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February 4, 2016

The business of building robust public health systems

Public health is generally not considered part of the conversation when discussing businesses. But like any business, public health agencies carry out multiple procedures daily: routine practices such as administering vaccines or registering new patients can be viewed as business processes and require a systematic flow of activities to promote quality of care. To ensure public health systems and services are efficient, we employ business process analysis—an approach to understanding how work is accomplished by identifying the activities, participants and information involved. Before making changes to any organization’s business operations, it is critical to first undergo business process analysis.

I took this photo of everyday children walking together during my visit to Mozambique.

Analyzing business processes helps identify strengths and weaknesses within workflows. At PHII, we support public health practitioners to use information and information technology more effectively. We work with agencies and public health ministries to document their current processes and pinpoint areas of improvement to help them maximize the use of their information systems. Through our Collaborative Requirements Development Methodology (CRDM) ™, we’re able to recognize inefficiencies, redundancies and bottlenecks within a process and define requirements for how information systems can bridge those gaps by streamlining activities. As a result, agencies reduce the costs, time and effort associated with ineffective processes.

However, business process analysis is not a quick fix, and there are things to consider before embarking on this approach. Because it’s not always inexpensive to remap a business process, practitioners should weigh if there is more benefit to their agencies than harm. They should also think about the feasibility and whether or not business process analysis will succeed and have a positive impact on the people who are doing the work.

Business Process Analysis

  • Critical before redesigning any business process
  • Helps identify strengths and weaknesses within workflows
  • Not a quick fix: consider costs and organizational goals first

We’re currently working on the CDC’s Stop Transmission of Polio (STOP) Program, an effort to eradicate polio and encourage routine immunizations. The program’s human resources team recruits and trains public health professionals to perform field work in sub-Saharan Africa and Asia and physically filters through applications to identify final candidates. Because of the volume of applicants, this manual process has become inefficient and timely. We’re using business process analysis to evaluate the program’s manual recruitment practices and gather functional requirements that will lead to the acquisition or development of an electronic system that will automate their recruitment process. A software solution will allow them to receive and review applications electronically, upload résumés, match qualified candidates and collect onboarding information.

But electronic, web-based systems may not work for everyone. In places like sub-Saharan Africa where computer competency and internet service are challenges, a streamlined manual process that minimizes human error and maximizes the data collected could be more beneficial. Our Mozambique Workforce Planning project is one example. Like most sub-Saharan African countries, Mozambique doesn’t produce the number of professionals needed to care for the population and therefore faces a shortage of health care workers. The workforce allocation tool helps distribute the limited care practitioners to the areas of greatest need. To do that, Mozambique’s Ministry of Health needs accurate data to understand how many health professionals there are, what their specialties are and where they’re located to plan how to allocate them to a specific region. Our team is also providing technical assistance to the United Republic of Tanzania Ministry of Health and Social Welfare to analyze and make available timely, comprehensive and practical recommendations that can be used to inform human resources for health planning and allocation decisions that will support the scale-up of HIV/AIDS treatment and other health care services.  

These examples tell us that domestic and international projects could be polar opposites in their needs and the goals they need to achieve with their information systems. But the common theme in redesigning any business process is specifying the agency’s objectives to understand where the shortcomings are. That’s the premise behind the methodology we use, and business process analysis is our vehicle to strengthen public health systems worldwide.