From Bed Management To Workflow Management and Experience Orchestration

What kind of conference do I enjoy most? Apparently, a TeleTracking 2015 Client Conference, which I attended last week in Nevada. As a premed-accounting major (only one I’ve ever heard of), TeleTracking was full of customer success stories about reduced costs and increased revenues. With an MS in Industrial Engineering, TeleTracking was full of IE concepts (cycle time, throughput, capacity management, and utilization rates). Plus an MS in Intelligent Systems (medical informatics), TeleTracking was full of health IT, interoperability, and care transition technology.

Big picture: TeleTracking was about two areas rapidly gaining prominence in thinking about healthcare and health IT: productivity and experience. There is an important connection between these two concerns. What is the connection? I am sure I will surprise no one who follows my tweets or who has read this blog before: Workflow.

You may have heard of the cocktail party effect? It occurs when you hear something just sort of pops out at you, punching through a noisy environment. It’s usually a word or sound that has special significance to you. Your name. Your baby crying. Or, in my case, I’ve never been anywhere where I heard, over the crowd noise, all the “workflow”s I heard at TeleTracking. In my opinion, this is a very good thing.

TeleTracking 2015 occurred in a great location: Lake Las Vegas, Nevada.

At TeleTracking the following statistics stood out.

  • Baptist Memorial reduced time to admit a patient 75 percent, from one hour to 15 minutes.
  • Health First reduced time to discharge a patient 81 percent, from 9.1 hours to 1.7 hours.

There were actually many impressive statistics. I’ll focus on just the above, because I don’t want this blog post to be too statistics heavy. Just know this: I saw hundreds of statistics about improved overtime; dirty bed response times, turnaround times; missed transfers and transfer volumes; unplanned discharges, avoidable discharge delays, calls per day between nurses, pharmacists, and front desks; transport request durations, incoming transfers, patient throughput times and satisfaction scores; and a lot more.

I’ve used a variety of “workflow informatics” technologies for several decades. The statistics I saw and heard are consistent with my previous experience. However, workflow tech is still relatively rare in healthcare. And I’ve not seen it applied as the scale TeleTracking is applying in not just large hospitals but across entire health systems with multiple hospitals (with associated opportunities to address interhospital transfer problems and opportunities).

Let’s turn from productivity improvement to patient experience improvement. There is a direct causal arrow from efficiency to improved patient experience.

Imagine you are waiting for a bed or waiting to go home. Imagine waiting an hour for the bed and nine hours to go home. Now imagine waiting 15 minutes for a bed and less than two hours to go home.

Here’s another example, one involving a TeleTracking core competency, “tracking” people, objects, task, and workflows. Moment by moment, TeleTracking tracking tracks patient location. Apparently there is an app allowing families to see whether their family member is in their room or not. This prevents, for example, a college student from taking a bus crosstown to the hospital to visit his mom, only to find her room empty.

TeleTracking tracks more than just people and objects, but tasks and workflows as well. In this, TeleTracking is in what academics called “process-aware” territory. Process-aware information systems have some kind of model of process, or workflow, and use this model to improve all kinds of useful statistics, from cycle time to throughput, to task visibility and safety, to visualizing workflow state, in real-time, as in, “the patient’s wound was just closed”, represented using a suture symbol.

Real-time workflow and task status is useful to lots of people, from those who clean the operating room to nurses waiting for the patient up on the floor. This same information, which can be so valuable for creating more efficient and safe patient workflows, is also extraordinarily appreciated by families waiting for news of their family member’s progress. They can watch their loved one’s journey, step-by-step, through each major stage of operating room and surgical workflow, via a real-time dashboard.

There is a pattern here. The same real-time data, about healthcare events happening and status changing, is essential for both greatly improving healthcare workflow efficiency AND patient experience. To me, this was the most exciting potential that TeleTracking made me think of: Can we make our healthcare system much more efficient while at the same time greatly improving patient experience? Yes, but it takes a combination of real-time visibility into all relevant healthcare workflows and using that information to drive other real-time workflows to improve efficiency and experience.

I enjoyed TeleTracking 2015 Client Conference, for reasons already stated, and the Pittsburgh connection. TeleTracking is based where I lived for twelve years. Every time I met a TeleTracking staff member, I asked them where they lived and hung out. From Cappy’s on Walnut in Shadyside to the 54C between the Southside and Oakland, we had great fun comparing professional and personal workflows and life-flows of another kind!

In particular, I finally met Pittsburgh’s Bill Strickland, who keynoted the conference. His life story of creating successful communities by believing in the best, not the worst, in people resulted in multiple standing ovations.

I tweeted the following, toward the end of the conference. I was trying to distill down to a single tweet what I found most interesting about TeleTracking. It’s pretty dense, and really intended for fellow healthcare workflow tech geeks. But it might be useful to unpack and explain as a summary and conclusion to this post.

“Remarkable scale of event-driven propagation of patient & task state across HC enterprises 2 apps & users”

By “event-driven propagation” I mean when something happens, information that something just happened is immediately sent somewhere useful. Why is this important? Because in healthcare lots of things can’t happen until some prerequisite thing has happened but most current healthcare organizations and health IT systems aren’t very good at this, so stuff that should get done, instead languishes. The results are delays, longer cycle times (time from beginning to end of workflows), and reduced throughout and capacity.

By “patient & task state” I mean tracking not just the location of things objects and people, but also tracking status changes, such as from not-ready-to-be-discharged to ready-to-be-discharged, or starting-surgery versus finishing-surgery. This kind of information, instantly propagated to the right person and the right can dramatically improve hospital workflow, especially patient flow.

By “across HC enterprises 2 apps & users” I mean workflows inside of one healthcare organization, such as a hospital, can be enormously important to workflows inside another healthcare organization, such as a hospital receiving a transferred patient. (In fact, I recently wrote about this topic during a 7000-word, five-part series on workflow interoperability).

Finally, by “Remarkable scale” I mean I haven’t previously seen such quantity of tracked data, and also sophisticated combination of different kinds of tracked data, display of that data, and triggering of complex healthcare workflows using that data. Much of the health IT world is about patient data in databases put there by a variety of means, but recently especially electronic health records. This kind of data is important, for patient care and understanding outcomes, but we need more. We need data about when important healthcare events occur and then means to drive other healthcare events. To me, this is the important secret sauce TeleTracking brings to the healthcare and health IT table.

All in all, great conference! Learned a lot. Confirmed a lot (about things I believe about healthcare workflow and workflow technology). And enjoyed a lot.


On Periscope!

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P.S. Below are some of my tweets during the TeleTracking conference. There were some great slides, both from customers and from employees.

  • Community Access Portal (provider facing)
  • Command Center
  • On-Call Schedule

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