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Gaston Gives BPM A Healthy Diagnosis

What began as an effort to automate HR procedures has morphed into a widening business process management initiative touching wide-ranging work at Gaston Memorial Hospital.
Gaston Memorial Hospital is slashing the time involved in handling myriad tasks -- from addressing patient complaints to tracking charges -- thanks to an aggressively growing business process management initiative it began less than a year ago.

"It pushes things through the building more quickly," said Gaston Memorial systems analyst Tom Parnelle. "Before, if we got a complaint, it might end up on somebody’s desk and nobody would know it was there."

Gaston, a general and acute care facility west of Charlotte, N.C., is currently programming its patient compliance processes into a new BPM application, called e-Work, from Metastorm. Complaints made to hospital staff -- about food, for instance -- are entered into the system and routed to the appropriate hospital manager to correct the problem. The system also notifies the hospital’s public affairs office, which follows up with managers on corrections.

Gaston took the application live in August 2003, starting with the human resources department. "HR was first. It’s more visible, the quickest return on your investment," Parnelle said. "More people can touch it."

Since then the hospital has begun using the application to manage more processes, from tracking charges and reporting incidents like patients’ adverse drug effects to making investigations into deaths.

E-Work includes a component called Process Designer that lets non-IT users model workflow through a graphical, drag-and-drop interface. IT models workflow in the software itself using the same design interface, and carries out any necessary database integration work.

The software alerts hospital personnel via e-mail when the system determines it’s time for them to take action related to completing a certain process. Users can access the flow of events related to ongoing issues via the hospital intranet, which queries a SQL server that tracks process data. The e-Work software resides on the hospital’s Microsoft IIS Web server. The work processes that flow through e-Work now depended on intra-office mail and direct verbal instruction before.

Users who want to print reports related to issues in the system get information using Microsoft Access, which draws information from the database using an ODBC interface. Gaston’s Performance Improvement staff, a non-IT group charged with streamlining hospital processes and handing them to IT for entry into Metastorm, can access higher, more cumulative levels of data through Access.

Gaston Memorial’s Performance Improvement group -- whose job Parnelle likened to industrial engineering -- models new processes on paper and then works with IT to role-play them. Performance Improvement, IT and the people who will use the new procedure, such as nurses or care coordinators, sit at PCs and test the process as it’s been coded by IT. Parnelle’s technology staff takes suggested changes, and the hospital launches a limited pilot on the new process. If needed, IT will train personnel in the new process.

Training on new processes has become less necessary as hospital staff have become accustomed to the system, Parnelle said. He added that employees’ desire to automate more business processes is increasing as well.

"At first, people were like, 'Oh no, something new.' Now they're saying, 'We need Tom to write us a workflow,'" Parnelle said. "It became intuitive for them."

Gaston has yet to carry out a cost analysis on the Metastorm application. Parnelle said the hospital has drastically cut its use of paper and intra-office mail. More significant at this point is the time savings the application has enabled. A new job posting, for example, might have required three to five managerial approvals that passed from hand to hand via intra-company mail prior to the e-Work deployment.

"It could have taken weeks" or gotten lost, Parnelle said. But he’s seen that change first-hand. "We sat and watched one go through in seven minutes one day."

Metastorm charges customers based on a combined user, server and application structure. A license that would support 250 users typically runs about $100,000, said Metastorm director of product marketing Laura Mooney. Annual maintenance is 18%.