Assignment 2 - HIM6350
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Assignment 3
Stephen Skinner
University of South Florida
HIM6350: e-Medicine Business Models
Week 3
May 21, 2023
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Process Flowchart
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Swim Lane Diagram
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SIPOC
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Sharp (2009) defines a business process as “a collection of activities that is a way to get
something done.” When analyzing the medical imaging process for a patient presenting to the
emergency department (ED) for X-rays, there is a collection of steps within the entire process
that ultimately leads to a patient having his or her images taken and a report being sent to the ED
physician to carry out a proper course of treatment guided by the results of the diagnostic reports.
Imaging patients in the ED satisfies the seven pointers for defining a business process as
per Sharp (2009). It involves customers and stakeholders – the patients, nursing staff, physicians,
imaging staff, and more. Patients arriving at the ED with a complaint that needs imaging is the
triggering event. Multiple activities take place in order for the patient to go from the waiting
room to the X-ray room and a diagnostic report being made by the radiologist. All of the steps
are interrelated because they are necessary for the patient to receive the X-rays and carry on with
the course of treatment. Automation is involved with this process as well. In the old days,
everything was paper-based and would require hand-written prescriptions for X-rays to be
physically brought to the imaging department. Now, orders are available at the click of a few
buttons in a highly connected network of computer systems within the hospital.
The four guidelines on discovering business processes by Sharp (2009) relate to this
imaging process. Each process is triggered by an event – the patient arrives to the ED for
imaging, which starts the process from the triage provider submitting X-ray orders to the final
imaging report being sent to the electronic health record (EHR) so the ED physician can view it.
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In the end, the patient is provided a service that will help figure out the source of pain he or she
is experiencing, radiographers are provided work to perform that keeps them employed and aids
in the patient care process, radiologists are sent images that they are able to read and make
diagnoses for patients, and ED physicians are able to base their treatment plans off of the results
of the imaging. The “work item” goes from an imaging order sent to the radiology information
system (RIS) to the actual X-rays taken for patients.
This process is also well-formed because it meets the criteria set forth by Sharp (2009).
The process name would be in verb-noun-noun format – ‘X-ray ED Patients.’ The result is
countable, because many individual patients present to the ED for X-rays and therefore a count
can easily be made of the number of studies performed. The result of this process makes multiple
stakeholders happy, from the patient to the ED providers that rely on imaging in order to carry
out patient care. If a patient presents with an arm that looks like a wet spaghetti noodle, the
doctors rely on imaging to determine if the arm is fractured and the best course of treatment
moving forward.
As a whole, medical imaging is essential to any ED simply because of the critical and
acute nature of patients arriving. Hitti et al. (2017) found that 46.8% of patients in the United
States underwent some form of imaging during ED visits. That means almost one in every two
patients will have imaging performed and therefore processes need to be constantly analyzed and
improved to maintain optimal patient care. Kwok et al. (2021) utilized swim lane diagrams that
mapped out an ED X-ray process in order to identify areas where imaging turnaround time could
be reduced to ultimately improve patient care.
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References
Hitti, E. A., El-Eid, G. R., Tamim, H., Saleh, R., Saliba, M., & Naffaa, L. (2017). Improving
emergency department radiology transportation time: A successful implementation of lean
methodology.
BMC Health Services Research
,
17
(1). https://doi.org/10.1186/s12913-017-
2488-5
Kwok, M.M.K., Chiu, A., Chia, J., & Hansen, C. (2021) Reducing time to X-ray in emergency
department ambulatory patients: A quality improvement project.
BMJ Open Quality
,
10
(2). doi: 10.1136/bmjoq-2020-000995
Sharp, A. & McDermott, P. (2009). Workflow modeling: Tools for process improvement and
application development. (2nd Edition). p. 31-46. Artech House.