Workflow: it's one of the hot new words in healthcare technology. During product demos, in seminar rooms, and on vendor Web sites, promises of improved workflow management abound.
"In the past six months, workflow has become a big part of demos. I'm seeing more and more of it all the time," observes Gerry Schultz, vice president of sales and marketing for NextGen, a Tustin, Calif.-based vendor. NextGen's advertising promises that the company's EMR "streamlines workflow."
"There is something of a buzz," concurs Richard Yonis, CEO of AcerMed; his company calls its product line a "complete workflow solution."
While it's clear that workflow solutions are becoming more popular, what's less clear is what workflow improvement actually means -- especially to a practice's bottom line.
Without a doubt, good solutions can cut overhead and eliminate errors and redundancies. However, some practices could benefit simply by reviewing their existing processes with an eye toward improving efficiency -- no purchase required.
What does it mean?
"Most folks don't understand what [workflow management] really means. It's a phrase that's just used across the board," complains Sam Brandt, vice president of clinical informatics for Siemens Medical Solutions.
One definition? Any product -- be it electronic medical records (EMR) or a personal digital assistant (PDA) reminder program -- that reduces redundancies, eliminates "dropped balls," and fine-tunes rough-edged work processes. The idea is that if everyone in the practice can effortlessly do what needs to be done, when it needs to be done, without forgetting key steps, the whole practice will be more relaxed and more profitable. The goal is to avoid waiting for someone else to do their job so you can do yours. Think about how many times you've had to delay a procedure because the supplies weren't stocked up, for example.
To illustrate the concept of workflow management, Brandt suggests imagining a McDonald's restaurant. When an order comes in, the fry guy drops a basket in the fryer, the burger girl flips a patty, and the clerk rings up the sale and fills a soda, while the customer fumbles for change. They don't need to coordinate. No one forgets the pickles. Everything is ready when it needs to be.
Compare that to the medical experience Deborah Walker, of practice management consulting firm Boehm Walker Associates, had during a physician visit with her mother. First, she says, they signed in at the front desk and sat down. Two minutes later, the receptionist called them back with a question. They sat back down -- eventually, several more times, as the staff needed other bits of information. The intake process alone took three or four steps on the part of both the staff and the patient. Nothing was ready when it needed to be.
In most physician offices, "workflow is a continuously interrupted pattern," according to Frank Rhie, MD, chief medical officer of Alteer, a software company in Irvine, Calif. His example: Paper medical charts force everyone in the office to take tasks only to a point before they have to stop, because someone else has the medical record they need.
To be sure, the daily procedural lapses in any average physician office are numerous: A service at the hospital never gets billed. Patients needing a check-up are not called. Insurance is not verified. Anything that helps iron out these wrinkles can go right to a practice's bottom line, and help everyone get home in time for dinner.
"Today's physicians are faced with decreasing profit. Improving workflow makes nonrevenue-producing processes happen much more efficiently," says Schultz.
Another plus: Some workflow management systems collect metrics showing where existing systems fall apart and how fast each process goes, says Brandt. "You can see where the roadblocks are. It gives you what you need to do quality analysis."
Making workflow work