IEEE Technology and Society Magazine - Winter 2013 - 15

around the world how they would rate the importance
of transparency in quality and pricing information to
a sustainable health system. More than half of those
leaders replied that it was "very important."
However, in a complex, highly dynamic, specialized,
and multidisciplinary sector like healthcare, transparency is unlikely to be achieved without the right tools
or if it is resisted by the organizational culture. One of
the challenges facing senior health system decision
makers is therefore to generate corporate strategies that
will drive transparency in their organizational cultures
as well as their processes. Achieving transparency as a
genuine value rather than a simple requirement can be
accomplished through a strategic plan that progresses
step by step, case by case, and hospital by hospital.

change in the organizational culture that executes the
processes.

Culture of Transparency versus
Culture of Blame

In the healthcare field, processes that carry a risk
of medical errors take on special importance, not
least because the issue involves a variety of different
stakeholders. "Everybody is concerned with medical errors," says Silvana Quaglini of the Department
of Computers and System Science at the University
of Pavia. "Patients are more andmoreinformed and
demand medical excellence, healthcare personnel
are more and more worried about increasing complaints, and healthcare administrators are worried
about waste of resources andincreasinginsurance
Turning Black Boxes into Glass Boxes
fees," she adds [3].
Process mining, a set of techniques for the autoMost case studies show that the cause of medimatic discovery of processes, is one of the most
cal errors is more likely to be a chain of events than
promising methodologies for achieving
the act of an isolated individual. This
transparency.
implies that a key step in reducing these
Most case
In his book "Process Mining: Diserrors would be to create a culture of
studies show
covery, Conformance and Enhancetransparency in which the individual is
that the cause of seen as part of a broader social network
ment of Business Processes," wil M. P.
medical errors
van der Aalst shows how this approach
performing the different tasks that make
has successfully brought transparency
up the organization's processes. Makis more likely
to the processes of different types of
ing these processes transparent would
to be a chain of
organizations such as banks, local
put an end to the culture of individual
events than the
governments, and industrial plants [8].
blame, with its incessant focus on "indiact of an isolated vidual errors" and excessive supervision
There are also a variety of experiences
on record in which process mining has
of "specific tasks" that so often ends up
individual.
been applied in healthcare settings to
undermining the basic coordination that
identify where a process begins, what
is so essential to any work team.
decisions were taken, and where the process ends.
In stark contrast with the blame culture, transparIn a case study at the Academic Medical Center
ency is synonymous with an overall vision that puts
(AMC) of the University of Amsterdam, a group of
the emphasis on coordinating the flow of tasks as a
researchers from the Eindhoven University of Techway of lowering the likelihood of errors. Furthermore,
nology's Department of Information Systems found
by focusing on the process as a whole rather than its
that process mining enabled them to explicitly capture
individual parts, it promotes a sense of responsibility
knowledge about a healthcare setting. As they conat the team level. In other words, with transparency
cluded, "we were able to derive understandable modcomes the awareness that working as a team is what
els for large groups of patients. This was confirmed
generates good results.
by people at the AMC hospital" [4].
Achieving transparency is a two-fold learning proIn addition, since process mining displays inforcess that consists in defining and then internalizing
mation in a visual format, users can more readily
knowledge of existing processes. But it also means
appreciate how processes really occur within their
tackling the much tougher job of actually replacing
organization. Leonardo Torres, the author of a
the individual blame culture with a culture of transmaster's thesis on process mining in healthcare,
parency that puts the accent on the responsibility of
has noted that "[the] combination of the techniques
the whole medical community for its successes as
(process mining and visual analytics) had a posiwell as its failures.
tive effect due to the fact that medical specialists
were able to understand the results in an easier
Social BPMas Tool to Drive
way" [7].
Organizational Transparency
Transparency as a value can be realized with the
Social business process management (social BPM)
help of newly available tools. But is not simply a
is a tool that uses social media such as community
matter of the right technology, for it also involves a
web pages, blogs, or on-line social networks to drive
IEEE TECHNOLOGY AND SOCIETY MAGAZINE

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wINTEr 2013

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