[Written with respect to the #Kareochat Twitter chat about healthcare’s “Not My Problem” problem, hosted by …]
This blog post has two parts. First is a brief account of my interactions with a beloved member of the Twitter community, who recently passed away after a long illness. She frequently tweeted about her experience with a dysfunctional healthcare system. In the second part I pivot to workflow technology and healthcare’s “Not My Problem” problem.
First, a bit about my own connection.
I met Jess in 2013 at Google Glass meetups in Washington, DC. Hardly knowing me, Jess invited me to the zoo (she was like that).
Let's plan to go to the zoo next week – meet with glass at 4:30 at the zoo? They have otters & pandas!
— Jess Jacobs ()
We tweeted about recording dates and times of healthcare events (workflow!).
I've tried/done a min-to-min w/ stopwatch of hospitalizations – problem is when you're really sick you can miss some events
— Jess Jacobs ()
I also referenced one of her tweets about her “most actionable patient instructions I’ve ever seen” in a blog post called The Workflow Prescription.
These are the most actionable patient instructions I've ever seen. Dr. Joe 's my unicorn!
— Jess Jacobs ()
I didn’t know Jess well, but she was the kind of person I instantly liked.
Relative to healthcare’s ‘Not My Problem’ culture (to be discussed during 8/18/16 #KareoChat), there most definitely is a workflow angle. Here is a quote from .
“In the BPM organization, delivering customer value and optimizing process performance are two central goals….This discourages the “not my problem” mentality and the practice of throwing issues over the functional wall.”
From a systems engineering perspective (one of my grad degrees), systems and workflows must be designed so as to not allow problems to disappear between the cracks (handoffs). In a business process framework (what used to be called workflow management systems) “problems” are “tasks”. These tasks are literally represented in the computer, so they can be tracked. If a problem/task is assigned to a person or role, the person or collection of people, cannot say “not my problem.” It IS their problem because the workflow model says it is their problem. The workflow model is a contract-like agreement to participate in, and execute, a workflow or process. If problems/tasks aren’t dealt with, then, because task status is transparent and visible to everyone, both during and after the fact, this is how BPM solves (or at least better manages) the “not my problem” problem.
Tasks also need to be tracked between healthcare organizations. For more information about the kind of interoperability necessary to avoid “Not My Problem” between organizations, see either of my five-part series…
One may object that healthcare’s “Not My Problem” problem is a cultural, not a technological issue. I would argue it is both, and using BPM has important potential affects on organizational culture.
T4 Many think no connection between culture & workflow. They are so wrong! Workflow can "reinforce" culture
— Charles Webster MD ⎌ ()
“Visible organizational structures and processes”
T2 But note workflow indirectly influences values & assumptions! So workflow is one lever to change culture
— Charles Webster MD ⎌ ()
Healthcare has historically underinvested in “process-aware” technology, both the older workflow management systems and current business process management systems. Fixing healthcare’s “No My Problem” problem will require a healthy dollop of workflow technology.
Here are the questions for the upcoming #KareoChat tweetchat.
- Have you seen the “Not My Problem” culture in healthcare? Where and what impact did it have?
- How can small practices avoid the “Not My Problem” culture that sometimes exists?
- What can a small practice do to become more patient focused?
- Will becoming more patient focused be good or bad for a small practice’s business? Why or why not?
- What can we do to better help chronic patients who are suffering like #UnicornJess suffered?
- Do we see the “Not My Problem” issue in health IT towards doctors? How?
P.S. Yeah, I know, I need to get rid of the Blab link. Maybe in a couple posts…
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