Driving Question:
More data coming from different sources makes information
management difficult. How can the health sector manage the increasing volumes
of information but enable its effective processing in support of decision
making?
Assignment:
Pretend you are the Chief Information Officer of the
Department of Health. Which of the four major enterprise architecture
frameworks will you choose to manage the information coming in from regional
health units and DOH hospitals? Why? Write a blog post on your answer.
The four frameworks are evidences of man striving to find
ways to improve the flow of things through creating frameworks and
methodologies. The article of Roger Sessions: A Comparison of the Top Four Enterprise-Architecture
Methodologies describes these frameworks (and methodologies) and inspected
their effectiveness (disclaimed as subjective). The top four frameworks were
critically analyzed and were somewhat graded. Not basing from the scores that
each one got, I’ve chosen TOGAF (The Open Group Enterprise Architecture) to
answer this week’s assignment.
Let me enumerate the reasons for the selection:
1. It tackles four categories of enterprise architecture
that we need. These major categories guide us to create a Holistic approach to
a given situation.
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| Image from:http://msdn.microsoft.com/en-us/library/bb466232.aspx |
a. Business architecture – Describes the processes the
business uses to meet its goals
b. Application architecture- Describes how specific
applications are designed and how they interact with each other
c. Data architecture- Describes how the enterprise data
stores are organized and accessed
d. Technical architecture- Describes the hardware and
software infrastructure that supports applications and their interactions
2. It has a complete
process from conception to finishing point. What really attracted me to the
Framework is the ADM. For it being a “cycle” presents endless possibilities for
solutions.
To illustrate the TOGAF’s efficiency, let us find a solution
to one of the CIO’s problems: The interoperability of government rural health
units and hospitals for easy consolidation of reports. These reports should be
processed for decision support. And for decision making to be more justifiable
and effective, one should have a quality data for analysis.
TOGAF’s ADM (Architecture Development
Management) recommends dividing the process into 8 phases after frameworks and
principles are primed. Let me merge the problem (interoperability) to the ADM.
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| Image source: http://pubs.opengroup.org/architecture/togaf9-doc/arch/chap02.html |
Framework and
Principle-Initiatives should be first primed before anything else. As the
CIO, it is my duty to ensure that everyone’s on board and is willing to
cooperate to have the problem solved. Let us say that the best solution is to
have a new Central Information System that will consolidate health data and is
interoperable to the existing EHR’s deployed by the government and various
sectors. A committee will then be formed to analyze the current situation of
the information management in the Philippines. The key elements and leaders
will be oriented to the framework as suggested.
Phase A (Architecture
Vision)- Key players and representatives (leaders) of each unit will be
then identified. As the CIO, I’ll make sure that everyone understands the
objectives and will lead them to a common goal: Interoperability for a good
quality data. The majority will then decide on what interoperability standards
to be used based on each setting and environment. Together, bottlenecks and
roadblocks will be identified at the early stage to institute timeliness and
accuracy. The baseline and specified targets should be established.
Some of the examples of roadblocks would be, platforms to be
used, timeline of development, relay mechanisms, security and confidentiality,
validation of data etc.
Setting the baseline and target examples would be, reiterating
what data is really needed to minimize redundancies that may cause doubled
workload not just centrally but also to peripheral units. Let’s say for this
one, we just need to focus on mortality and morbidity.
Phase B (Business
Vision)-The important part of this phase is the detailing of baseline and
target business objectives. It defines the processes and transactions down to
the grassroots. For example, data flow transactions are graphically describe as
follows: Patient àPrimary
Health worker à
MHO (Municipal Health Office)àPHO
(Provincial Health Office)àDOH
Regional Office. All the processes in between will have their descriptions for
its smooth course. All the stakeholders
(like the patient and health worker) in between transactions will also be
identified. In this stage the “What is it for me?” question will be answered.
Business arising from the problem should be addressed.
Phase C (Information
systems architecture)- From the identified processes, responsibilities,
roles and privileges, the Central Information System will be designed. But
thorough risk and gap analysis should be performed first. Stakeholder
consultancy should also be considered. The identified baseline and target in
Phase A should be embedded in the planning and design of automation. The key
players (implementers) should begin to redesign or comply with the agreed
standards.
Phase D (Technology
architecture)- The backbone and platform should be planned. The committee
and key elements will decide or present solutions if there are no laid out
plans yet. For the problem, let’s say the Government decides to put up its own
telecommunications network and database. The committee will tap these resources
and ask the Government to provide internet to all units, from the primary level
going to the national level. The committee also ponders that it will be best if
it will have its own database hooked up to the Government’s database for easier
management and have lower risk of security breaches.
Phase E (Opportunities
and solutions)- The committee will then identify how this would be
implemented to the key units. Identify what sub-transactions will be undertaken
by each unit. Identify the incentives that will be created when these
transactions will be performed. For example, when government primary care level
units provides an NCD mortality list electronically of 4P’s beneficiaries, the
unit will receive capitation from Philhealth and DSWD. This would somehow
encourage compliance in the primary level alone.
Phase F (Migration
Planning)- The key units will try the new Information but will be
subjective to cost-benefit analysis. As for the description, migration
performed from the old system to the new. Feasibility of the new method will be
tested in small scale before the bigger scale roll out.
Phase G (Implementation
Governance)- From the migration planning, specifications of each
transaction and sub-transactions will be reviewed and created. The new method’s
risk and issues will be further identified. Acceptance level of each user will
also be assessed.
Phase F (Architecture
Change Management)- based from the risk and issues identified, the
committee will have the chance to modify the plans and re-establish the design.
The cycle will continue until main goal of interoperability to have an accurate
Morbidity and Mortality reports consolidation is reached.
3. Reviewing the four major frameworks, TOGAF is highly
modifiable to fit to the Philippine setting. For example,
“Phase G (Implementation Governance)- From the migration planning, specifications of each transaction and
sub-transactions will be reviewed and created. The new method’s risk and issues
will be further identified. Acceptance level of each user will also be
assessed.”
We can set Phase G for sustainability
planning instead of implementation governance. Risk analysis and acceptance
criteria can be tackled in Phase F.
4. Still in modifiability characteristics of TOGAF, even though
there are little documents for templates. It has guidelines for input and
output. From here we are not limited to create our own given the condition that
it coincides with the guidelines. Characterized as generic, this is a good
opportunity for us to have a best fit to a framework that is not created for a
particular group or enterprise.
To summarize, the best way to manage complex data coming from
various sectors and source is to have an organized system that is managed and
maintained by an enterprise architecture framework that guides the key elements
in every stage or phase. TOGAF stands out in terms of flexibility and
architectural design making it suitable to the national eHealth initiatives of
the Philippines.
References:
1. Sessions R. A Comparison of the Top Four
Enterprise-Architecture Methodologies
2. Enterprise Architecture (EA) and the Health Metrics
Network (HMN) Framework: A Federated Approach for Interoperability
3. TOGAF® 9.1 > Part
I: Introduction > Core Concepts
4.The Zachman Framework For Enterprise Architecture: Primer
for
Enterprise Engineering and Manufacturing
5. Canlas RD Jr. PHIS: The Philippines Health Information
System - Critical Challenges and Solutions
Source: www.cclfi.org/files/PHIS.pdf
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