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.