Have you heard of the phrase “photobomb”? This is a photo including the unexpected appearance of an unintended subject in a camera’s field of vision as the picture is taken. Well, just call me the “workflow bomber” because I keep showing up at data-oriented events shouting about workflow.
— KQEDscience (@KQEDscience) August 21, 2015
That’s me, in the lower right. (And on the right? That’s one of my more data-oriented #HITsm colleagues looking at me, well, owlishly…)
Topic 1: Do you think there is a difference between #InformationGovernance and #DataGovernance in healthcare versus #WorkflowGovernance? Why or why not?
There’s a big, big difference between data and information governance versus workflow governance (though less so between information and workflow governance than between data and workflow governance).
But workflow governance is extremely important to data and information governance, as we shall see.
“Data governance (DG) refers to the overall management of the availability, usability, integrity, and security of the data employed in an enterprise. A sound data governance program includes a governing body or council, a defined set of procedures, and a plan to execute those procedures.”
“Information governance is a holistic approach to managing corporate information by implementing processes, roles, controls and metrics that treat information as a valuable business asset.”
One could argue that IG overlaps with WG, and it does, because it specifically mentions processes, which is almost synonymous with workflows, depending on context. However, I think it’s worth taking a look at BPM Governance (Business Process Management, umbrella term for modern workflow and related technologies).
There are five key elements to BPM governance:
- Measurement of workflow performance (cycle time, throughput, bottlenecks, rework, errors, etc.)
- Ownership (who has the right to create and execute workflows)
- Accountability (how are process owners held accountable for workflow performance)
- Control (how much control do owners have over workflows?)
- Support (how are workflow creators, managers, and executors supported to make sure workflows Perform best?)
Topic 2: Who do you see as the proper owner(s) of #WorkflowGovernance in an organization and why?
As is the case of data and information, ownership is a thorny issue. Workflows often span departmental fiefdoms; so breaking down workflow silos is essential to beginning-to-end workflow ownership and accountability. Sometimes it is who ever is responsible for the most important or most numerous steps in a workflow. Sometimes it ownership becomes the responsibility of a “Workflow Council” (which sort of reminds me of hospital form design committees).
Topic 3: Of the #WorkflowGovernance drivers listed, which do you think are the most important and why? Which drivers are missing?
Here’s the thing. If different organizations, at different times and in different contexts, any of the following drivers may become the most important. One of the primary values of workflow technology is the ability to quickly change workflows in response of evolving conditions, such as, in this case, changing governance drivers. In this you can see workflow tech’s unique contribution. Data is static and tactical. Workflow is dynamic and strategic. Increasingly, data and information governance will be made possible because it is workflow that changes data. In other words, future systems data and information governance will increasingly rely on systems of workflow and process governance.
Drivers of Workflow Governance:
- Regulatory Compliance
- Improve patient safety/patient care
- Need to manage and contain costs
- Need for clinical, quality, and/or business analytics
- Changing payment environment
- Need for increased standardization
- Need to integrate and/or improve systems and technologies
- New care delivery models (population health management)
- Lack of trust or confidence in workflow and processes
Topic 4: How do you see #WorkflowGovernance affecting Population Health? What technologies are involved?
Great question! As I’ve written about win the past, in several blog posts, the most mature population health solutions today invariably have some sort of workflow engine powering a care coordination platform.
- Population Health Management and Business Process Management
- Business Process Management Tackles Population Health Management
Topic 5: What do you think the workflow risks are for an organization without a formal #WorkflowGovernance framework?
Just as there are many risks to an organization without a system of data and information governance, there are many risks without a system of workflow governance. However, since most healthcare organizations have immature workflow technology, these risks are a combination of immature and under appreciated as well. Workflow governance will increasingly attract attention as healthcare organizations adopt more sophisticated interior-facing and exterior-facing workflow platforms.
I’ll highlight just one, unique to workflow technology, risk, that of “workflows gone wild.” As it becomes easier and easier to create new workflow application, without having to be a Java, C-sharp, or MUMPs programmer, there tends to be an explosion of workflow creation. The combination of pent-up need, creativity, and easy-to-create workflows results a dramatic increase in workflows, which may not work together well. So some sort of central authority, sometimes called a CoE, or Center of Excellence in the BPM world, is needed.