example of a responsibilities driven business architecture alignment effort
DESCRIPTION
This document uses the Microsoft Connected Health Framework (CHF) to illustrate a Responsibilities Driven Business Architecture Alignment effort conducted by a fictional Healthcare organization that wants to adopt the CHF.TRANSCRIPT
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EBMM-TRIADS™ Responsibilities Driven Business Architecture Alignment
Case Study: The Microsoft CHF
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Table of Contents 1-Introduction ........................................................................................................................................................................ 6
2-The EBMM-TRIADS ........................................................................................................................................................... 6 3-EBMM-TRIADS Shared Relationships ............................................................................................................................... 8 4-Responsibilities-Driven Business Architecture Alignment ................................................................................................ 12
4.1 Business Responsibilities and Motivation Alignment: WHO-WHY Relationships ............................................. 12 4.1.1. Market Segments Generate Customer Demands and Relationships ............................................................. 12
4.1.2. Influencing Organizations are Sources of Influence ....................................................................................... 13
4.1.3. Stakeholders are accountable for Business Strategies and Objectives .......................................................... 13 4.1.4. Stakeholders can be a type of Driver .............................................................................................................. 13
4.1.5. Governance Body enforces Business Policies ............................................................................................... 14 4.2 Business Responsibilities and Strategy Alignment: WHY-WHAT Relationships .............................................. 14
4.2.1. Business Capability Roadmaps describe Changes to Business Capabilities ................................................. 14 4.2.2. Business Strategies and Objectives drive changes to Business Capabilities ................................................. 14 4.2.3. Business Initiatives and Programs drive changes to Business Capabilities.................................................... 14
4.2.4. Customer Demands and Relationships drive Products and Services ............................................................. 14 4.2.5. Value Proposition drives Required Competencies .......................................................................................... 15
4.2.6. Directives govern the use of Assets ............................................................................................................... 15
4.3 Business Responsibilities and Operation Alignment: WHAT-WHO Relationships ............................................ 15
4.3.1. Business Units are responsible for Business Capabilities .............................................................................. 15 4.3.2. Business Units are responsible for Assets...................................................................................................... 16 4.3.3. Business Units provide Products and Services .............................................................................................. 16
4.3.4. Business Units consume Products and Services ............................................................................................ 16
5-Responsibilities-Driven Business Architecture Alignment and the Microsoft CHF ........................................................... 17 5.1-BUSINESS POLICIES ............................................................................................................................................. 20 5.2-CAPABILITY ROAD MAP ........................................................................................................................................ 20 5.3-CHF BUSINESS CAPABILITIES ............................................................................................................................. 21
5.4-CUSTOMERS’ DEMANDS and RELATIONSHIPS .................................................................................................. 22
5.5-MARKET SEGMENTS ............................................................................................................................................. 23
5.6-PRODUCTS and SERVICES................................................................................................................................... 24 5.7-REQUIRED COMPETENCIES ................................................................................................................................ 25 5.8-VALUE PROPOSITION ........................................................................................................................................... 25
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5.9-YOUR ORGANIZATION'S ASSETS ........................................................................................................................ 26 5.10-YOUR ORGANIZATION'S BUSINESS INITIATIVES & PROGRAMS ................................................................... 27
5.11-YOUR ORGANIZATION'S BUSINESS STRATEGIES & OBJECTIVES ................................................................ 28 5.12-YOUR ORGANIZATION'S BUSINESS UNITS ...................................................................................................... 29 5.13-YOUR ORGANIZATION'S GOVERNANCE BODY................................................................................................ 30
5.14-YOUR ORGANIZATION'S STAKEHOLDERS ....................................................................................................... 31 5.15-WHO-LIKE BUSINESS ARCHITECTURE ELEMENT INSTANCES ...................................................................... 32
INFLUENCING ORGANIZATIONS ............................................................................................................................. 32 ITU ............................................................................................................................................................................ 32
MARKET SEGMENTS ................................................................................................................................................ 32
CARE PROFESSIONALS (D) .................................................................................................................................. 32 CARE PROVIDERS (P) ............................................................................................................................................ 33
FUNDING ORGANIZATION (F) ............................................................................................................................... 33 PERSONS (C) .......................................................................................................................................................... 33 POLICY MAKERS and LEGISLATORS (G) ............................................................................................................. 34
RESEARCHERS and ANALYSTS (R) ...................................................................................................................... 34 5.16-WHY-LIKE BUSINESS ARCHITECTURE ELEMENT INSTANCES ...................................................................... 34
BUSINESS POLICIES................................................................................................................................................. 34 Using Cloud Computing ............................................................................................................................................ 34
Using Portals ............................................................................................................................................................ 35 Using SOA ................................................................................................................................................................ 35
CAPABILITY ROADMAPS .......................................................................................................................................... 36
Maturity Model for e-Health and e-Care ................................................................................................................... 36
CUSTOMER DEMANDS AND RELATIONSHIPS ....................................................................................................... 36 C2C .......................................................................................................................................................................... 36 C2P .......................................................................................................................................................................... 37 D2C .......................................................................................................................................................................... 37
D2D .......................................................................................................................................................................... 38
F2C ........................................................................................................................................................................... 38
F2F ........................................................................................................................................................................... 39 F2P ........................................................................................................................................................................... 40 G2C .......................................................................................................................................................................... 40 G2D .......................................................................................................................................................................... 41
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G2F .......................................................................................................................................................................... 41 G2G .......................................................................................................................................................................... 42
G2P .......................................................................................................................................................................... 42 P2D .......................................................................................................................................................................... 43 P2P ........................................................................................................................................................................... 43
R2F ........................................................................................................................................................................... 44 R2G .......................................................................................................................................................................... 44
R2R .......................................................................................................................................................................... 45 VALUE PROPOSITIONS ............................................................................................................................................ 45
Microsoft Value Proposition for Health and Social Care ........................................................................................... 45
5.17-WHAT-LIKE BUSINESS ARCHITECTURE ELEMENT INSTANCES .................................................................... 47 BUSINESS CAPABILITIES ......................................................................................................................................... 47
ASSESSMENTS AND CARE PLANS ...................................................................................................................... 47 CARE FACILITIES AND SCHEDULES .................................................................................................................... 47 CARE PATHWAYS .................................................................................................................................................. 48
CARE PROFESSIONALS ........................................................................................................................................ 48 CLINICAL AND CARE DATA MANAGEMENT ......................................................................................................... 48
CLINICAL CODING AND DATASETS ...................................................................................................................... 49 COSTS AND PRICES .............................................................................................................................................. 49
CURRENT CLIENTS, PATIENTS AND CARE RELATIONSHIPS ........................................................................... 49 HEALTH AND CARE CLASSIFICATIONS ............................................................................................................... 50 INVESTIGATIONS, ORDERS, TESTS AND RESULTS ........................................................................................... 50
MEDICATIONS AND TREATMENTS ....................................................................................................................... 51
ORGANIZATIONS, CARE PROVIDERS AND SERVICES ...................................................................................... 51 PATIENT AND CLIENT GROUPS ............................................................................................................................ 52 PATIENT AND CLIENT JOURNEY .......................................................................................................................... 52 PATIENT AND CLIENT MANAGEMENT ................................................................................................................. 53
PERSONAL AFFILIATIONS AND ENTITLEMENTS ................................................................................................ 53
PERSONAL CARE RECORDS ................................................................................................................................ 54
PERSONAL CONSENTS ......................................................................................................................................... 54 PERSONAL HEALTH AND CARE STATUS ............................................................................................................ 55 PERSONS AND IDENTITIES ................................................................................................................................... 55 PROCESSES AND PROTOCOLS ........................................................................................................................... 56
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PROFESSIONAL ROLES AND TEAMS ................................................................................................................... 56 RULES ENGINE ....................................................................................................................................................... 56
SOCIAL CARE CODING AND DATASETS .............................................................................................................. 57 WAITING LISTS ....................................................................................................................................................... 57
PRODUCTS AND SERVICES .................................................................................................................................... 58
CARE PROFESSIONAL SERVICES ........................................................................................................................ 58 CARE PROVIDER SERVICES ................................................................................................................................. 58
FUNDING ORG SERVICES ..................................................................................................................................... 58 PERSON SERVICES ............................................................................................................................................... 59
POLICY MAKER SERVICES.................................................................................................................................... 59
RESEARCHER and ANALYST SERVICES ............................................................................................................. 59 REQUIRED COMPETENCIES .................................................................................................................................... 59
Connected – Interoperable by Design ...................................................................................................................... 59 Dependable – Proven and Robust ............................................................................................................................ 59 Extensive Partner Ecosystem ................................................................................................................................... 59
Productive – Familiar Tools to Automate the Way Users Work ................................................................................ 59 REFERENCES .................................................................................................................................................................... 60
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1-Introduction
We present an approach that tackles the number one issue faced by most organizations: Aligning
Business and IT. We do so by presenting a Business Architecture meta-model called the
EBMM-TRIADS and its practical application to aligning an organization's Business Motivation,
Business Strategy, Business Responsibilities, and Business Operation. Each one of the four
EBMM-TRIADs shares three sets of relationships with the other TRIADs. The relationships contained
in each one of those sets impose alignment constraints on the types of Business Architecture elements
hosted by the TRIADs. So each set of constraints represents a dimension of alignment between two
TRIADs. The number of relationships contained in each set indicates the strength of alignment
between the two TRIADs that share the set. Therefore the EBMM-TRIADs can provide a solid
reference for a qualitative and quantitative characterization of the alignment achieved by an
organization through its existing and targeted Business Architectures.
We illustrate our approach with a case study of a Business Architecture Alignment effort conducted by
a healthcare organization that wants to adopt the Microsoft Connected Health Framework (CHF).
2-The EBMM-TRIADS
The EBMM-TRIADs are a conceptual meta-model of a business architecture and as such they model
the types of elements and their associated relationships involved in the definition of an actual business
architecture. The four EBMM-TRIADs elegantly break down the complexity found in Nick Malik's
initial EBMM [1] by showing how its business architecture elements participate in four very common
views of any Business Architecture: Strategy, Motivation, Responsibilities, and Operation. Each
TRIAD combines three fundamental interrogatives taken from the following set: WHY, WHAT,
WHO, and HOW. Each interrogative group contains several types of Business model elements that
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entertain relationships with each other (e.g Success Metrics and Measures [WHY] set Performance
Criteria for Business Strategies and Objectives [WHY]). The EBMM-TRIADs are an attempt at
integrating fundamental interrogatives similar to the purpose of the Zachman Framework’ s (ZF)
Integration Relationships between any two cells of the same perspective (ZF Row) [2,3]. Each TRIAD
lists relevant types of business model elements and their respective relationships. Those relationships
are between elements that belong to different interrogative groups (e.g. Business Strategies and
Objectives [WHY] drive changes to Business Capabilities [WHAT]).
Figure 1 – The EBMM-TRIADS
Figure 1 is a high level view of the EBMM-TRIADs. These are the interrogatives that define each
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TRIAD:
Business Strategy TRIAD: HOW does WHAT fulfil WHY
Business Motivation TRIAD: HOW does WHO influence WHY
Business Responsibilities TRIAD: WHY does WHO do WHAT
Business Operation TRIAD: HOW does WHO do WHAT
The EBMM-TRIADS have practical applications to Business Architecture Alignment. The approach
that we present can be used to guide an organization through the steps required to achieve a strong
alignment between Business Motivation, Business Strategy, Business Responsibilities, and Business
Operation.
Our approach is valuable because it tackles the number one issue faced by most organizations:
Aligning Business and IT [4]. A practical definition of alignment is given by Henderson and
Venkatraman as “Alignment between business and IT is the degree of fit and integration between
business strategy, IT strategy, business infrastructure, and IT infrastructure”[5]. The EBMM-TRIADs
allow a precise characterization, both qualitative and quantitative, of the degree of fit and integration
between Business and IT.
3-EBMM-TRIADS Shared Relationships
Each EBMM-TRIAD shares three sets of relationships with the other TRIADs as shown in Figure 2.
The relationships contained in each one of those sets impose Alignment constraints on the types of
Business Architecture elements hosted by the TRIADs. So each set of constraints represents a
dimension of alignment between two TRIADs. The number of relationships contained in each set
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indicates the strength of alignment between the two TRIADs that share the set. This provides a solid
reference for a qualitative and quantitative characterization of the alignment achieved by an
organization through its existing and targeted Business Architectures [6].
The sets of relationships shared between the TRIADS are as follows:
Business Strategy and Business Operation shared relationships:
o HOW to WHAT
Business Processes and Activities properly manage Assets
Business Processes and Activities produce and consume proper Data Objects
Assessment Metrics evaluate Business Capabilities
System Interaction Points are described in Use Cases or User Stories
Applications properly impact Business Capabilities
Applications are involved in providing useful Products or Services
o WHAT to HOW
Business Capabilities are implemented through Business Processes/Activities
Data Objects are created or used in Applications
Business Requirements describe Application Features
Business Strategy and Business Motivation shared relationships:
o WHY to HOW
Directives govern Business Processes and Activities
Success Metrics and Measures track success of Business Processes and Activities
Value propositions are inputs to Finance and Revenue Models
o HOW to WHY
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Assessment Metrics prioritize Capability Roadmaps
Key Performance Indicators track Success Metrics and Measures
Business Strategy and Business Responsibilities shared relationships:
o WHY to WHAT
Business Initiatives and Programs drive changes to Business Capabilities
Business Strategies and Objectives drive changes to Business Capabilities
Customer Demands and Relationships drive products and services
Value Propositions drive Required Competencies
Directives govern use of Assets
Capability Roadmaps describe changes to Business Capabilities
Business Responsibilities and Business Operation shared relationships:
o WHO to WHAT
Business Units are responsible for Assets
Business Units are responsible for Business Capabilities
Business Units consume Products and Services
Business Units provide Products and Services
Business Responsibilities and Business Motivation shared relationships:
o WHO to WHY
Governance Body enforces All Business Policies
Stakeholders are accountable for Business Strategies and Objectives
Stakeholders can be a type of Driver
Market Segments generate Customer Demands and Relationships
Influencing Organizations are sources of Influence
Business Motivation and Business Operation shared relationships:
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o WHO to HOW
Business Units perform Business Processes and Activities
In the previous Relationships List, we have highlighted in blue Business model elements that appear in
multiple Relationship sets. Highlighted in green are the Business model elements that appear more
than once but only within one Relationship set. None-highlighted Business model elements only
appear once across all Relationship sets.
Figure: 2
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There are 4 possible Alignment approaches, each defined by the TRIAD that triggers the alignment
effort. We have demonstrated that a Responsibilities-Driven Business Architecture Alignment can be
significantly more efficient than its counterparts. The interested reader can refer to the following
presentation for an overview of each approach and its efficiency:
How to Use the EBMM-TRIADS to Conduct a Business Architecture Alignment Effort [7]
4-Responsibilities-Driven Business Architecture Alignment
We advocate using a Responsibilities-Driven approach to aligning Business and IT Architectures. We
have provided a quantitative rational in past presentations [7].
Let’s now explain our view from a qualitative standpoint by providing a series of steps that logically
define relevant Business Architecture elements that can support a rational formulation of a Business
Organizational structure.
4.1 Business Responsibilities and Motivation Alignment: WHO-WHY Relationships
4.1.1. Market Segments Generate Customer Demands and Relationships
An Organization’s success is irrevocably tied to its customers’ satisfaction and loyalty. To ensure that
an organization is properly aligned with its customers’ expectations, it must have a reliable and
comprehensive enough understanding of its Market Segments. Clarifying the specific demands or
expectations of each Market Segment allows the organization to justify its engagement towards each
targeted customer group. Customers’ trust and hopefully their long term loyalty can then be effectively
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secured and nurtured by the organization through its profound understanding and undisputable
fulfillment of customers’ expectations.
4.1.2. Influencing Organizations are Sources of Influence
Influencing organizations could be Partners, Competitors, or Regulatory bodies. In some sense,
Partners and Regulatory bodies are also Customers of the organization since they bring specific
constraints or expectations often key to the organization’s success. Competitors’ influence is
undeniable as they often cater to the same pool of customers as the ones targeted by an organization.
Here again, knowing the strengths and weaknesses of Competitors as well as the organization’s own is
key to the formulation of a Business Strategy that can ultimately secure the organization’s desired
market position.
4.1.3. Stakeholders are accountable for Business Strategies and Objectives
With a clear understanding of Customer Demands and Relationships and the proper consideration of
influences generated by Partners, Regulatory bodies, and Competitors, Organization Stakeholders are
empowered to formulate effective Business Strategies and Objectives that have a high probability of
securing a desired Market Position. It is fundamental to hold Stakeholders accountable for those
Strategies and Objectives as described next.
4.1.4. Stakeholders can be a type of Driver
Stakeholders when held accountable for a given set of Business Strategies and Objectives become
advocate for their effective implementation. Some stakeholders will carry this responsibility further
than others by actually driving the Business Strategies and Objectives toward their fulfillment and by
being actively involved in or accountable for all activities required for their realization.
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4.1.5. Governance Body enforces Business Policies
Some Stakeholders play the role of Governance body by creating and enforcing Business Policies
applicable to the entire Organization and/or specific Business Units. These Business policies are
meant to support and articulate agreed upon Directives that contribute to the achievement of the
established Business Strategies and Objectives.
4.2 Business Responsibilities and Strategy Alignment: WHY-WHAT Relationships
4.2.1. Business Capability Roadmaps describe Changes to Business Capabilities
A Capability Roadmap is a well-articulated set of successive changes to the organization’s Business
Capabilities aimed at progressively transforming the organization from its current state to its desired
future states. Capability Roadmaps must be prioritized according to selected Assessment Metrics that
highlight the most valuable opportunities for Capability improvements. Therefore, Capability
Roadmaps are solid foundations upon which Business Initiatives and Programs can be chartered.
4.2.2. Business Strategies and Objectives drive changes to Business Capabilities
The organization’s desired future Capabilities are the outcome of fulfilling its Business Strategies and
achieving its Business Objectives.
4.2.3. Business Initiatives and Programs drive changes to Business Capabilities.
Business Initiatives and Programs chartered from Capability Roadmaps drive changes to Business
Capabilities in a coordinated and effective manner.
4.2.4. Customer Demands and Relationships drive Products and Services
Properly assessed and understood Customer Demands and Relationships along with Influences
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created by Competitors, Partners, and Regulatory bodies all come into consideration for the
formulation of desired product and service offerings that effectively package Business Capabilities
specified by Capability Roadmaps.
4.2.5. Value Proposition drives Required Competencies
The Value Proposition can be formulated by describing the rationale behind an organization’s featured
products and services. Securing the targeted Market Position mandates Required Competencies
through exceptional Capabilities included in or contributing to the organization’s product and service
offerings.
4.2.6. Directives govern the use of Assets
Once an organization has defined its Value Proposition and Required Competencies, it can elicit its
Assets. Assets are resources employed, possessed, or controlled by the organization in order to deliver
its products and services. The next step is for the Governance body to formulate Directives that govern
the use of Assets in a way that contributes to the achievement of the established Business Strategies
and Objectives.
4.3 Business Responsibilities and Operation Alignment: WHAT-WHO Relationships
4.3.1. Business Units are responsible for Business Capabilities
The organization is now in a more reliable position to consolidate its structure by forming or allocating
Business Units responsible for each Business Capability. Required Competencies can guide this
allocation process.
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4.3.2. Business Units are responsible for Assets
From the previous elicitation of Business Assets and their respective Directives, the organization can
further refine its structure by designating Business Units responsible for each Asset.
4.3.3. Business Units provide Products and Services
Since Products and Services package Capabilities and since Business Units have been mapped to the
Capabilities that they are responsible for, it is possible to determine which Business Units provide
which products and Services based on the Capabilities packaged within products and services.
4.3.4. Business Units consume Products and Services
A Business Unit consumes a Product or Service when it uses a Product or Service that is provided by
another Business unit.
The previous steps have contributed to aligning only 3 Business Architecture Dimensions out of 6
possible ones by examining 15 out of 30 total Relationship Rules.
We have explained how to address the remaining 3 Dimensions of Alignment in our presentation
titled: “EBMM-TRIADs Deep Dive: The Chemistry of Business and IT Alignment”[9]
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5-Responsibilities-Driven Business Architecture Alignment and the Microsoft CHF
The remainder of this document uses the Microsoft Connected Health Framework (CHF) to illustrate a
Responsibilities- Driven Business Architecture Alignment effort conducted by a fictional Healthcare
organization that wants to adopt the CHF [8]. This is a link to the Microsoft CHF website:
http://www.microsoft.com/health/ww/ict/Pages/Connected-Health-Framework.aspx
We will identify key CHF Business Architecture actual elements and we will link them to their
EBMM-TRIADS classifications. The fictional organization has specific Business Architecture
elements not directly addressed by the CHF; we will highlight them and link them to CHF Business
Architecture elements that influence or constrain them.
When the Business Responsibilities TRIAD triggers the Business Architecture Alignment cycle, the
following types of relationships are first examined:
FOR BUSINESS MOTIVATION & RESPONSIBILITIES ALIGNMENT
-WHO to WHY Governance Body enforces All Business Policies Stakeholders are accountable for Business Strategies and Objectives Stakeholders can be a type of Driver Market Segments generate Customer Demands and Relationships Influencing Organizations are sources of Influence
FOR BUSINESS STRATEGY & RESPONSIBILITIES ALIGNMENT
-WHY to WHAT Business Initiatives and Programs drive changes to Business Capabilities Business Strategies and Objectives drive changes to Business Capabilities
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Customer Demands and Relationships drive products and services Value Propositions drive Required Competencies Directives govern use of Assets Capability Roadmaps describe changes to Business Capabilities
FOR BUSINESS OPERATION & RESPONSIBILITIES ALIGNMENT
-WHO to WHAT Business Units are responsible for Assets Business Units are responsible for Business Capabilities Business Units consume Products and Services Business Units provide Products and Services
The fictional organization’s specific Business Architecture elements that are not directly addressed by
the CHF are highlighted in Yellow in the previous relationship list.
Figure 3 is an example of a healthcare organization’s Business Architecture model based on Business
Architecture element types found in the Business Responsibilities TRIAD. Figure 3 incorporates CHF
Business Architecture elements that are relevant to most healthcare organizations. Business
Architecture elements that are specific to our fictional healthcare organization are symbolized by
yellow boxes and would need to be detailed by that organization.
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Figure 3: Responsibilities-Driven Business Architecture Model for Healthcare Organizations
object Responsibilities-Driv en Business Architecture Alignment
WHO
MARKET SEGMENTS
PERSONS (C) :MARKET
SEGMENT
CARE
PROFESSIONALS
(D) :MARKET
SEGMENT
CARE PROVIDERS
(P) :MARKET
SEGMENT
FUNDING
ORGANIZATION (F) :
MARKET SEGMENT
INFLUENCING
ORGANIZATIONS
INFLUENCING
ORGANIZATIONS
RESEARCHERS and
ANALYSTS (R) :
MARKET SEGMENT
WHY
CUSTOMERS DEMANDS and
RELATIONSHIPS
CUSTOMERS DEMANDS and
RELATIONSHIPS
P2P :CUSTOMER
DEMANDS and
RELATIONSHIPS
D2D :CUSTOMER
DEMANDS and
RELATIONSHIPS
C2C :CUSTOMER
DEMANDS and
RELATIONSHIPS
G2G :CUSTOMER
DEMANDS and
RELATIONSHIPS
R2R :CUSTOMER
DEMANDS and
RELATIONSHIPS
F2F :CUSTOMER
DEMANDS and
RELATIONSHIPS
C2P :CUSTOMER
DEMANDS and
RELATIONSHIPS
D2C :CUSTOMER
DEMANDS and
RELATIONSHIPS
G2C :CUSTOMER
DEMANDS and
RELATIONSHIPS
F2C :CUSTOMER
DEMANDS and
RELATIONSHIPS
P2D :CUSTOMER
DEMANDS and
RELATIONSHIPS
G2D :CUSTOMER
DEMANDS and
RELATIONSHIPS
R2G :CUSTOMER
DEMANDS and
RELATIONSHIPS
G2F :CUSTOMER
DEMANDS and
RELATIONSHIPS
R2F :CUSTOMER
DEMANDS and
RELATIONSHIPS
F2P :CUSTOMER
DEMANDS and
RELATIONSHIPS
G2P :CUSTOMER
DEMANDS and
RELATIONSHIPS
WHAT
PRODUCTS and
SERVICES
PRODUCTS and
SERVICES
PERSON SERVICES :PRODUCTS and
SERVICES
CARE PROFESSIONAL SERVICES :
PRODUCTS and SERVICES
CARE PROVIDER SERVICES :
PRODUCTS and SERVICES
POLICY MAKER SERVICES :
PRODUCTS and SERVICES
POLICY MAKERS
and LEGISLATORS
(G) :MARKET
SEGMENT
FUNDING ORG SERVICES :
PRODUCTS and SERVICES
RESEARCHER and ANALYST
SERVICES :PRODUCTS and
SERVICES
BUSINESS POLICIES
CAPABILITY ROAD MAP
Maturity Model for e-Health and e-Care :CAPABILITY
ROADMAP
Using Portals :
BUSINESS POLICY
ITU :INFLUENCING
ORGANIZATION
Using Cloud
Computing :
BUSINESS POLICY
Building Composite
Applications :
BUSINESS POLICY
Using SOA :
BUSINESS POLICY
VALUE PROPOSITION
Microsoft Value Proposition for Health and Social
Care :VALUE PROPOSITION
REQUIRED COMPETENCIES
Connected –
Interoperable by
Design :REQUIRED
COMPETENCY
Productiv e –
Familiar Tools to
Automate the Way
Users Work :
REQUIRED
COMPETENCY
Dependable – Prov en
and Robust :REQUIRED
COMPETENCY Extensiv e Partner
Ecosystem :
REQUIRED
COMPETENCY
WHO
YOUR
ORGANIZATION'S
BUSINESS UNITS
YOUR
ORGANIZATION'S
BUSINESS UNITS
YOUR ORGANIZATION'S
GOVERNANCE BODY
YOUR ORGANIZATION'S
GOVERNANCE BODY
YOUR
ORGANIZATION'S
ASSETS
YOUR
ORGANIZATION'S
ASSETS
YOUR ORGANIZATION'S
STAKEHOLDERS
YOUR ORGANIZATION'S
STAKEHOLDERS
YOUR ORGANIZATION'S BUSINESS
STRATEGIES & OBJECTIVES
YOUR ORGANIZATION'S BUSINESS
STRATEGIES & OBJECTIVES
YOUR ORGANIZATION'S BUSINESS
INITIATIVES & PROGRAMS
YOUR ORGANIZATION'S BUSINESS
INITIATIVES & PROGRAMS
CHF BUSINESS CAPABILITIES
PERSONS AND
IDENTITIES :
BUSINESS
CAPABILITY
PATIENT AND
CLIENT GROUPS :
BUSINESS
CAPABILITY
PERSONAL HEALTH
AND CARE STATUS :
BUSINESS
CAPABILITY
PERSONAL
AFFILIATIONS AND
ENTITLEMENTS :
BUSINESS
CAPABILITY
PERSONAL
CONSENTS :
BUSINESS
CAPABILITY
PATIENT AND
CLIENT JOURNEY :
BUSINESS
CAPABILITY
PERSONAL CARE
RECORDS :
BUSINESS
CAPABILITY
PATIENT AND
CLIENT
MANAGEMENT :
BUSINESS
CAPABILITY
ASSESSMENTS AND
CARE PLANS :
BUSINESS
CAPABILITY
HEALTH AND CARE
CLASSIFICATIONS :
BUSINESS
CAPABILITY
MEDICATIONS AND
TREATMENTS :
BUSINESS
CAPABILITY
INVESTIGATIONS,
ORDERS, TESTS
AND RESULTS :
BUSINESS
CAPABILITY
CARE PATHWAYS :
BUSINESS
CAPABILITY
PROCESSES AND
PROTOCOLS :
BUSINESS
CAPABILITY
ORGANIZATIONS,
CARE PROVIDERS
AND SERVICES :
BUSINESS
CAPABILITY
CARE FACILITIES
AND SCHEDULES :
BUSINESS
CAPABILITY
WAITING LISTS :
BUSINESS
CAPABILITY
CARE
PROFESSIONALS :
BUSINESS
CAPABILITY
PROFESSIONAL
ROLES AND TEAMS :
BUSINESS
CAPABILITY
CURRENT CLIENTS,
PATIENTS AND
CARE
RELATIONSHIPS :
BUSINESS
CAPABILITY
COSTS AND PRICES :
BUSINESS
CAPABILITY
CLINICAL AND CARE
DATA MANAGEMENT :
BUSINESS
CAPABILITY
RULES ENGINE :
BUSINESS
CAPABILITY
CLINICAL CODING
AND DATASETS :
BUSINESS
CAPABILITY
SOCIAL CARE
CODING AND
DATASETS :
BUSINESS
CAPABILITY
Describes changes to
Driv e changes to
Driv e changes to
Responsible for
Are Accountable for
Responsible for
Gov ern use of
Enforces
Prov ide
Consume
Driv e
DRIVE
Generate
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The various types or classifications of Business Architecture elements belonging to the Business
Responsibilities TRIAD are presented next.
5.1-BUSINESS POLICIES
Formally documented management expectations and intentions. Policies are used to direct decisions,
and to ensure consistent and appropriate development and implementation of Processes, Standards,
Roles, Activities, IT Infrastructure etc.
Connections
Connector Source Target Notes
Dependency Enforces
Source -> Destination
YOUR
ORGANIZATION'
S GOVERNANCE
BODY
BUSINESS
POLICIES
Dependency Govern use of
Source -> Destination
BUSINESS
POLICIES
YOUR
ORGANIZATION'
S ASSETS
5.2-CAPABILITY ROAD MAP
A Capability Roadmap is produced as the result of a maturity assessment. A maturity assessment is
an element that describes a process that takes place at a specific point in time, and which does not
question if the business is doing the right thing, but rather evaluates if the business is doing things
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right. (The former is the scope of a business model assessment).
Once a capability roadmap is generated, it becomes a driver in its own right. In order to make a
change to the business, based on any driver, the business would charter a business program.
Connections
Connector Source Target Notes
Dependency Describes changes to
Source -> Destination
CAPABILITY
ROAD MAP
CHF BUSINESS
CAPABILITIES
5.3-CHF BUSINESS CAPABILITIES
A business capability is a conceptual "element" of a business. In many ways, a capability is the basic
building block of a business in the same way that atoms and molecules are the building blocks of
matter.
A business capability is a stable component of the business architecture describing "what" a company
does, whereupon a business process describes "how" it does it. It is important, when creating a
business architectural model, to keep these interrogatives independent of one another.
A business capability is implemented by process, people, technology and information. Business
capabilities provide a stable anchor point as process re-engineering, sourcing and technology
optimization occur. Linking business capabilities to strategies drives prioritization and focus enabling
efficient and effective execution.
Connections
Connector Source Target Notes
Dependency Describes changes to
CAPABILITY
CHF BUSINESS
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Connector Source Target Notes
Source -> Destination
ROAD MAP
CAPABILITIES
Dependency Drive
changes to
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
STRATEGIES &
OBJECTIVES
CHF BUSINESS
CAPABILITIES
Dependency Drive
changes to
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
INITIATIVES &
PROGRAMS
CHF BUSINESS
CAPABILITIES
Dependency Responsible for
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
CHF BUSINESS
CAPABILITIES
5.4-CUSTOMERS’ DEMANDS and RELATIONSHIPS
The customers’ demands and relationships element of the business model describes in precise terms,
the motivations that lead customers to buy products and services from the business, and how the
business nurtures those motivations through marketing and support activities.
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The most important relationship any business can have is the one with their customers, and a failure to
precisely describe the motivations that lead a customer to connect with the business can lead to errors
in judgment that can ultimately cause the business to fail.
Connections
Connector Source Target Notes
Dependency DRIVE
Source -> Destination
CUSTOMERS
DEMANDS and
RELATIONSHIPS
PRODUCTS and
SERVICES
Dependency Generate
Source -> Destination
MARKET
SEGMENTS
CUSTOMERS
DEMANDS and
RELATIONSHIPS
5.5-MARKET SEGMENTS
The customers’ demands and relationships element can be further broken down into market segments,
with a detailed analysis of the buying habits or expectations of various types of customer within a
particular segment.
Connections
Connector Source Target Notes
Dependency Generate
Source -> Destination
MARKET
SEGMENTS
CUSTOMERS
DEMANDS and
RELATIONSHIPS
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Connector Source Target Notes
5.6-PRODUCTS and SERVICES
This element of the business model describes the specific products and/or services offered by the
business. It is important to recognize that the specific products or services developed must derive from
customer demands in order to effectively provide revenue. This relationship, between customers’
demands and the products offered, is the central focus of marketing in many organizations.
Connections
Connector Source Target Notes
Dependency Consume
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
PRODUCTS and
SERVICES
Dependency Drive
Source -> Destination
CUSTOMERS
DEMANDS and
RELATIONSHIPS
PRODUCTS and
SERVICES
Dependency Provide
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
PRODUCTS and
SERVICES
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5.7-REQUIRED COMPETENCIES
An area or group of business capabilities where the business must excel in order for the business
model to be successful.
This is a general concept, not a specific grouping of business capabilities. This part of the business
model drives the need for specific business unit capabilities to perform at higher-than-average levels
of effectiveness and efficiency.
Connections
Connector Source Target Notes
Dependency Drive
Source -> Destination
VALUE
PROPOSITION
REQUIRED
COMPETENCIES
5.8-VALUE PROPOSITION
The central notion of a business model, the value proposition describes how the business, through its
activities, adds value to the consumer or marketplace. The Value proposition binds together the
notions of customer demands, required competencies, revenue models and business partnerships. It is
a statement from the viewpoint of the target customers that informs everyone "why" the business'
products and services are valuable.
Assessments of a business model often focus on this element. Many businesses make the mistake of
“chasing money” by offering products and services that are ill-suited to develop, support, or make
money from. By focusing on the value proposition, many businesses can clarify their objectives and
focus their energies on those opportunities that are most likely to deliver value to their customers and
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themselves.
Connections
Connector Source Target Notes
Dependency Drive
Source -> Destination
VALUE
PROPOSITION
REQUIRED
COMPETENCIES
5.9-YOUR ORGANIZATION'S ASSETS
In the context of this model, an asset is any property controlled by a business unit through a business
process. The management of that asset is subject to the constraints created by business directives
(policies).
A resource can represent anything that the business must employ, possess, or control in order to
deliver on a required competency. Examples of a resource may be:
- a person or group of people able to fulfill a particular role or mission
- a building, office, suite, or store in which some activities are performed
- a physical asset used in the process of fulfilling a capability
- materials or inputs to manufacturing
- inventory of goods to be sold or distributed
- inventory of services ready to be provisioned or provided
- cash or equities
- Intellectual Property
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Connections
Connector Source Target Notes
Dependency Govern use of
Source -> Destination
BUSINESS
POLICIES
YOUR
ORGANIZATION'
S ASSETS
Dependency Responsible for
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
YOUR
ORGANIZATION'
S ASSETS
5.10-YOUR ORGANIZATION'S BUSINESS INITIATIVES & PROGRAMS
Initiatives are chartered (or proposed) project designed to change the ongoing structure, capabilities,
or performance of the overall business. Typically, initiatives are chartered to create a measurable
improvement in a business capability, often through process improvement, technology improvement,
structural change (reorganization, insourcing / outsourcing, etc.), or accountability changes
(governance, reporting, scorecarding, incentives).
Initiatives are intentional effort chartered to make a change to the manner, approach, products,
structure, and/or contractual relationships that make up the various functions of the business.
A business program is defined as:
A group of related business projects managed in a coordinated way to obtain benefits and control
not available from managing them individually. Programs may include elements of related work
outside the scope of the discrete projects in the program.
An ongoing set of capabilities within a business unit aligned to organizational commitments.
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Connections
Connector Source Target Notes
Dependency Drive
changes to
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
INITIATIVES &
PROGRAMS
CHF BUSINESS
CAPABILITIES
5.11-YOUR ORGANIZATION'S BUSINESS STRATEGIES & OBJECTIVES
Strategy is a complex set of related statements used to motivate the creation of projects, the setting of
goals, and the achievement of objectives by employees and partners of an enterprise in support of a
business goal. It is not a course of action in itself, but instead it provides the general outlines of a
course of action sufficient to drive specific changes in business operations. Strategies are defined in
terms of objectives.
Objectives are measurable milestones that support a strategy and measure the achievement of a
business goal. Objectives must be measurable and must have a target date.
In the EBMM, strategies and objectives are described by the same element because the statement of a
strategy is often broken down into measurable objectives which then inspire lower level strategies for
attaining them. As such, neither of the concepts is complete without the other to complement it.
Connections
Connector Source Target Notes
Dependency Are
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Connector Source Target Notes
Accountable for
Source -> Destination
YOUR
ORGANIZATION'
S
STAKEHOLDERS
YOUR
ORGANIZATION'
S BUSINESS
STRATEGIES &
OBJECTIVES
Dependency Drive
changes to
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
STRATEGIES &
OBJECTIVES
CHF BUSINESS
CAPABILITIES
5.12-YOUR ORGANIZATION'S BUSINESS UNITS
A group of people that employ tools, processes, and information to perform their responsibilities.
Usually organized in a hierarchy (which means that one business unit can include a number of
sub-units, and so on). Business units perform business processes.
A business unit is composed of business units, all the way down to the department and team level.
The role of a business unit is to provide resources (money, staff, infrastructure, governance) to enable
business processes to occur.
Any use of one business unit by another takes place through a business service. The business units
that offer the service are said to “provide” it while the business units that rely upon that service are said
to “consume” it. In smaller organizations, it is uncommon to see a single business service provided
by more than one business unit.
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Connections
Connector Source Target Notes
Dependency Consume
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
PRODUCTS and
SERVICES
Dependency Provide
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
PRODUCTS and
SERVICES
Dependency Are
responsible for
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
YOUR
ORGANIZATION'
S ASSETS
Dependency Are
responsible for
Source -> Destination
YOUR
ORGANIZATION'
S BUSINESS
UNITS
CHF BUSINESS
CAPABILITIES
5.13-YOUR ORGANIZATION'S GOVERNANCE BODY
A group of individuals with the right to create and enforce business policies applicable across business
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processes.
Connections
Connector Source Target Notes
Dependency Enforces
Source -> Destination
YOUR
ORGANIZATION'
S GOVERNANCE
BODY
BUSINESS
POLICIES
5.14-YOUR ORGANIZATION'S STAKEHOLDERS
A "driving stakeholder" is a person within an organization that owns accountability for a business
strategy or objective. This person is a stakeholder to a business strategy but may also be the source of
that strategy and is clearly a driving force in insuring that it comes about. To be an effective driver, a
stakeholder must not only be accountable for an objective, but must have some kind of formal
relationship with the person or team that is responsible for delivering on that objective.
Connections
Connector Source Target Notes
Dependency Are
Accountable for
Source -> Destination
YOUR
ORGANIZATION'
S
STAKEHOLDERS
YOUR
ORGANIZATION'
S BUSINESS
STRATEGIES &
OBJECTIVES
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5.15-WHO-LIKE BUSINESS ARCHITECTURE ELEMENT INSTANCES
INFLUENCING ORGANIZATIONS
ITU
International Telecommunications Union, an agency of the UN, indicating that at least 50 percent of
the global population now pays to use a mobile phone. Much of this growth is in Africa. Further, the
ITU estimates that nearly a quarter of the world’s population now has access to the Internet.
MARKET SEGMENTS
CARE PROFESSIONALS (D)
Care Professionals, in a medical context, include doctors, nurses, and allied care professionals.
Doctors would include general practitioners, physicians and surgeons, and mental health specialists.
Nurses would include hospital, community, and specialized nurses, such as cancer care nurses. Allied
care professionals, who usually need formal training and accreditation before they are employed,
would include medical assistants, dental hygienists, physio- and occupational therapists, laboratory
technicians, medical equipment technicians, radiographers, medical secretaries, medical coders, care
assistants, caterers, porters, and drivers.
In a social care context, care professionals would include social workers, counselors, community care
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workers, and many accredited volunteers and private sector careers. In certain, clearly defined
circumstances, they might include special needs teachers, home care assistants, personal financial and
legal assessors and councilors, police and probation officers, and addiction treatment and prevention
specialists.
CARE PROVIDERS (P)
Care Providers include hospitals, clinics, care and residential homes, medical practices, laboratories,
and other organizations that accommodate and treat patients or clients. They provide physical
premises and facilities and operate medical and other equipment. They operate administrative and
clinical systems and employ care professionals.
FUNDING ORGANIZATION (F)
Funding Organizations are those bodies—public or private—that provide the funding for e-Health
and e-Care. They include national and local government departments like Ministries of Health or
Social Work departments, official agencies like National Health Services, insurance companies, and
charities and philanthropic organizations.
PERSONS (C)
Persons are national citizens; resident aliens; short-term visitors; and tourists in need of or receiving
medical attention, social care, or allied treatments. When health care is involved they are called
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“Patients,” if social care then “Clients,” and in commercial situations “Customers.”
POLICY MAKERS and LEGISLATORS (G)
Policy Makers and Legislators are government departments, quasi-government organizations, and
professional bodies responsible for the organization and regulation of care services on a national or
regional basis. This would include the enactment of legislation, the provision and control of funding,
and the setting and governance of professional standards of care and process.
RESEARCHERS and ANALYSTS (R)
Researchers and Analysts are scientific, medical, statistical, and other professionals, institutes, and
bodies interested in the analysis of trends, treatments, procedures, medications, facilities, screening
programs, care initiatives, and many other aspects of Health and Social Care. Typically their interest
lies in the experiences of groups of patients or clients rather than individuals, and patient information
should be anonymized before use.
5.16-WHY-LIKE BUSINESS ARCHITECTURE ELEMENT INSTANCES
BUSINESS POLICIES
Using Cloud Computing
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The concept incorporates Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and
Software as a Service (SaaS) as well as Web 2.0 and other recent technology trends that have the
common theme of reliance on the Internet for satisfying the computing needs of the users. SaaS
vendors provide common business applications online that are accessed from a Web browser, while
the software and data are stored on servers “in the cloud”.
Using Portals
The portal is a vital piece of technology. It enables the assembly of relevant data from multiple
sources, which can be presented to the user in a coordinated, task-oriented manner. It provides
comprehensive content management and search capabilities, enables participation in shared business
processes, and facilitates enterprise-wide information sharing across organizational boundaries.
Portals must provide reliable means of establishing identity and ensuring privacy and confidentiality.
Using SOA
Service Oriented Architecture (SOA) provides the principles and guidance to transform an
organization’s array of heterogeneous, distributed, complex, and inflexible systems into integrated,
simplified, and highly flexible resources that can be changed and composed to more directly support
business goals. SOA ultimately enables the delivery of a new generation of dynamic applications
(sometimes called composite applications). These applications provide end users with more accurate
and comprehensive information and insight into processes, as well as the flexibility to access it in the
most suitable form and presentation factor, whether through the Web or through a rich client or mobile
device. Service orientation uses standard protocols and conventional interfaces—usually Web
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services—to facilitate access to business logic and information among diverse services.
CAPABILITY ROADMAPS
Maturity Model for e-Health and e-Care
Our (Microsoft) impression is that many current implementations are concerned with moving from the
Baseline, Level 0, towards Integration, Level 1, rather than from an integrated platform through the
Trigger Point to Transformation, Level 2, and eventual Revolution. In other words, Transaction might
be happening, but Transformation and the Trigger Point most definitely are not.
The main thrust of the CHF Architecture and Design guidance is to help bridge the gap between Level
0 (the Baseline) and Level 2 (Health 2.0) by ensuring that Level 1 (Integration) is effectively and
efficiently implemented. In this part of the CHF ADB we present a Business Pattern that can be
regarded as a template for Levels 1 and 2.
CUSTOMER DEMANDS AND RELATIONSHIPS
C2C
PERSONS to PERSONS:
-Community Care
-Self-help Groups
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-Charities
-Social Services
-Insurers
Typically concerned with self-help groups and community-based activities, including social services.
In this group we would include charitable groups and activities such as hospices, elderly care, and
other tertiary-care initiatives. We would include insurers in this set of interactions in so far as they
trade with citizens and may represent patients in the arrangement of suitable care and treatment.
C2P
PERSONS to CARE PROVIDERS:
-Appointments
-Admissions
-Discharges
Typically concerned with administrative transactions such as the making of appointments, attendance
at outpatient clinics, and hospital admissions and discharges.
D2C
CARE PROFESSIONALS to PERSONS:
-Patient Doctor Relationships
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-Episodes of Care
Typically concerned with episodes of patient care or treatment. These interactions are subject to
stringent confidentiality requirements, including the observance of specific professional and ethical
relationships.
D2D
CARE PROFESSIONALS to CARE PROFESSIONALS:
-Care and Clinical Roles
-Groups and Teams
-Triage
-Delegation of Care
-Client/Patient Referrals
Typically concerned with the referral of patients for further examination and treatment; case reviews
and triage; peer knowledge and information sharing; and the delegation of care as well as the
organization and management of clinical groups and specialist teams.
F2C
FUNDING ORGs to PERSONS:
-Registrations
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-Contracts
-Community Care
-Screening Programs
Typically include the transactions involved in the registration and enrollment of persons for various
services; the calculation and collection of premiums, contributions, and payments for care services and
programs; and the operation of health assurance activities such as screening and risk assessment
sessions.
F2F
FUNDING ORG to FUNDING ORG:
-Strategic and Business Planning
-Marketing and Product Planning
-Administration
-Funds Management
-Records Management
-Programs and Plans
-Targets and Budgets
Typically include a full range of business management activities such as strategic and business
planning activities, marketing and health and care product planning, financial planning and
management, business improvement programs, and the setting and monitoring of financial and
organizational targets.
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F2P
FUNDING ORGs to CARE PROVIDERS:
-Standards of Care
-Direct Funding
-Performance
-Audit
Typically concerned with funding and audit, measuring and improving performance, and monitoring
of standards of care.
G2C
POLICY MAKER to PERSONS:
-Registration
-Awareness Programs
-Screening Programs
Typically concerned with registration for national and regional services and initiatives such as
screening programs and community-based care activities. Citizens often will pay for their health
service either as part of general taxation or through a specific, homologated charge.
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G2D
POLICY MAKERS to CARE PROFESSIONALS:
-Registrations
-Standards of Care
-Professional Bodies
-On-going Education
Under the term “Policy Makers and Legislators” we include not only national governments and state
and regional authorities but also professional bodies concerned with registration of care professionals
and the setting and observance of professional standards of care.
G2F
POLICY MAKERS to FUNDING ORGs:
-Standards of Care
-Indirect Funding
-Performance
-Audit
Typically concerned with the setting and monitoring of budgets, levels of expenditure, and the audit
and appraisal of performance.
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G2G
POLICY MAKERS to POLICY MAKERS:
-Strategic Planning
-National Administration
-National Programs
-Targets and Budgets
-Coding Standards
-Service Frameworks
Typically include the overall definition, planning, and execution of national policy; the administration
of the national service including the setting and monitoring of national targets and budgets; the
definition and management of national programs; and the definition and monitoring of
disease-specific service frameworks and guidelines.
G2P
POLICY MAKERS to CARE PROVIDERS:
-Standards of Care
-Performance
-Audit
Typically concerned with the setting and monitoring of standards of care and audit and performance
measurement activities. Depending on the national business model in use, these interactions may take
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place either directly or via the appropriate funding organization.
P2D
CARE PROVIDERS to CARE PROFESSIONALS:
-Engagements
-Assignments
-Schedules
-Test and Assessment Requests and Results
-Administration
Typically falling into two types: administrative activities around engagement and assignment to
particular roles and responsibilities, and clinical activities associated with patient care and treatment,
such as requests for tests and imaging and the use of specialized facilities and equipment.
P2P
CARE PROVIDERS TO CARE PROVIDERS:
-Client/Patient Administration
-Clinical and Social Care Systems
-Monitoring Systems
-Laboratory systems
-Imaging Systems
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-Pharmacies
-Care Management
-Facilities Management
These are many and varied, covering patient administration and clinical care; the management of
facilities; and the provision of specialist services such as laboratories, imaging systems, and specialist
diagnostic equipment. Independent services such as dentists, opticians, and pharmacies may also be
included in this grouping.
R2F
RESEARCHERS to FUNDING ORGs:
-Projects
-Results
Typically concerned with requests for, formulation of, and financing of research studies, statistical
analyses, surveys, opinion polls, and so on, as well as the reporting of results.
R2G
RESEARCHERS to POLICY MAKERS:
-Projects
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-Results
Typically concerned with requests for, formulation of, and financing of research studies, statistical
analyses, surveys, opinion polls, and so on, as well as the reporting of results.
R2R
RESEARCHERS to RESEARCHERS:
-Collaborative Projects
-Anonimized Data Access
-Data sharing and Publication
-Methods and Procedure Research
-Treatment Analysis
-Drug Trials
Typically concerned with the organization and conduct of research and evaluation projects including
collaborative projects, data collection and sharing, trials and evaluation of drugs and treatment
procedures, and so on.
VALUE PROPOSITIONS
Microsoft Value Proposition for Health and Social Care
The key features of the proposition, realized using the Connected Health Framework, are as follows:
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Connected – Interoperable by design
Open architectures built on industry standards that facilitate the flow of patient information and
clinical knowledge seamlessly through the care continuum and across agencies
Leverage legacy application and infrastructure investment
Productive – Familiar tools to automate the way you work
Let clinicians be clinicians: improve adoption
Enable delivery of public health services in a standardized, replicable manner
Dependable – Proven and Robust
Applications that support 24/7/365 Health and Social Care operations
Financially stable
Extensive partner ecosystem gives decision-makers a choice
Best Economics – Driving down the cost of Health and Social Care technology
Create ROI faster than traditional investments
An integrated platform that lowers TCO overall
Local delivery model
Scalable from single providers to county-wide programs
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5.17-WHAT-LIKE BUSINESS ARCHITECTURE ELEMENT INSTANCES
BUSINESS CAPABILITIES
ASSESSMENTS AND CARE PLANS
Assessments are structured analyses of a patient’s or client’s condition or situation. They are made
using an agreed, applicable common protocol by one, or usually more, care professionals and perhaps,
professionals from other disciplines. The result of an assessment is a plan for the patient’s or client’s
care and hopefully recovery.
The Assessments and Care Plans component provides capabilities and services to aid the conduct of
the assessment, the production of the care plan and its subsequent execution.
CARE FACILITIES AND SCHEDULES
The Care Facilities and Schedules Component contains basic details of facilities operated or used by
an organization unit (e.g. of hospitals, clinics, etc.) which includes accommodation to bed level,
schedulable equipment such as scanners and major diagnostic devices and treatment facilities such as
theatres.
Facility and Team schedules are maintained.
It also provides details of team schedules so that the joint availability of a physical facility and its
operating and supporting personnel can be ensured.
No capability for workload leveling or schedule optimization is provided at this stage.
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CARE PATHWAYS
The Care Pathways Component provides services in support of standard programs of treatment and
care for defined diseases and medical and social conditions. Such programs are often applicable at a
national level and include target timings for the provision of treatment. A Care Pathway is lengthy and
may last for some months or even years. Although standard programs are specific, an individual care
pathway for a particular patient or client can be constructed to suit individual circumstances and may
be modified, in flight, to respond to changes in the patient’s or client’s condition. Thus the Care
Pathway is built from “phases” which lie between major decision points on the pathway. Segments
contain “activities” which specify actions to be taken in the course of treatment. In terms of
granularity, these planned events correspond to Patient Events.
CARE PROFESSIONALS
The Care Professionals’ Component records details of individuals employed contracted or assigned to
professional work within the Health and Social Care domain, their specific roles and effective dates.
CLINICAL AND CARE DATA MANAGEMENT
A Patient Encounter might involve taking measurements, readings, and so on. For a particular medical
condition of procedure there is a defined set of items that should be recorded.
The Clinical Data Management Component provides facilities to define the items required for each
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encounter type.
Optionally, data may be structured using archetypes as used in the OpenEHR methodology
CLINICAL CODING AND DATASETS
This component manages the data capture and maintenance of Clinical datasets, the items of
information that should be recorded for a medical condition or procedure.
Mechanisms are provided to anonymize such that the specific patient is not identifiable
COSTS AND PRICES
The Costs and Prices Component provides means of recording the prices and costs of Health and
Social care activities and billing the appropriate “payer”.
Means are available to record standard unit costs for the elements of care activity e.g. Facility usage,
Professional Time, Prescription Item, Test and Images, etc. and the billing tariff for defined care
activities. Actual usage of the billable elements is recorded and thus margins and Price variances can
be calculated.
CURRENT CLIENTS, PATIENTS AND CARE RELATIONSHIPS
Patients and Clients are formally assigned to Care Professionals.
Each Professional has established “care relationships” in which they are charged with specific aspects
of individual patient’s care. The Current Clients, Patients and Care Relationships Component
maintains these care relationships.
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Care Professionals have a formal range of permissions to access “their” patient or client data derived
from their roles, specialties and team memberships or by specific wish of the patient or client.
This component maintains and communicates a record of accesses made to patient related data by each
Care Professional. This includes information on the use of clinical overrides.
HEALTH AND CARE CLASSIFICATIONS
The Health and Care Classifications Component maintains and applies a categorization scheme for
summarizing the disease, medical or social condition or procedures involved in patient or social care
client care. A Health Subject may comprise smaller, more detailed Health Subjects and in turn may be
a sub-division of a more general Health Subject.
A Health Classification may align with a medical “Specialty” – such as “geriatrics” or “cardiology” or
“gastroenterology”, etc. or the Social care equivalents such as “care of the elderly” or “visual
impairment”, etc.
A Health Subject qualifies Patient Events, Consents, Permissions and Roles of Care Professionals.
Health Subjects provide a common denominator between schemes and the component provides a
translation service between a code value in a particular scheme and the corresponding code in another.
INVESTIGATIONS, ORDERS, TESTS AND RESULTS
Orders are created in order to perform tests or to carry out various imaging or diagnostic examinations.
Orders are raised as a result of a Patient Encounter and are sent to the appropriate laboratory or facility.
Coordinated sets of orders can be specified to carry out a detailed investigation. Tests involving
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samples are usually carried out anonymously as far as the patient is concerned; the test being identified
by a sample number with is related back to the patient by the requestor. Tests and examinations carried
out on the person are clearly not anonymous. Some orders are not patient-related and others are for
non-clinical purposes (e.g. catering). Orders may be grouped in sets for one patient or be for a group of
patients.
Tests and examinations are carried out using standard processes and may involve automated or manual
activity.
The Investigations, Orders, Tests and Results component provides capabilities to manage and conduct
order processing and results production.
MEDICATIONS AND TREATMENTS
The Medication Component offers basic information on medication items, their recommended usages
and dosages and information about their use in conjunction with other medications. It provides only a
quick reference and is not intended as a full prescribing system or pharmacopeia.
ORGANIZATIONS, CARE PROVIDERS AND SERVICES
This component is concerned with the provision of Organizational information about official bodies,
private companies and any enterprise active in the broad health and social care domains in response to
a request from any approved consuming process. Organizational Information includes data about
organizational units, their structure (both hierarchical and matrix), and their inter-relationships.
An important sub-set is that of Care and Service Providers who provide diverse Health and Social Care
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related services of various types and functions. They include hospitals, general practices, groupings of
providers (e.g. Health and Social Care trusts), ancillary disciplines such as dentists and opticians,
tertiary facilities such as care homes, hospices, etc.
PATIENT AND CLIENT GROUPS
The Patient and Client Groups component provides facilities for the definition, formation, operation,
analysis and reporting of patient/client groups and the population of such groups with relevant patients
or clients.
Screening Groups are formed to perform preventative medicine and clinical surveillance of defined
groups of patients.
Care Groups are formed to provide help and assistance to persons with similar care needs and might
include self help and voluntary care sector activities as well as “official” provisions.
PATIENT AND CLIENT JOURNEY
Patient and Client Journey Component summaries of care received or to be received in future by a
patient or client for a specific medical or social condition at a particular time or over a defined
timeframe.
Planned care is described by the Patient Journey. This may be based on a generic care pathway for a
particular disease or condition. However, the care pathway is usually customized for the patient
particular situation and needs. The Patient Journey is also records “future” events which are used as
triggers for appointment making.
Care Records are usually held in local systems but may be accessed remotely via Patient Data Links
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held in the Patient Identity and Health Status Component.
PATIENT AND CLIENT MANAGEMENT
The Patient and Client Management Component handles all administrative actions with regard to a
patient or Client relative to arranging, conducting, recording and reporting patient or client contacts
and interactions in both primary and secondary care health settings and social care situations.
Activities include receiving and responding to referrals, making appointments, handling admissions,
monitoring attendance and “patient processing”, handling discharges and clinic and session
attendance.
Also included are the maintenance of indices of patients registered with a Care Provider and attending,
or who have attended, a particular facility operated by a Care Provider.
PERSONAL AFFILIATIONS AND ENTITLEMENTS
The Personal Affiliations and Entitlements Component indicate from whom a person receives health
and social care and the nature and extent of the care services provided
The affiliation will be with a national health service or an insurance scheme or care plan organization.
The entitlement will describe the extent of cover and the applicable terms and conditions
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PERSONAL CARE RECORDS
This component manages Patient and Client Care Records – the summaries of care received by a
patient or social care client for a specific medical or social condition at a particular time or over a
defined timeframe.
The component provides functionality and data to support the actual provision of patient care. Planned
care is described by the Patient Journey.
The actual care received is recorded in a structured manner in the form of Patient Events (or spells of
care), Patient Episodes (such as a hospital admission) and Patient Encounters (an interaction with a
care professional) such as a consultation, examination or administration of a treatment or perhaps a
merely a telephone conversation). Looked at another way, a Patient Encounter entails a single
interaction between patient and professional, a Patient Episode is a related series of encounters, with a
clear beginning and end such as a stay in hospital, addressing a particular patient condition or
complaint. A Patient Event (sometimes called a “Spell of Care”) encompasses a number of episodes
over a period of time, perhaps lifelong, addressing a particular condition or complaint.
Care Records are usually held in local systems but may be accessed remotely via Patient Data Links
held in the Patient Identity and Health Status Component.
PERSONAL CONSENTS
The Personal Consents component manages the default values for granting access to patient or Social
care client data pairing Health/Care Subjects with professional roles. It also supports the recording of
specific consents which note the wishes of a patient or client in granting or denying access to his or her
record. It also handles the reversal of default consents by patients and clients and the granting of
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specific access rights to nominated Care Professionals in respect of individual patients, clients and
health/care subjects. The component can also compose “Sealed Envelopes” – a virtual, protected set of
patient information and data links (for example, pertaining to a particular health subject) which may be
opened by authorized care professionals in defined situations like emergencies.
PERSONAL HEALTH AND CARE STATUS
The Personal Health and Care Status Component offers data regarding a person’s current wellbeing
such as would be useful in providing a summary to a new health or social career.
This includes current medication and medical problems and allergies that would be of assistance in
emergencies and for treatment when away from home. In effect the component constitutes a summary
health record.
PERSONS AND IDENTITIES
The Persons and Identities Component stores, maintains and enables access to data regarding a Person,
their Health enrollment (as Patient) and their Social Care enrollment (as Social Care Client).
Capabilities are provided to input, validate, maintain, store and output personal demographic data such
as name and address, personal details, family relationships and care arrangements and limited medical
and social care-related data.
A linkage is provided via the personal identifier to the different identifiers used in the health and care
domains, of which there could be many.
Details of patient and client care and treatments are often stored in local doctors, care professionals,
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hospital and social work department systems in local ePRs (electronic patient records) or eCRs
(electronic care records). Linkages are provided to these systems in the form of pointers, or URLs to
the appropriate ePR or eCR records.
PROCESSES AND PROTOCOLS
A Clinical or Care Process describes the activities undertaken by a specific Health and Social Care
Team. Clinical or Care Process Actions are the individual actions taken. These are described at a level
of granularity such that when commenced an action must be completed or restarted. Examples might
be x-rays or blood tests. The component manages the definition of the clinical or care process and its
actions.
PROFESSIONAL ROLES AND TEAMS
Care Professionals perform defines roles and are organized in groups and teams dedicated to specific
activities in clear areas of treatment and care. The Professional Groups and Teams component
maintains the definitions of roles and the structure and membership of each group and team. These
structures are used to determine the access permissions of individuals to patient records either on the
basis of role or team membership.
RULES ENGINE
Two Business components that are often required are for Clinical Decision Support and Health and
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Social Care Knowledge Management. However, since business components are fully encapsulated,
the functionality and data (or “rules”) associated with decision support and knowledge management
are usually included within the specific component. Sometimes however, the logic involved is part of
the overall business process and is dependent upon interactions between components, for example, in
following a particular patient journey based on patient condition and treatment availability. This is
sometimes called a “rules engine”. In this case the logic is contained within the business process as
distinct to the actual business component.
A Rules Engine Component would contain a Rules Database which for example might contain
Prescribing rules, Clinical Process rules, Datasets rules (value ranges etc), Form Set rules, scheduling
and capacity management rules and the rules used to raise clinical and administrative alerts. The Rules
Database might also contain lists of valid codes e.g. departmental codes.
SOCIAL CARE CODING AND DATASETS
This component manages the data capture and maintenance of Social Care datasets, the items of
information that should be recorded for a social condition or procedure.
Mechanisms are provided to anonymize such that the specific client is not identifiable
WAITING LISTS
The Waiting Lists component provides capabilities to manage demand for patient/client: professional
interaction and facility usage.
The approach is simple – capacity of teams and team members and also for facilities is expressed in
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units or “slots” of defined duration – a consultation or a hospital bed for a day is regarded as a “slot”.
Requirements (i.e. appointments or orders) are allocated to slots, the nature of the requirement
determining how many slots will be required of any particular team discipline or facility. The “queue”
of requirements is maintained in a number of lists sequenced by arrival and modified by urgency. Lists
are serviced by multiple teams and facilities by allocating a requirement to a slot.
PRODUCTS AND SERVICES
CARE PROFESSIONAL SERVICES
Typically concerned with the viewing and maintenance of permissions to access patient data and the
creation, updating, and audit of the patient Care Record.
CARE PROVIDER SERVICES
Typically concerned with the recording of activities such as patient attendance; maintenance of
waiting lists; the scheduling of teams and facilities; and the recording of examination and test results
FUNDING ORG SERVICES
Typically concerned with administrative processes, funds management, billing and cash flow
management, records management, management and statutory accounting, and so on.
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PERSON SERVICES
Typically concerned with the setting and maintenance of patient-supplied data such as some
demographic details, family information, and, importantly, the viewing and variation of consent data
for patient data access.
POLICY MAKER SERVICES
Typically concerned with the setup and maintenance of national administrative facilities; standard
procedures and coding systems; and the setting of targets and budgets
RESEARCHER and ANALYST SERVICES
Typically includes project planning and control, the management of test and trial data (usually
anonymized), and trial results processing and publication.
REQUIRED COMPETENCIES
Connected – Interoperable by Design
Dependable – Proven and Robust
Extensive Partner Ecosystem
Productive – Familiar Tools to Automate the Way Users Work
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REFERENCES
[1] Malik N. The Enterprise Business Motivation Model (EBMM) : http://motivationmodel.com/wp/
[2] Sowa J. F. and Zachman J. A.(1992), Extending and Formalizing the Framework for Information Systems Architecture, IBM Systems Journal, 31/3, pp 590-616.
[3] Anaya V. and Ortiz A. (2005), How enterprise architectures can support integration. Proceedings of the first international
workshop on Interoperability of heterogeneous information systems. pg. 25‐30.
[4] Chen L. (2010), Business–IT alignment maturity of companies in China. Inform. Manage. 47, 1, 9–16
[5] Henderson, J. C. and Venkatraman, N. (1992), Strategic Alignment - A model for Organizational Transformation Through Information Technology. Oxford University Press, 97–117 [6] Ullah A. and Lai R. (2013), A Systematic Review of Business and Information Technology Alignment. ACM Transactions on Management Information Systems (TMIS). Volume 4, Issue 1 [7] Pragmatic Cohesion Consulting, LLC, How to Use the EBMM-TRIADS to Conduct a Business Architecture Alignment Effort: http://www.slideshare.net/adidierk/how-to-use-the-ebmm-triads-to-conduct-a-business-architecture-a
lignment-effort [8] Microsoft Connected Health Framework (CHF):
http://www.microsoft.com/health/ww/ict/Pages/Connected-Health-Framework.aspx [9] Pragmatic Cohesion Consulting, LLC, Enterprise Business Motivation Model (EBMM) TRIADS - The Chemistry of Business and IT Alignment:
http://www.slideshare.net/adidierk/enterprise-business-motivation-model-ebmm-triads-the-chemestr
y-of-business-and-it-alignment