My last session at Gartner BPM 2013 is a discussion between Ian Gotts of TIBCO and their customer Tommy Richardson, CTO of Siemens Medical Solutions. I spoke with Siemens last year at Gartner and TUCON and was very interested in their transition from the old iProcess BPM platform (which originally came from TIBCO’s Staffware acquisition) to the newly-engineered AMX platform, which includes BPM and several other stack components such as CEP. Siemens isn’t an end-user, however: they OEM the TIBCO products into their own Soarian software, which is then sold to medical organizations for what Richardson refers to as “ERP for hospitals”. If you go to a hospital that uses their software, a case (process instance) is created for you at check-in, and is maintained for the length of your stay, tracking all of the activity that happens while you’re there.
With about 150 customers around the world, Seimens offers both hosted and on-premise versions of their software. Standard processes are built into the platform, and the hospitals can use the process modeler to create or modify the models to match their own business processes. These processes can then guide the healthcare professionals as they administer treatment (without forcing them to follow a flow), and capture the actions that did occur so that analytics can determine how to refine the processes to better support patient diagnosis and treatment. This is especially important for complex treatment regimes such as when an unusual infectious disease is diagnosed, which requires both treatment and isolation actions that may not be completely familiar to the hospital staff. Data is fed to and from other hospital systems as part of the processes, so the processes are not executing in isolation from all of the other information about the patient and their care.
For Siemens, BPM is a silver bullet for software development: they can make changes quickly since little is hard-coded, allowing treatment processes to be modified as research and clinical results indicate new treatment methods. In fact, the people who maintain the flows (both at Siemens and their customers) are not developers: they have clinical backgrounds so that they are actually subject matter experts, although are trained on the tools and in a process analyst role rather than medical practitioner role. If more technical integration is required, then developers do get involved, but not for process model changes.
The Siemens product does a significant amount of integration between the executing processes and other systems, such as waiting for and responding to test results, and monitoring when medications are administered or the patient is moved to another location in the hospital. This is where the move to AMX is helping them, since there’s a more direct link to data modeling, organizational models, analytics, event handling from other systems via the ESB, and other functionality in the TIBCO stack, replacing some amount of custom software that they had developed as part of the previous generations of the system. As I’ve mentioned previously, there is no true upgrade from iProcess to AMX/BPM since it’s a completely new platform, so Siemens actually did a vendor evaluation to see if this was an opportunity to switch which product OEMed into their product, and decided to stay with TIBCO. When they roll out the AMX-based version in the months ahead, they will keep the existing iProcess-based system in place for each existing client for a year, with new patient cases being entered on the new system while allowing the existing cases to be worked in place on the old system. Since a case completes when a patient is discharged, there will be very few cases remaining on the iProcess system after a year, which can then be transferred manually to the new system. This migration strategy is far beyond what most companies do when switching BPM platforms, but necessary for Siemens because of the potentially life-threatening (or life-saving) nature of their customers’ processes. This also highlights how the BPMS is used for managing the processes, but not as a final repository for the persistent patient case information: once a case/process instance completes on patient check-out, the necessary information has been pushed to other systems that maintain the permanent record.
Modernizing the healthcare information systems such as what Siemens is doing also opens up the potential for better sharing of medical information (subject to privacy regulations, of course): the existence of an ESB as a basic component means that trusted systems can exchange information, regardless of whether they’re in the same or different organizations. With their hosted software, there’s also the potential to use the Siemens platform as a way for organizations to collaborate; although this isn’t happening now (as far as I can tell), it may be only a matter of time before Siemens is hosting end-to-end healthcare processes with participants from hospitals, speciality clinics and even independent healthcare professionals in a single case to provide the best possible care for a patient.