Healthcare is going through an unprecedented changes. Some of the change is forced by external regulatory mandates and some by rising costs and a sense that if we don’t do something soon, out-of-c0ntrol costs will force even more change from the outside. It would be easy to call this a crisis moment, though crisis implies impending collapse. Rather than collapse, the more likely outcome without any detour off the current path is greater impact to the people who pay the heavy costs for the system as it is.
Healthcare BPM lag
By and large, the healthcare industry hasn’t followed the process management path that other industries adopted a while back. There are exceptions but most would agree that platforms and process weren’t adopted as quickly as in other industries. There are several reasons for this.
- A fractured and complex supply chain as patients, payers and providers all pursue their own agenda
- Because of the first point, there’s been no collaboration and no ownership of the outcome from an end-to-end view
- In many cases, the government or the employer are the buyer, adding another layer to an opaque business landscape
Discharge and Project RED
BPM practices adapted to healthcare have shown enormous benefits. Project Red is a great example led by Boston University. As a result of the early returns, 250 hospitals are applying reengineering principles to the very sticky problem of patient discharge and its impact on hospital readmissions. Add to the mix the Affordable Care Act’s provision to monitor stats on readmission and penalize hospitals for readmissions deemed avoidable.
National level notice is one thing, but penalties? Now people are paying attention. Interestingly, when people start to analyze the discharge process against traditional process improvement methods, one of the first observations is that the seeds of discharge success are sown at admission. The not-so-surprising conclusion? Only an end-to-end view of a patient’s entire stay and aftercare is useful for improving readmission statistics.
Project RED is a prototype of the improves that can be made in healthcare though the application of business process management. How many other highly common healthcare processes are also broken and could benefit from this now-proven approach? I think we can agree that the list is long.
Part of any deep dive on discharge quickly points out that the successful discharge of a patient is heavily dependent on what I’ll call the extended patient care community. From the moment the patient becomes a candidate for discharge, the involvement by hospital staff, the primary care doctor, pharmacists, physical therapists and the patient’s family is shown to be a big part of success. But how do so many people in different ‘systems’ communicate and coordinate? There are great opportunities for social solutions that break down system walls and allow for real-time, contextual communication between the parties.
Every nurse, doctor or discharge advocate that is tied to a computer terminal to do their job has been removed from directly caring for patients. Our reengineering of healthcare process has to be done with a heavy focus on making process simple, role-based and above all, mobile. So once, we’ve gotten the healthcare professional away from the fixed coputer, what if every nurse or doctor passing a room could automatically receive updates on the patients within simply because of their location? If that sounds futuristic, it isn’t. Software is already performing this function.
There are so many implications to what BPM in Healthcare means. Stay tuned as we continue to explore this area.