Why Business Leaders Should Handle Processes Before People


Jason Z. Rose, MHSA, is CEO of AdhereHealth, an innovative technology company dedicated to transforming healthcare.

Get any business leader talking about a new IT initiative in their company and, eventually, the conversation is sure to come around to the (generally correct) idea that technology can’t solve problems on its own.

“It’s not just computers (or cloud resources, or mobile devices, or a new artificial intelligence algorithm),” they’ll say. “It’s about people, processes and technology. You need all three.”

The basic idea makes sense, and it’s easy to see why such a simple slogan has taken root in the business world since the framework first emerged decades ago. But it’s always said in that same order: people first, then processes and then technology bringing up the rear. This impulse to emphasize the importance of people is understandable. But from a systems design perspective, it’s all backwards. And it can lead to disastrous results.

Really, the framework ought to be “process, technology, people.” When business leaders tackle processes first, they’re forced to carefully consider what outcomes they’re trying to achieve and then plan out what steps they need to take to achieve them. Next, they can determine which technologies will best enable those processes. Finally, they can give their people clear instruction on how to use new technologies to follow the processes that will achieve the desired result.

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This is just another way of saying that businesses must begin with the end in mind. Ultimately, this sort of business design is better for employees because they will know exactly what is expected of them and how to do their jobs to the best of their ability. What’s more, it will result in people being placed in positions where they can work to their highest ability, setting them up to succeed in their job roles.

In the clinical world, this is called operating at the “top of the license.” It’s why, when you go to the doctor for a checkup, your primary care physician is usually not the person who checks your pulse or draws your blood. Doctors are more than capable of performing these tasks—just as they’re perfectly able to schedule appointments or clean the carpets in their waiting rooms—but that’s not why they went to medical school. Not every professional has a skill set or a credential as clear and obvious as that of medical doctors, but well-designed processes in all fields will similarly result in employees working at their highest capacity.

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When we design workflows at AdhereHealth, we always want them to result in pharmacists spending their time performing medication reviews—in other words, operating at the top of their license. Now, this might sound like we start with “people” when designing our workflows. But really, we have to get the processes and the technology in place first. Only then can we be sure that our people are able to do their jobs to the best of their ability. For example, we ask ourselves what our pharmacists need to do their jobs effectively. The answer, of course, is that they need patients. But where do the patients come from? Well, we need software and analytics to create a pipeline of patients to perform the medication reviews on. Okay, but what exactly should the technology do to support the medication review? Ah. Now we’ve arrived at the process, where we begin designing our systems.

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Organizations need to actually write down the steps of their business processes—not at the end of their design initiatives, but at the beginning. This will ensure that processes are actually aligned with business goals rather than with the habits or preferences of employees and software developers. By identifying basics like “swim lanes” and handoffs upfront, organizations can create processes that not only meet business goals but also let technologists and end users know exactly what they need to do.

When businesses design good processes and take the time to write them down, they can then design technologies to make those processes as effective and efficient as possible. Only then can business leaders identify how many and which employees should take care of which tasks.


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