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Enterprise Architecture in Healthcare v2.0 Research | Blogs | Expert Opinions

Pekka Neittaanmäki

Dean of the Faculty of Information Technology

Professor, Department of Mathematical Information Technology

University of Jyväskylä

Miikael Lehto Anthony Ogbechie

Project Researcher Service Innovation Management

University of Jyväskylä University of Jyväskylä

JYVÄSKYLÄN YLIOPISTO

INFORMAATIOTEKNOLOGIAN TIEDEKUNTA 2017

TEKES HANKE: VALUE FROM PUBLIC HEALTH WITH COGNITIVE COMPUTING

TABLEOFCONTENTS

EnterpriseArchitecture:MuchMoreThanYou’reThinking....................3

TheRisingImportanceoftheEnterpriseArchitect.................................3

WhereIsEnterpriseArchitectureinHealthcare?...................................4

EnterpriseArchitectureinHealthcare....................................................5

RoleofEnterpriseArchitectureinHealthcareOrganizationsandKnowledge-BasedMedicalDiagnosisSystem.......................................6

IterativeApproachtoBuildanEnterpriseArchitectureforHealthInsuranceExchange...............................................................................7

APracticalGuidetoDevelopingEnterpriseArchitecture.......................8

EnterpriseArchitecturePavingtheWaytoWorldClassHealthcareDigitalStrategiesintheMiddleEast...............................................................10

HealthcareArchitecturefortheRealWorldMakingEA,SOA,andLocalizationMoreThanBuzzwords.......................................................11

EnablinganAgileHealthcareEnterpriseArchitecturewithBPM/SOAandSemanticTechnologies........................................................................12

3

EnterpriseArchitecture:MuchMoreThanYou’reThinkingMostusageoftheterm“EA”isfocusedprimarilyonwhatmightmorepreciselybecalled“ITarchitecture”or“informationsystemsarchitecture,”whichisconcernedwiththelogicalandphysicaldescriptionsofdata,applications,andhardwareassets.

EA“isablueprintfororganizationalchangedefinedinmodels[usingwords,graphics,andotherdepictions]thatdescribe(inbothbusinessandtechnologyterms)howtheentityoperatestodayandhowitintendstooperateinthefuture;italsoincludesaplanfortransitioningtothisfuturestate."AndblendinthenotionthatEAisallaboutcreatingadynamictoolforunderstandingtheenterpriseandmanagingenterprisetransformation,ananalyticaltoolforcontrollingenterprisecomplexity,asharedlanguagetofacilitateandexpeditecommunicationabouttheenterprise,andadecision-supportingknowledgebasetohelpmanagementcreateandmorequicklyachieveobjectiveslikestrategicadvantage,alignment,agility,efficiency,synergies,andvalue.

EA-relatedactivities:systemsdevelopment,systemsanalysis,systemsdesign,networkdesign,cyber-security,anddatadesignandadministration,butalsonon-ITthingslikestrategicplanning,businessprocessreengineering,changemanagement,humanresourcesplanning,securityandcontinuityplanning,innovationandtransformation,financialsystemsandcontrolsplanning,andmuch,muchmore.

Atsomepointyou’llneedtodealwithEAprocessesandprocedures,andtheplaceofEAinthingslikeresourceallocation,projectmanagement,cyberandphysicalsecurity,ITstandardsdevelopment,andenterprisestrategic,tactical,andoperationalplanning.

https://www.zachman.com/resources/ea-articles-reference/320-enterprise-architecture-much-more-than-you-re-thinking-dr-leon-kappelman

TheRisingImportanceoftheEnterpriseArchitectEnterprisearchitecturefocusesonfourcrucialC's:connection,collaboration,communicationandcustomers.Initssimplestterms,enterprisearchitectureistheprocessofaligningabusiness'sstrategicvisionwithitsinformationtechnology.Itconnectsdifferentbusinessunitsforsynergisticcommunicationandcollaboration,creatingamoreseamlesscustomer(orend-user)experience.http://www.cio.com/article/2439397/it-organization/the-rising-importance-of-the-enterprise-architect.html

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WhereIsEnterpriseArchitectureinHealthcare?Overthepasttwodecades,enterprisearchitecture(EA)hasgraduallyemergedtohelpinstitutionsinmanymarketsbuildnewoperatingmodelsandconnecttheiras-isandto-bebusinessstrategiesandITcapabilities.Thoughthedisciplinestilllacksindustrywideconsistency,EAadvocatesinbothacademiaandindustryreadilypointtosuccessfulEAframeworksofferingbusiness-ITgovernance,standardization,andmoresophisticatedsoftwareandinformationinfrastructures.

Infact,virtuallyalloftoday'shealthcarebuzzwordinitiatives--populationhealth,healthinformationexchanges,healthanalytics,medicalneighborhoodmodels,performanceandqualitymanagement--sharecommoncapabilitiesmanageablethroughEA.

ThereareclearreasonswhyEAshouldbeatthetopofeveryhealthenterpriseprojectportfolio:

1. Improvingperformanceandhealthoutcomes:Thequalityofanorganization's

processexecutionandanalyticalinsightsisdirectlydependentoninteroperability,automation,dataquality,andtimeliness.Ifyouwanttobuildaperformance-orientedhealthdeliverymachine,EAprovidestheengineandfuel.

2. Controllingcosts:EAhasaproventrackrecordofhelpingorganizationscontroloperationalexpendituresandincreasereturnonassetsthroughreductionsinhardwarepurchasing,softwarelicensing,stafftraining,andsupportcosts.EAisgoodbusinessregardlessoftransformationalgoals.

3. Protectingprofitability:Healthorganizationsareincreasinglycarryinghigherfinancialrisks.Theserisksarecompoundedwhenspendingdoesnotaddresssustainablecapabilitycreationandinsteaderodesmargins.

4. Managingsecurityandrisk:Foralltherightreasons,ACOsandPCMHsoftenincreasethenumberofpeople,processes,andsystemsinvolvedincaredelivery.Butcomplexityistheenemyofsecurity.EAoffersameansofcontrollingrisks.

5. Encouragingbetterplanning:Qualityandconsistencygohandinhand.Inthefaceofrisingcarepracticeandbusinessmodeldiversity,frontlinepractitionersneedconsistentprocessesfortreatingandmanagingpatients.EAprovidesacommonframeworkforbothdefiningandoperationalizingtheto-bestateofthebusiness.

http://www.informationweek.com/healthcare/leadership/where-is-enterprise-architecture-in-healthcare/d/d-id/898882

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EnterpriseArchitectureinHealthcareManyarchitecturegroupsinhealthcareorganizationsarestrugglingwiththecommunicationwiththerestoftheorganization.Inhealthcare,thepatientcureandcareprocessesarethecenteroffocus,andtheinformationisseenasrelativelyunimportantbymosthealthcareprofessionalsandmanagers.Thismakesitdifficultforarchitecturegroupstogainrecognitionfromboththeorganizationatlargeandfrommanagementinparticular.Inorganizationslikebanks,insurersorgovernmentagencies,wherelargepartsoftheprimaryprocessare‘inside’theinformationsystems,theperceptionofarchitectureisdifferent.Wealsoseethattheresponsibilitiesforarchitectureareoftennotassignedproperly.Thathastodowiththepreviouspoint,butalsowiththeorganizationstructuresinhealthcare.Therelativelyautonomousroleofphysiciansinhospitalsmakescentralizeddecision-makingoninformation-andIT-relatedissuesdifficulttoorganize.Vestedinterestsandspecificlocalneedsclashwiththegeneralgoalsofeffectiveandefficientinformationsystemsacrosstheorganization.Informationflowshavebecomethe‘circulatorysystem’oftheorganization.Manyorganizations,however,lackaclearoverviewanddonotpayadequatemanagementattentiontoinformation.Fragmentationofdatainsilos,inconsistencies,unclearresponsibilities,privacysensitivity,complexityandalargenumberofexternalinformationflowsarejustsomeoftheissuesthatmakethisagrowingproblem.Inparticular,theincreasedreportingpressurefromthegovernment,insurersandregulatorsmakesgoodmanagementinformationparamount.Thisisreallyanissuefortheboardroom,giventheseriousrisksinvolved.IntheNetherlands,recentpublicityaboutsubstantialfinesforhospitalsandphysiciansbecauseofinaccurateinvoicing,andtherefusalbyaccountantstoapprovethefinancialstatementsofhealthcareorganizationsclearlyshowtheneedforimprovementinthisarea.ThecomplexityofthehealthcaresystemintheNetherlandsandmanyothercountriesmakesthisachallengingtask.http://blog.bizzdesign.com/enterprise-architecture-in-healthcare

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RoleofEnterpriseArchitectureinHealthcareOrganizationsandKnowledge-BasedMedicalDiagnosisSystemHealthcareorganizationsareconfrontingvariousissues;themajorissueintheseissuesismedicalerrorsandprovidingmedicalserviceswheredoctorsareinexperiencedorabsent.Thehealthcareindustryaddressesthelackofinteroperabilityandintegrationamongsystems;itwillnevergettheadvantagesofanElectronicMedicalRecord(EMR).ManyhealthcareorganizationsoperateElectronicMedicalRecordsystemsindependently.Thesesystemsareincapabletoconnectwithothersystems.TheOpenGroupArchitectureFramework(TOGAF):ItisbasedonUnitedStatesDefenseDepartmentTechnicalArchitectureFramework.TheTOGAFwasintroducedin1995forinformationmanagement.Itisagenericframeworkand,forthisreason,anyfirmmayemploytheTOGAFfreelytodesignEA.TheTOGAFisthebesttodevelopanenterprisearchitecturemodelforKnowledge-BasedMedicalDiagnosisSystemsbecauseitprovidesastep-by-stepprocessintheformoflayeredarchitectures.TheTOGAFdividesenterprisearchitectureintofourlayeredcategories

• Businessarchitectureexplainstheprocessesusedforabusinesstoachieveits

goalsforinstancethebusinessarchitectureofhealthinformationsystemconsistofhealthserviceslikepatientrecords,individualhealthrecords,classificationofdiseases,symptomsandprocedures,diagnosticreports,suggestions,prescriptionsandtreatmentplans,etc.

• Applicationarchitecturedealswiththedevelopmentofdifferentapplicationsandtheinteractionbetweenthem.Thisarchitectureishighlyapplicableinthedesigninganddevelopmentofrelevantsoftwarerequirementforinterfacingwithhealthcaresystemslikestandardizedinstrumentsfordatacollection,data-communicationservices,dataanalysisandmodeling,reportgeneratingandspeechrecognitionapplicationinlocallanguage.

• Dataarchitectureexplainsmethodsofdatastorageandretrieval,Datamodels,Metadatadictionary,Classificationstandardsandsystems

• Technicalarchitectureexplainshowsoftwareinfrastructureandhardwareinfrastructuresupportapplicationsandtheirinteractions,Local/wideareanetworks,OperatingsystemInteroperability,mobilephonetechnology,speechrecognitiontechnologyandwebtechnology.

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-17752016000200181

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IterativeApproachtoBuildanEnterpriseArchitectureforHealthInsuranceExchange

OracleArchitectureDevelopmentProcess

OracleEnterpriseArchitectureFramework

http://www.oracle.com/us/solutions/enterprise-architecture/arch-planning-healthcare-exchange-1556909.pdf

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APracticalGuidetoDevelopingEnterpriseArchitectureEnterprisearchitectureisalogicalorganizationofabusinessanditssupportingdata,applications,andITinfrastructure,withclearlydefinedgoalsandobjectivesforthefuturesuccessofthebusiness.Atypicalarchitectureconsistsofdiagrams,ormodels,thatshowhowaspectsofyourbusinessrelate.Forexampleanorganizationalchartisamodelofhowbusinessunitsrelatetoeachother.

Businessesshouldhavean"as-is"architecturethatrepresentsitscurrentstate,andaplannedarchitecturetoshowthedirectionofthebusinessoverthenextonetofiveyears.

Enterprisearchitecturealignsthefollowingkeyareas.Notetheexamplesineacharea:

• Business:Processes,strategies,organizationcharts,andfunctions• Information:Conceptual,logicalandphysicaldatamodelstoshowwhat

informationisneededandhowitrelatestootherinformationForexample,acustomerandanorder

• Application:Portfolios,interfaces,andservices• Infrastructure:Networkconceptdiagrams,technologyreferencemodelsStep1.Identifythepurposeofyourarchitecture

• Whatinformationisimportantforthearchitecture?• Howmuchdetailisneededtosupportanalysisanddecisionmaking?• Whowillproduceorusethearchitecture?• WhatistheexpectedROIofthearchitecture?• Whatarethemaintenanceconsiderations?Step2.Identifyyourbusinessquestions

• Whatistheimpactofretiringanapplication?• Whatistheimpactofmovingalocation?• Whatapplicationsareneededtosupportabusinessprocess?• Whatistheimpactofreplacingservers?• Whatprocessesneedtobedevelopedtosupportanewstrategy?• Wherearethegapsorredundanciesinourapplicationportfolio?Step3.Identifyassumptionsandbusinessrules

Everybusinesshasrules.Forexample,ifyouarecapturinginformationaboutcriticalbusinessprocesses,youmustalsocaptureanyregulationsorcorporatestandardsfortheprocess.

9Youshouldcaptureassumptionsaboutyourarchitecture,suchas"NewapplicationinformationwillbeuploadedonFriday"or"Everybusinessunitisresponsiblefordocumentingbusinessprocesses."

Step4.Identifyyourframework

Thefollowingindustrystandardframeworkscanhelpyoucreateanenterprisearchitecture:ToGAF,Zachman,EA3,andDoDAF.Usingastandardframeworkgivesyourarchitecturea"skeleton"thatyoucanthenbuildoutwithyourmodels.

Aframeworkalsoprovidesguidanceonwhatinformationyouneedtocapturebasedonthestakeholderswhowillusethearchitecture.Itprovidesguidanceonorganizinginformationbutdoesnotsuggestaspecificimplementationforyourarchitecture.

Aframeworkhelpsorganizethekeyareasofthearchitectureandidentifiestheviewsyouneedtomodel,suchastheperspectiveandthedataneededtoanswerbusinessquestions.

Step5.Createametamodel

Ametamodelisanabstractviewofyourarchitecture.Itshowsthedatayouaretryingtocapture,andtherelationshipsamongthedata.Thisiswhereyourealizealignment,whichisbasedonanswerstoyourbusinessquestions.

Yourmetamodelshouldincludethefollowingfeatures:

• Relationshipsbetweenthearchitectureelements.Forexample,abusinessprocesstoanapplication.

10• Definitionsoftheelements.Forexample,themeaningoftheterm

"application"andwhatpropertiesyouwillcapture.• Traceabilitytobusinessquestions.Forexample,ifyourquestionis"What

applicationssupportwhatbusinessprocesses?"Youknowyouneedabusinessprocessandanapplicationinyourmetamodel,withadirectorindirectrelationshipbetweenthem.

Step6.Identifythemodelsneededinthearchitecture

Afterknowingtheaudienceandthecontentyouwanttomodelyoucanthenidentifythediagramsyouneedtocreate.ItisimportanttorememberthatyoucannotuseasinglediagramtomodeleverythinginyourEA.Further,separationofthearchitecturalviews,suchastheapplicationviewfrombusinessview,isabestpractice.

Step7.Integratethearchitecture

Linkthedatathatyoucapturedtogetherbasedontherelationshipsyouidentifiedearlier.Ifyouhaveexistingarchitecturesforprojectsorlinesofbusiness,andyouwanttocreateanenterprisearchitecture,theeasiestapproachistopopulateyourEAfromthebottomup.Takeexistingarchitecturesandpullcommonelementsintoarepository.Movingforward,trytostandardizethemodelsandterminologythatisusedacrosstheorganization.

Allowforatleast50%ofthetimeallottedtodevelopingamodeltobeforanalysis;thisincludesreviewingthemodeltoverifyandvalidateit.Doquantitativeaswellasqualitativeanalysis.Mathisimportant,especiallyforshowingROI.Quantitativeanalysiscanbeusedtoshowbottlenecksinaprocess,timesavings,costsavings,andeliminationofredundanciesifyouuseanindustrystandardmethod.https://www.ibm.com/developerworks/rational/library/enterprise-architecture-maximum-value/index.html

EnterpriseArchitecturePavingtheWaytoWorldClassHealthcareDigitalStrategiesintheMiddleEastMorespecificallyHealthcareEnterpriseArchitecture(EA)isthepracticethatshowsanorganizationhowtobalancethedeliveryofimmediatebusiness-valuewhiledevelopingalonger-termstrategiccapability.Thisstrategiccapabilityholdsthepromiseofmakingtheorganizationmoreresponsivetochangethroughthedetailedunderstandingofbusinessprocesses,thealignmentofbusinessandIT,andthecouplingofknowledgemanagementwithenterprisetransformationprograms.

11EnterpriseArchitectureuseswelldevelopedframeworkssuchasZachman,TOGAF(TheOpenGroupArchitectureFramework)andSoA(ServiceOrientedArchitecture)todefinethebusiness,information,data,applicationsandtechnologylandscapes.

Insimplertermseachofthesedimensionshaveartifactslikethebusinesslayerwouldincludetheorganizationsroles,theorganizationalstructure,theirstrategicobjectives,documentedbusinessprocessmaps,theirvaluechain,etc.

BycreatingrelationshipsbetweenthemodulesusedbyspecificorganizationalunitsusingtheframeworksofEnterpriseArchitectureyouwouldbeabletounderstandthegapsineachofthesedimensionsaswellashaveahigh-level(somewhataerial)viewofeachartifact(asset)inyourbusinessalsoreferredtoasyourenterpriseandbeabletoplotthedesiredtargetstateenterprisearchitecturewhichwillclearlydemonstratethedeploymentroadmapforyourbusinesstoachievethedesiredlevelofmaturityinyourhealthcaredigitalstrategy.Theotherveryvaluableaspectistheabilitytohaveclearvisibilityofallyourbusiness,information,data,applicationsandtechnologyassetsandre-useratherthanre-purchasewiththeintentofreducingcostandduplication.

http://health-e-solutions.com/blog/enterprise-architecture-healthcare/

HealthcareArchitecturefortheRealWorldMakingEA,SOA,andLocalizationMoreThanBuzzwordsFivesuccessmeasuresofyourarchitecture...

5)Durable,withdecreasingrateofchange-Evolution,notrevolution.Ifyougetitright,changesbecomesmallandincremental4)Standards-based,withvariancesthatarelocalizedtominimizeimpact.

-Buildonexistingwork -Departonlywhereyouneedto -Anytimetwothingstouch,thattouch-pointshouldbeastandard3)Product-neutral-Organizationscannotaffordtobasetheirentirefutureonadependencyofanyoneproduct

2)Clear

-Makesureyourarchitectureisunderstandable,concise,andaccurate -Use“separationofconcerns”and“viewpoints” -Makesureyourarchitectureissuitableforitsintent

121)Useful-Architecturesthatsitonshelvesaddnovalue-Receivingandaccommodatingfeedbackindicatesthatthearchitectureisbeingused.-Measuringfeedbackisametricofuse

https://www.uef.fi/documents/677096/736588/Solea09-Rubin.pdf/a8da086a-73a4-4bba-bd42-13d18042d764

EnablinganAgileHealthcareEnterpriseArchitecturewithBPM/SOAandSemanticTechnologies

http://www.omg.org/news/meetings/workshops/SOA-HC/presentations-2011/14_A-6_Chow.pdf