At AHIP Institute Workflow Tech and Process Automation Were Well Represented

This is one of two short trip reports for last week’s America’s Health Insurance Plans (AHIP) Institute in Nashville. The other trip report focuses on a specific product and vendor attending AHIP Institute.

Wednesday and Thursday last week I wandered around the AHIP exhibit floor asking pointed questions about workflow and workflow technology. What I found reminded me of the Connections TV series:

“the entire gestalt of the modern world is the result of a web of interconnected events, each one consisting of a person or group acting for reasons of their own motivations (e.g., profit, curiosity, religious) with no concept of the final, modern result to which the actions of either them or their contemporaries would lead. The interplay of the results of these isolated events is what drives history and innovation”

I strongly feel there is a similar gestalt, right now, regarding use of workflow tech in health IT. A friend of mine compares it to supersaturated fluid. Health IT conversation is supersaturated with discussion of “workflow.” I believe this discussion is starting to crystalize around opportunities for workflow tech to better manage healthcare’s “Workflow Problem.” Also check out my 10 part series on the coming intersection between health plan IT and Business Process Management.

In this blog post I’ll summarize what I found, archive some of my favorite tweets, and consider where we (ragtag band of workflowistas) need to go next.

Before I got to the AHIP Institute, I did what I usually do before a conference with a substantial concentration of health IT exhibitors. I looked at every exhibitor website, searching for the following phrases.

  • health insurance workflow
  • “Business Process Management” OR BPM
  • “workflow management system”
  • “workflow engine”
  • “process orchestration” OR “workflow orchestration”
  • workflow “patient experience” OR “patient engagement” OR “customer experience” OR “customer engagement”
  • “customizable workflow” OR “customizable workflows”
  • workflow interoperability
  • workflow “patient experience” OR “patient engagement” OR “customer experience” OR “customer engagement”
  • “health plan” workflow

The first thing that struck me, when I started walking the exhibit hall, was that, compared to HIMSS15, there was much more mention of workflow tech related terms. I didn’t formally quantity this, but I’d guestimate between five times as much but possibly as high as a magnitude.

  • Rules-based processing
  • Industrial style process model
  • Robotic process automation
  • Workflow automation
  • (and similar)

I stopped at booths mentioning anything similar to the above phrases. I expressed interest and asked for elaboration. And, in some cases, I shot what I call a One-Minute Interview. I captured the video using Google Glass, uploaded to YouTube, and tweeted on the #AHIPinstitute hashtag, almost on the spot.

In the following video Marcia talks about “robotic” claims processing tasks. These are routine tasks that are ideal for automating. Just prior to the video she mentioned taking the percent of claims that are completely accomplished without any manual human intervention from 70 percent to 97 percent in one health plan. What a great example of using process-aware health IT to dramatically reduce work for humans, and in doing so, freeing those humans to perform even more important work requiring creative problem solving. Good job Marcia!

The following video is interesting because it highlights how important workflow, and depictions of workflow, are becoming for marketing purposes. (In this vein, check out my Marketing Workflow Is An Incredible Opportunity To Differentiate Health IT Products, And You!) In the video, you will be walked through a classic swim-lane-based process model for physician credentialing.

I often point out that workflow management system technology is literally decades old in other industries, but is only now diffusing into healthcare. Claims processing is probably the major exception to my general statement. For example, Healthsuite has been at it for 30 years! Certain backroom functions, such as insurance and human resources, are among the most similar to other industries. So it makes sense that true workflow automation is more advanced in health insurance than other areas of healthcare and health IT. I knew this intellectually. But it was still something it actually see evidence of this at AHIP Institute.

One idea that really struck me was this. Health insurance is a reservoir, on the payer side, of workflow technology and expertise I’ve been evangelizing for on the health IT provider side. I believe health payer IT and health provider IT will inevitable merge over the next 10 years. This merge will require not just syntactic (message transport) and semantic (message translation) interoperability, but workflow interoperability) (sometimes called pragmatic interoperability).

Might health insurance IT be a major path for diffusion of workflow technology into health IT?! Interestingly, some of the care management IT architectures (determining what the software *can* do, but not what it may currently be configured or used for) I saw were more sophisticated than what I saw on the health IT provider side at recent HIMSS conferences.

However, not all was the completely rosy, when it came workflow technology at the AHIP institute. As I noted in this tweet, some vendors were actually privately bemoaning their own lack of classic workflow management functionality, such as triggers and alerts.

…or this tweet, about health plan IT vendors being reluctant to intrude into EHR areas of responsibility.

That sums up my general observations about the AHIP Institute. For more specific, see my other AHIP Institute trip report. Oh, just one more tweet! :)

I like the giant golden halo effect.

P.S. Oh yes! I just remembered! I promised workflowistas some thoughts on where we need to go next. It’s pretty much the same Healthcare Workflow Triple Aim I always expound upon.

  • Educate about the importance of healthcare workflow and workflow technology.
  • Find and highlight health workflow IT people, companies, and success stories.
  • Recruit the best workflow minds and technology into healthcare and health IT.
This entry was posted in healthcare-BPM. Bookmark the permalink. Post a comment or leave a trackback: Trackback URL.

Post a Comment

Your email is never published nor shared. Required fields are marked *


You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

You can add images to your comment by clicking here.