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Challenges and Opportunities of BPM Implementation in the Healthcare Industry

BPM Implementation March 1, 2021
Challenges and Opportunities of BPM Implementation in the Healthcare Industry
Kishor Venkatesh R

Content Developer


Manual effort drives many processes in the healthcare industry, leading to much paperwork. It is no secret that healthcare institutions are losing money considering new patients wait in the admission areas until the billing department procure release slips for patients occupying a bed from other departments. 

A study predicted that 60% of healthcare organizations would see negative margins due to lost revenue by 2025 if they do not keep up with policy changes and the economy. A recent study said labor cost alone accounts for 60% of non-capital costs making it the most considerable expense in US healthcare organizations. 

Healthcare organizations face the challenge of providing expert care and generating revenue while keeping abreast of developments in treatment protocols and managing business aspects. It highlights the need to combine human input with technological implementation to drive greater efficiency and future-proof their establishments. 

BMP in healthcare – a market overview 

Healthcare organizations are increasingly leveraging AI and ML-based solutions to optimize their workflow and gain better insights from the data they have to improve quality. As of now, they are banking on partnerships and digital initiatives to boost growth. The market worth USD 8.8 Bn in 2020 is expected to reach USD 14.4 Mn by 2025, with a CAGR of 10.5%. 

Roadblocks in implementing BPM 

There are various challenges healthcare organizations have other than costs in implementing BPM. 

  • New compliance and regulationsIf new regulations warrant gathering additional data to analyze, healthcare institutions may find it troublesome to integrate new processes and deliver quality patient care. Failure to meet future demands due to regulatory changes can lead to financial losses and patient dissatisfaction. 
  • Security: Cyberattacks can hamper business processes. Contrarily, the advantages, disadvantages, and integrating security into a business process model are not entirely understood. 
  • Management of multiple BPs: Since process improvements like removing bottlenecks and eliminating redundant steps take time, the transition from one business process stage to the next can be slow and contain faults. 
  • Misalignment between strategies and IT: Business processes involve people from different backgrounds and departments, involving complex and comprehensive organizational analysis. Misalignment between business strategies and IT may result in the business failing to use IT support. 
  • Operational complexity: Software engineers developing the process are not the same people working on the processes. Healthcare is manually intensive, with much paperwork doing patient admissions, charts, billing, and care performed hands-on. The complexity of the operations is high. 

Impact of implementing BPM 

BMP can alleviate inconsistency and chaos and overcome challenges that come with human-intensive, service-oriented organizations. Some of the other capabilities include: 

  • Reducing inefficaciesProcesses are often fraught with wastage of time and money due to manual effort, poor interdepartmental handoff, and inability in overall monitoring. Companies can remove inefficiencies by shedding light on them. 
  • Improve collaborationDepartments can collaborate to simplify communication between stakeholders and make processes mobile enough to facilitate on-the-go approvals. 
  • Insights and reporting: BPM can provide instant reports and analytics for valuable insights on process performance. 
  • Efficient legal complianceIt can prevent safety, security, and compliance issues due to a lack of transparency. Stakeholders can stay updated about changes, helping companies ensure processes meet internal and external safety, compliance, and security standards. 
  • Comprehensive dashboards for greater visibilityStakeholders can procure data from multiple touchpoints to leverage it to improve operational efficiency, minimize errors and delays leading to improvement in the bottom line and a higher patient care level. 

Application areas 

Healthcare institutions want to alleviate regulatory headaches, simplify processes, reduce redundancies, and make their customer service better, potentially saving money and increasing revenue. Below are how healthcare institutions can use BPM. 

BPM in healthcare

Healthcare cost management solutions company MultiPlan was looking for a gateway to manage claims financial risk by replacing their Lotus Notes database with an off-the-shelf solution to integrate with their financial management programs, ERP, offer an electronic approval process, and improve the capital and expenditures business process. 

MultiPlan used a process automation platform’s timeline software, Process Timeline, which executed the process for all expenses, large and small. They later extended it to document attachments such as vendor quotes, RoI analysis, accounts payable, and more. 

Creating value with BMP 

BMP can help healthcare institutions understand the value-creating flow of work and non-value-creating activities. Creating a high-level process model can stimulate dialog on the cross-functional business processes creating value. 

Below is an example of high-level process for an insurance provider. 

Core processes > Sell products, develop the network, manage providers, pay claims, solve problems 

Support processes > Recruit talent, manage technology, manage finances, procure products and services 

After recognizing the need to take a process-based view, healthcare institutions can model, analyze, redesign, and automate critical business processes. 

Opportunities with BPM 

Here are the areas identified by Draup that healthcare institutions should focus on. 

Short-term focus areas: Document management is a major issue. Hospitals can improve response time and patient satisfaction by automating new patient onboarding, medical records management, and patient release. It can perform document quality management too. 

Medium-term focus areasInstitutions can remain compliant with regulations, employee/data confidentiality, and make healthcare professionals follow current-mandatory procedures. If not weighed down by a disproportionate amount of regulation, BMP can accelerate clinical trials and streamline new medication approvals. 

Long-term focus areasHealthcare institutions can automate treatment decision-making automation and AR/VR-based employee training. Professionals can also use AR/VR to perform a complete advanced cardiac life support protocol (surgeries). 

To conclude, regulatory complexity, inefficient processes, continuing cost pressures, and changing patient expectations present significant challenges for healthcare institutions. Successful BMP implementation increases efficiency, ensures regulatory compliance, and streamlines data gathering, analysis, and reporting. 

New and improved BMP practices will play a key role in the future. Healthcare automation will present more opportunities for service providers. Draup for Sales is an account intelligence and real-time sales signals tracking platform that empowers service providers to seize sales opportunities. 


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