THE ADvANCE Of PROCESS MANAGEMENT TECHNOlOGY IN HEAlTHCARE

The advance of process management
technology in healthcare
With 21st Century technology having been at the healthcare profession’s fingertips for quite some time now,
Bharat Patel, CEO of X-Genics, asks ‘why it has taken so long for paper to disappear?’
Who hasn’t heard of Jim Clark, the
legendary founder of Netscape? As
Netscape started to decline, he decided
to put more than $100 million of his
personal fortune into a new venture
called Healtheon as the next big thing.
The premise was quite simple. The vast
majority of the healthcare system in the
US was paper-based, from patient records
right the way up to invoicing and insurance
approvals, with huge inefficiencies and
a market crying out for technology.
Whilst he was making this investment
to revolutionise healthcare IT, I just
happened to be in the US, in the same
market place, but with a different product
for physicians. After a week of research,
we concluded there was a market, but it
was going to be impossible in the near
future, whereas Jim decided the opposite
and parted with his $100m. Top security
data centres and sophisticated software
systems followed as did much more
investment running into hundreds of
millions, which he eventually all but lost
because none of the GPs registered for
the service and he was forced to sell out
to WebMD, a health information portal.
How can two people reach completely
opposite decisions on the same set of
facts? The reason for this is simple –
Jim Clark started his research at a high
level, talking to health maintenance
organisations, government departments
and giant health insurance companies,
all of whom were trying desperately for a
solution in a market that promised billions
of dollars of business. We started at the
humble end, the physician’s surgery, and
found that unlike in the UK, none of them
had computers, and to do any business
whatsoever, each of the practices would
have to invest at least $20,000 just to get
on to the internet and none of them was
willing to put their hand in their pocket.
To deliver anything nationwide would
mean you would have to pay each client
$20,000 to use your product, so we just
had a nice lunch and went back home.
The paperless office and workflow
technology did not hit the physicians’
practices for many more years. The
fundamental lesson for any new technology
is simple. Know your market. To solve
any problem, if you don’t understand
exactly how your customer works
and how they will actually use your
technology, you are taking a big risk.
The quest for a paperless office
In the UK of the 21st century, every GP
has a desktop and every practice has
a scanner and document management
software dedicated to patient
management systems. However, when
it comes to administration systems,
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SOftware & programming
even in the larger practices, paper
documents rule the world and there
are virtually no process management
systems for anything whatsoever.
Even consulting rooms are booked using
scraps of paper, leading to under-billing
or complete omissions, resulting in loss of
income, and there are very few electronic
rota systems – an item essential to
running a practice. In a recent case, an
Excel-based rota system was delegated
to a member of staff with insufficient
training. The staff member struggled with
the task, asked for help to no avail and
predictably messed up the rota, resulting
in chaos in the office. The management’s
solution was to sack the staff and start
all over again, no doubt reverting to
a good old paper-based system.
Readers in management positions will
see how wrong this is at several levels
from training to man management.
However, the fundamental problem
again is that the business has not
procured a simple – to-use, fool-proof
system to carry out this simple task.
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It is not uncommon for company policies
to be downloaded from the web. According
to this misguided thinking, it is better to
go for the cheap and cheerful solution,
paying perhaps £150 a year to access
reams of draft documents, where all you
do is download everything you can, print it
out and create a fat file full of procedures
and forms. This is hardly an improvement.
It is clear that many practice managers
prefer the comfort of paper and find moving
around physical documents easier than
dealing with an electronic system. Why?
When it comes to IT literacy, it is not
unusual to find that specialists are
brought in by practices to do a CSV to
Word document mail merge, or that staff
lack confidence in switching between
application windows. Workflow systems
don’t stand a chance in this environment.
Problems for system providers
From a commercial perspective, if 80
per cent of your target market is unlikely
to use your sophisticated product, you
don’t produce for it because training and
installation is going to be a real challenge
and if the client does not see a good
cost benefit ratio, you have no sale and
thin margins at best. In the meantime,
everyone opts for the safe option, paper.
The key to weaning practices off paper is
a pincer movement. You need to create a
system that is simple to use and combine
this with excellent training and support.
Finding off-the-shelf software that
delivers process management through
a deceptively simple interface isn’t so
difficult these days and can be relatively
inexpensive. Add to this the fact that you’ll
have everything you need in one place
and every report at the press of a button,
and this creates the value proposition
and a compelling reason for the user to
call time on their paper-based system.
About the author
Bharat Patel is CEO of X-Genics,
a producer of risk measurement
and prevention systems.
[email protected]
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