When it comes to change management, Todd Coffee, senior director of enterprise process solutions at Tenet Healthcare Corp. in Dallas, recommends taking a user-controlled approach.

"The art of BPM is in creating a highly adaptable and even amorphous solution that can allow for ad hoc, on-the-fly, user-controlled changes to a process. Without the latter, change management will always be a risk for successful BPM initiatives," Coffee said.

The use of Pegasystems Inc.'s BPM product lets Coffee's team bring applications to production much faster than they could before. "And our ability to make ongoing tweaks to the system has improved by orders of magnitude," he said. The technology lends agility to Tenet Healthcare's business process improvement efforts, but that agility in turn also results in rapid changes for users.

Having people on board is critical because it is not possible to automate all functions within a process. "Certainly not those that are the most valuable to the company," Coffee said. "It is essential, as you bring application solutions to individuals whose expertise is instrumental to the outcome of the process, to allow their expertise to be fully leveraged, not thwarted in the name of automation."

Coffee's approach to business process improvement began almost nine years ago with such low-value-added processes as one for contract review. Although such processes do not affect customers and may be low-value-add, they still must be fluid and flexible because stakeholders need to make ad hoc changes, and contract terms and conditions often change, he said.

Today Coffee's focus is on business process improvement in critical business areas including compliance and telemedicine. Tenet Healthcare's pilot telemedicine practice offers remote diagnosis and treatment to stroke patients from a network of national experts.

A combination of focusing on the people behind the process and the use of BPM tools has paid-off, Coffee said. Project initiation to production delivery times dropped from about four months to as little as six weeks.

And once a BPM program takes root, stakeholder demand will shift naturally to continuous improvement, he said. He strongly recommends a BPM center of excellence that includes a feedback loop for ongoing improvements. "The quality of the feedback loop depends on accurate and extensive reporting capabilities and close customer interaction. Plan to provide detail as to process volumes and process timing, including averages, as well as ranges; and have a mechanism to routinely engage stakeholders for their perspective on the applications."