Please use out­-mail/in-mail, we are BPMx users

The last thing any Civerex BPMx user wants is to receive e-mail messages relating to a case.

This causes great inconvenience and puts data at risk in ‘need-to-know’ transaction processing applications.

 “Mary is a day-shift nurse this week at Lyons Memorial Hospital.

It’s 15:30 hours, she is doing an assessment for a patient called John Doe and has reached a stage in the processing where she has a question she needs to put to the clinical director. The director is not in the building. 

At the assessment step on John Doe’s care pathway (a private instance of a hospital best practice workflow), Mary composes an out-mail detailing the issue at hand and asking for advice and assistance. Then she goes off shift.”

Jason, one of eight night-nurses this week, arrives at 1600 hours.

At 16:10 hours he goes to his Order InTray where he sees the open John Doe assessment.  Because Mary used out-mail* (instead of the hospital e-mail system) he sees a copy of Mary’s inquiry and, as a result of the passage of time, he also sees the clinical director’s in-mail response to Mary’s request. He ‘takes’ the order, locking it down, and completes the assessment.

What have we learned from this?  

Firstly, we have just saved 15 hours and 50 minutes. Ordinary e-mail would have, without extraordinary measures, imposed a 16-hour delay to completion of the assessment.  

Mary could have put a ‘hold’ on the assessment asking someone on the night shift to call her at home. In order for this to go anywhere, Mary would have to have logged into her e-mail from home to see the response to her request from the director. Not much continuity of care here.

The director could have taken the trouble to find out who is on night-shift and sent the response to Mary’s request to all eight nurses.  Not very efficient.

The solution to this problem was to have users use out-mail/in-mail to send messages to peers and domain expert (this is a good way to reduce admin/medical errors). Only with out-mail/in-mail do inquiries go from tasks to experts, with responses coming back to tasks.

An important side benefit from the use of out/in mail is that copies of both messages in a BPMx system go in real time, in the case of a healthcare example, to the patient EHR. Users are able to see data, as it was, at the time it was collected, on the form versions that were in service at the time, complete with date/timestamps and user signatures.

 *In the Civerex BPMx, the out-mail/in-mail service is called CiverMail™.  It ships with CIVER-PSYCH, CIVER-MED and CIVER-SUPPLIER.


Management consultant and process control engineer (MSc EE) with a focus on bridging the gap between operations and strategy in the areas of critical infrastructure protection, connect-the-dots law enforcement investigations, healthcare services delivery, job shop manufacturing and b2b/b2c/b2d transactions. (C) 2010-2018 Karl Walter Keirstead, P. Eng. All rights reserved. The opinions expressed here are those of the author, and are not connected with Jay-Kell Technologies Inc, Civerex Systems Inc. (Canada), Civerex Systems Inc. (USA) or CvX Productions.
This entry was posted in Automated Resource Allocation, Business Process Management, FIXING HEALTHCARE and tagged , . Bookmark the permalink.

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