Archive | February, 2007

It’s the process not the stars

One of my favorite quotes is the following from Toyota which appeared in the HBR article “Decoding the DNA of the Toyota Production System” a few years ago.

“We get brilliant results from average people managing brilliant processes. We observe that our competitors often get average (or worse) results from brilliant people managing broken processes.”

I was reading a Malcolm Gladwell (author of Blink and The Tipping Point) article a friend had sent me a while ago from the New Yorker called “Are Smart People Overrated?” which made a similar point.  The article itself is very interesting and talks about the culture at Enron which was a culture of “stars” focusing on MBAs that grabbed the bull by its horns and ran with it.  It points out that stars work to write books or in other individual focused challenges, but “organizations that are the most successful at that task are the ones where the system is the star”.

The article compares Enron’s failure and the Navy’s failure in WWII vs. the German U-boats to the successes of Southwest, Wal-Mart, and Procter & Gamble.  All of the later are cultures more focused on the process versus creating a culture of all-stars.

As you think about the importance of process, these are good examples.  Building a process that survives turnover, acquisition, market change, and other typical issues is critical.  Your processes need to be able to adapt and change, but they also need to have codified implicit knowledge so that you can survive change.

Stockholm Process Syndrome

I was talking about Stockholm Syndrome this morning, and it hit me.  This is the explanation for why users or companies struggle to move away from a bad process.  We have all been there where we are part of a process which is obviously broken…BUT, we are so close to it, and it is all we know.  We don’t know how to change our situation.

I think the problem is that people become comfortable with the process they know even if it’s bad.  They have found a way to make it work for them.  They know the rules.  They understand it’s faults.  So, why move away from it.  Change looks scarier than the current state.

So, how do we move on.  The key is showing users a better way.  Helping them understand the longer term value.  Putting them in touch with people using a better process.  It’s about managing change so that a better process can take over.

Patient as Process Instance

Anyone who has ever been sick knows that our healthcare process is inefficient.  There is lots of paper.  There are numerous handoffs.  Things get dropped.  Patients spend lots of time resolving things that should be automated.  Well, I am not going to give you the answer since there are millions out there trying with limited success.

But, I do think a BPM framework (strategy, process, and technology) makes sense here.  First, I think you need to abstract the healthcare industry.  Think of each component (MinuteClinic, doctor, hospital, outpatient clinic, home health nurse, pharmacist, insurance company, PBM, case manager, therapist, acupuncturist, personal trainer) as a system within an overall company.  Second, think of the patient experience as a process filled with logical steps and driven by rules.

Conceptually, you have a systemic view of healthcare that parallels a typical process view of a inter-company process.  You have constituents.  You have a process.  You have rules.  You have systems (i.e., companies).  Ideally, each of these systems (e.g., the physician’s office computer) could be accessed by the process using a common language.  (I am speaking to a Services Oriented Architecture (SOA) without going there technically.)

Each time a patient engages the system through a doctor’s appointment or a visit to the ER, a new process instance would be initiated.  The patient could be tracked through the process and know where they were at any time.  All the constituents would have shared data (i.e., a personal medical record) about the history of this patient.  Rules would be codified so hopefully there were less errors or miscommunications.

Now, who pays for this is the question which I am not going to debate.  But, the system is broken and finding some fix is important.  I think this is a lens through which to view the problem.

ROT (Return on Time)

“So, what if you could maintain the same work hours and still be able to avoid growing your headcount without compromising quality, customer service, transactional cycle time, throughput, and all those wonderful metrics.” (The Power of Process, pg. 99-100)

I will give credit to Kiran Garimella in The Power of Process for “coining” a new term – Return on Time – that captures one of my thoughts around time management.  I think the struggle all of us have in any type of role is prioritization and improvement without simply throwing hours at the problem.  At a BPM conference in Boston last year, one of the speakers talked a lot about this also.  His point was that the one thing most executives no longer have is time to sit back and think.  Trying to step back, think strategically and plan for the long term is a luxury.

In an ideal state, BPM can help with this.  Most of what makes our days unplanned and chaotic is fire-fighting.  The cause for lots of fire-fighting are exceptions or unplanned events.  Lots of this can be resolved by investing upfront.  By documenting SOPs (standard operating procedures) about how to handle known exceptions keeps them from being issues.  Just like building software, upfront investment in the right requirements and user involvement minimize your changes on the backend.

Business Process Management can free up time by doing the following:

  • Requiring documentation of your process and agreement on how things will be done (policies & procedures) and how exceptions will be handled
  • Capturing internal knowledge which sits with your process SME and codifying it
  • Building out rules about situations that automatically make decisions
  • Creating escalation paths that no longer require manual involvement to track some piece of paper down and give it to a different person for approval while person X is on vacation
  • Providing process level dashboards that allow management to see bottlenecks and forecast issues rather than reactive measures where nothing can be done

Since time is a key asset in planning for the future and being innovative (not to mention reducing stress), any tool or management approach that helps with this should be highly regarded.  I believe we are starting to see some of this, but I doubt we will ever see a published business case that talks about ROT.

Outbound IVR Process

Here is another example from a previous life.  As part of my direct marketing program, we used to use automated outbound calls from a company called Silverlink.  They do a great job with the calls and providing management tools to monitor the calls.  But, a BPM solution could have helped us to automate the process around Silverlink.  The following scenario is how it could be:

  • When a new client is enrolled, the set-up form could include a checkbox for participation in the direct marketing program.  The set-up form and process would also capture client approval for co-branding along with a jpg of their logo and other information to personalize the communications.
  • That checkbox could initiate a process which pulled in client data from the set-up form, ran a query of their member data (name, address, phone number), and automatically enrolled them in the direct marketing program.
  • A rule could exist that would check against any stipulations in their contract to determine whether they were active participants in message approval or whether they had already signed off on the general messaging within the program.
  • The existing CRM system could be used to manage the campaigns or a BPM rules-based system could be used.  In either case, the system is looking at each case or process instance and determining which direct marketing path to follow, which letter to use, when to trigger a call, and providing status to the call center agents.
  • Any change to the messaging (client, patient, regulatory, research based) could be made and all notifications and approval requests would be triggered by the system and managed by the system.
  • Coordination with outside vendors such as Silverlink would be automatic and rules could be used to monitor their call volume versus inbound call capacity to determine automatically how to throttle up or down the number of events.
  • Stoplight type triggers could be used by the system to monitor different events and rules written to trigger process changes or initiate problem resolution automatically.

To some people this may seem very basic, but I know I am not alone in managing many of these processes with lots of paper, implicit rules, offline databases, and other tools.  The discipline of BPM as an approach and the technology to automate and manage it can add a lot of value here.

Mgmt Tools (off subject)

This is a little off topic, but I get asked the question a lot about why the LinkedIn link is on the blog or about what tools I use to help me manage connections and information.  There are a lot out there, but I have stuck with three for the past few years.  I was about to add a fourth (Spinvox) which takes your voicemails, translates them to text, and e-mails them to you, but it doesn’t work with my phone service right now.

  1. LinkedIn – This is a great professional version of Friendster or MySpace.  It allows you to post your profile and link to connections of yours.  It takes the whole concept of Six Degrees of Separation and makes it real.  I was skeptical at first, but I jumped in and uploaded my Outlook contacts.  When I found out that 50 of my friends already used the tool, I was hooked.  I introduced the tool to one friend, and within a month, he had 5,000 of his contacts “LinkedIn”.  It has been great for networking and reconnecting.  And, There was a recent article in Business 2.0 that talked about LinkedIn finally getting over the 3M active user hump.
  2. Plaxo – I am sure I don’t use this to the fullest, but it allows me to post my electronic business card and send automatic updates.  If two people have signed up for Plaxo, the service automatically updates your Outlook (or other service) with any changes to the person’s card.  With all the job changes (internal and external) these days, this is very helpful.
  3. Google desktop – Although I am a fairly organized person, I can’t keep up with everything these days.  Not to mention that what seems like a good typology one day may not make sense a month from now or during a fire drill.  So I use Google’s desktop tool which indexes your hard drive and allows you to keyword search every file you have and all the websites you have visited.  It is great.

So much for the digression, but I recommend all the tools.

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