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Value Stream Mapping for Health Management

Value Stream Mapping (VSM) is a versatile Lean tool in both the manufacturing and service industries. It has been successfully applied to just about every industry, including health services. It also combines very effectively with Six Sigma tools and methods to improve process capability, as well as output product quality and stability.

Unfortunately, there are many ways to apply VSM and most of us struggle to appreciate its power and versatility.  Here's a simplied approach for using a Value Stream Maps to improve individual health, (and without the taktzeit).

This discussion builds on our previous article Applying Statistical Process Control to Health Monitoring.  That was a practical discourse on Six Sigma methods, where we provide a  tool in Excel to give the reader a real "hands-on" insight to Process Control charts in particular.

In manufacturing and production assembly lines, processes need to be analysed in detail along with cycle and takt time to improve efficiencies and overall throughput. This also applies in many service industries, including IT Service Management, Helpdesks and Call Centres especially.  In the case of the Health Management example here, the cycle time is a full day, and we are more interested in the overall effectiveness of the combined sub processes in producing improved output, or rather outcomes.

It is critical to identify and monitor the KPIs (key perfomance indicators) for successful daily outcomes and this was the focus of the Health Tracker tool covered in our previous discussion. This tool and the KPIs were speciffically targetting people with Type 2 Diabetes, as well as the millions of people in tye high-risk Pre-Diabetes stage. However, the methods and tools can easily be adapted for more general and wider usage in health monitoring and management.

I must restress here, that our tools and suggestions here are never intended to replace professional medical advice, medication and health plans.  However, we certainly hope to encourage individual ownership and focus on his/her own health improvement.  Monitoring and daily / monthly reflection, planning and revision can provide an improvement supplement, or help where nothing else is in place.

Value Stream Maps hing around a breakdown of the processes involved in the production cycle, and we have used two additional methods here to understand the processes that affect our health on a daily basis.

The first is a SIPOC tool. SIPOC (Supplier-Inputs-Processes-Outputs-Customers) has been in use since the 80s with TQM, and later Lean and Six Sigma. It's a very simple tool to build (eg. a paper list or an Excel table).  For our exercise, I used the very versatile SmartDraw application to quickly generate the following SIPOC chart.

The second tool that made a lot of sense in a daily health management process cycle was a  process time line map. At this stage we were not interested in the cycle time for each process step, whether eating luch or going for a mid-mornng walk.  What is more important is the the accumulated processes, and their sequence, inputs outputs, and contribution to customer value.  In this case the customer being the individual owning the health plan.

The Healthtracker tool we developed has a certain level of complexity, hence the (computer savy) person managing the health plan may not be the "end user" individual targeted for health improvement.  We discussed the variants of Customers and End Users in a article last year. 

Once again, we used the SmartDraw application to build this timeline. The different processes are colour coded into events, food comsumption and calorie burning activities.  Bear in mind our examples have not necessarily been optimised against any professional opinion. The merely show the tools and provide a baseline to start a Health Management and Improvement plan.

Finally, we can construct a Value Stream Map that bests suits the objectives, in this case stability and steady improvement.  

If we understand how the various components, suppliers, processes, sequences, outputs and Key Performance Indicators (KPIs) influence and impact overall health results (daily and over time) we can make more informed judgements on improving the individual processes and outcomes.

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