Monday, December 14, 2009

Omnibus Workflow Technology: Streamlining Clinical and Business Processes

An interesting article by Walter Kerstead at this link, titled Software's Guiding Hand, discusses how workflow technology helps clinicians at behavioral (psychological/psychiatric) hospitals/agencies avoid mistakes while increasing efficiency by promoting best practices. Following are some quotes:
…in most behavioral healthcare agencies best practices are detailed in policy/procedure manuals gathering dust on shelves…because they are not readily available at the point of service…[and] usually are not written in a quick-to-read format…[If put online, you would only] have readily accessible reader-unfriendly information.
The answer is to convert best practice narratives into administrative and clinical processes that a software system interprets to guide patients along care pathways...Staff members no longer need to worry what the next intervention is, who should do it, where, when, or how…[which reduces] your chances of being noncompliant with best practices…[without requiring] more staff and expense.
…In healthcare...we can report to managers on a minute-by-minute basis the "time remaining to a state of noncompliance" (e.g., "you will be noncompliant with the best practice in 12 hours"). Put a sufficient number of alerts at the right places on care paths and you can detect evolving problems and take action…The results are increased staff efficiency, greatly reduced administrative and clinical errors, increased throughput, improved compliance, and improved outcomes.
Such workflow technology can be applied not only to behavioral healthcare, but to all healthcare disciplines in which treatment is more than a "one-shot" (single visit/session) process. That's because it expands the capabilities of computerized clinical pathways.

Clinical pathways software transform evidence-based practice guidelines into a series of interventions spanning multiple days of care. This heatlhcare is for hospitalized patients and for patients being treated by multidisciplinary teams focused on providing coordinated care. Care events are mapped on a timeline or series of tasks including tests/assessments, treatments/procedures, medications, consultations, diet, teaching (including patient education), and preparing for discharge or transfer. The pathways, therefore, are clinical workflows depicting the activities/interventions to be done based on specific criteria. They also document deviations/departures (variance) from the recommended tasks. More advanced pathways also provide guidance in determining diagnoses and related procedures (through expert systems), collecting outcome data, identifying reasons for and nature of any variance, and showing how the variance relates to outcomes.

How does the workflow technology Mr. Kerstead described increase the capabilities of computerized clinical pathways? By also focusing on business workflows related to the clinical workflows. For example, in addition to providing clinical pathways functions, it guides and streamlines:
  • Compliance reporting processes, which include informing clinicians, mangers and office staff when certain forms must be completed and sent to authorization and accreditation organizations.
  • Implementation of key business processes, ranging from billing and submitting insurance claims, to tracking and ordering supplies, to managing human resources, etc.
Because this omnibus technology manages both clinical workflows (pathways) and associated business workflows in a coordinated manner, the benefits to a healthcare organization, and those they serve, are greatly increased.
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