During a recent project engagement, my client stressed his observation that physicians often have unique expectations associated with process flow. Of the examples shared, one worth noting was associated with a frequent physician need to minimize the time needed to search for patient records. While practitioners of the five steps of the Six Sigma process, DMAIC, might view this as a typical cycle time problem, the situation here has a bit of a twist in the sense that total cycle time of the process flow for patient record search was not the concern. The concern that my client communicated was solely focused on the time needed by the physician themselves to perform this particular process activity.
This seemingly simple observation had important implications when planning to automate the patient record search process. Refer to the left diagram below, an abbreviated swim lane diagram that depicts this process. While this diagram shows the manual request and search for a patient record, the automated version of this process, depicted in the right diagram, involves the same steps save the need for an office worker to search through paper records. The hypothetical office worker search time, here shown as 20 minutes (a figure presented by my client as a realistic example), was not seen as a frequent physician concern, since requests are made, the physician goes about their business rather than waiting, and results are received as if this process followed the dotted line of the diagram.
Now observe the automation of this process that was provided by the e-Health portal we implemented for this client. All of the same essential process steps remain, but other than reduction in cycle time, there is no longer a dotted line from request search to receive result since it is now the physician themselves performing the search process, albeit via the e-Health portal. While the architectural quality of performance is the focus here, the value ladder in this scenario also leads to cost implications. In the first scenario, additional costs not associated with direct patient treatment are involved. In the second scenario, additional costs are essentially eliminated since patient record search cycle time is extremely low and patient treatment is virtually uninterrupted, minimizing any significant opportunity cost.