Complex decision making requires better collaboration

The Use of Technology to automate simple tasks has been widely adopted. Calls are routed by computer-driven call centers, for example. E-mails broadcast information in a fraction of the time it would take a manual process. More complex tasks, however, require a human driver, and those tasks are in higher demand today.

According to McKinsey & Company research, high-value decision makers who perform complex tasks-known as tacit interactions-are being hired more than other types of employees. This is partially because automation of less-complex tasks allows labor resources to be focused on tacit interactions. Companies that figure out how to use technology to increase the productivity of those high-value employees will gain a competitive advantage.

"Ultimately, tacit processes are about collaboration enabling business processes," says Dennis Schmuland, MD, national director, U.S. health and life sciences for Microsoft Corp., and an MHE editorial advisor.

"The key to technologically enabling tacit business processes is . . . fusing those three areas with the existing business processes," Dr. Schmuland says. "It's getting those three components of collaboration into the tacit processes."

A lack of collaboration was an issue at Calypso Healthcare Solutions, a firm in Seattle that helps health plans, employers and third-party administrators identify and recover medical claim overpayments.

"We had piles of paper," says Jessica Grassman, manager of shared services for Calypso. "Sometimes two people would be auditing the same claim. It was very inefficient."

A little more than a year ago, the company introduced a workflow system that included an automated assignment engine for the auditors' project assignments, but also allowed for manual assignments, Grassman says. It records which claims are overpaid and then uses that data to improve the automated assignment engine. The application actually becomes smarter over time, based on past history.

In addition, Calypso's application enables managers to track performance based on real metrics. Real measurements of a tacit process are hard to come by without technology, according to Dr. Schmuland.

DECISION MAKER

At Highmark Inc., in Pittsburgh, the plan expects to see a 10% cost savings on the process of approving employee disability claims, and is able to decide if the claims qualify 25% faster, thanks to a software tool added on to an existing data-diagram software product.

"It provided me with a business rationale for staffing changes," Maria Hare, corporate health services manager for Highmark says. "Normally bringing a process in-house that will require more staff resources is a hard case to sell, but the data showed that it was the most cost-efficient and streamlined way to do it."

Dr. Schmuland says the experiences Highmark and Calypso had are typical of many others in the healthcare industry.

One tell-tale sign that a company isn't collaborating efficiently is e-mail overload, he says.

"They're shipping around mounds of information that are impossible to digest, and creating storage and archiving problems for IT as a result, because they don't have a more efficient platform to promote collaboration. Collaboration is the currency of healthcare today," he says.

Jamie J. Gooch is a Cleveland-based freelance writer.