Reference models a case study for healthcare
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The document discusses the development of a healthcare reference framework sponsored by the Norwegian healthcare authority to facilitate healthcare reform. It highlights the importance of using industry reference models to standardize processes and improve communication within the healthcare sector. The framework aims to enhance healthcare delivery and interoperability, particularly in the context of South Africa's evolving national healthcare debate.
Reference models a case study for healthcare
- 1. 1C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t dw w w . r e a l i r m . c o m LEADING ENTERPRISE ARCHITECTURE VALUE ™ Reference models: A Healthcare Case Study
- 2. 2C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d The Norwegian Healthcare Authority in the South Eastern Region (Helse Sør-Øst) is sponsoring the development of a Healthcare Reference Framework. This reference model is a prerequisite for healthcare reform in the region and uses best practices and learning gleaned from industry reference models, such as those developed by the Telecommunications, Natural Resources, Supply Chain Council and other industries. The presentation will focus on the Healthcare vision and business motivation driving the development and adoption of industry reference models. The business case for increased South African participation will be presented. Sarina Viljoen is collaborating with the Norwegian Helse Sør-Øst Healthcare Authority to develop this model, using her background as the forum director of The Open Group's Exploration Mining, Metals and Minerals forum (EMMMv). Invite
- 3. 3C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Agenda
- 4. 4C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Norway Population: 5 Million Land boundaries: 2,542 km Sweden Finland Russia Coastline: 83,281 km Area of Norway: 385,252 km² (South Africa measures 1,221,037 km²)
- 5. 5C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Healthcare in Norway
- 6. 6C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Geography, cities and healthcare Geographic – 1 central governance (the directorate)/ 4 regional healthcare enterprises/ 50+ hospitals (secondary healthcare) 450+ municipalities (primary healthcare) / 3000+ GP offices Governing and decision making within the geography Own resources Right to decide
- 7. 7C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Healthcare reform The status quo: 20+ years resulted in no standard processes (except sup-optimal processes within companies) and many thousand applications and information islands (HSØ have between 2900 and 3500 applications) Subsequent is also the lack of standardization and systematic work on the information structures itself… Regulations and privacy laws have clinical information belonging to the individual organizations and must be protected there
- 8. 8C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Vision: High quality health services equal to all, regardless of age, place of residence, ethnic background, gender or personal economy. Drivers: Citizen response/ demand Political focus Patient safety Quality of care Alignment to best in class Healthcare reform
- 9. 9C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Drivers
- 10. 10C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d
- 11. 11C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Developing a Reference model for Healthcare • Enterprise Architecture focus since 2009/10 • 139 TOGAF trained individuals in Healthcare alone • Understanding the need for a common reference within Norway • No context reference model work found.
- 12. 12C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Industry Reference frameworks o Exploration, Mining, Metals and minerals (EMMMv ) o Information & Communications Technology (TMF with Frameworx) o Supply Chain (SCORE) o Retail (ARTS) o Oil & Gas (PCATS) o Financial Institution (CIM)
- 13. 13C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Information and Telecommunications Industry (tmforum - Frameworx)
- 14. 14C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d The Association for Retail Technology Standards (ARTS) The Association for Retail Technology Standards (ARTS) of the National Retail Federation is an international membership organization dedicated to reducing the costs of technology through standards. Since 1993, ARTS has been delivering application standards exclusively to the retail industry. ARTS has four standards: The Standard Relational Data Model, UnifiedPOS, XML, and the Standard RFPs (in partnership with NRF). Membership is open to all members of the international technology community-- retailers from all industry segments, application developers and hardware companies.
- 15. 15C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d To provide an “example”/ typical industry answer for the questions the organisation in the industry faces: What information do we need How does it all hang together Where will it have an impact/ be used How are we serving customers/ delivery products/ transforming inputs into outputs What do we need to do When does it need to be done Who will do it and Why are we doing it The intent of industry frameworks
- 16. 16C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d They all seem to focus on the following elements Business Process Information/ Data maybe Business Capability invariably application and/ or service component included …and aspects of integration or flow Common themes in the reference frameworks
- 17. 17C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Objectives of Healthcare Reference Framework To educate on what we do, how and where we do it and why To improve communication; focusing the conversion To define scope and context; for planning and conversion To support strategy development To create clear lines for roles and responsibilities To create standards for the concepts defined in the framework To allow for the comparison of things To enable re-use across programmes/ projects and organisations To support a common/ balanced view of applying our resources and effort To focus our resources on areas of differentiation To better utilise our data through understanding scope, context and positioning To align objectives of the various divisions of the organisation (IT, Business)
- 18. 18C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d 1.1.The Business Process Framework as a focus for enterprise mapping Now, alongside this use of the Business Process Framework as the basis for defining process decomposition, it has also been commonly used as the default starting point for analyzing and mapping how the Business Process Framework process elements relate to the relevant area of application. For example, a company may look to map the Business Process Framework into its business and may therefore want to identify departmental roles and boundaries using the Business Process Framework as a tool in this. It is an important, but possibly subtle, point that alignment with the Business Process Framework depends on adopting and using the individual process elements within the Business Process Framework but that this does not mandate that these must be kept in the arrangement shown in Figure 1. In other words, the key requirement for staying aligned with the Business Process Framework is aligning with individual process definitions (as set out in GB921D and the related model, etc) rather than Use of the Business Process Framework 2. To support enterprise mapping
- 19. 19C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Using the Framework to create a common understanding of my organisation and the scope of processes we perform
- 20. 20C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Some background: Project ”klinisk dokumentasjon” identified the need for a better understanding of where in the hospital and how the clinical information will be used In the same project we realized that there is no model or visualization of the businesses (helseforetak), and one was created as a communication tool (the ”house”) We have been working with the hospital in Østfold to understand and describe how ”Industrial IT” fits in to a ”helseforetak” context – findings… We have searched for other healthcare reference frameworks – findings??? There is high awareness on applications, infrastructure and lack of IT resources – where is the business focus and business structure? What (and how) do we communicate with the business leaders without context? Health Reference Framework (HRF): Enabling transformation
- 21. 21C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d HRF Vision
- 22. 22C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Business reference model Objective: To provide a common definition of the business elements that will enable the transformation of the structure, to achieve our defined strategy and deliver the desired outcomes (i.e. performance) Proposed Elements: Business Area, Function, Process, Role
- 23. Business Reference model v 00 02 Assess the Problem Assess Patient Requirement Treat the Patient Close and FollowupAccess Healthcare Input: Patient Identity Input: Vital Statistics Input: Referral Information Input: Value Compass Input: Symptoms Input: Medication Input: Treatments Output: Problem Description Input: Patient Identity Input: Problem Description Input: Hypothesis Input: Clinical Investigation Results Output: Treatment Options Output: Qualitative Plan Output: Risk Assessment Output: Diagnosis Output: Capacity and Cost Analysis Input: Patient Identity Input: Clinical Scores Input: Treatment Plan Input: Treatment Location Output: Procedural Related Investigation Output: Treatment Metrics Output: Side Effects Output: Rehabilitation Plan Output: Procedure Codes Output: Complication Details Input: Patient Identity Output: Guidance Advice Output: Individual Plan Output: Rehabilitation Plan Output: Discharge Letter Output: Value Compass Input: Patient Identity Input: Healthcare Caregiver Info Input: Availability of Care Output: Vital Statistics Output: Referral Information In/Output: Symptoms
- 24. Assess Problem Assess Patient Requirement Treat the Patient Follow-up Healthcare Enterprise Support Discuss Symptoms Plan Requirement Plan Need Plan Treatment Provide Guidance Perform Research Manage Finances Govern Healthcare Enterprise Educate Patients and relatives Educate Healthcare Practitioners Access Healthcare Realise Symptoms Contact Caregiver Determine Options Transfer Patient Assess Need Diagnose Patient Describe Viable Options Assess Treatment Perform Treatment Monitor Patient Evaluate Patient Discharge Patient Norway HRF - Business Reference modelContact: Roar Engen roar.engen@helse-sorost.noPatient Centric Business Process Version 00.02 16 May 2012 Manage Risk Manage Compliance
- 25. 25C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Information Map Objective: To enable information sharing and reuse across the Healthcare sector in Norway via the standard description and discovery of common information and the promotion of uniform information management practices Elements: Information categories, Information Elements, Information Owners
- 26. 26C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Existing standards for Healthcare (informationn exchange)
- 27. 27C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Existing standards for Healthcare (informationn exchange)
- 28. Healthcare Practitioner Patient Symptoms Vital statistics Patient personal info Medication Problem description Treatment Specialisation area Organisation Patient Event Clinical Investigation Results Referral Facility Vehicle Resource Asset Legal Agreement Party Financial Transaction Regulatory Requirement/ Framework Diagnosis Value Compass Qualitative Plan Risk Assessment Treatment Options Capacity & Cost Hyphothesis Patient relatives Location Norway HRF – Information Map
- 29. 29C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Application reference model Objective: To categorise and define a common definition of the application capability required, where the application is a combination of the process executed and the data delivered. Elements: Application Categories, Application Functionality
- 31. 31C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Performance reference model Objective: To categorise and define a common model for defining the business metrics to be used for determining organisational performance. Elements: Measurement Category, Measure
- 32. 32C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d
- 33. 33C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d
- 34. 34C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d Collaboration and co-opetition are the key words With South Africa debating national healthcare, a reference framework to enable the conversation and eventually interoperability will be fundamental Healthcare, hospital and medical aid organisations and their suppliers should start considering the extended enterprise in a new world with national health Consider joining a South African collaboration on the topic Contact me for more detail Reference models
- 35. 35C o p y r i g h t R e a l I R M S o l u t i o n s ( P t y ) L t d sarina.viljoen@realirm.com Realirm.com http://za.linkedin.com/in/sarina +27 82 825 3496 Contact