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Why does the healthcare industry has the lowest BPM maturity ?

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by Frank Luyckx in ARIS BPM Blog posted on 2010-05-23

Within my previous blog I have given an overview of the BPM maturity for each of the industry segments. Based on the input of more than 1000 maturity checks, the Healthcare segment seemed to have the lowest BPM maturity.

Figure : Overview of the BPM maturity across industry segment

To better understand what the consequences of this low BPM maturity are, we have performed additional analysis on the trends within the hospitals and several in-depth BPM maturity assessments within hospitals in the Netherlands.

 This BPM maturity analysis consisted out of the following steps:

  1. Identify the strategical trends within the hospitals
  2. Identify the related BPM projects within the hospitals
  3. Determine the average BPM maturity within the hospitals
  4. Evaluate the results of the BPM maturity assessments

 1          Indentify the strategical trends within the hospitals

The Roland Berger strategy group has identified the following trends within the hospitals:

  1. The patients should be able to compare the hospitals, therefore the general availability of the performance indicators and the quality indicators should be improved.
  2. The patients require medical treatments from different organisations like specialist, doctors, physiotherapy. Therefore the cooperation and alignment of these organisations is essential to make sure to deliver high quality care and cure for reasonable costs.
  3. The long term strategy and product portfolio of the hospitals should be clearly defined and based on the current (regulatory) requirements from the government  and insurance companies.
  4. The hospitals should make clear choices which treatments should be provided, in order to make sure the hospitals improve their profitability and logistical performance.
  5. The productivity of the hospitals should be improved to resolve the increasing demand for medical healthcare in the future. 

2          BPM projects within the hospitals within the Netherlands

Based on these trends, within many hospitals, the following BPM projects are initiated:

  1. Alignment of the medical pathways between the different departments, to clarify the cooperation between the different departments, to optimize the way of working.
  2. Integration of the medical pathways into the structure of the ERP, HIS (Hospital information System) and EPD (Electronic Patient Database) to ensure the alignment of departments and the configuration of the ICT systems.
  3. Alignment of the medical pathways with other healthcare organisations and the ICT integration within an accepted E-health platform.
  4. Integration of the medical pathways into standardized workflows and to set up a cost reporting system, to get better insight into the cost of every treatment.
  5. Alignment and rationalisation of the application portfolio required for the medical pathways and the elimination of the redundant applications.
  6. Improve the process performance of the medical pathways by defining the PPI (Process Performance Indicators) and by setting up a balanced score card reporting environment.
  7. Monthly monitoring of the risks and compliancy regulations to make sure that the hospital is prepared for the yearly healthcare audits. 

Figure : Healthcare processes across the different healthcare organisations


3          Results of the BPM maturity assessments within the hospitals

Many of these BPM projects do not deliver the expected results because the BPM issues, as identified by the in-depth BPM maturity assessments, have not been resolved. The Enterprise BPM Framework gives an overview of the most important BPM issues: 

Figure : Overview of the BPM issues within Hospitals

Many of the hospitals do not have a BPM governance organisation in place which can resolve the issues as identified by the BPM maturity assessment.

The awareness of the benefits of BPM is not clear and it is difficult to get the full commitment of the Central Management Team (CMT)


4          Evaluate the results of the BPM maturity assessment

The ICT managers / BPM process managers of many hospitals know that the BPM issues should be resolved first, but they do not have the required authority to resolve these issues.

The hospitals have a special organisation structure in which the employees (doctors) have a big influence on the decision making process within the CMT and the ICT/BPM strategy.

Figure : Doctors are driving the ICT & BPM standards  

The low BPM maturity level as indentified within several hospitals, indicates that the BPM decision process within the hospitals should be improved by the alignment of the demand (doctors) and supply (BPM/ICT) into a BPM change board.

Within this BPM change board the pro and cons of the BPM project decisions are elaborated and the knowledge of every participant is appreciated, so the optimal BPM project portfolio for the hospital is made and the priorities within the BPM roadmap can be agreed.

The BPM projects are necessary for the hospitals to make sure they are ready for the future and can survive in a world in which the profitability of the hospitals becomes more and more important. The enterprise BPM framework can help organisations to indentify the required BPM projects and create an effective BPM roadmap with the associated ROI.

As long as the CMT of the hospitals is not fully committed to support the BPM change board and install a fully authorized BPM governance organisation, the hospitals will have problems to efficiently complete the BPM projects and the healthcare segment will remain to have the lowest BPM maturity level in the market.

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Stefan Geis posted on 2010-05-27

Goedemorgen Frank,

I found your article very interesting, thank you! With some years in the defense and energy sector, I have absolute no background in the health care industry - apart from seeing one or the other emergency room as byproduct of mountainbiking ;-)

From my viewpoint as patient, I take the freedom to not care about BPM maturity levels. It would be interesting whether there is any correlation between the BPM maturity level and customer satisfaction. Did you gather such data as well? And if so, is there a correlation, and is it positive or negative? One reason for my question is that I remember a study by McKinsey on the performance of hospitals around the world where Germany was one of the top ranked nations, with major improvements over the last 10 years or so. KPIs studied were like "average time spend per patient with a given diagnosis" and etc. However, the public German opinion on health care in hospitals decreased considerably over the same time span. Which might correlate with other statistical data like the spread of MRSA virus.

From my experience in the industries above, and especially in SMBs, there are doctors (aka business experts with goals that are all but aligned with BPM) everywhere. To me, BPM based on tools like ARIS is a sort of craftsmanship at best. To bring about the organizational changes, to align corporate culture correspondingly is then the proof of mastery.

Best regards,


Frank Luyckx posted on 2010-05-28

Stefan, thanks for your positive feedback.

The BPM maturity levels measures the allignment of the business processes and the Enterprise Architecture within the organisation, towards the optimal delivery of the products and services to the customers. This automatically results in higher customer satisfation. Please review my previous blogs about the relationship between the maturity level and ROI and some of the reference cases allready published by IDS Scheer. 

The BPM issues as identified within this study are valid within almost all industry segments where the doctors can be replaced by departemental managers or other stakeholders.

Business Process Management is not only the utilization of ARIS, but also the implementation of a BPM project portfolio to improve the allignment within organisations (again see my previous blogs). ARIS can be the glue between the different projects to make that the project deliverables are reused.

I completely agree that the mastery is to bring the organisational changes, hopefully the awareness of the BPM issues will help to change the corporate culture.