Jay Rath
What do beer, running shoes and fighter planes have in common with medicine? The answer is a challenge to IT vendors of every type in every field, whether inside or outside healthcare: workflow.
“I know we’re supposed to complain about interoperability, but it’s not a challenge,” warns Darren Dworkin, Chief Information Officer at Cedars-Sinai Medical Center. Actually, “the hard part is workflow integration.”
Dworkin’s comments came during a fascinating interview by Jonah Comstock at MobiHealth News. His perception is echoed to a remarkable degree by Scott Krawitz at AlleyWatch, a site that focuses on broad technology and startup news.
A business technologist and entrepreneur, Krawitz points to $100 million and even $1 billion “horror stories” about IT implementation at Nike, Miller-Coors, the U.S. Air Force, and between Oracle and Montclair State University. “What exactly is wrong here?” he asks.
Healthcare is of course much different than those organizations. It’s a highly professional, specialized field that includes a myriad disciplines, all coming together in service to the patient. It cannot reasonably be compared to any conventional industry – except, it turns out, when it comes to IT.
“Once I saw a healthcare company spend $100 million on a solution that was not implemented correctly – and employees did not use it,” warns Krawitz. The common factor in each of his examples has everything to do workflow.
“Leaders forget that companies consist of three legs,” he says. He defines them as process, technology and people. Put them all together and you have workflow.
Integrating the Workflow
Or as Dworkin at Cedars-Sinai puts it, describing different parts of IT solutions, “It’s not about getting A and B to talk to each other.” Instead, it’s about creating the experience for a clinician “who doesn’t know whether he’s in A or B and, by the way, shouldn’t have to care because we’ve integrated the workflow.”
Meg Bryant at HealthCare Dive agrees. What’s needed are solutions that improve patient outcomes while simplifying workflow, she says, citing a 2016 American Medical Association survey.
No matter how clinically valuable a technology might appear to be, if it makes the doctor’s job harder it’s going to face adoption hurdles. Bryant cites Dr. Alex Ding, a diagnostic and interventional radiologist, who says, “Seamless clinical workflow integration is critical to the long-term success of a technology. This is often the hardest piece for a new technology company to realize, understand and implement.”
Plug-and-Play? Not so fast!
Management of any endeavor run into trouble when they expect “plug and play” says Dworkin. The situation can be rich with irony.
“With an enterprise system, companies are supposedly creating an automatic workflow and efficiencies by adding technology into their processes.” But it doesn’t always work that way.
Vendors must “try to think like doctors and approach their product with the same types of questions providers would have,” says Bryant. “Is it really needed? Does it improve the current way of doing things? Will it make things worse for doctors or their patients?”
Keeping the Workflow at the Forefront
Krawitz offers guidelines for any organization looking for IT solutions:
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Begin with the end in mind: “What should the workflow look like?” What is the optimal technology journey?
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Remember one size doesn’t fit all: Pay more attention to your own users, and less attention to other organizations. “This prevents what I have observed in the past – seeing managers who say, ‘All my competitors are using ERP solution X, so it must be the right one.’ ”
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Have a champion to advocate: Business and technology leaders need to work together on driving change management – or risk failure.
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We’re creatures of habit: Techies may boast about “disruption” or “transformation” while your actual users roll their eyes. Let employees instead know how the new system will allow them to do their jobs more efficiently.
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Follow up: “Are we always checking in? It’s not enough to ‘do it right’ and then flip the switch, hoping the lights stay on. Are we bringing our employees along on the journey?’ ”
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Do you really need that Ferrari? It’s sexy, shiny and fast. But maybe you’d be better off with a pickup truck, or even a bicycle. “Know what your company and customers’ real needs are. Problems arise when the optimal customer journey is not mapped and the wrong technology system is chosen.”
Creating a Seamless Experience
The automotive analogy is similarly handy for Dr. Frederick A. Browne, a member of the AMA’s Physician Innovation Network. Say you’re building all the parts of a healthcare automobile, he says. “We could have the best tire ever, but if it’s not going to fit on the car, it doesn’t really help anybody.”
If the workflow is seamless to the clinician as they’re moving between different tools, says Dworkin, “that’s the game. It’s a very high priority for us.”
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