The Role of Process Mining in the Healthcare Industry with Example & Use Cases

02 Nov The Role of Process Mining in the Healthcare Industry with Example & Use Cases

Process mining in healthcare entails employing process mining technology to clinical processes, focusing on identifying areas and methods for implementing quality improvement strategies aligned with healthcare requirements. Healthcare processes encompass diagnosis, treatment, and disease prevention, all aimed at improving patient well-being. It serves as a valuable tool for healthcare practitioners, facilitating comprehensive comprehension and analysis of these processes, ultimately enhancing overall process efficiency.

Process Mining empowers healthcare institutions to better understand their operations and pinpoint areas ripe for enhancement. Consequently, healthcare providers can improve the quality of patient care, curtail expenses, and elevate results by scrutinizing process-related data, including patient records and clinical procedures. This analytical approach also serves to comply with regulatory mandates and the preservation of patient care quality and safety.

Role of Process Mining in Healthcare

The role of process mining in healthcare has emerged as a transformative approach to enhancing patient care, operational efficiency, and data-driven decision-making. Process mining, rooted in data analytics and process optimization, offers healthcare organizations the tools to gain profound insights into their internal processes and patient pathways, thereby identifying opportunities for improvement.

One critical application of process mining in healthcare is optimizing patient flow. Emergency departments and hospitals frequently face challenges in managing patient flow efficiently, which can lead to overcrowding, delays, and potentially adverse health outcomes.

By using process mining techniques, healthcare providers can visualize, analyze, and identify bottlenecks and inefficiencies in the patient flow. This analysis can enhance resource allocation, reduce waiting times, and enhance patient care.

Moreover, process mining in healthcare industry helps in improving billing and revenue cycle management. By automating debt collection and monitoring patient treatments, healthcare organizations can reduce bad debts, increase revenue, and enhance financial stability.

Process mining also plays a pivotal role in ensuring that healthcare providers adhere to regulatory requirements and maintain the highest standards of patient care, ultimately improving patient outcomes.

How is Process Mining Used in Healthcare?

For Process Mining in healthcare to function effectively, it necessitates access to data detailing how healthcare processes operate. Fortunately, the healthcare industry has abundant data resources, spanning patient health records, monitoring data, appointment scheduling systems, and financial plans.

However, the primary challenge lies in organizing and managing this vast trove of data.

Process Mining Tools offer the capability to illuminate the inner workings of business processes, pinpoint bottlenecks often arising from manual inputs, assess the efficiency of automation, and reveal areas mature for automation. Healthcare Information Technology (IT) applications, encompassing Electronic Health Records (EHR), Enterprise Resource Planning (ERP), and Laboratory Information Management Systems (LIMS), can be rapidly dissected, integrated, and digitally reconstructed.

This enables healthcare organizations to visualize patient check-ins, initial assessments and diagnoses, treatment, medication management, ongoing care, billing, and more.

Furthermore, process mining serves as a tool for identifying the reasons behind variations in process duration. Healthcare providers can scrutinize the time lapses between two consecutive care events, enabling comparisons between different departments, regions, or individual employees.

From a cost management perspective, providers can pinpoint specific incident types that extend the time and expenses incurred during the patient care process and take appropriate measures.

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Characteristics and Challenges in Process Mining

Data Maturity and Collection Challenges:

While private sectors often have well-defined process workflows stored as log data with timestamps in IT systems, healthcare organizations may lack this level of data organization. Electronic patient records are available but may not be structured to capture individual activities with timestamps, necessitating significant data preparation and expertise.

Data in healthcare settings can be sourced from various origins, including separate spreadsheets, which must be linked to specific pathways or referrals before applying process mining in healthcare analytics.

Data Privacy Concerns:

For actionable insights, organizations need to pinpoint individual patients, residents, or patient cohorts. This requires obtaining additional approvals to use datasets containing identifiable individual information.

Data Analysis Competency Shortages:

Healthcare and community organizations often lack the routine expertise to conduct data interrogations for identifying actionable insights. Analytics capabilities within these institutions are frequently understaffed, with limited opportunities to invest in testing and adopting new tools and techniques.

Benefits of Process Mining in Healthcare

Process mining provides healthcare employees with valuable insights into their workflows, enabling them to optimize their work and enhance patient care’s safety, quality, and efficiency.

Here are the benefits of process mining in healthcare:

• Enhanced Operational Efficiency: Through the analysis of process data, process mining can pinpoint bottlenecks and inefficiencies within healthcare workflows, empowering employees to streamline their tasks and enhance workflow efficiency.
• Workload Reduction: Process mining identifies automation possibilities that can help healthcare professionals reduce their workload, enabling them to concentrate on more essential and value-added responsibilities.
• Improved Patient Safety: Healthcare employees can utilize process mining to identify areas for enhancement in patient safety, reducing medical errors and adverse events.
• Elevated Quality of Patient Care: By optimizing healthcare procedures, process mining assists healthcare staff in delivering higher-quality care, ultimately enhancing patient outcomes.
• Informed Decision-Making: Process mining equips healthcare workers with data-driven insights into their workflows, enabling them to make more informed decisions and take proactive measures to enhance performance.
• Increased Productivity: Automating repetitive and time-consuming tasks by healthcare professionals increases productivity, allowing them to allocate more time to critical responsibilities.

Process Mining in Healthcare Examples

Here are the real-life instances where process mining revolutionizes healthcare operations. In one scenario, it tackles surgery punctuality, unveiling hidden inefficiencies. In contrast, it optimizes emergency room processes, enhancing patient experiences and operational efficiency.

These process mining in healthcare examples showcase the transformative potential of process mining in the healthcare sector.

Surgery Punctuality:

In a healthcare scenario, a surgery manager grapples with recurrent delays in surgery punctuality. Patients faced issues being transported to the operating room, and the source of the problem was unclear. Accusations were exchanged between doctors, the transportation service provider, and station staff. The surgery manager suspected the surgery teams might also contribute to the problem.

To solve this, process Mining aims to comprehensively analyze and uncover inefficiencies in the patient delivery process. Data from the hospital’s KIS and the transportation provider’s app revealed shared responsibility for delays, with distinct patterns in call reliability and time disparities.

As a result, Process Mining’s insights led to addressing relevant teams and optimizing the transportation provider’s workload distribution, showcasing its efficiency in healthcare settings.

Emergency Room:

In a healthcare example focusing on the emergency room, the situation is characterized by limited capacity and a growing, diverse patient influx. Standardizing the emergency room process becomes a necessity. The project’s objective is to use NuMantra’s process mining application for visualizing the existing processes comprehensively, thereby gaining a realistic overview of emergency room operations and identifying organizational and technical enhancements.

The project uses timestamps from the KIS database to visualize the patient journey, from arrival through triage, diagnostics, doctor visits, and medical dismissal. The analysis reveals areas for improvement, particularly in cycle times, especially up to triage, and the quality of triage, which, although good, has room for enhancement.

Additionally, the to-be process doesn’t consistently conform to standards, showcasing the potential for refining and optimizing emergency room procedures.

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Process Mining in Healthcare Use Cases

Healthcare providers are employing process mining to enhance processes in various applications, some of the below are process mining in healthcare use cases:

Billing and revenue cycle management:

Billing and revenue cycle management have been a challenging area in healthcare. A major contributing factor is the intricate nature of billing and collection procedures, often demanding significant time and resources when using manual methods.

By harnessing the data already present in healthcare systems, providers can construct comprehensive digital models of their daily processes, pinpointing areas for enhancement. These improvements may encompass automating debt collection, minimizing bad debts, and continuously monitoring patient treatments to reduce grievances and optimize revenue generation.

Emergency Departments:

The typical duration for managing a patient’s arrival at the emergency department is three hours, often causing stress for all parties involved. Patients must undergo triage, receive admission for required care, be assigned to the appropriate healthcare practitioner, get scheduled for X-rays or scans, and ultimately be assigned a hospital bed or discharged.

Healthcare providers can harness process mining to construct an all-encompassing, authentic process model that accounts for variances and exceptional cases. This allows providers to anticipate and prepare for periods of high activity, reduce the time from arrival to seeing a doctor, and eliminate the redundancy of entering patient data for various processes.

Care Delivery:

In an increasingly consumer-driven world, patient expectations are evolving. They now demand more from their healthcare providers, whether it’s the convenience of a digital front door to healthcare services, personalized communication, or more valuable interactions with their healthcare professionals. Patients seek easily accessible information and on-demand services.

Process mining empowers healthcare providers to visualize the patient journey comprehensively and subsequently implement new and enhanced communication channels. These can encompass self-service portals, self-check-in kiosks, and the streamlining of referrals, claims, and diagnostic processes through the assistance of digital automation.

Patient Pathways:

Traditional patient pathways, whether within treatment protocols or specific medical conditions, often appear rigid and standardized, primarily serving administrative and operational purposes rather than catering to the unique biological needs of individual patients. Process mining allows healthcare providers to scrutinize data sources, identifying and exploring common variations in how these pathways are navigated.

For example, healthcare providers can pinpoint areas where certain age groups, genders, or other variables have experienced adverse effects from a treatment plan. This data is crucial for averting similar problems down the road. Process mining aids in ensuring that all the prescribed steps within a patient pathway are adhered to, shedding light on the consequences of any missed stages in a pathway.

Integrated Care:

The importance of population health management and integrated care on a global scale is continuously growing, particularly underscored by the lessons learned from the pandemic. Collaborative efforts with other public services and shared accountability for individuals’ well-being and health outcomes have gained profound significance.

Technology is widely recognized as a pivotal player in the evolution of integrated care systems, facilitating the harmonization of disparate systems, procedures, and stakeholders. Process mining offers an instrumental tool for all entities within an integrated care framework to assess the effectiveness of their collaboration and pinpoint areas for enhancement.

Conclusion

Process mining in the healthcare industry is a transformative approach that empowers healthcare organizations to enhance patient care, operational efficiency, and data-driven decision-making. By analyzing process-related data, healthcare providers can optimize patient flow, improve billing and revenue cycle management, ensure regulatory compliance, and ultimately enhance patient outcomes.

While having challenges, process mining tools provide valuable insights into healthcare workflows, enabling improved efficiency, reduced workloads, enhanced patient safety, higher quality care, informed decision-making, and increased productivity.

NuMantra’s process mining application as part of the Hyperautomation Saas platform, offers specialized guidance in the healthcare sector, addressing queries related to process mining. Further, our solution consultants have the proven expertise to aid healthcare professionals in understanding and implementing process mining tools effectively, ensuring optimal utilization for workflow optimization, patient safety enhancement, and data-driven decision-making, ultimately improving healthcare processes and patient care quality.