Healthcare Software

Hospital Processes are Highly Collaborative and Asynchronous

The Problem. Hospitals and clinics contain a large number of autonomous individuals all working to deliver healthcare. There is opportunity for collaboration, but work almost always takes place between caregiver and patient. When a difficult case presents itself, multiple staff members may participate to gain experience, but for common, routine cases work can normally be done without discussion.

For routine cases such as diagnostic tests, communication between team members is normally not necessary. Each member can be given a list of the patients scheduled for that day and each can work through his or her workflow in the most efficient manner.

If there is no way for a team member to check on the progress of another, however, the caregiver will need to physically ask his colleague if he is done his part of the workflow. If not, he will need to keep checking until the case is ready.

For Example. Consider the example of the workflow of a cardiac exercise test:

• Patients are scheduled by a clerk who creates the appointments
• Patients present themselves to the front desk and are directed to an examination room
• A technician finds the patient record associated with the patient who is in the room and completes the test
• A doctor pulls the cases for which the test is complete, interprets the results and completes a report for each
• An assistant forwards the results of the test to the patient’s family doctor and anyone else involved in the case

Here, each team member is working through his or her own work log. When an employee is finished a case, it then becomes someone else’s work, which then gets passed onto someone else until the case is complete. If the system is not able to identify the progress of the case for each of the interested participants, participants will not know when to contribute.

Solution. Traditionally, a piece of paper has been used to synchronize team members. If you had the piece of paper, it meant you were the one who had to work. However, since it would take a while before the paper arrived on your desk, getting the paper implied that you had to do a lot of work, and as soon as possible. It is much more efficient to let people work when they want and do as much work as they want.

For this reason, healthcare software should support a workflow process in which each member is empowered to have autonomy over tasks, but is able to get a sense of how many tasks need to be completed.

Each user may have drastically different work patterns. In the example above, clerks and technicians work on a daily schedule whereas the physicians may work on a weekly or an “every couple of days” schedule. Physicians are always getting interrupted and distracted, and so their schedules are usually more erratic.

An employee who is not able to do all of her work at once, for example, can do as much as she has time for and leave the rest for later. Even if doctors can only interpret results twice a week, for example, this does not block an assistant from forwarding the test results for the cases that are already interpreted. The assistant can do other work and then receive a notification from the system when the doctor has completed more cases.

Communication between healthcare professionals is largely asynchronous. This asynchronous user behavior needs be understood by developers so that the resulting application maps to the existing workflow process.