BPM+ Health Case Studies

Learn how BPM+ is being adopted in healthcare and why it's making a difference to improving the quality and delivery of care.

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The time lag between the latest medical knowledge and the integration into clinical workflows has devastating consequences for all of healthcare's leading actors (Patient, Provider, Payer) & stands a firm barrier to realizing value-based care outcomes. Learn how BPM+ is being deployed to heal healthcare today.

Public Health

Public health is the science and art of preventing disease, prolonging life, and promoting health through assessment, policy development and assurance for both communicable and non-communicable diseases alike. The ability to access and use data as close to "real time" as possible is essential in ensuring timely and appropriate public health responses to emergent situations impacting both disease and the environment. Ultimately this is about empowering the ability to assess, evaluate, and respond to protect individuals and populations to mitigate or prevent disease.

Appropriate interventions to target spread and management of infectious diseases hinge upon the ability to expedite case investigation of positive reportable lab results and to provide timely evaluation and response to immediate needs. Whether protecting individuals and community or mitigating and preventing outbreaks, public health efforts have historically been hindered as a result of variations and inconsistencies in processes, workflows and data. While specific case investigations and subsequent contact tracing may vary based on the disease and situation, the process of case investigation and contact tracing (CI/CT) is foundationally similar.

Indian Health Service

The Indian Health Service (IHS) is an agency within the Department of Health and Human Services with responsibility for providing health services to American Indian and Alaska Native (AI/AN) people. The IHS manages over 100 healthcare facilities nationwide, including 24 hospitals, while self-governance tribes and urban Indian organizations operate another 22 hospitals and over 400 outpatient clinics. Most locations are integrated care settings, where multiple disciplines – medical, behavioral health, optometry, dental, others – provide care under one roof.

IHS and many tribal/urban facilities utilize an internally developed health information technology suite called the Resource and Patient Management System (RPMS) that includes a certified electronic health record (EHR) and more than 80 other applications supporting processes from patient registration through the billing cycle. RPMS had its origins over 40 years ago and is a distributed solution, with hundreds of independent databases installed at sites across the country. It is also highly configurable to adapt to local preferences. This means that organizations have had decades to evolve disparate workflows within just about every business process. Evident when introducing new capabilities, in collecting and aggregating data, and on-site review and assessment, these differences have been identified in findings from both Joint Commission reviews and CMS surveys, and are key considerations as the agency seeks to modernize its process and IT portfolio.

Mayo Clinic

Mayo Clinic is a nonprofit organization committed to clinical practice, education and research. Its knowledge management program is charged with capturing, indexing, storing, and enabling delivery of evidence- and expert opinion-based consensus best practices for application across the enterprise.

Problem

Table 1. Relevancy of Case Study to Org Change Mgmt. Factors — Table 1. Relevancy of Case Study
to Org Change Mgmt. Factors.

Optimal care delivery depends on our ability to apply current best practice knowledge to every patient encounter. Driven both by the need to promote and maintain quality, our ability to accommodate what is an increasingly rapid pace of medical discovery while not further burdening our clinical staff is critical as we seek to keep up with all the latest diagnosis or treatment recommendations. We face multiple challenges in this regard:

Adopting and applying new clinical knowledge can be slow and uneven, particularly considering the diversity of care settings spanning from small community-based practices to subspecialty quaternary care.
Mitigating against increasing cognitive burden faced by Clinicians. This includes an exploding volume of patient data, increasingly sophisticated (and complex) electronic health records and clinical systems.
Determining seamless integration approaches for knowledge delivery solutions into EHRs, which serve both as the system of system of record and driver of clinical workflow
Clinical subject matter experts have limited capacity to create and maintain knowledge resources

Mayo Clinic has built multiple solutions designed to deliver relevant clinical guidance into the clinical workflow. Those experiences have led us to seek model-driven, standards-based solutions to serve as the underpinning to managing and delivering knowledge and provide the adaptive responsiveness necessary to meet evolving needs.

Reducing EMR Burden and Improving Outcomes

The American College of Emergency Physicians (ACEP) is the leading professional organization promoting the highest quality of emergency care and serving as the leading advocate for emergency physicians and their patients. Representing more than 38,000 emergency physicians, emergency medicine residents, and medical students, ACEP works to develop evidence-based clinical policies, education and training, and a host of other activities related to the advancement of emergency medicine. ACEP uniquely understands the burden emergency clinicians face daily: patients are new, unscheduled, and high volume, the pattern of care is variable and almost unnavigable, data discovery is onerous, and hospital EMR's are packed with poorly designed protocols, and is actively working to address these concerns.

Why BPM+ Health?

Without the right protocol-development model, we risk adding clinician burden and adversely affect the momentum around digital transformation. So, we searched for a model with key characteristics:

Human and Machine Readable
Defined Scope
Market Viability
Scalability
Cross-Specialty Appeal

Business Process Management Plus (BPM+) is the ideal model because it has these characteristics.

BPM+ in Ambulatory Care

Across different disciplines and even within one ambulatory care setting, providers frequently have their preferred method of documentation. Providers often view documentation differently, and it is not uncommon for progress notes to be captured in "shorthand" as a reminder to the physician but not necessarily decipherable or usable by others in ongoing care. This variation in documentation may impact the quality and outcome of care delivery and the patient experience of care. These issues intensify as patients receive care across locations, adversely impacting continuity of care. The impacts are that ambulatory encounters are often imprecisely or inadequately documented. They generally provide only enough precision to meet billing requirements, but insufficient for decision support or to meet advanced care needs if warranted.

Why BPM+ Health?

Without the right protocol-development model, we risk adding clinician burden and adversely affect the momentum around digital transformation. So, we searched for a model with key characteristics:

The BPM+ Health Adoption Playbook provides assessment tools and approaches to improve institutional process adoption agility and efficacy.
The Readiness Assessment and Maturity Model lets you evaluate your process exposure areas; identify care continuity gaps.
BPM+ modeling allows for clear, precise workflow definition, clinical pathways.

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