Harness Social, Mobile, Analytics, Cloud-Enabled Health Insurance Application Development Platforms

[I'm attending AHIP Institute 2016 in Las Vegas! Tweet me (@wareFLO) for a "Tweetup!" :)]

(Get my whitepaper! Business Process Management (BPM) in Healthcare!)

Healthcare is like a very large insular country that’s been closed off from the rest of the world for a long time but now it’s opening up. The same forces that are affecting many other verticals, such as social, mobile, analytics and cloud, particularly, are also affecting healthcare. This is sometimes portrayed as an almost a perfect storm. We need to be come more social. We need to become more mobile. Etc. But how, given limited resources and creaky old legacy enterprise tech, can we possibly do go in all these directions at once?

These technologies and these new industries, if you look under the hood, often the most successful platforms have workflow automation, workflow engines, the ability to draw out a workflow or to systematically improve the workflow with the data, possibly big data.

What if I told you that there was an application platform that dramatically reduces time to market, talks to your back-end systems, and has a much better user experience than traditional health IT? Oh, one more thing. Well, actually, four more things. Applications created on this platform automatically leverage social, mobile, analytics and cloud. That’s a modern Business Process Management application platform.

Those folks you hire who are already used to Facebook/Twitter style activity stream user interfaces? That’s the UI to this BPM application platform. (Plus it can appropriately consume and generate public social media content, while securing sensitive content which much be secured.) Mobile? Design your application by drawing workflows and forms. Then push a button, to generate cross-platform and native mobile apps. Analytics, especially time-stamped analytics, so important to find and eliminating bottlenecks, workarounds, and rework, are build into a wide variety of dashboards and key performance indicators. Finally, cloud. You chose. Public or private.


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

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Enable Health Plan Workflow And Process Change Necessary For Accountable Care

[I'm attending AHIP Institute 2016 in Las Vegas! Tweet me (@wareFLO) for a "Tweetup!" :)]

(Get my whitepaper! Business Process Management (BPM) in Healthcare!)

Health plan IT systems undergo three kinds of change: information accretion, system tuning, and structure transformation.

Information accretion is simply the addition of new rows of data in databases or XML files in XML based systems. In human terms, it’s like learning new phone number one day or a new joke the next.

System tuning is the gradual increase in performance, such as speed and accuracy that occurs over time. Users tweak settings, create shortcuts, and get faster themselves at use of the system through practice. One of my favorite stories about practice is the psychologist who studied eighty year old cigar makers in Miami, who started when they younger then ten years old. He measured speed and consistency. Guess what. They were still improving! Something like that happens with the “cognitive systems” we create out of combining software and people. In often cases, even badly designed software can gradually become better over time, as folks find tweaks and workarounds and themselves compensate for system design flaws.

What about structural change? That indeed is the hardest. Over time, you learn more and more facts, you get faster and more accurate, but every once in a while, old ways of doing things are no longer sufficient. The world has changes but you have not. At this point you can still in your heels, or you begin the painful job of question fundamental assumptions, in effect, attempting to redefine yourself. IT systems are a lot like this. The “structure” of an IT system is in its database structures (models) and workflow structures. Changing database models is difficult, but it generally well understood in health IT. However, workflow is a very different animal. Many health plan workflows are essentially hardcoded in if-then and case statements in 3rd generation languages such as Java and C#. Have you heard the old joke about how many programmers does it take to change a lightbulb? Only one, but in the morning your toilet and stove are broken. Changing workflow requires changing software and changing software is difficult, expensive, and dangerous.

Unless! Unless workflow is coded using high-level models of workflow, that humans can understand, but which can still be executed by workflow engines. That is modern BPMs give to software development. It is much easier to change software systems after they’ve been designed and deployed, because, essentially, they don’t have to be recompiled, retested, etc.

Take a look at one of my most popular blog posts, A Litmus Test for Detecting Frozen Workflow. And then stop by Appian at AHIP Institute (booth 1316) to see if Appian can pass my litmus test for frozen workflow.


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

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Maximize Health Plan External and Internal Workflow And Process Transparency

[I'm attending AHIP Institute 2016 in Las Vegas! Tweet me (@wareFLO) for a "Tweetup!" :)]

(Get my whitepaper! Business Process Management (BPM) in Healthcare!)

“Transparency” is the rage these days in healthcare. As well it should be! Transparent prices. Transparent costs. Transparent governance. But I’m going to talk about transparent processes and workflow. I’ll talk about transparency in two senses, at “design time” and at “run time.” Design-time is when you are designing software. In the old days, and still to some extent today, for specialized applications, design-time was when you typed code into the programming code editor. Run-time was when you executed that code and observed its behavior. If it didn’t run, or if it did but behaved badly, you’d go back to design time, find the problem (debug) and then enter run-time again, to see if you improved the situation.

Another phrase that means basically the same as process transparency is workflow visibility. About which I’ve given an entire 45 minute webinar. I cover the topic with respect to clinical tasks, not health plan tasks, but the underlying concepts are the same. (Plus, in terms of the underlying IT infrastructure, clinical and health plans tasks do increasingly overlap these days, especially in the area of the medical management function.)

You can think of a workflow system (an informal phrase I use that include BPM) as a collection of tasks and these tasks having states: pending, started, postponed, reassigned, escalated, cancelled, completed, etc. When a task is completed, other task may be automatically started, assigned to users, or roles (collections of user, anyone which can complete the task). Moment-by-moment all tasks and all task states can be displayed. If you’ve never used a workflow system, you have no idea how valuable such a display is to preventing even the possibility of someone dropping the ball, so to speak, with result of languishing task (and an increasingly pissed customer).

Consider what we’ve covered so far: rapidly creating new products, pulling together legacy data & workflow, and then being able to literally watch all tasks flow through the system. In addition to see what tasks are in what states, just think of the extraordinarily detailed time-stamped analytics, so you can retrospectively find and eliminate bottlenecks and rework (but that’s a design topic, or, should I say, a re-design time topic, I’ll address more later).

Finally, transparent processes and workflows lend themselves to “externalization” by the health plan. Feed these tasks, and ability to check on their status, to mobile apps used by customers is a great way to save money and increase engagement. Done right, of course!


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

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Integrate Clinical And Financial Health Plan Systems to Provide Unified View Of Data And Workflow

[I'm attending AHIP Institute 2016 in Las Vegas! Tweet me (@wareFLO) for a "Tweetup!" :)]

(Get my whitepaper! Business Process Management (BPM) in Healthcare!)

I have an unusual pre-med major. Straight As in the number one ranked Accountancy program in the world (University of Illinois, Champaign-Urbana). I was also working on a masters degree in Industrial Engineering, focusing in usability and workflow.

I can still remember a giant light bulb going off over my head, during my first year of medical school. To maximize quality and minimize cost health IT needs to better integrate clinical and financial information systems.

At the time, in those early days, this was just an idea. There were no such systems. The clinical and the healthcare financial domains were complicated enough, and there wasn’t even the infrastructure across which to communicate. This lightbulb idea seemed like a pipe dream.

Today, of course, many people have had this idea, and there are many products and services aiming to bridge this traditional divide. I’ve been tracking the evolution for decades. There is no better single technology for integrating clinical and financial data and workflow than modern workflow technology.

This integration requires interoperability, for sure, but a special kind of interoperable above and beyond traditional notions of sending and decoding a message. It requires what I call workflow interoperability, also sometimes referred to as pragmatic (term from linguistics) or task interoperability.

Modern BPM has many sterling qualities, including the ability to rapidly prototype and then deploy mature products and then to continue to change and improve those products…. Including more useable user interfaces, because all and only data and options relevant to each step of a workflow are shown to each users… But modern BPM is also used, though mostly outside healthcare so far, to integrate wide varieties of legacy enterprise systems based on disparate technologies. If that doesn’t describe a crying need in health IT, I’ll eat my BPM hat. Take a look at this following slide I tweeted from the recent Appian World conference.

“Spider in the web”! Connecting disparate systems and technologies? Need sound familiar? Healthcare IT!

SOAP, email, JMS (Java Messaging Service), SQL, REST, (and bunch of enterprise systems): sound familiar? It should remind you of what are called interface or integration engines in health IT. However, modern BPM application platforms are different, and in my mind, better, in an important way: they have customizable user interfaces. This is the task interop, pragmatic interop, workflow interop layer that is so, so, immature in much of today’s health IT. Of course, if you want to create your own UI apps, you can, because you can call into BPM platforms and return both data and workflow state (something else that is missing in a lot of health IT today).


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

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Systematically Improve Health Plan Member Customer Engagement With New Products

[I'm attending AHIP Institute 2016 in Las Vegas! Tweet me (@wareFLO) for a "Tweetup!" :)]

(Get my whitepaper! Business Process Management (BPM) in Healthcare!)

A major sweet spot for companies today — to both shave costs and increase customer engagement — is to externalize internal enterprise workflows via combination of cloud-based social and mobile workflow tech. When I speak of customers, I’m not just speaking of insured (potential) patients. I include providers, employers, and brokers, and even other stakeholders such as health plan employees and fraud, waste, and abuse investigator. In fact, the entire of notion of customer-facing, self-service portals will expand, eventually, to include everyone who is a customer, which is everyone, even internal health plan customers.

By “portal”, I don’t mean a website. Increasingly portal access is via native mobile apps. Modern Business Process Management applications, built by drawing workflows and customizing forms, without traditional programming in 3rd generation languages such as Java and C# is the key to rapidly creating and testing and improving new mobile health plan products to a wide variety of external and internal customers.

If you can’t find what you want or need out there among prepackaged software offering… If you’re intimidated by the thought of creating your own software solution the old-fashioned way… Really get close to and understand your customers and create new health plan products and services using a new-fashioned, low-code workflow and work platform….

… Such as the Appian BPM Work Platform. As I mentioned earlier (and I’m sure to mention again, below), I’ll be hanging out at the AHIP Institute Appian booth (1316, next to CMS). Come by to talk shop about healthcare workflow and workflow technology, and see how easy it is to quickly draw and execute native mobile app access to enterprise data and workflow.


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

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