Wellness Through Workflow: How Workflow Contributes to a Better Patient Experience in Healthcare
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Transcript of Wellness Through Workflow: How Workflow Contributes to a Better Patient Experience in Healthcare
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A TelmedIQ Webinar Presentation:
Wellness Through Workflow: Structured Messaging Contributes to Better Patient Experience
[The Webinar Will Begin Shortly]
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Webinar Housekeeping
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Outline
• Who Am I?• The System Behind The Smiles• Patient Experience and Workflow • Healthcare’s Workflow Wall• How Can Structured Messaging Help?• Wrap-up & Synthesis
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Charles Webster, MD, MSIE, MSIS• Degrees– Medicine– Industrial Engineering– Intelligent Systems (Medical Informatics)– Accountancy (premed)
• 1st undergrad medical informatics program• CMIO for EHR vendor for decade+• Helped three medical practices win first three
consecutive HIMSS Davies Awards
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Hear “Workflow”? Tweet @wareFLO
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Hear “Workflow”? Tweet @wareFLO
@wareFLO #POWHIThttp://ehr.bz/blabworkflow
People & Organizations FixingWorkflow with Health IT
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People & Organizations FixingWorkflow with Health IT
#POWHIT
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People & Organizations FixingWorkflow with Health IT
#POWHIT
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Blab
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The System Behind
The Smiles
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“What’s needed in restaurants, car dealerships, department stores, and every place else is systems — not just smiles — that guarantee good service. Every business is composed of systems. Those systems must work together to create a process that is efficient and responsive to a customer’s wants.”
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“The Systems Behind The Smiles”
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“The Systems Behind The Smiles”
40%-60%
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“The Systems Behind The Smiles”
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“The Systems Behind The Smiles”
40%-60%
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The Workflow Behind
The Smiles
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Patient Experience
"The sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care.”
http://www.theberylinstitute.org/?page=definingpatientexp
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Patient Experience (The Smiles)
"The sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care.”
http://www.theberylinstitute.org/?page=definingpatientexp
Vision Values
RecognizeUnderstand
Remember
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Patient Experience (The Systems)
"The sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care.”
http://www.theberylinstitute.org/?page=definingpatientexp
@wareFLO #POWHIThttp://ehr.bz/blabworkflow
Interactions & Continuum (The System)
The orchestrated touch-points of people, processes, policies, communications, actions, and environment ... Before, during and after the delivery of care
http://www.theberylinstitute.org/?page=definingpatientexp
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Orchestration & Choreography
• Two important terms from workflow tech• Orchestration implies central workflow
conductor• Choreography implies distributed workflow
control, more like a jazz ensemble• Modern workflow systems are hybrids
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Workfl
ow
Tech
nology
(Proce
ss-Aware
Info Syste
ms)
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Secu
reStr
uctured
Mes
sagin
g
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Interruption Statistics
• 50% of all healthcare errors are slips and lapses, such as not executing intended but interrupted actions
• 43% of interruptions affect care tasks• ~50% of pages to physicians interrupt
direct patient care• 42% of pages are non-urgent
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The Workflow Prescription
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What Is Workflow?
A series of steps, consuming resources, achieving a goal.
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What is Workflow
• Series of steps/tasks/activities• Consuming resources/costs (HC system &
patient’s money, attention, time)• Achieving goal(s)/benefits• “Process” and “workflow” usually (not always)
synonymous
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What is Workflow Technology?
• Generally? – Any technology facilitating workflow…
• Narrowly?– Executable models of work or workflow– Consultable (by computer or human)– Often visually represented• Workflow diagrams• Calendars & rules• Dynamic checklists
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Workflow Tech vs Info Tech
• Info tech “affects” workflow–Influences workflow (+ or -)
• Workflow tech “effects” workflow–Drives workflow (+)
• IT “hardcodes” workflow• WT “softcodes” workflow
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What Is Structured Messaging?
• Pre-build message structure• Sent securely over Internet• Structured messages occur in workflows• Repeating same structures leads to familiarity• Familiarity leads to speed & accuracy• Structured data & workflow facilitates
automation via workflow technology
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Structured Messaging (Calendar)
• Forms (and therefore data, recognition faster than retrieval memory)
• Calendar (shared mental model shared with workflow engine)
• Rules (proactive intelligence re routing & escalation)
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Structured Messaging (Calendar)
“softcoded” user interface & workflow
Calendar Rules Forms
Shared mental/machine model
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Structured Messaging & Workflow
AutomaticWorkflow engine drives
workflows without requiring manual human intervention
(tho can be overridden)
@wareFLO #POWHIThttp://ehr.bz/blabworkflow
Structured Messaging & Workflow
AutomaticWorkflow engine drives
workflows without requiring manual human intervention
(tho can be overridden)
TransparentWorkflow engine tracks task
status, which can be displayed to human users,
supervisors & administrators
@wareFLO #POWHIThttp://ehr.bz/blabworkflow
Structured Messaging & Workflow
AutomaticWorkflow engine drives
workflows without requiring manual human intervention
(tho can be overridden)
TransparentWorkflow engine tracks task
status, which can be displayed to human users,
supervisors & administrators
Interruptions!
@wareFLO #POWHIThttp://ehr.bz/blabworkflow
Structured Messaging & Workflow
AutomaticWorkflow engine drives
workflows without requiring manual human intervention
(tho can be overridden)
TransparentWorkflow engine tracks task
status, which can be displayed to human
supervisors & administrators
FlexibleWorkflow engine does whatworkflow rules tell it to do,
workflow rules are “softcoded”therefore easy to change
@wareFLO #POWHIThttp://ehr.bz/blabworkflow
Structured Messaging & Workflow
AutomaticWorkflow engine drives
workflows without requiring manual human intervention
(tho can be overridden)
TransparentWorkflow engine tracks task
status, which can be displayed to human
supervisors & administrators
FlexibleWorkflow engine does whatworkflow rules tell it to do,
workflow rules are “softcoded”therefore easy to change
ImprovableTime-stamped task status data can be used to find, eliminate
bottlenecks & rework, improving cycle time and consistency
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Value-Add Ons…
• Multimedia (text, voice, images)• Converting between voice & text• EHR integration • HIPAA compliance (of course!)• Cross-platform (mobile, desktop)• Intelligent message routing & escalation
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Thought Experiment
What if we had automated workflow first, instead of data?
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How Do We Get To This?
Data(resources/costs)
Goal
s/Be
nefit
s
End
Start
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We Can Add Data To Workflow
Data(resources/costs)
Goal
s/Be
nefit
s
End
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We Can Add Data To Workflow
Data(resources/costs)
Goal
s/Be
nefit
s
End
@wareFLO #POWHIT
We Can Add Data To Workflow
Data(resources/costs)
Goal
s/Be
nefit
s
End
@wareFLO #POWHIT
We Can Add Data To Workflow
Data(resources/costs)
Goal
s/Be
nefit
s
End
Start
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We Can Add Workflow To Data
Data(resources/costs)
Goal
s/Be
nefit
s
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We Can Add Workflow To Data
Data(resources/costs)
Goal
s/Be
nefit
s
@wareFLO #POWHIT
We Can Add Workflow To Data
Data(resources/costs)
Goal
s/Be
nefit
s
End
Start
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Which Order Makes Most Sense?
• I’d argue adding data to workflow. • We’re stuck w/adding workflow to data• Need to extremely flexible workflow
tech to existing data investments• Argument for structured messaging as a
“platform”
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Experience & Engagement
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Effect of Technology
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Consumerization
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Workflow (including Messaging)
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Re-Integrating Data & Workflow
MSIE, MSIS
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Re-Integrating Data & Workflow
MSIE, MSIS
DATAWORKFLOW
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Re-Integrating Data & Workflow
MSIE, MSIS
DATAEHR
Health ITMedical
Informatics
WORKFLOWTQM
Six Sigma, LeanProcess
Improvement
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Re-Integrating Data & Workflow
MSIE, MSIS
DATAEHR
Health ITMedical
Informatics
WORKFLOWTQM
Six Sigma, LeanProcess
Improvement
Workflow TechnologyProcess-Aware Info Systems
@wareFLO #POWHIThttp://ehr.bz/blabworkflow
Re-Integrating Data & Workflow
MSIE, MSIS
DATAEHR
Health ITMedical
Informatics
WORKFLOWTQM
Six Sigma, LeanProcess
Improvement
Structured Messaging
Wellness & Workflow
• State of being in good physical and mental health
• Series of steps, consuming resources, achieving a goal
Resources/Costs
Goal
s/Be
nefit
s
Sickness
Wellness
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Blab
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In Closing…
• Thank you! • Questions/Comments• Tweet me at @wareFLO using #POWHIT• [email protected]• Join Blab on Workflow & Patient Experience– Top of the hour– http://ehr.bz/blabworkflow– Chrome or Firefox browsers
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About CGH Medical Center
100 Bed Acute Care Facility
140+ Physicians/1400 Staff
140+ Physicians
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Structured Messaging + Workflowsat CGH
Existing Patient
New Patient
Admissions
On-Call Physician
• Over 10+ messages types that get automatically triaged
• Communication around recurring events are now highly streamlined (ex. Radiology orders)
• A more reliable system than using phones and voice messages
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Message Types and Getting theRight Communications Data
The Benefits of Workflow and Structure
•Regimenting communications data
•Critical information for specific events is now required
•Communication issues such as patient handoffs are now more reliable
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Making CommunicationsMore Intelligent
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Q&A
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Thank You for Attending
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Or contact us directly at:
p. 1.888.364.9305
to receive a free demo of our solutions.