Trisotech Telemedicine Webinars Series
Process Automation in Telemedicine: Improving Efficiency

Presented at FHIR North 2021 by
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Dr. John Svribely, CMIO at Trisotech

Denis Gagne, CEO & CTO at Trisotech

Informed Consent (also known as Consent for Medical Treatment) is required prior to most medical procedures. It allows the patient to actively participate in decisions about what his or her own care. Informed Consent is therefore an integral part of Patient-Centered Care.

FHIR defines a Consent resource that is meant to cover four different uses cases: Privacy Consent, Medical Treatment Consent, Research Consent, and Advance Care Directives. Currently, only the Privacy Consent use case has been elaborated.

In this session we will explore the usage of the FHIR Consent Resource for the purpose of Informed Consent. This process will be captured using the BPM+ set of standards and combined with the usage of the FHIR Consent resource.

Attendees will learn about:

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What is Business Process Management?

What is BPM?

All businesses have processes. Processes are typically differentiated from projects because processes are predictable and repeatable. They are the building blocks of operating a business.

While many organizations have similar fundamental processes, the unique parts of their processes, dictated by their specific business methods, form the basis of the organization’s competitive advantage and often their “culture.” A process can be defined as a series of steps leading to identified outcomes. Common business processes are often named with descriptions like Opportunity-to-Order, Order-to-Cash, or Employee Onboarding. The sequence of work and steps performed can vary from instance to instance based on inputs, decisions, timing, dates, etc. However, regardless of the value of these variables, to properly define a process one must know all the possible paths and outcomes in advance i.e., predictability.

Business Process Management is a management discipline with the key goals of discovering, modeling, analyzing and optimizing business processes. While some BPM solution providers might include business process automation – a BPM engine or automation platform – as part of BPM, Trisotech defines process automation as a separate discipline. As a methodology, BPM can be thought of as similar to (and sometimes encompassing) other methodologies like continuous improvement (CI) or total quality management (TCM).

Why is BPM Used?

Once a predictable process has been defined through process discovery, it can be optimized – often called process improvement – and performed over and over in a standard way i.e., repeatability. By the act of discovering and defining a process, the resulting process documentation becomes a valuable organizational asset. The use of BPM can improve business operations’ performance and agility, lower costs and add value to customer products and services. Often cited specific benefits include higher efficiency and productivity, reduced costs, increased revenue, better agility, operational consistency, greater customer service focus, better regulatory compliance, increased security, and higher operational visibility.

Business Process Management Software in healthcare

BPM in Healthcare

Utilizing Business Process Management in Healthcare provides a huge array of opportunities to deliver better patient care and services, reduce errors, improve profitability, and ensure regulatory compliance at every level.

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Process-driven healthcare organizations can create standardized clinical guidelines that facilitate consistent organizational policy, patient diagnosis, treatment, and reporting for both individuals and populations. Business processes can also provide real-time feedback and recommendations to providers, be embedded in most patient encounter systems, and integrate the use of standards like FHIR® and CDS Hooks.

Business processes are not just valuable in the clinical setting, however. They are also extensively used in healthcare insurance and patient services settings. Examples of these types of processes include claims processing, pharmaceutical and durable medical equipment (DME) pre-authorizations and patient, provider, and facility scheduling.

Business Process Management Software in finance

BPM in Finance

Business Process Management is helping to fuel the disruptive FINTECH industry as well as assisting existing financial institutions and service providers in transforming the way they do business to remain competitive.

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End-to-end business processes are facilitating the digital transformation revolution that has put the customer in the center of a 360 degree organizational view. That in turn has led to the optimization of existing operations and customer-centric policies and procedures. Standardized processes lead to higher operational visibility as well as better and more easily audited regulatory compliance.

BPM is driving better risk assessment and management, underwriting decisions, lending automation, servicing automation, insurance claims processing, and many other financial activities. By using predictable and repeatable business processes the financial industry is experiencing higher growth rates, greater profitability, more rapid digital adoption, higher rates of compliance, improved efficiency, and better security than ever before.

Trisotech BPM Solutions
What is Business Process Management Software from Trisotech?

Digital Enterprise Suite

Trisotech provides 100% browser-based business process management discovery and modeling tools in cloud-hosted or on-premise environments. The process discovery tool – the Discovery Accelerator – helps business people describe the Who, What, When, Where, and Why of how their processes work through simple interactive screens and/or existing written policies, guidelines, business rules or other documents. These business observations can then be turned into an initial workflow starter diagram with the click of a single button.

Business processing modeling software from Trisotech – the Workflow Modeler – is used to produce a visual workflow using the international standard BPMN (Business Process Management Notation) via an intuitive drag-and-drop visual interface. These model diagrams provide comprehensive documentation, analysis, collaboration, and reporting features recognized as the gold standard in the process modeling industry and can be used directly by the Trisotech business process automation software. Using Trisotech’s BPM tools and combining the Workflow Modeler business process mapping software with the Trisotech Business Automation platform gives customers an unrivaled, powerful, and comprehensive low code/no code application development capability.

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Trisotech Featured in HealthTech Magazine Cover Article

Montreal, QC – May 25, 2021 — Trisotech (, a leading provider of Intelligent Business Automation-as-a-Service, today announced that it has been featured as the cover story in a Digital Health special edition of HealthTech Magazine titled Trisotech – Bridging the Business-IT Divide.

Trisotech, through their digital transformation solutions, is driving innovation in many industries including healthcare. Trisotech healthcare clientele include international and U.S. acute care hospitals, healthcare insurance organizations, renowned teaching hospitals, and healthcare professional organizations.

The cover article discusses how using Trisotech workflow and business decision modeling along with Trisotech automation engines helps healthcare organizations blend IT challenges with clinical practices. According to Trisotech Founder, CEO and CTO, Denis Gage, “Most healthcare providers want centralized, easy-to-understand and change standard process and decision methodologies. They not only want tools that adhere to international standards for building those processes and decisions, they also want those tools to support other standards like FHIR® for data storage and retrieval and CDS Hooks for real-time decision support at the point of care. We do all that and more.”

“We are very pleased that HealthTech Magazine has recognized our transformative innovation in the healthcare space,” continues Gagne, “and has provided this article that delves into our innovations in an informative and easy to understand way. We are also pleased to be a founding member of the BPM+ Health community where these ideas including our nearly 1,000 free pre-built evidence-based workflow and decision models are being put into practice every day. These models are human-readable, machine automatable, and embeddable in most medical encounter systems. Healthcare organizations can use these models, created under the direction of Trisotech CMO John Svirbely, as they are, or quickly and easily modify them to fit the exact nature of their organization’s policies and procedures. Healthcare organizations can also, of course, create their own processes and decisions from scratch since the easily understood visual models can be built and shared by practitioners, IT and business people.”

Founded in 1996, Trisotech aids enterprises in realizing their Digital Transformation goals by visualizing, improving, innovating, transforming, and automating their most critical business processes.

About Trisotech

Trisotech is a global leader in digital transformation solutions. Trisotech The Digital Enterprise Suite is a highly visual and interactive software suite that enables technical resources to encapsulate programmatic logic and lets non-technical business people assemble the business logic to innovate, transform and improve their business. Combining concepts of simplicity, usability and collaboration in the cloud, the Digital Enterprise Suite is composed of theDigital Modeling Suite and the Digital Automation Suite. Trisotech customers use the Digital Modeling Suite to create a digital twin of their organization using visual models and the Digital Automation Suite to leverage business automation as a service in industries such as healthcare, finance, and the public sector.

Trisotech is a privately held company.



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Denis Gagne

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What Does a Workflow Management System Do?

Workflow Automation software executes computer-driven flows (processes) of human and system tasks, documents, and information across work activities in accordance with flow paths based on business decisions. Workflow Management software also ensures processes – both internally across organizational boundaries, and externally for Customer/Client interactions – are optimized, repeatable and auditable while still being quick and easy to change.

While Robotic Process Automation (RPA) has been making inroads in automating tasks within processes, Workflow Automation software is far more powerful than RPA. However, the two are both compatible and synergistic. RPA bots can automate individual tasks within a business process, but they typically can’t connect those tasks together. Good workflow engines allow RPA tasks to be included as part of a process.

Workflow Design software and Workflow Process software are being effectively used in practically every industry, frequently serving as standard operating procedures software. Digital Workflow software can be especially effective and valuable in two industries: Healthcare and Financial Services.

Workflow Automation Software
in Healthcare

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Business Workflow Automation Software

The Healthcare industry is large and diverse. While the focus in healthcare is usually on the front-line workers, the caregivers and providers, there are also multitudes of back-office workers.

Large-scale healthcare organizations are often in linked businesses, networking physicians and other providers, acute care hospitals, long term care facilities and insurance organizations. Using Trisotech’s Business Process Management software all these organizations can create secure standards-based software to help them store and retrieve data as well as standardize and automate workflows and decision making across all parts of their business.

Most healthcare providers want standard processes and decision methodologies that are centralized, easy to understand, automated through workflow engines, and quickly changed by SMEs without resorting to the need for heavy IT involvement. This, in turn, frees up IT resources to work on centralizing, consolidating and making available the latest technologies across organizational silos. This includes providing technologies to support standards like FHIR® for data storage and retrieval, Clinical Quality Language (CQL) and CDS Hooks for clinical decision support in real-time at the point of care. Trisotech’s Workflow Design software and Workflow Automation software supports all these standards and allows automated processes to be fast and easy to change as regulatory requirements and new medications and procedures evolve.

Using Trisotech’s workflow management software, healthcare organizations can develop evidence-based workflow and decision models that are human-readable, machine automatable, and embeddable in most medical encounter systems. While healthcare organizations can and do create their own automatable models, Trisotech also provides pre-built models including nearly 1,000 free customizable care pathways, clinical guidelines, and healthcare decision calculators in the BPM+ Health standard. This way, Trisotech’s process management software enables practitioners to stay updated, accelerate solution adoption and ensure greater consistency in care execution. Additionally, the comprehensive visual models offered by the Workflow Design software are readable by IT, providers and business people, serving as a guideline specification, the guideline logic, the guideline documentation, and the automation code for the workflow engine – all in a single visual artifact!

FREE customizable care pathways, clinical guidelines, and healthcare decision calculators

Moving to evidence-based practices is very desirable but also often difficult for healthcare organizations. Subject matter experts (SMEs) and clinicians constantly work with IT to translate large volumes of regulatory, new medication and procedure information into organizational policy. This is a consistent and expensive requirement for SMEs using their existing, often antiquated systems to keep information up to date. Trisotech’s Workflow Design software and Workflow Automation software solutions allow healthcare organizations to easily define and deploy evidence-based best practices that offer a consolidated view of the interactions and multiple touchpoints with patients, care pathways, and workflows at the point of care.

Back-office tasks such as pre-authorization, medical necessity determinations and off-label drug prescription approvals have a huge bearing on patient experiences. They are also time-consuming, expensive and highly manual activities. Utilizing Workflow Process software for these types of activities expedites decisions for waiting patients, allows for services to be rendered sooner, and increases ROI. Using Trisotech’s digital workflows paves the way for improving both the perceived and real quality measurements for any healthcare organization.

Healthcare Payers and Insurers are also leveraging Trisotech’s process management software to automate processes like claims processing and pre-authorization determinations, leading to more efficient decision making and significant cost savings. Trisotech’s Automated Workflow software can ensure the correct information is collected at the outset, help pay claims rapidly and organize case management for disputed or confusing exception claims. The workflow software also helps payers keep complete records in case of an audit. Health plan members benefit from a better experience as they can access the care they need with minimal delays and without surprises at the time of claim payments or billing.

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Workflow Automation Software
in Financial Services

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Business Workflow Automation Software

Financial services make up one of the economy’s most significant and influential sectors. This sector is made up of Banking Services including Retail Banking, Commercial Banking and Investment Banking. Also included are Investment Services, Insurance Services and Tax and Accounting Services.

These businesses are composed of various financial firms including banks, finance companies, lenders, investment houses, real estate brokers, insurance companies, etc. Trisotech has customers using its Workflow Design software and Workflow Automation software in all of these businesses. The typical description of this sector is Financial Services, but it is really made up of both services and Financial Products like mortgages, investments, credit cards, insurance policies, etc. This means that it is not only a business-to-business (B2B) sector but also has a huge business-to-consumer (B2C) component. Marketing, selling and servicing these products is fertile ground for Trisotech’s Workflow Automation software.

Various forms of proprietary financial software have been in use for decades and the adoption of those early technologies now presents the industry with an increasing risk in the form of technical debt. Old technologies are being disrupted by newer cloud-based offerings which include standards-based business process management software that is far better suited to meet the rapidly changing personalization, self-service, risk and compliance needs of today’s marketplace. Indeed, improving client service by automating policies, accounts, investments, claims and more using digital workflows is a cornerstone of the digital transformation efforts in financial services. To simplify the complex process of digital transformation and in order to streamline their processes and decisions, financial enterprises should render organizational workflows and business decision logic into international standards-based visual diagrams and documents. When using Trisotech’s Digital Enterprise Suite, not only can those visual diagrams be shared by business people and technical people they can also be automated by Trisotech’s workflow engine directly from those visual diagrams.

knowledge across your organization and free up your IT resources

Technology replacement is also very important because most organizations have their knowledge, policies and procedures embedded in large complex programs maintained by IT programming staffs. Today, “old school” practices like SMEs maintaining Excel spreadsheets for policies and rules (regulatory and organizational) that then must be “translated” by IT into traditional programming languages and proprietary rules systems are giving way to visual models incorporating standardized “decision services.” Using Trisotech’s Digital Enterprise Suite, modern workflows and decision services can be built and maintained by SMEs and turned into automated business processes by clicking a single button. This, in turn, frees up IT resources to work on centralizing, consolidating and making available additional more current technologies across organizational silos.


Primary challenges the financial industry is facing today include rapid and often massive regulatory changes, privacy, security, and fraud prevention, surpassing or keeping up with the competition by exceeding customer expectations, and replacing old technologies with emerging technologies. Trisotech’s workflow software is already recognized as the reference implementation for many international standards such as BPMN, CMMN, and DMN. In the financial industry Trisotech is rapidly taking a leadership position with its implementation of the Mortgage Industry Standards Maintenance Organization (MISMO) standard and support of other standards like the Financial Industry Business Ontology (FIBO), common database connections and multiple AI techniques.

For Fintech organizations, Trisotech’s Workflow Design software and Workflow Automation software accelerate digital transformation by providing the ability to easily define, deploy and maintain improved decision-making and workflows supported by artificial intelligence and machine learning in a graphical environment. While Trisotech’s Digital Enterprise Suite is being used by customers for everything from retail credit card processing to insurance claims processing, one area, underwriting, has been of particularly high value to customers.

Underwriting is the process by which an institution takes on financial risk – typically associated with insurance, loans or investments. Underwriting means assessing the degree of risk for each applicant prior to assuming that risk. That assessment allows organizations to set fair borrowing rates for loans, establish appropriate premiums to cover the cost of insuring policyholders, and creating a market for securities by pricing investment risk.

Underwriters evaluate loans, particularly mortgages, to determine the likelihood that a borrower will pay as promised and that enough collateral is available in the event of default. In the case of insurance, underwriters seek to assess a policyholder’s financial strength, health and other factors and to spread the potential risk among as many people as possible. Underwriting securities determines the underlying value of the company compared to the risk of funding its capital acquisition events such as IPOs. All of these activities lend themselves to digital workflow software solutions.

For example, mortgage loan origination. By utilizing Trisotech’s Workflow Design software, customers are able to build standard operating procedures software for loan origination that encompass the organization’s specific underwriting policies. These workflows can be created and maintained by underwriting experts while complex mathematical models, AI and privacy and security requirements are taken care of by IT personnel. Trisotech provides for all of this in a single common visual model understandable by both the business people and the IT personnel while still maintaining separation of concerns through granular permissions. Once the visual model is complete, a single button click can automate the workflow and make it available to Trisotech’s workflow engine part of the Workflow Process software.

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What Is Workflow in Software?

Digital Enterprise Suite icon

The unique capabilities of Trisotech’s Automated Workflow software are rooted in its ability to simplify the complex process of digital transformation for all. In order to streamline their processes and decisions, enterprises must first know what those processes and decisions are. Discovering and validating them is the responsibility of business leadership not solely IT. Thus, a must-do activity of digital transformation is rendering organizational workflows and business decision logic into international standards-based visual diagrams and documents. Then, they can be shared by business people and technical people and automated directly from those visual diagrams.

Trisotech calls this process Business Services Automation. The Trisotech offering includes visual Workflow Design software and visual Workflow Automation software.

Trisotech Workflow Automation Solutions

Digital Modeling Suite icon

Workflow Design software

The Workflow Design software includes workflow automation software (BPMN), decision automation software (DMN) and case management automation software (CMMN) along with a larger suite of application tools that facilitate workflow discovery, promote organizational standards use and support workflow design life cycles. The software also supports AI and RPA integrations, full API support and the configuration and management of users, permissions and models.

Digital Automation Suite

Workflow Automation software

Trisotech’s process Workflow Automation software includes workflow engines that can directly execute the business process management models. These workflow engines are utilized through RESTful APIs, provide the highest levels of privacy and security and can be containerized and thus scalable on demand across a wide variety of public and private cloud configurations including high availability configurations.

Trisotech’s Workflow Automation software also provides a full rich visual configuration interface supporting server environment configuration, audit logs, debugging tools and management of running workflow instances. Trisotech’s digital workflow software is high in value, low in cost and backed by world-class technical support.

Put succinctly, Trisotech’s Digital Automation Suite (DAS) is an API-first, container-based scalable cloud infrastructure for business automation. It enables complex automation of business workflows, cases and decisions in a simple, integrated run-time environment. It allows organizations to leverage business automation as a source of competitive advantage, via high performance, flexible, and linearly scalable automation engines. The Digital Automation Suite also offers an outcome-driven orchestration of AI and other emerging technologies using international standards and a microservices architecture.



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BPM+ Health Clinical Pathway Implementation Showcase
Healthcare Concept Maps combined with a FHIR® accelerator.

BPM+ models are based on open standards that can be used to visually depict the structure and behaviour of healthcare workflows and decisions. If these workflow and decision models are to completely model healthcare clinical guidelines, then they also need to orchestrate logical data structures of medical concepts and data in the electronic health record.

In this presentation, we look at:

As presented by:

John Svirbely and Denis Gagne

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