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The Relevance of Business Architecture in Health Care Reform
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The Relevance of Business Architecture in Health Care Reform The Relevance of Business Architecture in Health Care Reform Presentation Transcript

  • The Relevance of BusinessArchitecture inHealth Care ReformEric A. Stephens (@EricStephens)Oracle Enterprise Architect DirectorOracle NA Technology & Government ConsultingThe Open Group – Newport Beach, CA29 January 2013
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Organization for Economic Cooperation and DevelopmentHealth Care Costs Rising Worldwide (%GDP)3USSZFRDE0 5 10 15 201990-1999 avg 2000-2008 Avg Now
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.US Health Care Challenges - By the Numbers447.5M 16M $768 $8,233Uninsured Under-insured PremiumShortfallGov’tExpenditure
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Leading the Pack in Inefficiency5Source: IBM
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Health Care Reform inthe United States6
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Affordable Care Act 101• Rights and Protections - Preventative Care, Pre-existing Conditions• Insurance Choices - Insurance Marketplaces, Young Adult Coverage• Insurance Costs - Limits, Flexible Spending, Rate Reviews• Seniors - Preventative Services, Drug Discounts• Employers - Small Employer Tax Credits, Retiree ReinsuranceKey Provisions from the March 2010 Law7
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Affordable Care Act• Holistic view of consumers, both from a data and process perspective• Health and Human Services best practices and alignment• Comprehensive view of clients for workers• Cost reductions and economies of scale created by multiple clients• Integrated eligibility across multiple benefit programs• Configurability with minimal customization8Desired Outcomes
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Health Insurance Exchange Grantshttp://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html9
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Is this a TechnologyProblem?10
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.RAND Corporation Report - 2005/2013 ReassessmentElectronic Health Records - Overstated• Predicted $81B in savings for US Health Care system• Drove US federal government spending• Original report overstated benefits• Reassessment: “...little more planning and to set more standards...”11
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Process or Technological?Potential Tactics to Improve Health Care• Delay or prevent the contraction of chronic diseases by encouraging healthier lifestyles• Identify the onset of conditions earlier, leading to timelier intervention and better outcomes• Ensure patients receive consistent and appropriate treatment in all settings• Empower individuals to take greater control of their own health needs through self-care• Improve adherence to courses of medication and therapy to prevent acute episodesrecurring through coordination of care across providers• Incentivize providers to focus on prevention; break vicious cycle of diagnose-treat-release• Boost patient satisfaction and loyalty by actively improving their quality of life and care• Significantly reduce the costs of delivering medical care and processing claims12
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Lack of Cost Transparency a Challenge• What drives profitability - by case, service line, etc.?• Which activities and processes produce value and enhance quality?• How do contractual payer prices compare to costs?• How much capacity is being used?• Are equipment investments justified?13Process or Technological?
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.What is BusinessArchitecture?14
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Strategy & StructureDefinition of Business Architecture• Organizing logic for core business capabilities of an organizationwithout definition of the underlying implementation technology• Subset of Enterprise Architecture• Strong focus on capabilities - what the business does to further itsbrand and identity and to achieve its objectives• Demarcation between strategy and structure15
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Business Architecture, ca. 1900Before the Computer, Before the Electric Grid
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Key Business Architecture Activities17s across the entire Oraclet footprint.Scale: 13,000 Oracle experts inuntries, serving over 20 millionMethodology: Based ony standards, high quality resultscomplex projects.e Delivery: Onsite, offsite, ande, along with innovativens such as Expert Services andcture Services.es across the entire Oraclet footprint.Scale: 13,000 Oracle experts inuntries, serving over 20 millionMethodology: Based ony standards, high quality resultscomplex projects.e Delivery: Onsite, offsite, ande, along with innovativens such as Expert Services andcture Services.e Delivery: Onsite, offsite, ande, along with innovativens such as Expert Services andcture Services.D SERVICESwing related services arefrom Oracle Consulting:Business Consulting Services How We Are DifferentHow We Are Different
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Structure18
  • Business ArchitectureBusinessOrganizationBusinessRoleBusinessProcessBusinessCapabilityBusinessInformationLocationUsesassociated toRealizesUsesassociated toassociated toBusinessMeasureGoalBusinessStrategyRealizesassociated toRealizesUsesRealizesApplication ArchitectureApplicationServiceApplicationSoftwareRealizesassociated toRealizesUsesUsesInformation ArchitectureData ObjectData Formatassociated toData Contextassociated toGovernanceArchitecturePrincipleReferenceArchitectureStandardDirectiveDataStandardUsesUsesTechnicalStandardUsesUsesRealizesTechnology ArchitectureTechnologyCapabilityTechnicalSoftwareTechnicalHardwareRealizes
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Strategy,Motivation, andGovernance23
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Outcome-Driven Decisions25“Once we understand thebusiness context andmetrics for success, wecome back and say,‘Here’s how we can applytechnology to our businessdiscussion.’”
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.27EA Governance Implications• Explicit management of business architecture elements• Ownership of capabilities, functions, processes• Of the elements, which attributes to manage?• What is the lifecycle of a business architecture element?• How are business architecture elements rationalized in a portfolio?
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Where to Focus28
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Strategic Customer/Citizen Focus29
  • Thank YouEric A. Stephens (@EricStephens)Oracle Enterprise Architect DirectorOracle NA Technology & Government ConsultingThe Open Group – Newport Beach, CA29 January 2013
  • Copyright © 2012, Oracle and/or its affiliates. All rights reserved.
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Oracle Enterprise Architecture FrameworkJust Enough, Just in Time37
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.Capability Attribution ModelCourtesy of Forrester, with ModificationPeople Processes Issues/Risks Information• Engineering• Partners• Customers• Product LifecycleManagement• Budget• Timeline• Regulatory concerns• ProductFunctions Business Goals & CriticalSuccess FactorsMetrics Technology Enabler• Product R&D • Improve CustomerSatisfaction• Growth through Innovation• Customer/Partner satisfaction• Customer/Partner retention• Product R&D CollaborationPortalProduct R&D CollaborationActor/Role Process Constraint Data EntityProcess MeasureLogical TechnologyComponent38Driver/Objective/Goal
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.What is Design Anyway?Karl Urlich, University of Pennsylvania“Design is conceiving andgiving form to artifacts thatsolve problems”39
  • | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.What is Design Anyway?Ice Cube, Rapperhttp://www.youtube.com/watch?v=FRWatw_ZEQIhttp://www.nytimes.com/2011/12/08/garden/ice-cube-on-eameses-and-his-hometown-qa.html"…its not about the pieces,its how the pieces worktogether…structure andnature as one…”40
  • Copyright © 2012, Oracle and/or its affiliates. All rights reserved.