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Supporting social complexity in
       collaborative enterprises:
            a third agenda?

            UNICOM EA Forum

                 Philip Boxer
              Boxer Research Ltd
               September 2011
                                                      1

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                                   Copyright © BRL 2011
The need for enterprises to capture new forms of indirect value in
ecosystems, and the demand this creates for platform architectures that
can support customers within these contexts.




                                                                                 2

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                                                              Copyright © BRL 2011
So what is different about the third agenda?
What does this mean for architectural agendas?
What made this case of the third type?
Supporting social complexity


THE THIRD AGENDA

                                                                    3

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                                                 Copyright © BRL 2011
Contrasting Architectural Agendas
• Simplify and Unify
      – Aligning the systems with the business
• Differentiate and Integrate
      – Managing the complexity of supporting
        multiple businesses                                   These present
                                                                These are
                                                           systems-of-systems
                                                            system-of-systems
• A third agenda?                                             (SoS) agendas
                                                                 agendas
      – Indirect demands, collaborative alliances within
        ecosystems, platforms supporting multi-sided
        markets
      – How do we establish an ROI for a query
        engine?
                                                                              4

  .
                                                           Copyright © BRL 2011
Multi-sided markets:
                             counting the value of indirect customers
•     A multi-sided market supported by a platform is one in which:
      – There is direct value in the platform’s direct ‘one-sided’ relationships with
        each participant (e.g. direct support to a hotline responding to a citizen’s query)
      – The customers of collaborations between ecosystem participants are
        indirect customers (e.g. support to a collaboration between departments responding to a
           citizen’s query)
          – There is greater value in the indirect ‘multi-sided’ relationships the
            platform supports between collaborating ecosystem participants
                                                       2              4
                                                                              Indirect ‘multi-sided’
    Ecosystem                                                                 relationships
    participants
                                                 1
                                                                      …   n
                                                              3

                                                                               Direct ‘one-sided’
Evans, D. S., Hagiu, A., & Schmalensee, R. (2006).
Invisible Engines: How Software Platforms Drive                                relationships
Innovation and Transform Industries. Cambridge: MIT.
                                                           Platform
                                                                                                              5

      .
                                                                                           Copyright © BRL 2011
The value is in supporting the
                  collaborations
                                          Unmanned
                     iPhone            Airborne Systems             Orthotics            e-Government
                                            (UAS)

Supplier             Apple                    Thales            Orthotics supplier       IT Department

Platform         iPhone+Cloud                 UAS                Orthotics clinic         Query engine

Direct
                Service Provider*        Royal Artillery*          Clinician*/**       Query Hotline*/**
Customer
Collaboration                                                                              Between
                Between users and      Between operational      Between clinicians’
supported by                                                                           Departments and
                    their apps             capabilities          episodes of care      external Agencies
Platform
Indirect                                    Mission
                  Phone user**                                        Patient                 Citizen
Customer                                  commander**
Indirect                                                        Managing a patient’s
                Arranging a blind     Interdicting a fleeting
Customer                                                           chronic diabetic    Citizen’s Question
                      date                    target
Situation                                                             condition
                                    * - takes up role on the Platform
                          ** - leads the collaboration supported by Platform                              6

   .
                                                                                       Copyright © BRL 2011
SO WHAT IS DIFFERENT
ABOUT THIS THIRD AGENDA?
                                       7

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                    Copyright © BRL 2011
Healthcare:
             addressing the patient’s experience of their condition
Basis for               Health Risk                                           Type III
integrating             Governance                                            benefits               The ‘third agenda’
                        architecture
differentiated                                                                                      has to address social
behaviors                                                                                               complexity of
                          Referral                                                                  collaborating around
          Scope of                                            Type II
                         Pathway
                                                              benefits                               patient’s condition
       Architecture     architecture                                                                      over time

                           Care
                                             Type I
                         Pathway
                                            benefits
                        architecture

                                         Provision-of-      Episode-         Patient’s
                                          treatment-        of-care-        condition-
                                            centric          centric          centric             Basis of differentiation
                                                                                                  of behavior
                                                       Service Approach

             Type I - defining current demand for treatments and aligning delivery of product/service protocols.
             Type II - organising referral protocols and relationships between clinics to improve delivered episodes of care.
             Type III - extending the organisation of the clinical service to include through-life                             8
             management of patients’ chronic conditions.                                                    Copyright © BRL 2011
       .
Supporting the indirect customer’s
                      experience
                     Support Economics
                                 (optimization/
                            alignment of effort)

   Basis of
value-creation        Market Economics
                         (mutual reinforcement)
  enabled by
 architecture                                                                                                       The ‘third agenda’
                  Command Economics                                                                                has to address social
                        (functional consistency)
                                                                                                                      complexity of
                                                   Product-        Solution Customer-                             collaborating around
                                                    based           -based experience-                            customer’s experience
                                                   (treatments)    (episodes) based                                      over time
                                                                                   (conditions)

                                                   Basis of response to demand

                 Adapted from Zuboff, S., & Maxmin, J. (2002). The Support Economy: Why Corporations are Failing
                 Individuals and the Next Episode of Capitalism. New York: Viking; “What is strategy?” by Michael Porter.
                 Harvard Business Review Nov-Dec 1996. in Porter, M.E. (1998) On Competition, Harvard Business School
                 Press pp 39-73; Prahalad, C. K. & Ramaswamy, Venkatram. “The New Frontier of Experience Innovation.”
                 MITSloan Management Review 44, 4 (Summer 2003): 12−18.                                                                        9

       .
                                                                                                                            Copyright © BRL 2011
Quantifying indirect value:
           reducing the indirect customer’s costs of alignment


•       Examined the potential savings from improving eGovernment
        responses to requests for information from its citizens and businesses.
         – Using a platform architecture designed to support the variability in the nature
           of the requests,
         – produced an estimated 80% saving,
         – with 50% of this saving coming from a reduction in the variation in the costs
           of collaboration between departments across the anticipated variety of requests
•       Examined the economics of responding to demands in theatre for the
        interdiction of fleeting targets using Unmanned Airborne Systems.
         – Changing the role of the UAS to one of providing a platform architecture
           supporting the interoperation of other assets in theatre,
         – resulted in a 40% total saving on the operational costs,
         – with 30% of this saving coming from a reduction in the variation in the
           operational costs of missions across the anticipated variety of mission types.



                                                                                              10

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                                                                             Copyright © BRL 2011
WHAT DOES THIS MEAN FOR
ARCHITECTURAL AGENDAS?
                                    11

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                   Copyright © BRL 2011
Four kinds of SoS Agenda
                                                      No central management authority and no
                                                           centrally agreed upon purpose
* participant = participant in a
collaboration using a system-of-systems                      No                                            Yes              Many participants*,
                                                                                                                             none dominant
                               Component systems interact
                                 voluntarily at run-time                                  Virtual: Large-scale behavior emerges—and may be
                                                                                         desirable—but this type of SoS must rely upon relatively
                                                                                                   invisible mechanisms to maintain it.
                                No                                           Yes
                                                                                            Supporting multi-sidedness
Component systems retain independent design-                                 Collaborative: The central participants                Relatively few
    time ownership, objectives, funding,                                     collectively provide some means of enforcing             dominant
  development and sustainment approaches                                         and maintaining (run-time) standards.              participants*

                                                               Yes
 One participant*                No                                                                                         One participant*
  has dominance                                                                                                             given dominance
   Directed: the integrated system-of-systems is built                                        Acknowledged: changes in the (component)
    and managed to fulfill the specific centrally managed                                      systems are based on (design-time) collaboration
                  purposes of its owners                                                        between the SoS and the (component) system(s)



                                                                                                                                             12
                        Source of definitions: Systems Engineering Guide for Systems of Systems,
                        OSD, Version 1.0 August 2008. Brackets added.
       .
                                                                                                                           Copyright © BRL 2011
Collaborative SoS Agendas:
             SoS infrastructure supporting multiple collaborations
•    The participants in any one collaboration can be spread across multiple
     businesses and/or different parts of a single business
•    The participants participating in any one collaboration will define
         – Their value proposition
         – The indirect customers for whom they are creating value
         – The way they want their collaboration supported                     Demand-side
                                                                                perspective
                                             Indirect Customers

      Multiple
                                       Collaborations of participants
collaborations

                                            SoS Infrastructure
                 Platform                                                Supply-side perspective

• This means understanding the role of the platform from a demand-side
  perspective
                                                                                         13

     .
                                                                        Copyright © BRL 2011
For example:
                               The treatment of chronic conditions
                                                         Acute Care                 Primary Care                   Chronic Care
                                                         (directed)                (acknowledged)                 (collaborative)

                                                       HRGs aggregated              Primary care costs
                                                                                 aggregated across patient
                                  Patient              across patients for                                             Data used
Supported by        Periodic                           different kinds of           numbers adjusted
                                  Treatments                                         demographically
 Systems of      analysis of                               condition
  Record               costs
                aggregated                                                         PCT has to provide a
                                  Multiple           Role of support services
               by treatment                                                      range of services that can
                                                         subordinated to                                              Data used
                                  service             requirements of acute          be combined as
                                  episode               role as overheads         appropriate in response
                                                                                       to the patient
 Supported
                                                                                                                Characteristics of the
 by Systems     Analysis of                                                                                    episode series becomes
     of        through-life        Episode                                           Repeat episodes                a fundamental
                    costs of                              Not relevant
Engagement                         series                                            are not tracked           determinant of total cost
                 treatment                                                                                           of treatment

               USA data from: Crossing the Quality Chasm, National Academy Press 2003:
               • Chronic conditions, defined as illnesses that last longer than 3 months and are not self-limiting, are now the
                 leading cause of illness, disability, and death in the USA, and affect almost half of the U.S. population.
               • About 1 in 6 Americans is limited in daily activities in some way as a result of a chronic condition.
               • Disabling chronic conditions affect all age groups; about two-thirds of those with such conditions are under age 65.
               • The majority of health care resources are now devoted to the treatment of chronic disease.
               • In 1990, the direct medical costs for persons with chronic conditions was nearly 70 percent                  14
                 of all personal health care expenditures.
        .
                                                                                                              Copyright © BRL 2011
SO WHAT MADE THIS CASE
OF THE THIRD TYPE?
                                     15

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                    Copyright © BRL 2011
Through-life care is a socially complex
              process…
Referrals come from many                   Clinical responsibility is located in
different sources:                         different places:
•   Self-referral - from patient to        •   GP episode - intervention under
    wherever                                   the control of a GP
•   1ary referral - from GP to             •   Consultant episode - intervention
    consultant or to orthotist (a direct       under the control of a consultant
    referral)                              •   PAM episode - intervention under
•   2ary referral - from consultant or         the control of an other PAM
    PAM (under authority of
    consultant) to orthotist
•   3ary referral - from PAM (treated
    as 2ary if under authority of
    consultant)

                                                                                    16

    .
                                                                   Copyright © BRL 2011
… with each clinic having its own
          way of collaborating…
• Each clinic will set its own Key Performance Indicators
      – involving the development of protocols to build learning into the way it
        is managed
      – in a different PCT catchment context,
      – with a different mix of resources available to it,
      – developing its own particular mix of protocols through which to
        manage




                                                                                   17

  .
                                                                  Copyright © BRL 2011
… needing its own supporting platform
                         combining data-push and data-pull models

… and add to this              Patients and their conditions
integrating judgements by
the clinician about the
through-life management of
the patient’s condition                 Orthotists
                                                                Data-pull

                                      Local platform

The platform has to be
able to integrate data                Linking network
from a number of
sources, including its
own ‘local’ data…                                               Data-push
                                 External Sources of Data
                                                                                 18

       .
                                                                Copyright © BRL 2011
SUPPORTING SOCIAL
COMPLEXITY
                                     19

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                    Copyright © BRL 2011
The tools for analyzing gaps in alignment
Modeling Socio-technical ecosystem                                             Analysing Granularity of
                                     Distinguishing three different
  in relation to Indirect Demands                                                 supporting strata
                                             kinds of path
                                      Dependency              Value
                                      structures        propositions




                                               Accountability
                                                Hierarchies



           Analysing alignment of           Identifying Gaps between the existing       Designing a Platform
                   strata                              social processes                     Architecture




                                                                                                          20

       .
                                                                                         Copyright © BRL 2011
Designing support for the clinic:
              separating systems of engagement from systems of record
Social complexity of clinical                                                                                       Systems of
                                              Through-life management of condition                                 Engagement
process supported by
platform


                Timing and duration            Care Pathway          Episode-defining       Orthosis-defining                The
                within and between            characteristics,          condition               product                   Platform
Input by             episodes              recommended clinical
Clinician in                                                                                          Clinician’s         supports
                                                relationship                                          judgment linked
collaboration              Episode logic
                                                                                                      to judgment on
                                                                                                                             this
with other                 defined by                  Clinician’s            Clinician’s
                           practice                    judgment on            judgment on
                                                                                                      EDC                  process
clinicians
                                                       history and            prognosis
                                                       condition


operational
systems                                                                                                                 Systems of
                  Appointment                   Referral                Patient                 product,
                                                                                                                         Record
                                                                        condition                 cost,
                                                                                                 timing

                   Transport,                 Patient referral           Patient                suppliers
                 availability of            procedure, patient           record,
                   clinician,                     details,               EPR etc
                  delivery of               care responsibility,
                  orthosis etc                e-booking etc
                                                                                                                          21

          .
                                                                                                       Copyright © BRL 2011
Implementing commissioning-led
                         change
                    Commissioning-led                         Managed change

                                                          Acute & PCT Clinicians’
                      Clinically Driven                    referring relationships
                         Assessment                        across Care pathways
                                                                                              Currently
                               drives                                                         Informal
                                                                         drives
                                                                                              processes
                    Definition of SLAs for                  Output-based Chronic
                     output-based system      supports         Care Platform
                                              and
                                              sustains
                                                                         drives
                               drives

                                                               Investment in
                    Ongoing Performance                    changing/aligning clinic
                        Monitoring                                processes
    Without a
    Without a
 platform, these
 platform, these
processes are not                                          ‘Intelligent purchasing’
are not possible
     possible
                            All of these processes were piloted within pathfinders
                                                                                                       22

      .
                                                                                      Copyright © BRL 2011
What is different about the third agenda?
What does this mean for architectural agendas?
What made this case of the third type?
Supporting social complexity

CONCLUSION

                                                                  23

.
                                                 Copyright © BRL 2011
The value is in supporting the
                ecosystem
• I have shown something of the need for enterprises to be
  able to capture new forms of indirect value in ecosystems
    – This creates demand for platform architectures that can support the
      multi-sided demands of customers within these contexts.
• The point, of course, is that the architecture of the
  enterprise is no longer primary, the primary concern
  becoming to support the architecture of the collaborations.
    – This involves understanding the variety of ways in which the social
      complexity of collaborations create value…
    – … and therefore how the platform architecture can itself capture
      indirect value.
                                                                              24

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                                                             Copyright © BRL 2011

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Supporting Social Complexity in Collaborative Enterprises

  • 1. Supporting social complexity in collaborative enterprises: a third agenda? UNICOM EA Forum Philip Boxer Boxer Research Ltd September 2011 1 . Copyright © BRL 2011
  • 2. The need for enterprises to capture new forms of indirect value in ecosystems, and the demand this creates for platform architectures that can support customers within these contexts. 2 . Copyright © BRL 2011
  • 3. So what is different about the third agenda? What does this mean for architectural agendas? What made this case of the third type? Supporting social complexity THE THIRD AGENDA 3 . Copyright © BRL 2011
  • 4. Contrasting Architectural Agendas • Simplify and Unify – Aligning the systems with the business • Differentiate and Integrate – Managing the complexity of supporting multiple businesses These present These are systems-of-systems system-of-systems • A third agenda? (SoS) agendas agendas – Indirect demands, collaborative alliances within ecosystems, platforms supporting multi-sided markets – How do we establish an ROI for a query engine? 4 . Copyright © BRL 2011
  • 5. Multi-sided markets: counting the value of indirect customers • A multi-sided market supported by a platform is one in which: – There is direct value in the platform’s direct ‘one-sided’ relationships with each participant (e.g. direct support to a hotline responding to a citizen’s query) – The customers of collaborations between ecosystem participants are indirect customers (e.g. support to a collaboration between departments responding to a citizen’s query) – There is greater value in the indirect ‘multi-sided’ relationships the platform supports between collaborating ecosystem participants 2 4 Indirect ‘multi-sided’ Ecosystem relationships participants 1 … n 3 Direct ‘one-sided’ Evans, D. S., Hagiu, A., & Schmalensee, R. (2006). Invisible Engines: How Software Platforms Drive relationships Innovation and Transform Industries. Cambridge: MIT. Platform 5 . Copyright © BRL 2011
  • 6. The value is in supporting the collaborations Unmanned iPhone Airborne Systems Orthotics e-Government (UAS) Supplier Apple Thales Orthotics supplier IT Department Platform iPhone+Cloud UAS Orthotics clinic Query engine Direct Service Provider* Royal Artillery* Clinician*/** Query Hotline*/** Customer Collaboration Between Between users and Between operational Between clinicians’ supported by Departments and their apps capabilities episodes of care external Agencies Platform Indirect Mission Phone user** Patient Citizen Customer commander** Indirect Managing a patient’s Arranging a blind Interdicting a fleeting Customer chronic diabetic Citizen’s Question date target Situation condition * - takes up role on the Platform ** - leads the collaboration supported by Platform 6 . Copyright © BRL 2011
  • 7. SO WHAT IS DIFFERENT ABOUT THIS THIRD AGENDA? 7 . Copyright © BRL 2011
  • 8. Healthcare: addressing the patient’s experience of their condition Basis for Health Risk Type III integrating Governance benefits The ‘third agenda’ architecture differentiated has to address social behaviors complexity of Referral collaborating around Scope of Type II Pathway benefits patient’s condition Architecture architecture over time Care Type I Pathway benefits architecture Provision-of- Episode- Patient’s treatment- of-care- condition- centric centric centric Basis of differentiation of behavior Service Approach Type I - defining current demand for treatments and aligning delivery of product/service protocols. Type II - organising referral protocols and relationships between clinics to improve delivered episodes of care. Type III - extending the organisation of the clinical service to include through-life 8 management of patients’ chronic conditions. Copyright © BRL 2011 .
  • 9. Supporting the indirect customer’s experience Support Economics (optimization/ alignment of effort) Basis of value-creation Market Economics (mutual reinforcement) enabled by architecture The ‘third agenda’ Command Economics has to address social (functional consistency) complexity of Product- Solution Customer- collaborating around based -based experience- customer’s experience (treatments) (episodes) based over time (conditions) Basis of response to demand Adapted from Zuboff, S., & Maxmin, J. (2002). The Support Economy: Why Corporations are Failing Individuals and the Next Episode of Capitalism. New York: Viking; “What is strategy?” by Michael Porter. Harvard Business Review Nov-Dec 1996. in Porter, M.E. (1998) On Competition, Harvard Business School Press pp 39-73; Prahalad, C. K. & Ramaswamy, Venkatram. “The New Frontier of Experience Innovation.” MITSloan Management Review 44, 4 (Summer 2003): 12−18. 9 . Copyright © BRL 2011
  • 10. Quantifying indirect value: reducing the indirect customer’s costs of alignment • Examined the potential savings from improving eGovernment responses to requests for information from its citizens and businesses. – Using a platform architecture designed to support the variability in the nature of the requests, – produced an estimated 80% saving, – with 50% of this saving coming from a reduction in the variation in the costs of collaboration between departments across the anticipated variety of requests • Examined the economics of responding to demands in theatre for the interdiction of fleeting targets using Unmanned Airborne Systems. – Changing the role of the UAS to one of providing a platform architecture supporting the interoperation of other assets in theatre, – resulted in a 40% total saving on the operational costs, – with 30% of this saving coming from a reduction in the variation in the operational costs of missions across the anticipated variety of mission types. 10 . Copyright © BRL 2011
  • 11. WHAT DOES THIS MEAN FOR ARCHITECTURAL AGENDAS? 11 . Copyright © BRL 2011
  • 12. Four kinds of SoS Agenda No central management authority and no centrally agreed upon purpose * participant = participant in a collaboration using a system-of-systems No Yes Many participants*, none dominant Component systems interact voluntarily at run-time Virtual: Large-scale behavior emerges—and may be desirable—but this type of SoS must rely upon relatively invisible mechanisms to maintain it. No Yes Supporting multi-sidedness Component systems retain independent design- Collaborative: The central participants Relatively few time ownership, objectives, funding, collectively provide some means of enforcing dominant development and sustainment approaches and maintaining (run-time) standards. participants* Yes One participant* No One participant* has dominance given dominance Directed: the integrated system-of-systems is built Acknowledged: changes in the (component) and managed to fulfill the specific centrally managed systems are based on (design-time) collaboration purposes of its owners between the SoS and the (component) system(s) 12 Source of definitions: Systems Engineering Guide for Systems of Systems, OSD, Version 1.0 August 2008. Brackets added. . Copyright © BRL 2011
  • 13. Collaborative SoS Agendas: SoS infrastructure supporting multiple collaborations • The participants in any one collaboration can be spread across multiple businesses and/or different parts of a single business • The participants participating in any one collaboration will define – Their value proposition – The indirect customers for whom they are creating value – The way they want their collaboration supported Demand-side perspective Indirect Customers Multiple Collaborations of participants collaborations SoS Infrastructure Platform Supply-side perspective • This means understanding the role of the platform from a demand-side perspective 13 . Copyright © BRL 2011
  • 14. For example: The treatment of chronic conditions Acute Care Primary Care Chronic Care (directed) (acknowledged) (collaborative) HRGs aggregated Primary care costs aggregated across patient Patient across patients for Data used Supported by Periodic different kinds of numbers adjusted Treatments demographically Systems of analysis of condition Record costs aggregated PCT has to provide a Multiple Role of support services by treatment range of services that can subordinated to Data used service requirements of acute be combined as episode role as overheads appropriate in response to the patient Supported Characteristics of the by Systems Analysis of episode series becomes of through-life Episode Repeat episodes a fundamental costs of Not relevant Engagement series are not tracked determinant of total cost treatment of treatment USA data from: Crossing the Quality Chasm, National Academy Press 2003: • Chronic conditions, defined as illnesses that last longer than 3 months and are not self-limiting, are now the leading cause of illness, disability, and death in the USA, and affect almost half of the U.S. population. • About 1 in 6 Americans is limited in daily activities in some way as a result of a chronic condition. • Disabling chronic conditions affect all age groups; about two-thirds of those with such conditions are under age 65. • The majority of health care resources are now devoted to the treatment of chronic disease. • In 1990, the direct medical costs for persons with chronic conditions was nearly 70 percent 14 of all personal health care expenditures. . Copyright © BRL 2011
  • 15. SO WHAT MADE THIS CASE OF THE THIRD TYPE? 15 . Copyright © BRL 2011
  • 16. Through-life care is a socially complex process… Referrals come from many Clinical responsibility is located in different sources: different places: • Self-referral - from patient to • GP episode - intervention under wherever the control of a GP • 1ary referral - from GP to • Consultant episode - intervention consultant or to orthotist (a direct under the control of a consultant referral) • PAM episode - intervention under • 2ary referral - from consultant or the control of an other PAM PAM (under authority of consultant) to orthotist • 3ary referral - from PAM (treated as 2ary if under authority of consultant) 16 . Copyright © BRL 2011
  • 17. … with each clinic having its own way of collaborating… • Each clinic will set its own Key Performance Indicators – involving the development of protocols to build learning into the way it is managed – in a different PCT catchment context, – with a different mix of resources available to it, – developing its own particular mix of protocols through which to manage 17 . Copyright © BRL 2011
  • 18. … needing its own supporting platform combining data-push and data-pull models … and add to this Patients and their conditions integrating judgements by the clinician about the through-life management of the patient’s condition Orthotists Data-pull Local platform The platform has to be able to integrate data Linking network from a number of sources, including its own ‘local’ data… Data-push External Sources of Data 18 . Copyright © BRL 2011
  • 19. SUPPORTING SOCIAL COMPLEXITY 19 . Copyright © BRL 2011
  • 20. The tools for analyzing gaps in alignment Modeling Socio-technical ecosystem Analysing Granularity of Distinguishing three different in relation to Indirect Demands supporting strata kinds of path Dependency Value structures propositions Accountability Hierarchies Analysing alignment of Identifying Gaps between the existing Designing a Platform strata social processes Architecture 20 . Copyright © BRL 2011
  • 21. Designing support for the clinic: separating systems of engagement from systems of record Social complexity of clinical Systems of Through-life management of condition Engagement process supported by platform Timing and duration Care Pathway Episode-defining Orthosis-defining The within and between characteristics, condition product Platform Input by episodes recommended clinical Clinician in Clinician’s supports relationship judgment linked collaboration Episode logic to judgment on this with other defined by Clinician’s Clinician’s practice judgment on judgment on EDC process clinicians history and prognosis condition operational systems Systems of Appointment Referral Patient product, Record condition cost, timing Transport, Patient referral Patient suppliers availability of procedure, patient record, clinician, details, EPR etc delivery of care responsibility, orthosis etc e-booking etc 21 . Copyright © BRL 2011
  • 22. Implementing commissioning-led change Commissioning-led Managed change Acute & PCT Clinicians’ Clinically Driven referring relationships Assessment across Care pathways Currently drives Informal drives processes Definition of SLAs for Output-based Chronic output-based system supports Care Platform and sustains drives drives Investment in Ongoing Performance changing/aligning clinic Monitoring processes Without a Without a platform, these platform, these processes are not ‘Intelligent purchasing’ are not possible possible All of these processes were piloted within pathfinders 22 . Copyright © BRL 2011
  • 23. What is different about the third agenda? What does this mean for architectural agendas? What made this case of the third type? Supporting social complexity CONCLUSION 23 . Copyright © BRL 2011
  • 24. The value is in supporting the ecosystem • I have shown something of the need for enterprises to be able to capture new forms of indirect value in ecosystems – This creates demand for platform architectures that can support the multi-sided demands of customers within these contexts. • The point, of course, is that the architecture of the enterprise is no longer primary, the primary concern becoming to support the architecture of the collaborations. – This involves understanding the variety of ways in which the social complexity of collaborations create value… – … and therefore how the platform architecture can itself capture indirect value. 24 . Copyright © BRL 2011