Healthcare // Leadership
Commentary
11/20/2013
09:05 AM
Jason Burke
Jason Burke
Commentary
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Where Is Enterprise Architecture In Healthcare?

Implementing healthcare technologies is just the beginning. We need to plan how they will fit together.

(Source: Horia Varlan/Creative Commons, Attribution)
(Source: Horia Varlan/Creative Commons, Attribution)

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Jason Burke
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Jason Burke,
User Rank: Apprentice
11/21/2013 | 9:17:03 AM
Re: Explicit vs Hidden
Great comments, your points are very well made.  Common traits I've seen in EA failures include EA as an ivory tower, EA as a policy board only, and EA as a documentation function.  When EA is not connected to the on-the-ground issues of the organizations (such as solution development), it is a meaningless function.  However, I would also argue that a purely bottoms-up approach cannot deliver scalable capability in the areas where we see so many challenges in health care (for example, master data management).  So I believe in the need for a distinct function that bridges the top-down and bottom-up perspectives, but I think your first statement is spot on: there should not be EA-specific goals. EA's role should be focused on enabling business and IT goals, not creating new goals of it's own.  And whereas the strategy and governance should be top-down, virtually all of the execution should be bottom-up (i.e., where value is derived).
MatthewP956
IW Pick
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MatthewP956,
User Rank: Apprentice
11/20/2013 | 5:32:14 PM
Explicit vs Hidden
My experience with EA has been, unfortunately, negative in that where EA has been called out as a specific function with EA-specific goals, it has failed.  I believe that the failure is resultant of the separation of EA and its domain-specific activities from strategy, solution development and performance management.  Where I've seen it successful, is when it is built into the solution development model and has business goals attached.  The methods of delivery will be modified and the deliverables will also change to accomodate EA necessities - and this is a good thing - as those artifacts can then be reused for other solution-specific work.  The downside to this "bottom-up" method is that rework may result as the EA view will necessarily be incomplete.  This risk, IMO, is worth it as at least some progress will be made and the EA will be effectuated and developed through work that is meaningful to the organization.  In other words, please stop calling it out as "EA" - no one wants it as a separate, check-the-box, stage gate and when allowed, EA practioners can get carried away to no immediate positive result.
Jason Burke
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Jason Burke,
User Rank: Apprentice
11/20/2013 | 12:48:23 PM
Re: Who does this right?
Great question.  Not surprisingly, there are not a lot of great examples in health care yet.  Commonly cited examples outside health care include FedEx, John Hancock, and Dow. Payoffs are typically found in 3 general categories: cost avoidance (e.g., fewer software licenses, hardware, support resources), operational efficiency (e.g.,support simplification, staffing flexibility), and upside financial performance (e.g.,faster time to market, novel partnership enablement).  MIT's Center for Information Systems Research (MIT CISR) has some great additional background reading for those interested.
David F. Carr
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David F. Carr,
User Rank: Author
11/20/2013 | 9:55:03 AM
Who does this right?
I'm curious about your experience with organizations that really do this right (or more right than most) and what kind of difference it makes. Who would you point to, and what have the payoffs been?
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