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Managing complexity in healthcare


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Creating a platform to enable clinicians to manage the through-life characteristics of their patients' conditions.

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Managing complexity in healthcare

  1. 1. Managing Complexity using Enterprise Architecture Healthcare Example Bernie Cohen February 2011 1. Copyright © BRL 2005
  2. 2. 2. Copyright © BRL 2005
  3. 3. A Healthcare Example ● More than a million NHS patients rely on orthotics services. ● In 2005, it cost roughly £85 million to provide these services. ● Service demand had since been increasing with the aging population and the complexity of clinical conditions. ● A locally commissioned service based on clinical outcome would improve patient care and provide real value to the NHS.B. Cohen and P. Boxer, “Why Critical Systems Need Help to Evolve”, IEEE Computer, May 2010, pp 56-63.J. Hutton and M. Hurry, “Orthotic Service in the NHS: Improving Service Provision”, Proc. York Health Economics Consortium, Univ. of York, July 2009; 3 . Copyright © BRL 2005
  4. 4. Suppliers and their EcosystemEntails: ● identifying opportunities and threats to this service from operating more collaboratively within the larger ecosystem (the NHS) of suppliers and patients, and ● understanding the indirect patterns of demand arising from patients in this larger context. 4 . Copyright © BRL 2005
  5. 5. Beyond Classical EngineeringDemands appropriate modeling techniques that enable judgementsabout: • the impact of more complex care pathways on the way services can be delivered, • the economics of taking up an approach to care focused on managing conditions through-life, • the need to mitigate risks to effective care arising from collaborating within a more complex ecosystem, and • identifying the architectural tradeoffs needed to support greater varieties of collaboration. 5. Copyright © BRL 2005
  6. 6. Projective AnalysisSupports the supplier and its stakeholders in eliciting andstratifying the suppliers collaborative relationships in support ofthe indirect demands of its customer-patients in terms of a four-way partition of the larger healthcare domain: How Why identity Primary What For Whom realisation Task supply demand Primary Risk 6 . Copyright © BRL 2005
  7. 7. Orthotics Services in Visual PAN 7. Copyright © BRL 2005
  8. 8. Dependency Structure Matrix 8. Copyright © BRL 2005
  9. 9. Stratification Matrix 9. Copyright © BRL 2005
  10. 10. Landscape 10. Copyright © BRL 2005
  11. 11. … and moreFuture Events Other Material and LinksEA/OI Briefing (Unicom)• April 13 asymmetric 11 . Copyright © BRL 2005