The Key To Effective IT? Workflow Assessment

By Alan Worsham, Vice President of Consulting Services, Culbert Healthcare Solutions

Vendors typically sell healthcare IT solutions based on features and functionality, but don’t make the mistake of believing technology alone can maximize efficiencies. In reality, getting the most out of IT starts not by evaluating technical capabilities, but by analyzing workflows.

This is vitally important for providers investing considerable time and money in revenue cycle systems, EHRs, analytics platforms, and other technologies. Rather than trying to become IT experts, provider organizations should focus instead on how well their processes, enabled by new technology, support their organizational goals. This starts with a workflow assessment. 

An effective workflow assessment is not a one-time endeavor, however. It involves first uncovering an organization’s current state, then leveraging that knowledge to design a future state of processes that will move the needle on clinical, operational, and financial goals.

Start At The Beginning

People embarking on journeys these days often get directions from Waze or Google Maps. Before these tools can provide directions, though, you must first enter a starting point. It makes perfect sense — you can’t chart a path without knowing both the place of origin and the destination.

While the same concept holds true for healthcare IT implementations, too often the starting point is overlooked. In fact, one key to IT effectiveness is an honest look at the current state, with periodic reviews over time. An ideal assessment is an ongoing process that starts well before IT selection. To ensure any IT system will effectively support an organization’s goals, providers must first:

• Understand their current workflows.
• Recognize their workflow pain points, as experienced by both IT end users and leadership.
• Pinpoint why current workflows exist as they do. (Very often, the answer is, “We don’t really know. We’ve just always done it this way.”)
• Identify any goals not being achieved, as well as any needs not being met.
• Determine and prioritize new goals to pursue.

Once an IT system is chosen, providers should look at these factors again prior to implementation. That way, any shifts in priorities since initial selection can be addressed.

An abbreviated assessment should also be conducted 60-90 days post-implementation — and regularly thereafter — to verify continual progress toward goals even as business conditions and technical functionalities change. Ask the question, “What’s still not being achieved?” in order to keep an eye on the reasons for making the IT investment in the first place.

Evaluate From Multiple Perspectives

Gaining full vision of the current state entails more than just a review of documentation. While documentation can help explain intended workflows, it seldom mirrors reality. To understand how IT is actually being used on a daily basis requires observation from multiple vantage points.

Start by visualizing a patient’s path through the organization as a way to think through workflows. Shadow doctors, nurses, medical assistants, business office staff, and others to see how they truly use IT before, during, and after their patient interactions. Ask about what works well, as well as their pain points.

In addition, talk with senior management, line management, and end users about their processes. Find out what they believe is happening within various workflows — these beliefs often provide valuable insight into the desired future state.

Finally, examine the organization’s key performance indicators — from financial metrics such as claims denials, bad debt, and A/R aging to clinical indicators such as readmission rates and productivity measures. Look at trends and outliers by organization, department, provider, payer, and more to identify the biggest workflow issues and obstacles.

All of this awareness is critical for designing a future state in which IT effectively addresses the needs and goals of both end users and leadership.

Take A Collaborative Approach

Once existing workflows are better understood, two more steps are necessary to turn that insight into an actionable change management plan.

First, all stakeholders — including senior managers, line managers, end users, IT staff, operations staff, and clinicians — should be allowed to voice feedback regarding the plan. Complex workflows, especially, will need the collective buy-in of all stakeholders to be successful.

With feedback acknowledged, training programs should then be carefully designed around processes and workflows — not IT system functionality. Rather than IT-centric training, this kind of education helps each staff member answer the question, “How can I best do my job?”

Although more effective than traditional top-down implementations, a workflow-centered IT implementation requires a high degree of collaboration. The right balance must be struck between IT and operational leadership; efforts must be viewed as clinical or business projects supported by — not imposed by — IT.

A similar balance must occur between the needs of leadership and those of end users. Consequently, it’s often useful to call on the objective advice of consultants or colleagues who’ve undertaken similar changes. In many cases, these resources can supplement in-house knowledge of the IT systems or business processes at hand.

Keep Sight Of Your Goals

One of the biggest dangers in any IT project is losing sight of the underlying reasons why the technology is being implemented. So, to ensure maximum IT effectiveness, it’s vital to determine upfront how success will be measured. Track and report on those indicators before, during, and after implementation; they should become a standing part of leadership’s agenda.

After all, an IT system is only as good as the workflows it enables. By approaching implementation in an organized manner that starts with observing existing processes, pain points and performance metrics, provider organizations can effectively marry technology to workflows to achieve significant clinical, financial and operational goals.