Why smarter workflows are key to managing variation in healthcare

I’ve heard a lot of smart people give their prescription how to fix healthcare, but I don’t think anyone has put it as crisply as Don Berwick, MD:

“We have to maximize the variability in care that’s attributable to the patient and minimize the variability that’s attributable to the delivery of care.”

Stated a bit differently, we can see that most successful businesses in every industry follow this formula: treat the customer as an individual and standardize your business processes.

Personalization and standardization: The key to delivering high-quality care

If you treat the customer as an individual, you increase satisfaction and build loyalty. If you standardize your processes, you can invest the cost savings into further personalization, forming a virtuous cycle. At Pega, we’re dedicated to strengthening the twin pillars of organizational success: personalization and standardization. These imperatives cut across every industry, from healthcare to financial services to communications.

Total Joint Replacement (TJR) is a great application of this principle: If done efficiently and with sufficient attention to patient engagement, this procedure can be a huge benefit not only to the patient but also to a health system’s financial sustainability. If not, well, these surgeries can become a huge liability.

Some level of variability is necessary to address patients’ unique needs. Some patients may have low health literacy and may need more coaching on the importance of pre- and post- hospitalization care, including which signs and symptoms require medical attention after surgery. Some patients’ spouses may be unable to shoulder the burdens of caregiving and therefore may require support from home health aides. Some patients will develop complications at home and should receive telehealth or in-person care right away. Some patients will need transportation to and from the hospital.

Patient variation is inevitable, but smart workflows help manage this complexity

So, how do we go about managing variability while delivering high-quality, personalized care? It comes down to one thing: smarter workflows. You integrate your organization’s expertise into the workflow, so it's smart enough to know when to reach out to patients to screen for unmet needs and when that need requires a provider’s attention or when non-clinical staff can take care of it. These workflows can be set up to automatically identify and address needs, like scheduling a rideshare to an appointment after identifying a patient with a lack of transportation.

"I’ve seen a large health system improve care manager productivity by 50% by establishing processes that automate repetitive tasks and route administrative tasks to non-clinical staff. "

If you want to see these kinds of results, start by doing a little homework:

• First, ask your team what percent of their workload is top-of-license tasks. 20%? 40%? 60%? Consider questions like:
  • Are nurses scheduling appointments for patients instead of non-clinical staff?
  • Is self-service scheduling an option?
  • Are phone calls always used for screening and education, even when patients prefer SMS or email?


• Secondly, rank-order the biggest contributors to the administrative burden on your staff.


• Finally, imagine what your team will look like after you’ve freed them from their top three administrative burdens. Imagine the amount of creative problem-solving capacity that you could unleash. Imagine how you could empower your team to proactively engage patients to transform health outcomes.

Delivering higher quality care for lower costs requires a ‘force multiplier’ for overburdened care teams. Smarter workflows can be that force multiplier. Let Pega show you how to leverage your team’s expertise to build smarter workflows without ripping or replacing your core systems. Then, we’ll break down your vision into a roadmap with measurable, actionable steps. Finally, we’ll go live with a proof of concept in weeks, not months.