Architecting Standardization in a Complex Healthcare Organization, Sandy McCoy, Executive Director, Business Architecture, Kaiser Permanente
Session abstract: Technology-enabled health care requires an evolutionary approach to information management and protection of patient confidentiality. With the ever increasing usage of technology in the delivery of care, there is a heightened awareness and need for standards, well-defined architectures and transformational strategies.
In this session, Kaiser Permanente will be sharing some of their practical and innovative approaches to standardization and enterprise architectural concepts in a multi-billion dollar integrated care delivery system comprised of approximately 186,000 individuals serving over 8.6 million members.
Sandy opens by outlining the complexity aspects of Kaiser: Healthcare in general, ”The US Healthcare system is not a system at all.”
Also, the IT organization structure adds a complexity factor (National Solution Delivery, Regional Solution Delivery, IT Functional Organizations). EA needs to work across these layers.
Sandy has a good slide on the disconnected silos of healthcare, such as Rx, Primary Care, Research, Nursing Homes, Hospitals, etc.
A reformed US Healthcare system would have a hub & spoke model, coordination/connection center, with all the silos as spokes. This should result in lower costs and more positive health outcomes. Sandy is speaking of the systemic problem, not the politics.
“Dramatic change is coming to medicine – it’s becoming an information-based, technology enabled business”. – Economist quote from April 2009.
Challenge is in connecting all of these systems. Kaiser looking at semantic technology.
Kaiser’s vision: integrated model, scale and technology are providing the foundation for delivering truly real-time, personalized health care. Kaiser’s focus is on prevention.
What does this mean for enterprise architecture? Need to focus on the big ticket items. EA wants to move from chaos to harmony. Truth is, not a straight line. It goes uphill, there are blind turns and it’s treacherous.
Kaiser started by focusing on standards. Standards as a rallying point in a time and realm of chaos and confusion.
Visualization (using Troux tool) helped with standards understanding and adoption. Could see implications in context of the portfolio, rather than a list in an Excel spreadsheet.
Within 6 months, had all technology standards implemented in Troux, complete with lifecycle information. In those 6 months, started seeing the power of the tool. Now, they’ve branched into other areas: business focused systems, such as radiation systems.
Beyond standards, Kaiser is using Troux to understand the total investment in IT (portfolio) and potentially identify rationalization opportunities.
Business architecture: business function model and business capability model. In Troux, these are linked to application functions. Surfaced redundancy in portfolios — 11 G/L systems — and information lineage issues.
This is not a massive effort. They are taking an opportunistic approach. Focus on the information officers who see value in utilizing enterprise architecture information.
Kaiser has developed a Repository capability map. It’s their roadmap for using Troux, from application detail to business strategy.
Troux is not the answer to all things. Still need to do architectural modeling, such as Visio, and then connect the information. Sandy cautions not to use Troux as CMDB repository, etc.
Business architecture layer slide: people, capabilities, functions, information, applications, data stores. [Interesting notes: no strategy or process. Also, application layer doesn't belong in "business architecture" model. IMO.]
Lessons learned:
- Go Slow to go fast
- Do not market what you can’t support – refers to dependency on business to collect information required to support visualizations
- Don’t forget to practice what you preach
