Workflow eats everything in healthcare

How does change happen in healthcare? Some argue that you need a thoughtful strategy that you need to execute well. Others argue that you need to introduce culture shifts that slowly tweak the organization onto a different track.

Either way, “Culture eats strategy for breakfast,” as famed management guru Peter Drucker supposedly said.

It seems to be a chicken and egg question. Without a well-considered strategy, a culture will struggle with change. Without a receptive, engaged culture, no strategy has any hope.

A healthy dose

With this as the backdrop, a friend turned me on to a really solid podcast called, “A Healthy Dose.” The podcast is hosted by two venture capitalists and focuses on interviewing thought leaders in healthcare. The episode my friend recommended was excellent and focused on Rich Roth, Chief Strategic Innovation Officer for Dignity Health.

There were a number of things to like about the podcast, but one quote jumped out and literally stopped me mid-run on a foggy road in Vermont. I am going to paraphrase here for clarity’s sake, but Roth hit the nail on the head. Intraprenuers, entrepreneurs and other change makers should be focused on outcomes, but not forget the tactical, measurable steps to get there.

Then he said:

Culture eats strategy for breakfast,

but workflow eats everything in healthcare.

What does this mean?

For me, it hit home because too often big, disruptive ideas go after ultra-sexy outcomes, but do not necessarily take into account how people get their work done today. In other words, the outcome may not consider the workflow changes required to get to the end process.

For example, if you are trying to automate the end-to-end process of something like claims attachment processing, you need to consider the end-to-end workflow you might be disrupting. In healthcare, that might mean considering how a claims analyst at a health plan works with a medical record received from a provider. At the provider, it might mean considering how the patient financial services department and the release of information work together to get that medical record to the health plan.

Roth went on to say that while ROI is very important for new technologies, adoption of these technologies requires demonstrable, near-term and interim steps, which you can measure.

In other words, if you want to take on something like payer/provider collaboration for claims attachments, you need to provide evidence along the way that there is a causal link to the ultimate outcomes: Better care, lower costs, provider and improved patient satisfaction.

Why does this matter?

I have worked with a team at Hyland for the last four years to drive a disruptive change in the healthcare ecosystem. Our Mackinac product, to be released on September 8, is a secure workflow bridge between payers and providers for processes like claims attachments.

Every step in our journey over those four years, Roth’s statement about healthcare eating everything has proven true. The outcome of payer/provider collaboration is a worthwhile (and achievable) outcome.

That said, we have had to focus constantly on how the workflows are structured at payers and hospitals so we can fit into current environments and show measurable benefit along the way. It was great to hear Roth articulate a truth that we have been living for four years and Hyland has been living for 25.

Thanks for reading. If you are interested in talking about podcasts, intrapreneurship or why I was running on that foggy Vermont road, please reach out to me at mike.hurley at hyland.com.

* This post originally appeared on Pulse.

Mike Hurley

Mike Hurley is the industry manager for Health Insurance at Hyland, helping health insurance organizations transform business processes that drive value for members, providers and employees. Mike works with current and prospective customers to use our award-winning product, OnBase, to drive business transformation. He is also responsible for our high-value, high-impact health insurance solutions, the like Mobile Medicare Enrollment Solution for OnBase. Prior to joining Hyland, he was the founder and president of Swim Lane Software, LLC. Hurley founded Swim Lane in 2007 to create a solution that leveraged Software as a Service (SaaS) technology to automate the processing and adjudication of Medicare Claims through unique use Business Process Management (BPM) and Business Rules Management Systems (BRMS) technologies. Preceding Swim Lane, he founded Green Square in 1997 as a national consulting practice that connected technology with business strategy. As a boutique services firm, Green Square was aimed at driving stakeholder value at over 25 BlueCross BlueShield plans in the U.S. Prior to Green Square, Hurley founded Avalon Technologies, Inc., an award-winning systems integrator focused on Enterprise Content Management (ECM), workflow and Optical Character Recognition (OCR) technologies.

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