Reengineering Government Services

The whole business process redesign movement is pretty old. Davenport's Process Innovation came out in 1992. The book Reengineering the Corporation came out in 1993 and caught the publicity wave, as did Reinventing Government, a book that was big during the Clinton Administration...

Still, the report that Johns Hopkins hospital has had an urgent care chain open a branch on the campus of the Bayview Medical Center is interesting, and confirms the validity of some of my writings over the past couple years suggesting that governments reengineer public health and wellness services along these lines. See "Pressed hospital gets medical relief," from the Baltimore Sun. From the article:

Bayview sought out Patient First, seeing it not as competition but as a mechanism to unclog its crowded emergency department.... Gregory F. Schaffer, president of Hopkins Bayview, said he expects the hospital to get referrals from Patient First for high-end imaging, such as magnetic resonance imaging (MRI) exams, complex lab work and specialty care.

But he sees the main benefit as reducing a bottleneck at his hospital. "The thing that gets me excited about it," Schaffer said, "is that we have problems in the emergency department with nonemergency patients." The emergency department had 56,000 visits in the fiscal year that ended June 30, and is on a pace for 60,000 this year, he said.

The emergency room also is not convenient for those with nonemergency problems, he continued. "If you've been there three or four hours with a problem with your finger, and heart attacks or trauma cases come in, you keep getting triaged to the bottom of the list."
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This is a step towards re-engineering organizational processes. It's not a refiguring of how to deliver services more generally.