Just what the doctor ordered. Business process and operational decision management
Shaku Selvakumar 060001XT47 firstname.lastname@example.org | | Tags:  management healthcare websphere ibmimpact process decisionmgmt business
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Contributed by Pete Melrose. WebSphere Industry Marketing Manager. Follow Pete @petemelrose
IBM WebSphere Operational Decision Management (WODM), utilized correctly in conjunction with IBM Business Process Manager v7.5 (IBPM) by qualified medical or hospital personnel, holds the promise for healthcare delivery transformation as measured by decreased cost of care, reduction in medical errors and much-improved clinical outcomes. How can this be?
Because a principal source of medical practice and healthcare delivery problems is the failure to take all pertinent information into account in a timely manner. In fact, there is so much pertinent information to be considered in a timely manner in the diagnosis and treatment of a presenting patient or "case" that the capability of the human mind is exceeded, particularly in the case of a medical emergency. If hospitalization is required, the patient's stay from admission to discharge is fraught with risks typical of the hospital environment, including potential for nosocomial infection and incorrect procedures.
However, in similarly information-intensive and time-critical environments such as banking and public utilities, state-of-the-art information technology (IT) is applied to create a service level agreement (SLA) standard to which we all have become accustomed. For example, barring extraordinary circumstances, financial transactions are posted immediately upon execution with corresponding and predictable effects on other systems and accounts; and electrical power or telephone outages are subject to timely trouble shooting and prompt restoration of service. Why aren't such service levels characteristic of medicine and healthcare? A principal explanation is that the required IT capabilities are not applied.
Two of the traditional explanations for this situation are: IT isn't sufficiently accessible or affordable to complement the practice of medicine, and every patient case is different and dependent for resolution on the art of medicine. Careful consideration reveals that these explanations no longer are as true as they once may have been; because sophisticated software is available cost-effectively via the Cloud to mobile devices with suitable form factors; and IBM's WODM provides software support for timely decision-making (particularly in the context of an IBPM automated process). WODM's complex event processing capability can maintain "situational awareness" by receiving and evaluating parameter values that are critical to patient physiological status management (for example, blood glucose levels of ambulatory diabetics or vital signs of patients in intensive care unit) and also hospital facility monitoring (for example, pressure of clinical gas lines and inventory status/location of pharmaceuticals). When aberrant values of monitored parameters are detected (for example, a blood glucose level above the specified threshold for a designated period of time), the information is passed to the IBPM Boolean rules management capability to determine the next staff and/or system action to be taken (for example, notify the patient's designated clinician via mobile device).
The foregoing examples, none of which are particularly sophisticated and all of which are well within bounds of current medical and healthcare delivery expertise, are significant for two cost-beneficial and potentially life-saving reasons: they can be configured by healthcare administrative and clinical subject matter experts (SMEs), thus avoiding the need for extensive IT assistance; and they execute on a continuing and consistent basis for multiple cases and conditions simultaneously. These decision management characteristics cannot be achieved by human beings because of their inability to be either ubiquitous or omniscient -- they can't be in more than one place or take more than one action at a time, and their knowledge is limited.
HealthNow New York, Inc., a Blue Cross Blue Shield healthcare insurer, has realized the benefits of the rules management feature of WODM -- ILOG JRules -- by incorporation in its automated claims process. As a result, member enrollment times and administrative costs have been markedly reduced and a comprehensive audit trail of rules and decisions is maintained for continuous process improvement.
According to the Chief Enterprise Architect, John Walsh, “Providing innovative products and services while improving the availability, quality, and cost of healthcare is central to our corporate vision. WebSphere Process Server and ILOG JRules have enabled us to automate, optimize and monitor critical business decisions within our core processes.”
A United States healthcare company has built a business including a service network with 10,000 clinics nationwide where medical personnel are trained to inject biologics and vaccines. These clinics – which include urgent care community pharmacies in 50 states – typically operated with 40 percent of their capacity under-utilized. Healthcare Company reserves these under-utilized hours for patient injections, injection training and vaccine. Using the complex business events feature of WODM -- WebSphere Business Events -- the company staff can monitor locations for clinical and operational readiness and help ensure that all of the events that need to occur for a patient to receive treatment have happened. To verify the successful completion of the patient care process, the solution retrieves data that details the outcome of all events. The intuitive user interface of WebSphere Business Events provides drop-down menus for programming the logic of the events that must take place and their dependencies. Aside from its new event processing application, the company has used WebSphere Business Events to create applications for locating clinics, detailing patients’ insurance plans, and monitoring clinic resources.
To better understand the positive potential of IBM Business Process Manager v7.5 and WebSphere Operational Decision Management to facilitate medical practice and healthcare delivery transformation, please plan to attend IMPACT2012 in Las Vegas, NV, April 29th through May 4th. At Impact, you will have the opportunity to:
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