Understanding Waste for Lean Health Information Systems: A Preliminary Review

1. Understanding Waste for Lean Health Information Systems: A Preliminary Review Nadia AwangKalong & MaryatiMohd. Yusof Strategic Information Systems Group Centre for Software Technology & Management Faculty of Information Science & Technology UniversitiKebangsaan Malaysia

2. Outline • Introduction • Waste • Method • Results • Discussion • Conclusion

3. Introduction • Rising healthcare cost is due to service inefficiency that leads to huge medical errors • HIS: enabler and barrier to service improvement • Need for holistic and systems thinking approach to improve HIS effectiveness and efficiency Lean • identifying and eliminating waste • Lack of waste understanding – barrier to applying Lean in supporting HIS improvement.

4. Introduction • Limited Lean study in Health Information Systems (HIS) primarily in waste identification. • Review the literature to provide an insight into the nature of waste in HIS from the perspective of Lean management.

5. Waste • Refers to non-value added activity that exists in a process flow. • Also defined as any item for which a customer refuses to pay. • 7 categories of waste (manufacturing sector by Ohno): over-production, inventory, waiting, transportation, over-processing, motion and errors. • No waste categories identified in studies in the HIS domain

6. Methods • Electronic search: PubMed, Ebcohost, Science Direct, Scopus, ISI Web of Knowledge • Search terms: Lean, waste, healthcare, informatics and information technology • Key expert research, established textbooks, web search engines, and citation searching and chaining

7. Results • Models that can be used directly to evaluate waste and enhance Lean transformation in HIS are limited. • 8 research discussed waste models for the healthcare and IT domains • 4 in healthcare domain • 4 in IT domain

8. Results • Waste in healthcare • Direct application • Define a new sub category – expensive input • Minor modification to Ohno’s; new category -confusion • Waste in IT • Major modification; mapped new category with Ohno’s • Identify irrelevancy and inconsistency to IT service

9. Results

10. Discussion • We reviewed 8 waste models in the context of the healthcare and IT domains. • A total of 20 waste categories were summarized • 7 waste categories from the manufacturing sector exist in both the healthcare and IT domains. • Most of the proposed additional categories were actually covered in the existing Ohno’smodel, except • Environmental waste • Thus, the original waste model can be adapted to identify waste in both the healthcare and IT sectors.

11. Conclusion • Waste understanding in the IS context could contribute to a successful Lean transformation and improve HIS, but • Studies related to Lean waste identification in HIS are still limited, maybe due to • The nature of waste in the IS context is not clear and visible, unlike in the manufacturing domain. • Ohno’s waste model is suitable to be used as a guideline in understanding and identifying waste in both the healthcare and IT domains and subsequently for improving HIS.

12. Thank You! Maryati M. Yusof mmy@ftsm.ukm.my