Jason Z. Rose, MHSA, is CEO of Stick to Healthan innovative technology company committed to transforming healthcare.
Let any business leader talk about a new IT initiative in their company and in the end the conversation will surely turn to the (generally correct) idea that technology alone cannot solve problems.
“It’s not just computers (or cloud resources, or mobile devices, or some new artificial intelligence algorithm),” they will say. “It’s about people, processes and technology. You need all three.”
The basic idea makes sense and it’s easy to see why such a simple slogan has taken root in the business world since the framework first emerged decades ago. But it’s always said in the same order: first the people, then the processes, and then the technology comes behind it. This impulse to emphasize the importance of people is understandable. But from a system design perspective, it’s all the other way around. And that can have disastrous consequences.
Actually, the framework should be “process, technology, people”. When business leaders tackle processes first, they are forced to carefully consider what outcomes they are trying to achieve and then plan what steps they need to take to achieve them. They can then determine which technologies best enable those processes. Finally, they can give their people clear instructions on how to use new technologies to follow the processes that will achieve the desired result.
This is just another way of saying that businesses should start with the end in mind. Ultimately, this kind of business design is better for employees because they know exactly what is expected of them and how to do their job the best they can. In addition, it will lead to people being placed in positions where they can work to the best of their ability, making them successful in their position.
In the clinical world this is called operating at the “top of the license”. That’s why, when you go to the doctor for a checkup, your primary care physician is usually not the person to check your heart rate or take your blood. Doctors are more than capable of performing these tasks — just as they are perfectly capable of scheduling appointments or cleaning the carpets in their waiting rooms — but that’s not why they went to medical school. Not every professional has skills or a credential as clear and obvious as that of physicians, but well-designed processes in all areas will similarly lead to employees working at their highest capacity.
When designing workflows at AdhereHealth, we always want to ensure that pharmacists spend their time conducting drug assessments, in other words, working on top of their license. This may sound like we start with ‘people’ when designing our workflows. But really, we need to get the processes and technology in order first. Only then can we be sure that our people can do their job as well as possible. For example, we wonder what our pharmacists need to do their job well. The answer, of course, is that they need patients. But where do the patients come from? Well, we need software and analytics to create a pipeline of patients to run the drug assessments on. Okay, but what exactly does the technology need? to do to support medication assessment† Ah. Now we have come to the process where we start designing our systems.
Organizations need to actually write down the steps of their business processes – not at the end of their design initiatives, but at the beginning. This ensures that processes are actually aligned with business goals rather than the habits or preferences of employees and software developers. By pre-identifying fundamentals such as “swim lanes” and handovers, organizations can create processes that not only meet business goals, but also let technologists and end users know exactly what to do.
When companies design good processes and take the time to write them down, they can design technologies to make those processes as effective and efficient as possible. Only then can company leaders determine how many and which employees should perform which tasks.
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