Business Process Management - The methods, techniques and tools to design, enact, control and analyze operational business processes involving humans, organizations, applications, documents and other sources of information.

Solution Implementer: Geisinger Health System

Solution Provider: TIBCO Software, Inc.

Business Pain

Geisinger Health System is a physician-led health care system in central and northeastern Pennsylvania dedicated to health care, education, research and service spanning 40 counties, 20,000 square miles and serving 2.5 million people. Given the increasing volume and critical nature of the health care documents associated with serving a population of more than two million, information managers at Geisinger Health System knew they needed to upgrade their document storage and retrieval system. The goal was to build an enterprise-level system that would enable Geisinger to keep pace with the inflow of documents and make them available within 48 hours of receipt to physicians and other staff at any of the company’s approximately 50 clinics. In addition, Geisinger saw an opportunity to improve workflow in the health insurance component of its HMO customer service unit as well as the turnaround time in its accounts payable department.

To meet the goals outlined above and bring greater efficiency to clinical, business and financial processes across its organization, Geisinger has implemented TIBCO’s iProcess Suite, a comprehensive business process management (BPM) solution. Five key business imperatives drove the initiation of this project:

  1. HIPAA compliance - ensure process consistency, transparency and availability of records across systems, sites and departments.
  2. Patient safety - automate and streamline the processing of patient information so that the most up-to-date records are available to physicians and patients. 
  3. Improve customer satisfaction - improve turnaround time on customer service and support provided to Geisinger’s HMO plan members.
  4. Reduce costs - cut administrative costs resulting from manual, paper-based processes and reduce turnaround time on accounts payable procedures to capitalize on vendor discounts for on-time/early payment.
  5. Improve efficiency - through streamlined, consistent, automated processes.

Successful Solution

TIBCO iProcess Suite is a proven and comprehensive business process management (BPM) software solution that can be seamlessly introduced into an existing IT infrastructure. With a suite of application modules built on an open architecture, iProcess Suite is designed to provide a complete end-to-end process management solution that allows organizations to create an IT infrastructure that is based on their unique way of doing business. By leveraging TIBCO iProcess Suite to execute processes quickly, accurately and in a manner that can be easily audited and tracked, Geisinger is greatly improving performance in three areas:

  1. Clinical document management. Ensuring that health records and relevant clinical documents are up to date and readily available to patients and their physicians is critical to both patient safety and to complying with regulatory requirements such as HIPAA. TIBCO iProcess Suite is enabling Geisinger to automate and streamline the processing of patient information, greatly reducing administrative time involved and improving real-time access to this information across the organization.
  2. Customer service/support for Geisinger Heath Plan members. Geisinger’s managed care insurance operation wanted to improve turnaround time on resolving member contacts related to billing and claims issues. TIBCO iProcess Suite was used to simplify and automate a complex, multitiered process that spanned multiple lines of business, numerous stakeholders (including external regulatory agencies such as Medicare and DOH), and a diverse customer base.
  3. Accounts payable. TIBCO iProcess Suite was deployed to transform a 100 percent manual, paper-based invoice posting process into a 100 percent automated, virtually paper-free operation. The reduction in turnaround time on invoice processing has not only slashed administrative hours, it has also helped Geisinger to take advantage of vendor discounts offered in exchange for prompt payment of invoices.

The solution was installed in Q1, 2006 and implementation was complete within three months across the accounts payable and customer service processes and within six months for clinical document management.
Innovation

The imperatives listed in question 1 are typical concerns for many health care providers. What is also typical, and what Geisinger wanted to avoid, is a tendency for health organizations to address these issues with specialized point solutions or customized, homegrown approaches. Geisinger Health System serves patients via approximately 50 clinics and three major hospitals. As a result, patient information, technology systems and personnel are highly distributed. Geisinger wanted to implement a single solution that could be used to improve processes across specialties, departments, lines of business, systems and geographic locations - a solution that they found in the TIBCO iProcess Suite. Specifically, three key elements stood out:

  1. Enterprise-level solution: Unlike point solutions that may be hardwired to address one specific process area (like records management) but not another, TIBCO iProcess Suite is an enterprise-level solution that can be applied across functional areas, systems and organizational departments. Geisinger has been able to take advantage of the solution’s powerful process automation capabilities within their clinical, insurance and financial operations and easily sees the value it can bring to a wide variety of scenarios. In fact, the organization plans to apply the solution to 11 more systems in the next 12 months.
  2. Highly flexible/adaptable: In a real-time environment such as health care, it is important for organizations to be able to quickly adapt to changing conditions, 24x7x365. TIBCO iProcess Suite components such as the iProcess Modeler, iProcess Decisions rules engine and iProcess Engine execution engine enable users to easily model, analyze, test and create business rules and execute and modify processes without having to rely on IT help. The solution facilitates fast process design, redesign and reuse and additionally leverages service-oriented architecture (SOA) for quick development and deployment of new applications and processes.
  3. Independent process layer: Recognizing that a variety of systems may be involved in any one process, TIBCO’s iProcess Suite separates the management of processes into an independent process layer that operates across applications, people and organizational departments. By providing an independent environment for creating and continuously improving processes, the solution allows more value to be extracted from existing investments, so that Geisinger can leverage a range of systems and applications - including enterprise content management, financial systems, and document imaging software - to drive cross-enterprise process excellence.

Because TIBCO iProcess Suite is built on an open architecture, Geisinger found that it was easy to implement the solution and leverage its existing infrastructure to integrate cross-enterprise processes. TIBCO’s iProcess Modeler also gave Geisinger the ability to easily define the flow of complex processes involving multiple applications. The resulting processes were thus 100 percent customized to meet the unique challenges that Geisinger needed to address.
Quantitative Results

Clinical document management. By using TIBCO iProcess Suite as a foundation to build an enterprise-wide document imaging management system (DIMS), Geisinger moved from a 100 percent manual to 100 percent automated document management process. Before automating the steps spanning document intake, scanning, storage and distribution of patient information in digital form, the company used a manual system, which had accumulated a 15 million-page backlog of hard-copy documents. Today, all medical documents are scanned and made available in the electronic medical record within 48 hours. This type of real-time access to information is critical to patient safety - patient information such as CT scans, X-rays and ultrasounds can now be pinpointed and retrieved instantly, no matter where the information is as it flows through the many systems that need to “touch” it. With centralized document management in place, Geisinger has estimated cost avoidance savings (due to reduced liability costs stemming from an improved ability to locate supporting documentation) of approximately $200,000 in year one and $1.2 million in year two and going forward.

Customer service/support for Geisinger Health Plan members. With TIBCO iProcess Suite in place, Geisinger has been able to completely automate previously manual processes involving multiple stakeholders, lines of business and urgency levels (there are three levels of appeal open to customers, Level 1, Level 2 and Level 3, each of which is associated with a unique, corresponding process.) Case appeals processing time has been reduced by 67 percent, from 24 hours to just eight. This has resulted in administrative savings as well as an increase in customer satisfaction due to the fact that Geisinger is consistently resolving issues experienced by plan members more quickly and efficiently.

Accounts payable. Prior to implementing TIBCO iProcess Suite, Geisinger’s invoice posting process which covered the multiple, manual steps involved in receiving and preparing an invoice for payment, required an average of 12 to13 days per invoice. Personnel needed to open mail, sort the invoices by hand and manually enter the invoice into the appropriate financial system. Today, Geisinger has moved to a completely paperless process, where sorting, data entry, posting and all other related tasks are automated. When invoices arrive, they are now immediately scanned and automatically captured within iProcess Suite. Within several weeks of going live with the solution, Geisinger was able to reduce accounts payable processing time by 86 percent, slashing turnaround time to less than two days. This has not only greatly reduced the administrative hours required to process invoices, but has also enabled Geisinger to achieve a perfect record of early payments to suppliers and fully exploit vendor discounts offered as a result. Geisinger is anticipating savings of approximately $400,000+ per year on early payment discounts from vendors.

Qualitative Results

  • Patient documentation is available in real time, reducing the potential for medical errors and enabling better quality care.
  • Customer satisfaction has improved due to the fact that Geisinger is consistently resolving issues experienced by HMO plan members more quickly and efficiently.
  • Employees across the organization are more efficient as they no longer need to spend as much time on manual data entry and other repetitive tasks - leaving time for them to focus on higher value activities.
  • Greater process transparency and auditing capabilities make it easier for Geisinger to address compliance requirements such as HIPAA.

Sustainability

As mentioned, in a real-time environment such as health care, it is important for organizations to be able to quickly adapt to changing conditions, 24x7x365. TIBCO iProcess Suite components such as the iProcess Modeler, iProcess Decisions rules engine and iProcess Engine execution engine enable users to easily model, analyze, test and create business rules and execute and modify processes without having to rely on IT help. The solution facilitates fast process design, redesign and reuse and additionally leverages SOA for quick development and deployment of new applications and processes.

In addition, because iProcess Suite is built on an open architecture, it is easy to integrate with other systems and applications central to cross-enterprise processes, thus delivering long-term value that builds on existing technology investments.

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