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Why Complexity May Be Killing the NHS NPfIT

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Health Informatics New Zealand
Health Informatics New Zealand

The document discusses how complexity is a major challenge for large IT projects like the UK National Health Service's NPfIT program. It argues that complexity must be intentionally controlled and reduced through partitioning large systems into simpler, more manageable subsets that can be prioritized and iteratively developed. The NPfIT program's complexity was increased by having multiple implementations and deployments across different regions without sufficient partitioning. Reducing complexity is seen as key to the success of large-scale IT programs.

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Why Complexity May Be Killing the NHS NPfIT Paulo Rocha, Manager Strategy Services Roger Sessions, CTO, ObjectWatch Inc.
Agenda ,[object Object],[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
THE PROBLEM OF COMPLEXITY Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Key Assumptions ,[object Object],[object Object],[object Object],[object Object],[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Ways to Control Complexity ,[object Object],[object Object],[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Business Systems and Complexity Complexity = (Branches per Decision Point) Decision Points Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Partition to Reduce Complexity Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc 2,176,782,336 states (6 12 x 1) 93,312 states (6 6 x 2) 3,888 states (6 4 x 3)
Partitions Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
NPFIT AND COMPLEXITY Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
NPfIT Conceptual Architecture Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
A Complexity Multiplier ,[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc Key = type = implementation = deployment Southern CIS London CIS Eastern CIS North West West Midland CIS North East CIS CSC/ ISoft Accenture / ISoft Clinical Information System CSC/ ISoft BT/ IDX Fuijitsu / IDX
Partition to Reduce Complexity ,[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc Key = type = implementation = deployment Southern CIS London CIS Eastern CIS North West West Midland CIS North East CIS Clinical Information System NPfIT CIS
Partition to Reduce Complexity ,[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Conclusion - In Simple Terms ,[object Object],[object Object],[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
The Problem Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Traditional Complexity Management ,[object Object],Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc Order Layer What (Data) How (Function) Where (Network) Who (People) When (Time) Why (Motivation) 1 Scope Context Boundary (Planner) List of things important to the business List of processes the business performs List of locations in which the business operates List of organizations important to the business List of events significant to the business List of business goals/ strategies 2 Business Model Concepts (Owner) Semantic or Entity-relationship Model Business Process Model Business Logistics System Work Flow Model Master Schedule Business Plan 3 System Model Logic (Designer) Logical Data Model Application Architecture Distributed System Architecture Human Interface Architecture Processing Structure Business Rule Model 4 Technology Model Physics (Builder) Physical Data Model System Design Technology Architecture Presentation Architecture Control Structure Rule Design 5 Component Configuration (Implementer) Data Definition Program Network Architecture Security Architecture Timing Definition Rule Specification 6 Functioning Enterprise Instances (Worker) Data Function Network Organization Schedule Strategy
What Are Partitions? Unpartitioned Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc Set 1 Set 2 Set 3 Set4 Set 5
The SIP Process Phase Deliverables Goals Set stage for successful engagement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pain/Gain ABC identification ,[object Object],[object Object],[object Object],ABC Simplification ,[object Object],[object Object],[object Object],[object Object],Delivery Prioritization ,[object Object],[object Object],[object Object],Iterative Delivery ,[object Object],[object Object],[object Object],[object Object],Legend ABC = Autonomous Business Capability DI = Deployment/Implementation SIP = Simple Iterative Partitions Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc Preparation Partitioning Simplification Prioritization Iteration
Learning your ABCs Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
Learning your ABC Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
The Output – Types & Relationships Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
The Output – Priorities Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc

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Why Complexity May Be Killing the NHS NPfIT

  • 1. Why Complexity May Be Killing the NHS NPfIT Paulo Rocha, Manager Strategy Services Roger Sessions, CTO, ObjectWatch Inc.
  • 2.
  • 3. THE PROBLEM OF COMPLEXITY Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 4.
  • 5.
  • 6. Business Systems and Complexity Complexity = (Branches per Decision Point) Decision Points Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 7. Partition to Reduce Complexity Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc 2,176,782,336 states (6 12 x 1) 93,312 states (6 6 x 2) 3,888 states (6 4 x 3)
  • 8. Partitions Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 9. NPFIT AND COMPLEXITY Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 10. NPfIT Conceptual Architecture Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 11.
  • 12.
  • 13.
  • 14.
  • 15. Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 16. The Problem Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 17.
  • 18. What Are Partitions? Unpartitioned Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc Set 1 Set 2 Set 3 Set4 Set 5
  • 19.
  • 20. Learning your ABCs Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 21. Learning your ABC Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 22. The Output – Types & Relationships Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc
  • 23. The Output – Priorities Commercial in confidence | Copyright © 2007 Fronde Systems Group Limited and ObjectWatch, Inc