The provision of quality hospital services is a direct function of executing the suitable Healthcare Processes (H/P) in a most efficient manner. H/P are a series of activities aimed to diagnose, treat and prevent any diseases in order to improve a patient’s health and are supported by clinical and non-clinical activities, executed by different types of resources (physicians, nurses, technical specialists, dentists, pharmacists, clerks).

The main goal for H/P improvement is the high impact on patients life quality, but also the need to reduce the cost of services, improve capabilities in order to meet demand, reduce patient’s waiting times, improve resources productivity, and increase processes transparency.

While the analysis of both clinical and administrative processes can be useful in meeting these objectives, wee need to keep in mind that H/P are highly dynamic, complex, ad-hoc, and increasingly multidisciplinary, making their analysis and improvement more of a challenge.

In the past, different strategies were used to analyze hospital processes, including among others Business Process Redesign, Evidence Based Medicine, and Lean.

Process Mining (PM) is a relatively young research discipline, developed in the past 10 years into a leading technology by Celonis. PM focuses on extracting knowledge from data generated and stored in the databases of (healthcare, hospital, patient, etc.) information systems in order to build event logs that today, with intelligent process analytics involving AI and ML can be used to analyze and improve the real-time, executed processes.

Supported by various case studies with promising results in the healthcare domain, PM is an emerging tool for improving sustainable healthcare processes, aiming for process-aware Hospital Information Systems. The application of PM in healthcare allows health experts to understand the actual execution of processes: discovering process models, checking conformance with medical guidelines, and finding improvement opportunities.

Normally, any activity executed in a hospital by a physician, nurse, technician or any other hospital resource to give care to a patient is stored in a HIS (compound of databases, systems, protocols, events, etc.). Activities are recorded in event logs for support, control and further analysis. Process models are created to specify the order in which different health workers are supposed to perform their activities within a given process, or to analyze critically the process design.

Celonis EMS, powered by Celonis Process Mining and Process Intelligence, enables hospitals, clinics and other healthcare providers to discover understand and manage business process execution more effectively. It does this with end-to-end process visualization, patient journey visibility, intelligent document processing, greater efficiency, compliance risk management, continuous improvement, and cost reduction.

Healthcare providers can use process mining to improve processes across a wide range of applications, including those outlined below.

1. Billing and revenue cycle management
According to the American Hospital Financial Association, more than $576 billion in hospital bills have gone uncompensated, since 2000. This is partly due to the complexity of billing and collection processes, which requires a huge amount of time to recover payments using manual methods.
Using data that is already contained within healthcare systems, providers can build end-to-end digital models of their day-to-day processes and uncover opportunities for improvement. Ways to improve include automating debt collection, reducing bad debts, or carrying out continuous monitoring of patient treatments to reduce complaints and maximize revenues.

2. Emergency Departments
In many developed nations, the average time taken to process a patient who arrives in the emergency department was over three hours, growing as we speak. This is stressful experience for everyone concerned. Each patient must be triaged, admitted if care needs to be given, assigned to the relevant healthcare professional, scheduled for X-rays or scans, and either given a hospital bed or discharged.
Providers can use process mining to build a comprehensive, realistic model of processes that includes variations and exceptions. This means providers can predict and prepare for busy times, reduce door-to-doctor time and eliminate the need to re-enter patient data for different processes.

3. Care Delivery
As the world becomes more consumer-orientated, patients expect more from their healthcare providers. Whether this means enabling a digital front door to services, offering more tailored correspondence, or just getting more out of their interactions with clinicians, patients want information at their fingertips and services on demand.
With process mining, providers can visualize patient experience from beginning to end, and then introduce new or improved channels. These could include self-service portals or self-check-in kiosks, or better referrals, claims and diagnostics processes expedited by digital workers.

4. Patient Pathways
Standard patient pathways, whether through treatment programs or particular conditions, can be seen to be too rigid and formulaic, meeting administrative and operational needs rather than patients’ personal biological requirements. With process mining, providers can examine data sources to identify and explore common variants in how pathways are followed.
For example, providers can see where there have been side effects to a treatment plan according to age, gender or other variable, which will help to prevent the same problems happening in the future. Process mining can also be used to check that all of the steps built into a patient pathway have been followed, and what the consequences of missed stages in a pathway can be.

5. Integrated Care
Population health management and integrated care are increasing in international significance, and for good reason. The pandemic has demonstrated the importance of working together with other public services and sharing responsibility for people’s welfare and health outcomes.
Technology is widely seen as playing a critical role in the development of integrated care systems, helping to bring together disparate systems, processes and people. Process mining enables all parties in an integrated care system to identify where these are working well together, or where improvements need to be made.
Using Celonis EMS intelligent automation, healthcare organizations have access to a software platform that can automate any business process, interacting with line-of-business applications run by all parties.

More details on PM upon request