Every year, for the past 6 years, I systematically (some say obsessively) search for examples of workflow technology at the annual HIMSS conference. Six years ago, not much. This year, lots! For example, Ben Moore (CEO, TelmedIQ) spoke about, Why Secure Text Messaging Apps Aren’t Enough, in the Mobile Health pavilion. It was a fascinating mix of information technology, human communication, and classic process improvement themes. In fact, HIMSS tagged it Process Improvement, Workflow, Change Management. The first thing that caught my eye was this quote from its description:
“Many organizations, however, are finding that secure text messaging apps fail in healthcare environments because of their inability to recognize complex communication workflow underpinning patient care coordination” (my emphasis)
Next, there’s this slide:
I’m not going to go through TelmedIQ’s messaging architecture box-by-box, except to point out two things. First, the box in the lower right (workflow engine sighting!). And second, it bespeaks an extremely sophisticated software architecture, with lots of hooks to legacy and other health IT systems. I’d love to have a conversation with Ben someday, in which we visit each layer and component. I suspect it would illustrate just how much secure structured messaging is becoming a multi-functional platform. TelmedIQ certainly meets my definition of a Care Workflow Platform.
Here are my notes from Ben’s talk, high-lighting workflow themes:
- HIPAA compliant communication platform that focusses on workflow and care improvement through care coordination
- 300 customers, 80,000 end users
- Ben’s personal story daughter born prematurely, HC communications “shocking & stunning” (pager, requesting call backs, simple tasks took astronomically longer than they should have had to)
- Before Secure Texting, sending insecure SMS messages
- 5 years ago industry born, mobile apps securing emulating SMS (added value, retention policy, self destruct…)
- 600 bed hospital saved 40 nursing FTE per shift (hour and a half a day in time savings)
- 500 percent improvement communications workflow efficiency
- Reliability, adoption, user inclusion, structure & policy, integration
- put policy on message, escalation, if can’t reach user, try alternatives, calling, escalation policy
- Adoption issues, page is already embedded in workflow with 20 clinical systems
- patient-centric workflow, EMR can share with care team
- inclusion issue, system focusing on physicians vs nurses, must include all workflow stakeholders
- integrate with nurse call
- connect to all devices,
- put structure into the messaging, requiring certain fields based on message type enhances workflow (avoid back and forth workflow, more streamlined)
- policy, integrate with all on call platforms
- policy more than just schedule, reroute to different physician (routing engine)
- orchestration key to delivering useful information & be compliant with Joint Commission (re doc texting order to nurse)
- connecting all system is key part of our strategy as a company and we’ve done over 30 different vendor integrations with out platform
Back to that workflow engine sighting…
I’ve been tracking diffusion of workflow technology into health IT for two decades. Workflow engines are the single most important component of workflow technology. It is the workflow engine that executes, or consults, a model, or representation of work or workflow, to support workflow system users in their work. That TelmedIQ relies on a workflow engine is, to my mind, evidence the TelmedIQ messaging platform can do the four things for which I tout workflow technology in healthcare:
- Automaticity: workflows, sequences of tasks, fire automatically and save humans work
- Transparency: the state of current and past workflow is readily visible and apparent
- Flexibility: what triggers what tasks in what order can be changed by non-programmers
- Improvability: transparency and flexibility leads to improvability, workflow can be systematically improved
Ben gave an excellent talk on the importance to move beyond mere “secure messaging” to structured messaging and workflows. I’m delighted to see an underpinning of workflow technology within the TelmedIQ system architecture. And I look forward to observing TelmedIQ’s future evolution toward even more automatic, transparent, flexible, and systematically improbable workflows.
P.S. Here is a video of Ben’s HIMSS16 talk. I originally live streamed it on the #HIMSS16 hashtag using Periscope and then archived it to Katch.me. Where is was viewed over a hundred times…. but then Katch shut down. But not before I saved and uploaded to Youtube!
