Health Datapalooza? Good. Health Workflowpalooza? Even better!


  1. Why is Health IT behind in workflow-friendly technology and process awareness? How do we fix?
  2. Workflow, Communication, Tasks, and Business Process Management

I had a blast, monitoring the torrent of twending tweets containing #HDPalooza, from the Health Datapalooza conference. As usual, whenever I monitor a health IT-related conference hashtag, I search for tweets containing the conference hashtag and “workflow.” I appended those tweets to the end of this post.


Hey! What about workflow?

Coincidently I just finished a chapter on healthcare workflow technology for book on business process management. I say coincidently because there’s a paragraph about emphasis on data versus workflow. Before you read it I absolutely must emphasize I agree with the goal of freeing health data to be all it can be. It’s just that, unless we increase emphasis on the workflows along which that data flows, we won’t save money or make users happy.

(Excuse me for a moment while I don my flameproof suit…)

“Health IT focuses on representing data and manipulating data, leading to emphasis on meta-data, data about data. This is fine, as far as it goes. It’s just that it doesn’t go far enough and it is not sufficient to address healthcare’s thorny problems of (lack of) productivity, inflexible workflows, and unhappy users. The only way to systemically improve workflow is to represent workflow, and then think hard about steps to improve workflow. Just as data about data is meta-data and thinking about thinking is meta-cognition, workflow of workflow is meta-workflow. And thinking about meta-workflow in healthcare, health IT and medical informatics is sorely deficient.”

I in no way wish to diminish how hard we must think about health data. I just feel we need to think a little harder about healthcare workflow.

Anyway, I do listen and wait for openings to present themselves. I’m especially alert to opportunities to pivot from data to workflow. When defining healthcare processes came up, I couldn’t resist relating it to the workflow improvement life cycle.

Here’s the exchange (photoshopped into the order it occurred, original tweets are at the end of this post).


Here’s a slide from a recent webinar.


The slide represents the business process management life cycle: design, model, execute, monitor, and optimize. The slide also relates the BPM life cycle to the PDCA (plan-do-check-act) process improvement cycle that healthcare process improvement folks know well.

Do you see the connection between reengineering healthcare processes and defining, executing, monitoring, and optimizing them? OK. Do you see the connection between defining, executing, monitoring, and optimizing on hand and the BPM life cycle on the other? OK. Then do you see the connection between reengineering healthcare processes and the BPM life cycle? Good. I do too. I even started the Healthcare Business Process Management Blog because of the connection.

I think the following tweet (after the RT) refers to a historical under investment by healthcare in information technology relative to other industries.

By “ROI explanation?” I mean that current, relatively workflow-oblivious, health information technologies might not have the kind of return on investment necessary to quickly propel adoption, absent subsidies and penalties.

I’ve argued for a long time (200+ blog posts, 20,000+ tweets) the single most important route to more effective, efficient, and flexible health IT is to incorporate more elements of workflow technology. These systems used to be called workflow management systems (and sometimes still are). Many are now called business process management (BPM) systems or suites. There are also offshoots such as dynamic or adaptive case management.

Academics refer to these kinds of systems “process-aware” information systems, because they represent, execute, reason about and improve models of processes, or workflows. In healthcare, these models may be highly detailed, incorporating clinical reasoning. They also be more general, about high-level goals; what needs to be achieved but not exactly how. Healthcare will require some combination of these technologies to help manage healthcare’s chaotic and wasteful workflows.

As well put in the previous tweet, why invest in HIT if it can’t create savings or revenue? Make the goal of HIT to reduce waste and unit costs.


That said, I do see signs more process-aware technologies are making their ways into healthcare. Many of the social, mobile, analytics, cloud, and natural language processing platforms, used by startups and companies bent on disrupting older healthcare business models, include process-aware elements in their architectures. I suspect and hope next year’s #HDPalooza will have even more tweets containing “workflow”, reflecting even more mentions of workflow in presentations. After all, workflow is data too! (Check out my blog post on this topic: Clinical & Business Intelligence, Meet Process Mining (Submitted to #HIMSS13 Blog Carnival)

Maybe, just maybe, there’ll be a workflow-oriented track at next year’s #HDPalooza? I’ve even got a good hashtag:


Appendix (tweets containing #HDPalooza and “workflow”)

(Original tweets about defining, executing, monitoring, and optimizing processes.)

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