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Healthcare Work Processor
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Thingamy healthcare

Jun 19, 2015

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Health & Medicine

Sigurd Rinde

A work processor for health services
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Healthcare Work Processor

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Thingamy is a process based platform that can recreate any process in a health service. Uniquely it can run the unpredictable patient-, information-, and work-flows effectively and seamlessly.

Time is freed to be spent on patients. It ensures that the right information is delivered to the right person at the right time for increased quality, lower rates of error, reduced costs, and happier patients and staff.

All record keeping and reporting is automatic.

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Knowledge workers spend from 15% to 35% of their time searching for information.

15% of the time is spent on duplicating existing information.

IDC

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More US citizens died from “Avoidable medical errors” in the last two weeks than in the last ten years of warfare in Afghanistan and Iraq combined.

More than twice the number of Norwegians died from “Avoidable medical errors” last year than from all accidents combined.

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A recent study shows that 51% of hospital residents are not confident in their patient handovers. Adding a “handover application” reduced that figure to only 7%.BMJ

If more than half the physicians do not trust the handover process the patient flow is flawed.

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The symptoms are numerous:

Lack of time for patientsWaiting listsHigh error ratesLow patient satisfactionDissatisfied staffIncreasing costs

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A day in the workshop 1912:Business “flow”

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A day in the hospital 2012:Patient “flow”

Same old manual work flow...

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Work consists of two components:

1. Value-creation e.g. improving patient outcomes.

2. Non value-creation e.g. task distribution, reporting, management, looking for...

The non value-creation work adds up to between 55% and 75% of a knowledge worker’s time.

Non value-creation work needs to be minimised for better outcomes, increased capacity and quality:

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Enter Thingamy.

The only solution that can really handle knowledge work flows:

It saves you looking for relevant informationIt ensures correct distribution of tasksIt ensures proper patient handoversIt automatically generates reports and recordsIt ensures accountability and responsibilityIt eliminates duplicationIt minimises error sourcesIt adapts easily to changes

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This results in improved outcomes:

More time for the patientsShorter or no waiting listsLower error ratesHigher patient satisfactionHappier staffLower costs

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Thingamy is cloud based and ideal for mobile devices. On the surface it may look like any other

software - but under the hood it’s radically different so it can deliver truly better results.

The following user story only reflects our view of a simplified patient flow, a mere starting point for a solution which would incorporate the provider’s

own knowledge, practices and experience.

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Nancy, taking the “front of house” role, starts the process (equally this could have started with a primary care physician).

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She can choose the patient to be admitted from the list or add a new one. She’ll choose Peter Patient in this case.

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An existing patient would have previous cases which Nancy can choose from, or add a new case depending on the situation.

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Nancy adds the basic details to the new case (iPad keyboard here in the “thumbs” mode).

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The first step when handing over the case and patient to a diagnostician - choose the urgency level and speciality.

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The second step when handing over - choose who gets the request.Note: For better use of resources in this case we use “pull” instead of

“push” - services are “requested” instead of “assigned”.

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The case is owned by Nancy and will remain visible in this report, where she also can adjust urgency level or add recipients, until accepted by Sylvie or Jack.Note: A case will at all times only have one single “owner” for unequivocal

accountability.

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Health records consists of related objects - patient, cases, medication, etc. They are created and updated automatically.

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Sylvie has a diagnostician role, in her default interface she will see all requests and relevant information. Once she picks up a case the request disappears for everyone else. Sylvie is now the sole owner of the case.

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This “Case work” will remain a to do until she hands it over to somebody else. Everything is on one page - all the relevant information, choices and

fill-in fields. Everything you need when you need it.

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Same task, lower part of the screen. Note that the fields are author- and time-stamped for an easy historical view.

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Here we have some of the available choices. Note that only “handovers” will make this “Case work” task go away.

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Requesting X-ray - for John to pick up. Once complete it’s automatically part of the records and visible for all participants. After diagnosis, the

handover to a surgeon or a nurse can follow in the same manner. One seamless and fully flexible flow until discharge or handover to primary care.

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Reports are dynamic, for example a full overview of the hospital that shows everything from medication to gloves - all in real time.

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You can browse or search... now you can easily find Peter in bed 1-1-1.

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The information you need is delivered when you need it - this helps to reduce errors and frees up

time to be spent on patients instead.

Accurate and timely distribution of tasks and responsibility ensures that nothing is forgotten.

Thingamy records everything with zero duplication delivering any required report while saving time.

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Concept summary:We're not physicians, we're not nurses, we're not even healthcare IT specialists.

Actually, if we were physicians or nurses we'd be highly frustrated as healthcare IT is barking up the wrong tree.

What we know is how work works. Especially knowledge work, and healthcare is nothing but that.

The way work unfolds, how the workflow flows, that is what sets the scene for quality or not, for errors or not, for enough resources or not, for time well spent or not, and for everybody's happiness or not.

Work has two components - one part value-creation, one part non value-creation. The first, the value-creation, happens in a flow, in a process, the latter has one purpose, making the flow move forward.

When more people are involved and when the workflow is barely repeatable, then the non value-creation component increases dramatically - task distribution, collecting information, communicating, reporting, meeting, budgeting... to the extent that it costs us between half and three quarter of our time to keep the workflows moving.

That is why we shall give the health worker's unpredictable workflow, from A to Z, one proper and effective IT framework. Time will be freed from making the flow flow to be spent on patients. And we want to ensure that the right information is delivered to the right person at the right time for increased quality, lower rates of error and happier patients and staff.

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Technology summary:

Thingamy is a process based platform that can model any value creation flow from start to finish.

It can model any part of a health service but uniquely it can also easily expand to handle everything, including accounts, procurement, human capital and more.

Using a very different data, process, and reporting model it directly reflects the real world.

Scalability and security are built in to surpass any existing solution.

Thingamy is simply different, to allow your ideas and experience to be converted into new or changed processes in mere days at a low cost.

Privacy and security:Thingamy surpasses any privacy requirement thanks to our unique architecture. User information is stored discretely and is only linked to sensitive information using relationships. The result – it’s easy to control who sees what at any time.

The underlying process engine also plays a role, being aware of where the patient is in the process it makes it easy to configure what information is relevant and should be visible at any point in time. For example an insurer may have access to your information only when it is processing a claim on your behalf - and the same effect can be had for patients, researchers, governments and more.

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Addendum, example:

Specific clinical pathway + patient accounting

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When choosing or adding a new case a “Specific clinical pathway” option is given. These preliminary details can be set prior to arrival (with information

from ambulance etc).

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With a Specific clinical pathway the reception role will choose main surgeon and reserve operating theatre, tests and more (preset by hospital).

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Reserving operating theatre.

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Ordering X-ray. Instructions are preset according to hospital best practices.

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Surgery personnel is set and invited. Either any number or a preset group.

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Patient arrival and first triage to check if assumptions were correct.

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Surgeon interface: He’s already booked and is now owner of the case with the “Case work” task ready.

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Surgeon interface: Ordered but yet to be done X-ray, lab tests and other tasks are visible with all details.

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Surgeon interface: Ditto for the requests for surgery personnel.

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X-ray/scan interface: John is doing his job.

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X-ray/scan interface: After which he is asked if he wants to add procedure costs.

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X-ray/scan interface: Which he adds in a simple interface.

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And all costs are now visible in (for example) the medical records as above, related directly to the case. All real time with all details, to be used

to generate the final invoice.

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When anaesthetist, nurses and co-surgeons have accepted the request the booking with all details are now visible in their default interface.

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Surgeon interface: For each task done, for each surgery personnel acceptance, the surgeon is notified.

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Surgeon interface: With surgery completed the main surgeon adds his notes, the procedure costs and can now hand the patient off to post-op.