As a educator about process-aware tech in healthcare (workflow management systems, business process management, and dynamic/knowledge-based/adaptive case management software), I keep an eye on Siemens workflow-related white papers, product brochures, YouTube videos, conference presentations, and webinars.
Recently I attending a webinar sponsored by Siemens: How can Complex Event Processing, Business Process Management, and SWIM Help to Improve Performance, Quality, and Efficiency of Patient Care? SWIM stands for SWIM Workflow Initiative in Medicine — yes, a recursive acronym! At about the same time I discovered some wonderful new (to me, but seem very recent) product brochures and case studies.
I’ll summarize this content here, but I should mention I have no financial relationship with Siemens Healthcare. I just think that a rising healthcare BPM tide raises all boats, so to speak. By boats I mean People and Organizations improving Workflow with Health Information Technology. I even have a directory of #POWHIT profiles in where I award web badges!
— Charles Webster, MD (@wareFLO) February 21, 2014
“dynamic care plans, integrated within the embedded business process management technology, deliver patient-specific messages for evidence-based interventions at every point in the care workflow. An underlying workflow engine monitors the care plan activities for completion or deviations, triggering timely patient-specific interventions and event-based alerts, as well as escalating missed tasks to a specified care team member.” (ref)
Note the important role BPM and workflow engines play!
I’ll start with a couple slides and then an outline of the entire webinar. After that I highly workflow tech-related material from the recent brochures and use cases. Please, by all means, view a video of the webinar: It’s free!
The webinar included two presenters on related topics. Bradley Erickson, MD, PhD, of Mayo presented “SIIM Workflow Initiative in Medicine (SWIM) Lexicon: Measuring and Improving Workflow.” Marc Overhage, MD, PhD, presented on Business Process Improvement and Directions.
Nice overview of BPM benefits for healthcare workflow!
So true! It is finally begin to happen though, I’m happy to report.
And here is my distilled outline of the entire 50 minute presentation.
- How to Improve Workflow
- How to describe workflow
- Standard for collecting/accessing workflow events
- Time, EventID, SystemID, Additional info
- Collect workflow data from population
- Determine optimal workflows by department
- Use workflow engines to support optimal workflows
- Workflow Engine for brain tumor protocol
- We need event data
- What exists
- What doesn’t but is needed
- “Harmonization” (match ids, sync times)
- “Workflow engines are widely used outside of medicine. We need to catch up.”
- Business Process Management Technology
- Manage clinical processes from beginning to end
- Identify clinical workflow problems
- Monitor clinical workflow execution
- Calculate effectiveness & efficiency measures
- “Process = series of actions performed to achieve an intended result”
- “Workflow = In healthcare, either a sub-process performed by a single individual or a process”
- Simple processes
- Complex Processes
- Predictable & unpredictable
- Many steps
- Multiple paths
- Nested processes
- Many participants
- Many interfaces
- Change frequently
- Stroke Process Example
- Process Types
- Process vs Knowledge Workers
- Simple vs Complex Processes
- BPM -> CEP/BPM -> “Contextualization”
- Care Teams Need
- Contextualizing a model process
- Tweak executing BPM process every time one of the following changes
- Tweak executing BPM process every time one of the following changes
- Process monitoring prompts “re-contextualization”
The following is supplementary material I’ve been able to find in a series of product brochures and case studies. Again, I embolden specific references to workflow tech.
Workflow Technology: The Right Information at the Right Time
“the Soarian® system’s embedded workflow technology is critical in supporting improved care delivery and team collaboration. Any care delivery process includes many steps, creating multiple opportunities for variability and potential human error. The workflow engine helps the care team eliminate process variability, which in turn supports patient safety and positive outcomes. EMH also leverages the workflow technology to guide clinicians in addressing or completing time-sensitive care interventions. “The workflow engine works behind the scenes to gently remind and guide our teams to care for patients in a manner consistent with the evidence.”
“The fundamental advantage of the workflow engine over a rules engine is the level of sophistication. Being able to support a highly complex clinical process, monitor patient progression across the continuum of care, notify the appropriate clinician(s), and escalate if needed not only drives out variability in care but improves patient outcomes. The workflow engine is really helping us transform the way we care for patients at EMH.”
“EMH plans to use Soarian and its workflow capabilities to address future challenges and opportunities. “With healthcare reform, there are growing requirements for transparency and accountability,” says Wray. “We are highly focused on getting our IT solutions in place and optimized to support these changes.”
Physician Engagement Supports Workflow Efficiencies
“Like most community-based facilities, PVHMC physicians are independent. It was, therefore, imperative to align with the workflow demands of those who practice at different facilities with different EHRs and other systems.”
“I believe Soarian has much less ‘clutter’ on the screens, making the physician experience more streamlined and simpler,”
“Soarian’s clinical summary [as a rounding tool] allows us to view the most pertinent information in one location without having to search throughout the patient record. The way orders are set up not only makes it quick and easy to identify orders and results but to see if they have been completed or not.”
“The care team also uses Soarian’s embedded workflow engine capabilities to prompt clinicians about care interventions that are due or overdue. For example, nurses and clinicians receive real-time alerts when a patient has a documented risk of falling (via use of screening/risk assessment tools). Depending on the patient’s level of risk, the appropriate interventions populate the clinician’s worklist, further supporting documentation completion. Having optimized processes in place and information readily available helps the care team respond quickly, which can lead to more positive patient outcomes. “The prompts the workflow engine provides to staff, as well as the actionable worklists, contribute to timely execution of patient care interventions,” says Pam Crawford, PhD, MSN, RN, vice president of nursing and chief nursing officer. “The workflow engine is like a ‘helper’ for the nurses, ensuring those time-sensitive activities are completed.”
“The Soarian system helps physicians streamline their work by providing anytime, anywhere access to a patient’s complete medical history. “The ability of physicians to check their results, receive alerts via the workflow engine, and use CPOE capabilities all support physician affinity,”
How It Works.The Soarian workflow process.
“The Soarian system offers an embedded workflow engine that helps your organization coordinate and manage processes as well as clinical data from beginning to end—across departments, disciplines, and care settings—to help improve operational efficiencies and quality of care. From acute myocardial infarction to infection control management, care processes become more manageable with a solution that helps synchronize and automate activities. As illustrated in the MRSA example below, the workflow engine simultaneously manages numerous handoffs, notifications, and next steps to ensure the right person is performing the right task at the right time. You can further improve outcomes and care delivery by adapting and optimizing your own processes with the workflow engine in Soarian, using parameters that match the unique needs and goals of your organization. Parameters can include clinical roles, care protocols, quality benchmarks, and timing of notifications and escalations.”
“It leverages existing Soarian capabilities such as embedded workflow technology, a flexible service-oriented architecture, a superior user interface, and powerful analytics. Soarian Ambulatory supports cross-continuum capabilities like clinical worklisting and interdisciplinary plans of care to help synchronize care activities.”
“Embedded workflow engine helps synchronize clinical activities, supporting greater transparency, accountability, and adherence to evidence-based practices.”
“ Soarian workflows have become an essential part of how we provide care at Lake Health. Our end users, managers, and Quality department not only depend on them but are routinely thinking of new uses for the workflow functionality.”
“ The use of Soarian and the workflows has helped us address our patient safety initiatives and quality of care we deliver. We now have the data to support our decisions and the communication among care providers is improved.”
Siemens Healthcare was and is a pioneer in use of business process management software at or near the point of care. Siemens’ workflow-related white papers, product brochures, YouTube videos, conference presentations, and webinars play an important role in educating the health IT industry about enormous potential for business process management systems in healthcare.
Thank you Siemens Healthcare!