The Sharing Economy’s Crowdsourcing of Healthcare Workflow Will Require Workflow Tech

This post is promoted by Ryan Lucas (@dz45tr: get it? > “disaster”) moderating today’s #HITsm tweetchat. His topic is The Sharing Economy in Health IT. I’ve archived his questions/topics (and my short responses) below (since they disappear from their temporary link on HL7standards when replaced by the next weeks theme).

Last year I attended a presentation titled “Transformational Impact of Cloud Labor” here in DC. Much of it was relevant to health, healthcare, and health IT workflow! I’ve been meaning to write a long post on the topic, but that will have to wait until later. For now I’m archiving some of those tweeted slides, so I can tweet a link to them during the #HITsm tweetchat, and also as a reminder to return and elaborate later. (After I wrote that, I just couldn’t resist adding more remarks: read on!)

Much as been made of the potential Uber-ization of healthcare. Who will be the Uber of healthcare? (Before that, it was who will be the Amazon of healthcare?!) The sharing economy potentially exploits a variety of sorting, matching, and transaction cost reducing online mechanisms. Online platforms sort and signal who’s available to those in need of what they supply (transportation, in Uber’s case), and create temporary virtual enterprises to reduce transaction costs.

It’s happening in healthcare too, from online medical consults, to services that match your suddenly free time to suddenly available appointment slots. However, in contrast to Uber, many healthcare workflows are much more complex, consuming many more resources, over a much longer durations, and subject to many more complexities: expertise, insurance, and regulatory.

In healthcare, complexity is often too much for even expensive humans to manage well. Those are two important drivers of healthcare cost: the intrinsically difficult nature of the managed workflows, and the intrinsically expensive nature of the human expertise manage them. As a result, mistakes occur and time and motion is wasted.

At some point (not sure if it will be a tipping point, or a much more slow, but nonetheless inexorable process) health, healthcare, and health IT will begin to leverage a variety of workflow technologies. I’ve written hundreds of thousands of words, and tweeted tens of thousands of tweets, about them. But in this space, the sharing economy and the crowdsourcing of health, healthcare and health IT workflow (after all, a majority of H/HC/HIT costs are human labor) will likely be a lightweight (no install or one-click install from the cloud) participation in networks of flexible, but continually optimized, resources: people, supplies, knowledge, and experience.

Well, I’m just about out of time, if I want to show up at Ryan’s #HITsm tweetchat. But I encourage you to browse the next few slides. Who every will become the Uber of healthcare (or whatever comes after Uber) will necessarily deal with, and in some cases master, the following topics:

  • Variable cost
  • Programmatic access to human labor
  • Quality control
  • Workflow building blocks
  • Ideation
  • Freelance expertise
  • Software services
  • Microtasks

And, most important:

  • Asking the right questions
  • Selecting the right workers
  • Interating and optimizing

I’m looking forward to the tweetchat!

Archive of Ryan Lucas’ #HITsm questions for Friday, January 30, 2015:

#HITsm T1: Is a sharing economy model realistic for the healthcare industry, in whole or in part? Where? How?

As a whole, probably not at first. But for so-called low lying fruit? Of course! (Take me to the top of this post!)

#HITsm T2: What should a sharing economy model prepare for with the current status of #HealthIT and #Healthcare?

I’m a broken record on this. Move from current hoary systems to modern workflow tech in the cloud. (Take me to the top of this post!)

#HITsm T3: If a sharing economy model were to come about, who wins and who loses in #HealthIT and #healthcare generally?

Aye! There’s the rub. In the short, possibly even intermediate run, the workers. It could/would/will be wrenching. (Take me to the top of this post!)

#HITsm T4: What other technology models are out there that #HealthIT can borrow from to enable those changes?

Workflow management systems, business process management, dynamic/adaptive case management platforms. (Take me to the top of this post!)

#HITsm T5: Any other thoughts on #healthcare economic models and how #healthIT can help?

Workflow tech can’t fix screwed up healthcare economics. But that can’t be fixed w/o workflow tech. (Take me to the top of this post!)

Dear Health IT Folks, Please Submit a Proposal to The BPM and Case Management Summit!

Every year more ideas and technology from the business process management and case management software industry show up in the health IT industry. (BTW “case management” has a different, though related, meaning in the workflow industry than the healthcare industry.) For example, I see more-and-more BPM/case management IT vendors and professionals show up at the annual HIMSS health IT conference (see my HIMSS14 and Workflow: Are We Making Progress Taking Business Processes Out Of Applications?).


At the same time, knowledge about healthcare workflows and unique workflow technology requirements must flow in the reverse direction, back into the BPM and case management industry. The very best way to transport knowledge is in a human brain.

So, I encourage all health IT workflowistas to submit proposals (250-word abstract by Feb 28th) to the upcoming BPM and Case Management Summit here in Washington DC. Last year I encouraged health IT folks to attend, presented myself, and we had a great reception from the workflow folks. Here’s a link to my trip report from last year, including my presentation archived as a Youtube video: BPM and Case Management: US Healthcare Wants You, But May Not Know It, Yet!

Here is this year’s call for proposals (just 250 words!):

(BTW, ignore, for the moment, any buzzwords that may appear unfamiliar. The workflow tech industry and health IT often have different terminology for similar topics. You could very well be engaged in a BPM/case management initiative, but simply call it something different!]

Who Should Submit?

Program Leaders Involved With BPM, Case Management, Analytics, Architecture or Similar Initiatives

Practitioners and Consultants Experienced With Designing and Delivering Adaptable and Innovative Solutions Demonstrating Superior User Experience

Subject Matter Experts Engaged in Dynamic Business Processes and Data-driven Knowledge Work

Researchers and Educators Involved With Business Process Issues, Architecture and Modeling, Collaboration and Knowledge Worker Effectiveness, Standards Development, Information Interoperability or Related Fields

Why Should I Submit?

Submitting a proposal is quick, easy and risk-free. We will provide feedback to help refine your submission, and if selected you will:

Gain Visibility at the Industry’s Most Prestigious Forum, Plus the Opportunity to Network With Peers

Advance Understanding of Your Work and Achievements

Have the Opportunity to Published to With Visibility to an Audience of 10,000s Per Month

Be Considered for Inclusion in a Forthcoming Book

The topics below frame the topics covered during the event, however, you are welcome to submit a proposal on any subject you believe is relevant.

Case Management

Investigative Case Management approaches and applications

Definition of Adaptive Case Management (ACM) as its own discipline (apart from BPM)

Data-centricity (state transitions and data interchange focus) of case management activities

Impact of Case Management Modeling Notation (CMMN) on practitioners and tool vendors

Case management in targeted vertical markets (notably Financial Services, Insurance, Health Care, as well as Federal, State and Municipal Government)
Services integration in case management applications

Business Process Management (BPM)

Definition of business process management (BPM) as its own discipline (apart from ACM)

Impact of Business Process Model and Notation (BPMN) on practitioners and tool vendors

Process analysis and re-engineering using simulation, mining, and monitoring key performance indicators

Business process as-is anti-patterns and to-be redesign patterns (best practices)

Distributed, end-to-end, and cross-organizational business processes

Cloud impact on BPM and executing business processes in the cloud

Enabling data-driven business processes

Business Analytics

Impact of “big data” and attendant issues on business analytics

Survey of technologies for performing process monitoring and other business analytics

Promise of semantic technologies for bridging big data divides across authoritative data sources

Process mining and its application in business analytics

Modeling and predictive analytics for enterprise computing

Collaboration enterprise analytic platforms

Business process intelligence (e.g., process performance management)

Continuous, online analytics for big data in the enterprise

Business Rules

Business rule languages and engines

Managing granularity of business rules from the line-of-business (LOB) to the enterprise

Rules interchange and interoperability across heterogeneous execution platforms

Modeling business rules and the relation between business rules and business processes

Business rules and service computing

Business rules and compliance management, business process compliance

Event-Driven Rules-based Business Processes for the Real-Time Enterprise

Process and Data Governance

Role of process classification frameworks and other normative architectures

Demonstrating compliance and establishing provenance of submitted models

Service policies, contract definition and enforcement

Security/privacy policy definition and description languages

Policy interoperability

Information Interoperability

Making data interchange work across BPM and ACM a reality

Business object modeling methodologies and approaches

Taxonomies, ontologies and business knowledge integration

Master data management, data mining and (real-time) data warehousing

Flexible information models and systems (e.g., object-driven processes)

Data quality and trustworthiness

The role of NIEM and standard data descriptions to achieve interoperability

Evolution of SOA and API management to support mobile computing

A uniform resource identifier (URI) for everything the worker needs

Business Architecture Modeled Across the Enterprise

Enterprise architecture frameworks vs. business architecture frameworks

Design and population of architecture models – state of the market and practices today

Relationship of architectures to BPM and ADM disciplines

Enterprise or business architecture analysis, assessment and prediction

Cloud computing and the evolution of architectures

Enterprise ontologies and common vocabularies

Who Will Be On The HIMSS15 Top Ten List Of Healthcare Workflow Movers & Shakers?


During the upcoming HIMSS15 conference, April 12-16, in Chicago, at the peak of #HIMSSanity I’ll publish and tweet, one at a time, the HIMSS15 Top Ten List of People and Organizations improving Healthcare with Health Information Technology.

The Rules:

  1. I am not eligible.
  2. You’ve made a significant positive impact on healthcare workflow using information technology during the previous year…
  3. Or, you’ve published, in some online form, promising ideas or persuasive opinions about healthcare workflow. (This, because this whole healthcare workflow thing is so very nascent.)
  4. You have some presence on social media (basically, Twitter).
  5. Winners may publish the above POWHIT! social badge on websites as long as there is a link back to the Top Ten list.
  6. You don’t have to be an HIMSS15 exhibitor. (Though I’d love to drop by to “chat you up”, as my English accented wife puts it.)
  7. You don’t even have to be a HIMSS15 attendee. (Though I’d love to meet you face-to-face in Chicago.)
  8. The Rules is in no way affiliated with the book of the same name.
  9. I made the rules so I can break the rules.
  10. There is no rule number 10.

Listen To My Interview About Workflow On IntrepidNOW and Plans For HIMSS15

Many thanks to Joe LaVelle (@Resultant) at IntrepidNow!

  • What is the definition of workflow from the workflow guru?
  • What is a workflow engine?
  • How do workflow engines work with EHRs?
  • How many EHRS really have significantly configurable workflow?
  • Our listeners are interested in the role of standards with workflow? How do things like HL/7 and IHE play with workflow?
  • What vendors are really good at workflow?
  • Last year at HIMSS, #BigData was the star of the show; Will #BigWorkflow be the star of HIMSS15? What does Chuck have planned for HIMSS15?

Vishal Gandhi And His Amazing Technocolor Medical Practice Workflow Infographics From ClinicSpectrum

You may have seen the ClinicSpectrum infographics on the #HIMSS15 hashtag. They’re sort of hard to miss. 🙂

Vishal Gandhi (@csvishal2222), that’s who’s behind the prolific @ClinicSpectrum Twitter account, tweets some of the most amazing and eye-catching info graphics of any exhibitor at HIMSS15. They’re almost as colorful as his “Workflow Hat”.

My route to becoming interested infographics is a germ of an idea about creating beautiful workflow diagrams. It’s a bit a fantasy of mine, to imagine, a workflow diagram that is both incredibly useful and incredibly beautiful. In fact, several of Vishal’s recent animated cartoons remind me a bit of (much less entertaining) graphical animation of workflow generated by discrete event simulation programs (used to model and predict healthcare workflows).

So I jumped at the chance to sneak a peak at what goes into creating an infographic. In fact, I got to pour through hundreds of infographics, in various stages of completion. Relative to ClinicSpectrum’s product suite, the following infographics struck a chord.

I thing the above infographics are definitely heading in a direction I describe in my HL7standards guest post: Marketing Workflow Is An Incredible Opportunity To Differentiate Health IT Products, And You! I’d love to hear what other workflowistas think about using infographics to market workflow (which, in my piece, I argue is a big win-win for vendors AND customers). I look forward to more-and-more workflow-ish workflow-esque infographics from @ClinicSpectrum (and the rest of the companies attending HIMSS15).

I hope you are having as much fun at HIMSS15 as I am!

Please, please, please, I pathetically beg you, follow me on Twitter at @wareFLO!

PS I’d forgotten @jimmie_vanagon‘s doggerel Vishal’s Workflow Hat inspired… 🙂