Delivering Integrated and Standardized Health Services with BPM in Healthcare


Key takeaways

  • Business process management is a holistic approach that organizations can adopt to make improvements across process operations.
  • Healthcare is a process-driven industry, and BPM in healthcare plays a crucial role in improving process efficiencies. 
  • Streamlining healthcare workflows helps management make improvements in efficiency, productivity, and profitability.
  • BPM can help healthcare organizations understand and differentiate between the value-creating flow of work and non-value-creating activities.
  • BPM-based workflow automation solutions like Cflow enable healthcare organizations to streamline their workflows and standardize healthcare processes.

What is BPM in Healthcare?

Business process management is a holistic approach that organizations can adopt to make improvements across process operations. BPM is an organization-wide change that uses workflow automation to simplify and streamline processes.

The focus of BPM is to make improvements across the organization rather than a specific area. When BPM methodologies are applied to business processes operational efficiency is significantly improved and processes are aligned with the overall business objectives. BPM objectives are achieved by using workflow automation software like Cflow.

Healthcare is a process-driven industry, and BPM in healthcare plays a crucial role in improving process efficiencies. Adopting BPM in healthcare can help healthcare organizations take advantage of data, respond proactively to changes in the industry, reduce errors, and streamline processes to provide higher levels of patient care.

Several BPM healthcare case studies have shown that BPM practices enable organizations to remain compliant with federal and state regulations and requirements, such as specific data formats and real-time integration.

Through BPM healthcare insurers and healthcare providers can help structure how information, systems, and people interact. Meeting important process deadlines, earning incentive payments, and working towards continuously improving efficiency, are the capabilities that BPM brings to healthcare organizations.

Table of Contents

Challenges in Healthcare Industry

Industry consolidation, increasing pharmaceutical costs, increasing;y better-informed customers, and evolving regulations – are just some of the challenges that are swarming the healthcare industry. Healthcare organizations are constantly under a threat to increase operational efficiency.

To meet the rising expectations for quality of patient care, healthcare providers need new models of care that emphasize care coordination and delivery. Added to this, new payment methods need to be adopted in order to stay aligned with regulatory norms and digitization.

Audits and surveys conducted in the healthcare sector have identified the following primary challenges in this industry – complexity of regulations, emerging technology, cost pressures, evolving patient expectations, and industry consolidation.

Here are some of the challenges faced by the healthcare sector:

➤ Internal and external pressures to do more with less
➤ Declining Medicaid and Medicare reimbursements
➤ Changes in reimbursement policies
➤ Need for better performance management systems and system reengineering
➤ Need for more reliable efficiency metrics for care providers and hospitals
➤ Need to promote and utilize cost-effectiveness research
➤ Need for effective clinical integration policies

The major impediments to change in the healthcare sector are mostly internal factors like process workflows. Healthcare providers are stuck to a traditional functional mindset, which prevents them from adopting new work methodologies. Outdated or ineffective IT infrastructure in the health sector prevents them from delivering quality healthcare.

One of the most effective ways of addressing traditional mindset issues is to gain clarity on how work flows across various departments and areas of medical specialization. Once workflows in healthcare are mapped, it becomes easy to identify areas of improvement to create value for patients and customers.

This is where business process management (BPM) comes into play. BPM methodologies like workflow automation help improve business outcomes in the healthcare sector.

Healthcare Workflows at a Glance

Streamlining healthcare workflows helps management make improvements in efficiency, productivity, and profitability. Healthcare workflow management aims at fine-tuning hospital workflows to remove redundancies that eat up hospital resources, delay the provision of medical care, and slow patients throughout. Effective workflow management has been shown to reduce the potential for medical errors, ensure compliance with industry regulations like HIPAA, and improve the quality of care provided to patients.

Some of the healthcare workflows that are prime for automation are listed below:

1. Health Information Management

Health information management (HIM) is a set of practices that organize medical data so that it can be used for enhancing the quality of healthcare. HIM systems are made up of 5 functional areas – data capture, data analysis, information dissemination, health information resource management and innovation, and health information governance and stewardship. Form requests and approvals, medical chart requests, pharmacy recall notices, and pharmacy drug testing, are some of the tasks that can be automated within health information systems.

2. Patient admissions and discharge approvals

In healthcare institutions and hospitals, a number of patients move in and out on any given day. Patient admission and discharge processes are often stuck with unnecessary delays, waiting for the right doctor to receive and review the paperwork and sign off an admission or discharge. Automating the review and approval process saves a lot of time, and improves the patient experience.

3. Medication allocation

Errors in allocating medication are an all too common issue at hospitals across the globe. These errors may be caused by handwritten errors or due to the sheer volume of medication that needs to be allocated.

4. Medical documentation

Maintaining and updating patient medical records is very important in healthcare. Every doctor that treats a patient needs to have an updated record of treatment and medication given so far so that nothing is missed out and the health disorder is treated the right way.

5. Hospital facility management

The building maintenance and facilities are in charge of managing everything from building security access to fixing HVAC issues to maintaining cleanliness and hygiene. These requests need to be handled in a centralized and consistent manner, which allows staff to track the progress of facilities maintenance requests.

Creating value with BPM

How does BPM create value in healthcare?

BPM can help healthcare organizations to understand and differentiate between the value-creating flow of work and non-value-creating activities. Process-based change requires a complete understanding of the business landscape. By examining the organization in a process-based context, management derives inputs on process areas that need to be improved throughout the organization.

A high-level process model for healthcare stimulates dialogue on the cross-functional business processes that create value for the organization. Once healthcare organizations recognize the need to take a process-based view of the organization’s progress, BPM can step in to help them, model, analyze, redesign, and automate key business processes.

Document management is among the most labor-intensive healthcare processes that can be streamlined and simplified with BPM solutions. Using BPM solutions, healthcare organizations can do away with outdated paper forms and adopt online systems for recording and processing data.

Other key healthcare processes like new patient onboarding, medical records management, patient release, and medicine allocation, can be performed more quickly and efficiently by adopting BPM methods. Adopting BPM in healthcare improves response time and patient satisfaction significantly.

Another key area where BPM adds value in healthcare is regulatory compliance and risk management. BPM can be instrumental in assuring compliance with ever-changing regulatory policies. Compliance with operational processes with HIPAA regulations is mandatory for all healthcare organizations.

It is also essential that healthcare professionals follow procedures mandated by HIPAA regulations. Given the degree of consolidation in the healthcare sector, it is all the more important that divergent information technologies need to be aligned with the overall organizational goal. This is one of the areas that BPM can support in healthcare.

BPM can drive Big Pharma clinical trials and be useful in streamlining FDA approval of new medications. In general, these processes are weighed down by regulatory policies. Bringing BPM into the picture helps improve the processes such as patient enrolment at hospitals. BPM can be used to manage processes and data across a broad range of patient care issues.

The main areas where BPM can add value in healthcare are:

➤ Automate non-value add tasks and eliminate non-value-added ones
➤ Monitor and improve care delivery
➤ Automate the identification of critical conditions using analytics
➤ Identify and avert resource contentions
➤ Monitor cost, quality, and compliance metrics

BPM can help deliver more consistent and relevant patient care. When BPM is at the core of a healthcare organization’s approach to business, it allows people, systems, and information to interact with greater consistency. Applying BPM can change the way the business of healthcare is accomplished, with less waste and more cost savings.

BPM is recognized as a major trend in technology and leading healthcare organizations are looking to use BPM to improve operational efficiency.

BPM helps healthcare organizations in the following ways:

➤ Centralize and simplify business operations
➤ Provide a single portal for all employee requests and self-service
➤ Manage capital and operational expenditure processes
➤ Standardize the employee onboarding process
➤ Streamline incident reporting
➤ Ensure a compliant vendor approval process
➤ Handle incident management
➤ Reduce product cycles
➤ Improve internal audit controls

The BPM approach has been extensively used in the healthcare industry through continuous improvement, TQM, six sigma, business process reengineering, and benchmarking. The main focus of BPM in healthcare is to improve the quality of healthcare delivery.

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How Modern Clinical Communication Platforms Help Improve Healthcare Workflows

Improving communication is vital in healthcare workflow management. BPM platforms can play a significant role in improving communication in healthcare workflows. The use of outdated communication systems affects the quality of healthcare delivered at hospitals.

Modern clinical communication platforms can be accessed from multiple devices like smartphones, tablets, laptops, and desktops, from anywhere. BPM-based healthcare workflows also support text, video, and voice calls for instant connectivity between healthcare providers and patients.

The use of BPM-based systems in healthcare boost staff morale, faster patient throughput, fewer medical errors, and improvement in patient satisfaction scores and patient engagement.

Key Healthcare Workflows for Automation

Most healthcare workflows are labor-intensive and tedious. Even a minor error in healthcare workflows can disrupt patient services. BPM solutions can fine-tune healthcare workflow management to make improvements in efficiency, productivity, and profitability in healthcare. Automated workflow processes provide better internal controls, improve compliance, and enable businesses to gain a competitive edge by reducing work cycles and overhead. BPM-based workflow automation solutions like Cflow enable healthcare organizations to streamline their workflows and standardize healthcare processes.

We have listed popular healthcare workflows that can be automated for improving efficiency and productivity.

Patient Admissions and Discharge Approvals

Efficient management of patient admissions and discharge is important for hospitals. Admissions and discharge processes involve recording, reviewing, and approval of patient information. The crucial factor in patient admissions and discharge is timely approval. Inefficient approval processes result in patients waiting endlessly for the right personnel to approve their admission or discharge.

Automating the review and approval steps in the patient admission and discharge process enables real-time approvals. Workflow automation that is available as mobile apps can be used by doctors to approve patient requests on the go. Automation brings about standardization in admission and discharge approvals and eliminates the scope for errors and fraud.

Hospital Facilities Management

The building maintenance and facilities team at the hospital is tasked with everything from managing to build security access to maintaining hygiene across the hospital to fixing HVAC issues. Handling such large volumes of requests requires a centralized and standardized system. Automation of hospital facilities management enables efficient management of operations and allows staff to track the progress of facilities management requests via a centralized, intuitive portal.

Allocating Medicines

Wrongly allocated medicines due to human overlook is an all-too-common issue at hospitals around the world. Wrong medicine allocation could be due to errors in manually written notes or just dealing with the sheer volume of requests that come with manual processes. Automating medicine allocation minimizes errors in medicine allocation.

Physicians can select the right medication digitally so that everyone in the workflow is clear about the medication and there is a clear audit of who has seen and approved the medication. Digitizing medicine allocation ensures that the right medication reaches the right patient in a timely manner.

Running Patient Surveys

There is more to healthcare than just surgeries and allocating medicine, conducting patient surveys helps healthcare providers assess their core offerings. In addition to patient care, healthcare organizations offer extra amenities, top-notch housekeeping, bedside manners, and courteous staff behavior.

How does the organization rate itself on these facilities and amenities?

Patient surveys are the best way of ascertaining that patient services provided at the healthcare organization were satisfactory. When these surveys are done in the traditional way, they do not evoke satisfactory responses nor do they have a wide reach. When these surveys are run through a healthcare workflow management system, they ensure that a proper survey is carried out at the appropriate time. The data collected through these surveys is directed to the right person who can take corrective action or improve the process.

Medical Documentation

Updating and maintaining medical records is the most important part of healthcare. Very few healthcare organizations have medical records that are updated by every doctor who treats the patient. Adequate and accurate medical documentation is a struggle to achieve.

Automation of documentation will mean that medical records are consistently updated every time the patient is treated by doctors. Coupling this system with a cloud database ensures that all your files are safe and accessible from anywhere, at any time you need them.

Patient Admission

Patient admission is a cumbersome process that requires patients to go from desk to desk to fill out a zillion forms. Manual patient admissions add to the mental and physical pain that the patient is already in.

Automating the process saves time for the hospital by speeding up patient onboarding. The medical staff can spend less time on mundane activities in the admission process and more time attending to the patient. The overall patient experience is also greatly improved by automating patient admissions. The overall hospital operations are also streamlined by automating the admission process.

Claims and Bill Processing

Claims processing is a complex task that involves compliance and reporting tasks and requires a smooth flow of information. BPM technology simplifies claim processing by streamlining each associated activity.

Claims and patient appeals can be closely monitored and resolved quickly with a BPM system. Healthcare billing departments are often buzzing with chaotic activities. Generating a single invoice requires coordination with multiple internal departments.

Other healthcare workflows that can be automated via BPM platforms include vendor qualification, capital and operational expenditure requests, cyber security incident reporting, new product evaluation, health information management (HIM), human resources, and information technology.


BPM in healthcare is instrumental in streamlining healthcare workflows so that the potential for medical errors is significantly reduced and compliance with industry standards can be improved. A BPM workflow automation software like Cflow can automate key healthcare workflows within minutes. The document management system in Cflow allows users to scan, store, and manage documents easily. To explore more intuitive features of Cflow, sign up for the free demo today.

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