Five years ago, when I set up this blog, I set myself the task of tracking diffusion of Business Process Management and related process-aware technologies into healthcare. I also aimed to educate and market the same, to accelerate transformation of workflow-oblivious health IT into true process-aware health IT. I’ve written and tweeted about IBM (IBM: Using BPM Tools and Methodology in Healthcare) and Siemens (Complex Event Processing, Business Intelligence, and Business Process Management From Siemens Healthcare) leveraging BPM. See also my five-part series on the much trafficked health IT blog EMR and HIPAA: BPM-based Population Health Management & Care Coordination: Workflow, Usability, Safety & Interoperability Perspectives.
— Charles Webster MD (@wareFLO) August 26, 2014
So I’m delighted to see milestone, of a sort, achieved… a major health IT consortia is tackling in interoperability, and leveraging workflow technology, AKA Business Process Management (BPM) at the core of its “marketecture”.
This trend, to use workflow tech to solve interoperability problems is at the heart of my well-reviewed and tweeted From Syntactic & Semantic To Pragmatic Interoperability In Healthcare.
Read HSPC Incorporates, Gears Up to Tackle Interoperability Problem and then take a tour of slides from their slide deck. Take a look at the marketecture layers in the above slide: workflow, process, business model…. Then, there’s the title: Seamless Service Orientation with BPM and SOA. SOA stands for Service-Oriented Architecture. Those are the building blocks. But what puts the building blocks together? What is the usability cement combining the bricks into seamless whole? Business Process Management!
So, what is Business Process Management? I’ve written about this topic many, many times. Probably the best single overview of BPM from the point of view of its relevance to solving healthcare and health IT’s many workflow problems (usability, interoperability, and safety, to mention the top three), is my EMRs and EHRs Need to Solve “The BPM Problem”: Why Not Use BPM to Help Do So?
Now closely examine the next slide. “Workflow SDK… Intercepts actions and events on the OS level… Monitors state of every application… Delivers a seamless in the workflow integration.” What we’re essentially talking about here, is, a retrofitting of workflow-oblivious health IT legacy applications with the more modern process-aware BPM technology. The reason actions and events are intercepted at the operation system level, is there’s a natural decomposition of here, between app and OS. The apps may be monolithic. The OS may be monolithic. But there’s a place, between app and OS, where communications between apps and OS can be captured. Language translation systems often use this same technique. An app sends “Hello” to an OS managed dialogue box. The “hello” is trapped between app and OS (which manages dialogue boxes) and substitutes “Hola”. It will be very interesting to see is this approach will work.
— Charles Webster MD (@wareFLO) August 25, 2014
Now the following slide is the key, the key to combining two healthcare subdomains crying out to be reunited. On one hand we have the process improvement folks (quality improvement, Lean, 6 Sigma, etc.). On the other hand, processes are so mediated by software that they are essentially DICTATED by software. This is why doctors hate EHRs! The doctor’s workflow is different from the EHR’s workflow. But, unfortunately for the doc, it’s actually painfully EASIER to change the doctor’s workflow to fit frozen health IT workflow, than to change health IT workflow to fit the poor doc’s workflow. So many of our problems today, in the health IT industry, boil down to this unfortunate fact.
— Charles Webster MD (@wareFLO) August 25, 2014
What is to be done? CHANGE THE FACTS. That is, change what economists call the Production Function, and the rest of us engineers, scientists, analysts, and programmers call “technology.” And, if we change workflow-oblivous health IT technology into process-aware health IT technology, we can achieve a virtuous cycle. The processes that process improvement folks are trying to improve are locked up in software. But that software is directed by representations of workflow that can be improved by users editing process definitions and, increasingly, automatically through machine learning (Think Google Now for Health IT).
Compare the previous slide, from the HSPC slide deck, with the virtuous cycle rounding from workflow and process design, though execution and monitoring, then through simulation and optimization, and finally back through design and implementation of improved workflows and processes, with the following slide from one of my webinars several years ago. In this webinar the topic was the advantage of adding BPM technology to an ECM (Enterprise Content Management) system: Enterprise Content Management & Business Process Management: A Healthcare Game Changer.
THEN compare both slides to this classic depiction of the BPM life cycle from its Wikipedia entry.
All three of the previous diagrams, from the HSPC slide deck, my own slide about BPM and ECM, and the BPM Wikipedia entry, emphasize the virtuous cycle of process improvement that current workflow-oblivious health IT makes very difficult. In fact, one definition of BPM is, the “process improvement process” (done on steroids, with the right software.
By the way, one of these days I’ll put the aforementioned webinar online, including recorded narration, on YouTube. In the mean time, check out my BPM & Case Management: Healthcare Needs You! YouTube video.
To sum up this post: Hold Onto Your Hats: BPM in Healthcare is Taking Off!
Glad to see BPM pressed into use to tackle healthcare workflow interoperability!
P.S. I’m very interested in which BPM platform they will go with…. I suspect it will be one which one of the consortium partners already uses…. which means it might be… or … …. Whoever’s BPM stack is adopted, that is an enormously strategically powerful position in which to arrive!