I’ve taken entire courses in workflow. I’ve looked at hundreds of definition of workflow. The following is what I eventually “settled” upon.

“Workflow⁰ is a series¹ of steps², consuming resources³, achieving goals⁴.”

⁰ process
¹ thru graph connecting process states (not necessarily deterministic)
² steps/tasks/activities/experiences/events/etc
³ costs
⁴ benefits

Workflow technology is any technology that represents workflow as a model, explicitly (declaratively) or implicitly (neural network weights), and operates on the model/representation to automatically execute workflows or automatically support human execution of workflows. Academic workflow researchers call these “process-aware information systems.” The best know PAIS are BPM systems. However process-aware workflow tech is rapidly appearing in IT systems, such as Customer Relationship Management systems (CRM) and data and language “pipeline” platforms not typically referred to as BPM systems.

If one modifies my definition of workflow, though within my subscripted limits, to…

Process is a series of events, consuming expected resources, achieving expected benefits

…you arrive at a stochastic process closely resembling actuarial science’s generalized individual model (page 35 in Fundamental Concepts of Actuarial Science).

During my student days, we spent a lot of time estimating parameters and distributions, and then predicting behaviors of these stochastic processes. Sometimes we did so analytically with complicated equations (Markov Models). Sometimes we fell back on computer simulation (Monte Carlo).

A quick review of actuarial science literature indicate many of these same techniques are used today. I found questions about them on actuarial science exams and interesting papers by actuarial science researchers. I’ve appended links to some examples at the end of this post.

By the way, I believe my five predictions are incredibly relevant to a very topical topic: MACRA’s “virtual groups.” So I’ll close with this quote (stretches in italic due to me).

Virtual Groups

“…the MACRA Proposed Rule will likely put pressure on solo practices and small group practices, while favoring large groups.

Fortunately, the MACRA legislation offers a possible “salvation” for solo practitioners in that the rule allows for the formation of “virtual” groups. This would presumably enable smaller practices to band together (virtually) and to function as a larger group, spreading risk and potentially taking advantage of APMs and other benefits the MACRA legislation offers larger practice groups.

Unfortunately, CMS has decided that virtual groups, while mandated by law, were too complicated to set up. Consequently, it is proposing to delay the implementation of virtual groups until 2018.

What is especially ironic about this is that CMS states that virtual groups will be delayed due to the difficulty of establishing an efficient and effective “technical infrastructure” by the beginning of the 2017 performance period. Yet (of course) providers and software vendors are granted no such relief, even though they too will have “technical infrastructure” needs that will have to be enabled in their EHRs in that same restrictive timeframe.

The net result is that without the relief of virtual groups, the majority of small and solo practitioners may be even more unlikely to meet the MIPS standards during 2017, and are more unlikely to avoid penalties being assessed in 2019.”

What’s my point? Well, my predictions are ten years out, and therefore not likely to benefit small medical practices next year. However, I do think the concepts I invoke — virtual ACOs, pragmatic workflow interoperability, true costs, intelligent learning systems — are highly relevant in the long run. Therefore, even when fighting short-term fires, we need to keep our eye on long term goals, and paths to those goals.

Relevant to the #ActuarialChallenge, virtual intelligent learning ACOs will require actuarial science knowledge and experience to be successful. But, I also firmly believe, actuaries must leverage workflow technology to achieve the kind automatic, transparent, flexible, and systematically improvable workflow necessary to merge actuarial science secret sauce directly into ACO IT infrastructure.

@wareFLO On Periscope!


P.S. Here are some links and resources I consulted while writing this blog post.

Fundamental Concepts of Actuarial Science (fantastic introduction to AS if you hate math)

Introduction to Actuarial Science (edX course: videos, but also PDFs, ends with Monte Carlo simulation of life insurance)

Health Insurance: Basic Actuarial Models (Amazon, heavier going, but Fundamentals monograph and Intro edX course are good prereqs)

Society of Actuaries 2014 Exam MLC Models for Life Contingencies (includes questions about multiple state models)

Actuarial Calculations Using a Markov Model

Critical Review of Stochastic Simulation Literature and Applications for Health Actuaries

Stochastic Process (Wikipedia)

Constructing Probabilistic Process Models based on Hidden Markov Models for Resource Allocation (process mining to estimate state model transition probabilities)

Mathematical modelling of social phenomena

An actuarial multi-state modeling of long term care insurance

Estimation of disease-specific costs in a dataset of health insurance claims and its validation using simulation data

How Predictive Modeling Is Helping Employers Gain Control of Health Care Costs

Stochastic Modeling in Health Insurance

The ACO Conundrum: Safety-Net Hospitals in the Era of Accountable Care(Lean Six Sigma to ID and eliminate inefficient processes)

CMS ices reinsurers out of an ACO program

“The group practices were unable to track and manage the fluctuations in risk, and many went out of business. In recent years, organizations have tried to develop better cost tracking systems”

Multiple State Models

Actuarial Uses of Health Service Locators

Estimation of disease-specific costs in a dataset of health insurance claims and its validation using simulation data


Transforms the Insurance Industry with Cloud Modeling Platform

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2016 National Health IT Week Blab, I Mean Firetalk, Was Fun! 23 Participants, 50 Comments

For the second year in a row I hosted a group social video chat. Last year it was Blab (Replay Mid National Health IT Week Blab: Many Thanks to Participants!), this year Firetalk. We had 23 participants, from all of the world, including New Zealand and India. For a bit more information about how well Firetalk replaces Blab, Firetalk Group Social Video Chat as a Replacement for Blab in the Health IT Social Media Community.

If you join Firetalk, please create a channel and publicize it (on Twitter, obviously) so we can all subscribe to each other! I’m at

@wareFLO On Periscope!


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How Easy Is It To Integrate Availity APIs Into Your Payer-Provider Workflow? Very!

[I am writing this blog post in preparation and support for the upcoming #AskAvaility tweetchat Optimizing Payer and Provider Communications hosted by @shimcode and @HIT_MMartin(@Availity), at 1PM EST, Friday, September 30!]

The following (non-HIPAA sensitive) structured data was pulled across the Availity API (@AvailityAPI) into this blog post via execution of PHP in real-time when you viewed this post in your Web browser. (API stands for Application Programming Interface.)

Member Info (JSON string)nn

Member Info (JSON object)

object(stdClass)#367 (6) {
string(4) “ZENA”
string(6) “MARDIN”
string(4) “H123″
string(6) “Female”
string(1) “F”
string(28) “1942-09-15T04:00:00.000+0000″

Member Info


Back when I was a CMIO/programmer, we integrated a lot of third-party services with our EHR. In fact, we were constantly contacted by vendors and customers to integrate with this or that partner. We asked two questions of ourselves. Does it serve a need? How easy is it to add to our IT workflows? Clinicians and business people answered the first question. Programmers answered the second.

What’s the best way to see how easy it is to integrate a third-party into your health IT workflows? By taking a quick whack at it. See how far you can get with only a minimum amount of effort. In other words, the proof is in the (eating of the) pudding. It’s the only certain way to tell for sure whether the pudding is tasty, or the integration is (potentially) easy.


Sometimes, over a long weekend, a programmer (sometimes, me) sat down with an SDK (Software Development Kit) just to take a wee keek (as the Scottish say), and showed up Monday morning with a working prototype! This put a very different spin on the first question. Instead of a manager saying, sorry, we already have too many other priorities, they said, how soon can you finish this so we can sell it…

So, this morning I logged into the Availity - Developer Center for Health Care APIs to take a whack at it. I wanted to see how easy and fast it is to pull structured data into this blog post, using PHP (in which WordPress is written). It didn’t take very long at all! At the beginning of this post you saw a subscriber JSON string, a PHP JSON object, and name, gender, birth date, payer, and requesting physician NPI.

By the way, here is some entertaining context! (At least to me…) I attended the AHIP Institute this spring and I did what I (almost) always do. I search every website of every exhibitor for evidence they use workflow technology (workflow/process/orchestration engines, editors, mentions of Business Process Management, and so on). I tweeted I was doing so and then I tweeted what I found.

In the mean time Availity is waving its Twitter hand and tweeting: us, us, us! If you are interested in healthcare workflow, you have just got to come talk to use about our API platform and how it’s used to improve payer/provider workflow. The following is from my post AHIP Institute blog post, AHIP Institute Trip Report: Business Process Management & Workflow Engines.


The following conversation was interesting because Availity wasn’t actually on my initial list. However, they saw me tweeting about AHIP vendors and workflow and basically demanded I come to their booth. I’m glad I did. As Mark Martin explained, they provide the APIs (and a portal) that can be consumed by workflow tech. In fact, if you think about it, even if you have the best workflow engine in the world, you still need data to achieve whatever strategic goal you set. Availity goes beyond currently, typically available standard APIs to empower necessary administrative workflow between healthcare organizations. I love it. Thank you for your enthusiasm, seeing my #AHIPinstitute tweets, and reaching out about this important topic.

When it comes to healthcare APIs, the proof is in the (eating of the) pudding!


Thanks Availity!

@wareFLO On Periscope!


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Communication Ethics in Healthcare and Health IT


Today’s #HCLDR (Healthcare Leadership) tweetchat topic, What to Say When the Wrong Thing Was Said, hosted by @researchmatters, reminds me of a paper I wrote and presented over two decades ago (in Hong Kong!): Communication Ethics and Human-Computer Cognitive Systems. I discuss communication ethics and its relevance to designing intimate human-technology interfaces. My paper is mostly about humans using and communicating with intelligent tools, from intelligent prostheses to smart robots. In this post I retrieve some of those ideas and apply them to ethical human-to-human communication.

Communication Ethics

“Communication ethics, traditionally, involves the nature of the speaker (such as their character, good or bad), the quality of their arguments (for example, logical versus emotional appeals), and the manner in which presentation contributes to long term goals (of the individual, the community, society, religious deities, etc.) (Anderson, 1991 [in Conversations on Communication Ethics]). These dimensions interact in complex ways”


“Consider Habermas’s (1984) ideal speech…. Communication acts within and among cognitive systems should be comprehensible (a criteria violated by intimidating technical jargon), true (violated by sincerely offered misinformation), justified (for example, not lacking proper authority or fearing repercussion), and sincere (speakers must believe their own statements). These principles can conflict, as when an utterance about a technical subject is simplified to the point of containing a degree of untruth in order to be made comprehensible to a lay person. Thus, they exist in a kind of equilibrium with each other, with circumstances attenuating the degree to which each principle is satisfied.”

Medical Ethics

“Four principles—observed during ethically convicted decision making—have been influential during the last decade in theorizing about medical ethics (Beauchamp & Childress, 1994): beneficence (provide benefits while weighing the risks), non-maleficence (avoid unnecessary harm), self-autonomy (respect the client’s wishes), and justice (such as fairly distribution benefits and burdens, respect individual rights, and adherence to morally acceptable laws). People from different cultures and religions will usually agree that these principles are to be generally respected, although different people (from different cultures or ethical traditions) will often attach different relative importance to them.”

Pragmatic Interoperability

In another series of posts (five parts! 10,000 words!) I wrote about the concept Pragmatic Interoperability. Key to pragmatic interoperability is understanding goals and actions in context, and then communicating in a cooperative fashion. Healthcare professionals are ethically required to cooperate with patients. Implicature part of the linguistic science of cooperative communication.

“We’ll start with implicature’s core principle and its four maxims.

The principle is:

“Be cooperative.”

The maxims are:

  • Be truthful/don’t say what you lack evidence for
  • Don’t say more or less than what is required
  • Be relevant
  • Avoid obscurity & ambiguity, be brief and orderly”

I think most, or all, of the above ideas are relevant to figuring out that to say next, when the wrong thing was said. I will be looking for examples during the Healthcare Leadership tweetchat.

Healthcare Leadership Tweetchat Topics

T1 Beyond classical adverse events like wrong-site surgery or incorrect medication dose, adverse communication events can also occur in healthcare. What types of troubling or harmful communication issues have you experienced that affected your care?

T2 Perceptions vary. Patients may perceive something as a problem, whereas the healthcare team just sees business as usual. How can patients help clinicians understand that perceived problems are as important as actual problems?

T3 What steps can help (quickly) establish rapport between health care practitioners and patients so that if communication goes off-track, each is better equipped to address the problem or perceived problem?

T4 If nurses or other care team members observe poor communication between a physician and patient, what is their obligation–how should they attempt to address the situation?

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Health 2.0 Fall Conference Sponsors Using Business Process Management and Workflow Engines

I searched every website of every Health 2.0 Fall Conference sponsor, 87 in all. I found three companies that emphasize Business Process Management (BPM) and/or workflow engine technology. As I am always trying to encourage more use of workflow tech in healthcare and health IT, I am writing this post to highlight these progressive Health 2.0 sponsors.

The three progressive bringers of workflow technology to healthcare and health IT are…

From the Kainos Evolve website:

(about use of Alfresco Business Process Management software: very complimentary!)

“When we set out to design our Mobile-Enabled Healthcare Platform one of the biggest decisions we made was to use Alfresco for our Business Process Management (BPM) and Electronic Content Management (ECM) services. This decision had a major impact on our product, and we’re convinced we made the right choice, so I wanted to walk you through how we made it.”


“Workflow processes are a fundamental part of our platform. We have a number of core principles that we use to help guide us when we build product. Firstly, everything we build must be driven by the user need and all our applications must be mobile first, interoperable and extensible. eForms and Workflow is one way we make our platform extensible. We want our customers to use our tools to quickly build forms and model entire care pathways. We want them to do this independently without having to wait on features to be added to a product roadmap. But in a modern healthcare environment, traditional BPM is not enough. We need tools that are simple and easy to use, yet flexible.


Clinician’s behavior can not always be mapped using rigid processes. We need modern tools enabling ad-hoc tasks to be generated, dynamic processes to be modelled, simple collaboration between care providers and care recipients and analytics to measure and report on outcomes.”


ECM and BPM are traditionally two very distinct things. When we embarked on this journey we had a very clear vision to select the best tools for the job. This meant we wanted the best ECM product and the best BPM product from the best vendor in each space. We performed two separate and distinct evaluation exercises and I fully expected to be working with two products from different vendors. But midway through our journey it became clear that Alfresco offered something unique that didn’t exist anywhere else on the market. Yes, they have two separate products – Alfresco One for ECM and Alfresco Activiti for BPM, but in combination what they have created is something greater than the sum of its parts and so unique that I don’t really recognise it as either ECM or BPM. In fact, these terms describe something that I don’t really relate with. When I see the words ECM and (especially) BPM I think complex, heavy-weight, closed. Stale. Alfresco have created something different – something simple, something light-weight, something open. Something fresh. I don’t know what the term is to describe this. It’s not ECM and its not BPM, but its definitely the future.

From the Axway website:

Axway ProcessManager Key Capabilities

Use the BPMN-based graphical modeling environment to design processes and specify attributes

ProcessManager’s graphical modeling environment is based on the Business Process Management Notation (BPMN) 1.1 standard, which allows business analysts to represent business process logic and patterns by drawing a diagram.

Business analysts can then specify the attributes for the process objects, such as:

  • Relevant communication service (e.g., OFTP 2) for an incoming order
  • Back-end integration service for processing the order in the ERP system
  • Transformation service for converting the file (e.g., EDIFACT or XML)
  • Routing mechanism

The modeled process can then be tested and refined before it is put into production.”

And from BPM Visibility Paves the Road to Operational Excellence:

Business Process Management Systems (BPMSs) are extremely powerful, as they allow process automation and offer visibility on how an organization performs in its overall value creation network.

In fact, BPMSs can also provide visibility without automating anything, simply by consolidating flows of events. For instance, probes can be used to fetch information from legacy applications and generate events, which are consolidated by a BPMS providing visibility on parts of process instances about which one has very little information. Another important usage of non-automated processes is the control of events coming from business partners, ensuring that every collaboration’s participant provides the appropriate information at the right time (and in the right format) as defined per the service level agreement.

BPMSs make many aspects visible, most notably these two: the proper state of process instances and the different variables associated with each step, such as its cost or completion time. Hence, BPMSs can help predict the future state of an organization based on its current situation. For instance, BPMSs can help identify a potential bottleneck before it arises, and can easily correct it through something called “dynamic resource re-affectation.” BPMSs can also provide real-time visibility on specific customer cases and answer important questions (e.g., “Where is my order?”), ease human work and interactions, and identify who is responsible for what and who did what. A BPMS is simultaneously the rearview mirror allowing you to understand what happened, the windshield through which you view what is about to happen, and the steering wheel empowering you to modify and adapt your course of action.”

From a review of CareCloud:

“CareCloud has an innovative workflow engine and systems architecture”

“automatic notifications when anything takes place in your medical practice with a live feed. In real time you will know when charges are posted, when a patient checks in, or if an appointment gets rescheduled”

From the CareCloud website:

Accounts Receivable Best Practices: Automated Workflow Engine

By way of context, every year for the past 6 years I have searched every single HIMSS conference exhibitor website (1400+!) for “workflow engine” or “Business Process Management” (15% in 2016!). Health IT is gradually, but ever more quickly, moving from a purely data-centric orientation to a more balanced emphasis on both data and workflow. The primary area in which this trend manifests itself is in software architecture. The best known specific terms-of-art associated with workflow technology are workflow engine, workflow management, business process management, process orchestration, and process-aware (academia), to name a few. As workflow engines and BPM become better known in healthcare and health IT, the increasing presence of these phrases on health IT conference websites is but one harbinger of a much needed transition from data-only, to data-and-workflow, emphases.

Note, workflow tech diffusion into health IT is still a bit under the radar, so to speak. Other Health 2.0 sponsors likely leverage proprietary or third-party workflow engine and process-aware technology. It just isn’t on their website! This will also change, as the sterling qualities of workflow tech — automaticity, transparent, flexibility, and improvability — increasingly become valuable competitive marketing collateral.

@wareFLO On Periscope!


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