Leverage Modern BPM for Health Plans in the Regulatory and Compliance Space

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Every year, for the past six years, I search every website of every HIMSS conference exhibitor. For HIMSS15 that was around 1500 websites! For the first year, I did the same for every AHIP exhibitor website (150+).

Specifically, I search for healthcare workflow and workflow technology related terms (process maps, customizable workflow, workflow engine, process orchestration, BPM, etc.). And, indeed, the percent of websites with relevant content has approximately doubled every years (2, 4, 8, 16, 32 percent!) This search of workflow tech is occurring across almost every category of healthcare information management and IT. And compliance is one of the most prominent categories represented.

The following two-minute video lays out concisely the main advantages for BPM: adapting to, even exploiting, the absolute necessity of complying with a changing regulatory environment.



First of all, regulations change day-to-day, week-to-week. Many new regulatory concepts, especially in healthcare start out under specified. Any assumptions you make, and you have to make a lot, will likely have to change. Traditional, not process-aware application platforms have relatively frozen workflow and logic. But not modern BPM. Workflows and rules can be changed, without have to go back to programmers to make those changes in computer code.

Second of all, the regulatory compliance logic can be inserted directly into day-to-day workflows. So, instead of doing a bunch of work, say processing a pile of claims, and then running some of them through a compliance check, the regulatory logic is actually part of the workflow. This dramatically reduces duplication of effort and resources.


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10 Reasons Health Plans Should Double-Down on Modern Business Process Management

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