healthsystemCIO Podcast: Patient-Centric Workflow Mapping Exposes Gaps Product-Focused IT Teams Can Miss

Healthcare organizations invest heavily in technology, yet workflow gaps persist when IT teams are organized around individual applications instead of patient journeys.

In this “Live from HIMSS” episode of our healthsystemCIO's Partner Perspective series, Christina Kochan, Healthcare Solution Architect at CTG, draws on 15 years of clinical informatics experience and a nursing background to explain why patient-centric workflow mapping, value stream thinking, and service-line alignment produce better outcomes than product-focused IT structures. She also makes the case that true innovation is about iterative improvement.

CTG’s Kochan Says Patient-Centric Workflow Mapping Exposes Gaps Product-Focused IT Teams Can Miss

A surgeon’s workflow begins long before the operating room is ready. It starts in the clinic, moves through scheduling and communication between outpatient and inpatient teams, continues into surgery and recovery, and follows the patient back to ambulatory care. Christina Kochan, Healthcare Solution Architect at CTG, said that dynamic is exactly what many health system IT departments are structured to miss. When clinical informatics staff are assigned to individual applications, they optimize inside a single tool while patients move across five or six of them.

“If you have your clinical informatics teams organized to support applications, you’re going to miss things,” Kochan said. “One of the recommendations I always give for clinical informatics programs is that you want your informaticists to be organized by service line.”

As a registered nurse who entered informatics 15 years ago after growing frustrated with redundant EHR documentation requirements, Kochan has built her consulting philosophy around one foundational principle: map the workflow from the patient’s perspective. A nurse-centric or physician-centric map captures what happens inside one care setting, but a patient-centric map reveals every handoff, every system transition, and every gap between them. The distinction matters because patients generate data across multiple platforms. A third-party surgical application, for example, still depends on EHR data to function effectively. Recreating a patient chart in a standalone tool makes no sense when FHIR, HL7, and other integration standards exist to keep information flowing. Following the patient through each of those transitions exposes friction that an application-by-application review would never surface.

The Problem With Product-Focused IT

Many health systems still organize their IT departments around products. Application analysts are assigned to a single module within Epic, Oracle Health, or Meditech. Kochan said this structure creates blind spots at every boundary between applications. She pointed to a current call center engagement where multiple technologies are in play, and some workflows require transferring patients between applications. That transfer represents a seam in the experience where patients encounter friction, duplicate steps, or lose information.

Value stream mapping addresses the structural problem. Borrowed from manufacturing and adapted for healthcare, the approach follows the patient’s entire journey across departments, applications, and care settings. Kochan said the concept goes by different names in different industries, but the principle is the same: organize around the value delivered to the end user. For health systems, that means organizing clinical informatics by service line so that a single informaticist can trace a surgical patient from clinic visit through scheduling, the procedure itself, recovery, and post-operative follow-up.

Getting the Workflow Right on the Ground

Effective workflow analysis starts with observation, and Kochan has developed a deliberate approach. She shows up in scrubs, establishes clinical credibility with frontline staff, and asks probing questions while watching them work. The goal is to surface information that would never emerge from a conversation with a department manager.

She also stresses the importance of mapping exceptions. The standard workflow is the easy part. The real complexity shows up when a referral expires, a proxy issue blocks a parent from viewing a child’s chart, or a time-bound trigger never fires. The technology should absorb that complexity so clinicians do not have to, Kochan said. If a trigger depends on data buried in a progress note and not stored as discrete information, the technology needs to bridge that gap. She advises pushing the complexity into the technology build and keeping the clinical process simple.

Redefining Innovation

The common tendency to equate innovation with purchasing new technology misses the mark, she said, as deploying a new tool is just a step toward improvement. Real innovation, Kochan added, is a mindset of iterative change: redesign a patient-centric workflow, test the change, fail fast if it does not work, and adjust. Moving step 13 to step 11 in a clinical process might not sound dramatic, but if it eliminates friction and improves the experience for patients and providers, the result matters more than the label.

Take It Away

• Map workflows from the patient’s perspective.

• Organize clinical informatics by service line so informaticists follow the patient across ambulatory, inpatient, surgical, and recovery settings.

• Use value stream mapping to identify friction across the full patient journey, including the seams between applications and departments.

• Absorb complexity in the technology build so frontline clinicians experience simple, consistent processes.

• Treat innovation as iterative workflow improvement.

Every health system will face different challenges, from emerging AI tools to shifting patient expectations to evolving regulatory requirements. Kochan said the response should always be the same. “It’s everyone’s responsibility to continue to look at and see if things can just be better,” she said. “We can always get better. There are always new variables to the equation. And the reason we do that is so our patients can get the care that they need and deserve.”