Category Archives: Healthcare

Case Study – ArchiMate®, An Open Group Standard: Public Research Centre Henri Tudor and Centre Hospitalier de Luxembourg

By The Open Group

The Public Research Centre Henri Tudor is an institute of applied research aimed at reinforcing the innovation capacity at organizations and companies and providing support for national policies and international recognition of Luxembourg’s scientific community. Its activities include applied and experimental research; doctoral research; the development of tools, methods, labels, certifications and standards; technological assistance; consulting and watch services; and knowledge and competency transfer. Its main technological domains are advanced materials, environmental, Healthcare, information and communication technologies as well as business organization and management. The Centre utilizes its competencies across a number of industries including Healthcare, industrial manufacturing, mobile, transportation and financial services among others.

In 2012, the Centre Hospitalier de Luxembourg allowed Tudor to experiment with an access rights management system modeled using ArchiMate®, an Open Group standard. This model was tested by CRP Tudor to confirm the approach used by the hospital’s management to grant employees, nurses and doctors permission to access patient records.

Background

The Centre Hospitalier de Luxembourg is a public hospital that focuses on severe pathologies, medical and surgical emergencies and palliative care. The hospital also has an academic research arm. The hospital employs a staff of approximately 2,000, including physicians and specialized employees, medical specialists, nurses and administrative staff. On average the hospital performs more than 450,000 outpatient services, 30,000 inpatient services and more than 60,000 adult and pediatric emergency services, respectively, per year.

Unlike many hospitals throughout the world, the Centre Hospitalier de Luxembourg is open and accessible 24 hours a day, seven days a week. Accessing patient records is required at the hospital at any time, no matter the time of day or weekend. In addition, the Grand Duchy of Luxembourg has a system where medical emergencies are allocated to one hospital each weekend across each of the country’s three regions. In other words, every two weeks, one hospital within a given region is responsible for all of the incoming medical emergencies on its assigned weekend, affecting patient volume and activity.

Access rights management

As organizations have become not only increasingly global but also increasingly digital, access rights management has become a critical component of keeping institutional information secure so that it does not fall into the wrong hands. Managing access to internal information is a critical component of every company’s security strategy, but it is particularly important for organizations that deal with sensitive information about consumers, or in the case of the Centre Hospitalier de Luxembourg, patients.

Modeling an access rights management system was important for the hospital for a number of reasons. First, European privacy laws dictate that only the people who require information regarding patient medical files should be allowed access to those files. Although privacy laws may restrict access to patient records, a rights management system must be flexible enough to grant access to the correct individuals when necessary.

In the case of a hospital such as the Centre Hospitalier de Luxembourg, access to information may be critical for the life of the patient. For instance, if a patient was admitted to the emergency room, the emergency room physician will be able to better treat the patient if he or she can access the patient’s records, even if they are not the patient’s primary care physician. Admitting personnel may also need access to records at the time of admittance. Therefore, a successful access rights management system must combine a balance between restricting information and providing flexible access as necessary, giving the right access at the right time without placing an administrative burden on the doctors or staff.

The project

Prior to the experiment in which the Public Research Centre Henri Tudor tested this access rights management model, the Centre Hospitalier de Luxembourg had not experienced any problems in regard to its information sharing system. However, its access rights were still being managed by a primarily paper-based system. As part of the scope of the project, the hospital was also looking to become compliant with existing privacy laws. Developing an access rights management model was intended to close the gap within the hospital between restricting access to patient information overall and providing new rights, as necessary, to employees that would allow them to do their work without endangering patient lives. From a technical perspective, the access rights management system also needed not only to work in conjunction with existing applications, such as the ERP system, used within the hospital but also support rights management at the business layer.

Most current access rights managements systems provide information access to individuals based on a combination of the functional requirements necessary for employees to do their jobs and governance rights, which provide the protections that will keep the organization and its information safe and secure. What many existing models have failed to take into account is that most access control models and rights engineering methods don’t adequately represent both sides of this equation. As such, determining the correct level of access for different employees within organizations can be difficult.

Modeling access rights management

Within the Centre Hospitalier de Luxembourg, employee access rights were defined based on individual job responsibilities and job descriptions. To best determine how to grant access rights across an hospital, the Public Research Centre Henri Tudor needed to create a system that could take these responsibilities into account, rather than just rely on functional or governance requirements.

To create an access rights management model that would work with the hospital’s existing processes and ERP software, the Public Research Centre Henri Tudor first needed to come up with a way to model responsibility requirements instead of just functional or governance requirements. According to Christophe Feltus, Research Engineer at the Public Research Centre, defining a new approach based on actor or employee responsibilities was the first step in creating a new model for the hospital.

Although existing architecture modeling languages provide views for many different types of stakeholders within organizations—from executives to IT and project managers—no modeling language had previously been used to develop a view dedicated to access rights management, Feltus says. As such, that view needed to be created and modeled anew for this project.

To develop this new view, the Public Research Centre needed to find an architecture modeling language that was flexible enough to accommodate such an extension. After evaluating three separate modeling languages, they chose ArchiMate®, an Open Group Standard and open and independent modeling language, to help them visualize the relationships among the hospital’s various employees in an unambiguous way.

Much like architectural drawings are used in building architecture to describe the various aspects of construction and building use, ArchiMate provides a common language for describing how to construct business processes, organizational structures, information flows, IT systems and technical infrastructures. By providing a common language and visual representation of systems, ArchiMate helps stakeholders within organizations design, assess and communicate how decisions and changes within business domains will affect the organization.

According to Feltus, Archimate provided a well-formalized language for the Public Research Centre to portray the architecture needed to model the access rights management system they wanted to propose for Centre Hospitalier. Because ArchiMate is a flexible and open language, it also provided an extension mechanism that could accommodate the responsibility modeling language (ReMMo) that the engineering team had developed for the hospital.

In addition to providing the tools and extensions necessary for the engineering team to properly model the hospital’s access rights system, the Public Research Centre also chose ArchiMate because it is an open and vendor-neutral modeling language. As a publically funded institution, it was important that the Public Research Centre avoided using vendor-specific tools that would lock them in to a potentially costly cycle of constant version upgrades.

“What was very interesting [about ArchiMate] was that it was an open and independent solution. This is very important for us. As a public company, it’s preferable not to use private solutions. This was something very important,” said Feltus.

Feltus notes that using ArchiMate to model the access rights project was also a relatively easy and intuitive process. “It was rather easy,” Feltus said. “The concepts are clear and recommendations are well done, so it was easy to explore the framework.” The most challenging part of the project was selecting which extension mechanism would best portray the design and model they wanted to use.

Results

After developing the access rights model using ArchiMate, the responsibility metamodel was presented to the hospital’s IT staff by the Public Research Centre Henri Tudor. The Public Research Centre team believes that the responsibility model created using ArchiMate allows for better alignment between the hospital’s business processes defined at the business layer with their IT applications being run at the application layer. The team also believes the model could both enhance provisioning of access rights to employees and improve the hospital’s performance. For example, using the proposed responsibility model, the team found that some employees in the reception department had been assigned more permissions than they required in practice. Comparing the research findings with the reality on the ground at the hospital has shown the Public Research Centre team that ArchiMate is an effective tool for modeling and determining both responsibilities and access rights within organizations.

Due to the ease of use and success the Public Research Centre Henri Tudor experienced in using ArchiMate to create the responsibility model and the access rights management system for the hospital, Tudor also intends to continue to use ArchiMate for other public and private research projects as appropriate.

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The Open Group Boston 2014 – Day Two Highlights

By Loren K. Bayes, Director, Global Marketing Communications

Enabling Boundaryless Information Flow™  continued in Boston on Tuesday, July 22Allen Brown, CEO and President of The Open Group welcomed attendees with an overview of the company’s second quarter results.

The Open Group membership is at 459 organizations in 39 countries, including 16 new membership agreements in 2Q 2014.

Membership value is highlighted by the collaboration Open Group members experience. For example, over 4,000 individuals attended Open Group events (physically and virtually whether at member meetings, webinars, podcasts, tweet jams). The Open Group website had more than 1 million page views and over 105,000 publication items were downloaded by members in 80 countries.

Brown also shared highlights from The Open Group Forums which featured status on many upcoming white papers, snapshots, reference models and standards, as well as individiual Forum Roadmaps. The Forums are busy developing and reviewing projects such as the Next Version of TOGAF®, an Open Group standard, an ArchiMate® white paper, The Open Group Healthcare Forum charter and treatise, Standard Mils™ APIs and Open Fair. Many publications are translated into multiple languages including Chinese and Portuguese. Also, a new Forum will be announced in the third quarter at The Open Group London 2014 so stay tuned for that launch news!

Our first keynote of the day was Making Health Addictive by Joseph Kvedar, MD, Partners HealthCare, Center for Connected Health.

Dr. Kvedar described how Healthcare delivery is changing, with mobile technology being a big part. Other factors pushing changes are reimbursement paradigms and caregivers being paid to be more efficient and interested in keeping people healthy and out of hospitals. The goal of Healthcare providers is to integrate care into the day-to-day lives of patients. Healthcare also aims for better technologies and architecture.

Mobile is a game-changer in Healthcare because people are “always on and connected”. Mobile technology allows for in-the-moment messaging, ability to capture health data (GPS, accelerator, etc.) and display information in real time as needed. Bottom-line, smartphones are addictive so they are excellent tools for communication and engagement.

But there is a need to understand and address the implications of automating Healthcare: security, privacy, accountability, economics.

The plenary continued with Proteus Duxbury, CTO, Connect for Health Colorado, who presented From Build to Run at the Colorado Health Insurance Exchange – Achieving Long-term Sustainability through Better Architecture.

Duxbury stated the keys to successes of his organization are the leadership and team’s shared vision, a flexible vendor being agile with rapidly changing regulatory requirements, and COTS solution which provided minimal customization and custom development, resilient architecture and security. Connect for Health experiences many challenges including budget restraints, regulation and operating in a “fish bowl”. Yet, they are on-track with their three-year ‘build to run’ roadmap, stabilizing their foundation and gaining efficiencies.

During the Q&A with Allen Brown following each presentation, both speakers emphasized the need for standards, architecture and data security.

Brown and DuxburyAllen Brown and Proteus Duxbury

During the afternoon, track sessions consisted of Healthcare, Enterprise Architecture (EA) & Business Value, Service-Oriented Architecture (SOA), Security & Risk Management, Professional Development and ArchiMate Tutorials. Chris Armstrong, President, Armstrong Process Group, Inc. discussed Architecture Value Chain and Capability Model. Laura Heritage, Principal Solution Architect / Enterprise API Platform, SOA Software, presented Protecting your APIs from Threats and Hacks.

The evening culminated with a reception at the historic Old South Meeting House, where the Boston Tea Party began in 1773.

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IMG_2814Networking Reception at Old South Meeting House

A special thank you to our sponsors and exhibitors at The Open Group Boston 2014: BiZZdesign, Black Duck, Corso, Good e-Learning, Orbus and AEA.

Join the conversation #ogBOS!

Loren K. BaynesLoren K. Baynes, Director, Global Marketing Communications, joined The Open Group in 2013 and spearheads corporate marketing initiatives, primarily the website, blog and media relations. Loren has over 20 years experience in brand marketing and public relations and, prior to The Open Group, was with The Walt Disney Company for over 10 years. Loren holds a Bachelor of Business Administration from Texas A&M University. She is based in the US.

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The Open Group Boston 2014 – Day One Highlights

By Loren K. Baynes, Director, Global Marketing Communications

The Open Group kicked off Enabling Boundaryless Information Flow™  July 21 at the spectacular setting of the Hyatt Boston Harbor. Allen Brown, CEO and President of The Open Group, welcomed over 150 people from 20 countries, including as far away as Australia, Japan, Saudi Arabia and India.

The first keynote speaker was Marshall Van Alstyne, Professor at Boston University School of Management & Researcher at MIT Center for Digital Business, known as a leading expert in business models. His presentation entitled Platform Shift – How New Open Business Models are Changing the Shape of Industry posed the questions “What does ‘openness’ mean? Why do platforms beat products every time?”.

Van AlstyneMarshall Van Alstyne

According to “InterBrand: 2014 Best Global Brands”, 13 of the top 31 companies are “platform companies”. To be a ‘platform’, a company needs embeddable functions or service and allow 3rd party access. Alystyne noted, “products have features, platforms have communities”. Great standalone products are not sufficient. Positive changes experienced by a platform company include pricing/profitability, supply chains, internal organization, innovation, decreased industry bottlenecks and strategy.

Platforms benefit from broad contributions, as long as there is control of the top several complements. Alstyne commented, “If you believe in the power of community, you need to embrace the platform.”

The next presentation was Open Platform 3.0™ – An Integrated Approach to the Convergence of Technology Platforms, by Dr. Chris Harding, Director for Interoperability, The Open Group. Dr. Harding discussed how society has developed a digital society.

1970 was considered the dawn of an epoch which saw the First RAM chip, IBM introduction of System/370 and a new operating system – UNIX®. Examples of digital progress since that era include driverless cars and Smart Cities (management of traffic, energy, water, communication).

Digital society enablers are digital structural change and corporate social media. The benefits are open innovation, open access, open culture, open government and delivering more business value.

Dr. Harding also noted, standards are essential to innovation and enable markets based on integration. The Open Group Open Platform 3.0™ is using ArchiMate®, an Open Group standard, to analyze the 30+ business use cases produced by the Forum. The development cycle is understanding, analysis, specification, iteration.

Dr. Harding emphasized the importance of Boundaryless Information Flow™, as an enabler of business objectives and efficiency through IT standards in the era of digital technology, and designed for today’s agile enterprise with direct involvement of business users.

Both sessions concluded with an interactive audience Q&A hosted by Allen Brown.

The last session of the morning’s plenary was a panel: The Internet of Things and Interoperability. Dana Gardner, Principal Analyst at Interarbor Solutions, moderated the panel. Participating in the panel were Said Tabet, CTO for Governance, Risk and Compliance Strategy, EMC; Penelope Gordon, Emerging Technology Strategist, 1Plug Corporation; Jean-Francois Barsoum, Senior Managing Consultant, Smarter Cities, Water & Transportation, IBM; and Dave Lounsbury, CTO, The Open Group.

IoT PanelIoT Panel – Gardner, Barsoum, Tabet, Lounsbury, Gordon

The panel explored the practical limits and opportunities of Internet of Things (IoT). The different areas discussed include obstacles to decision-making as big data becomes more prolific, openness, governance and connectivity of things, data and people which pertain to many industries such as smart cities, manufacturing and healthcare.

How do industries, organizations and individuals deal with IoT? This is not necessarily a new problem, but an accelerated one. There are new areas of interoperability but where does the data go and who owns the data? Openness is important and governance is essential.

What needs to change most to see the benefits of the IoT? The panel agreed there needs to be a push for innovation, increased education, move beyond models of humans managing the interface (i.e. machine-to-machine) and determine what data is most important, not always collecting all the data.

A podcast and transcript of the Internet of Things and Interoperability panel will be posted soon.

The afternoon was divided into several tracks: Boundaryless Information Flow™, Open Platform 3.0™ and Enterprise Architecture (EA) & Enterprise Transformation. Best Practices for Enabling Boundaryless Information Flow across the Government was presented by Syed Husain, Consultant Enterprise Architecture, Saudi Arabia E-government Authority. Robert K. Pucci, CTO, Communications Practice, Cognizant Technology Solutions discussed Business Transformation Justification Leveraging Business and Enterprise Architecture.

The evening concluded with a lively networking reception at the hotel.

Join the conversation #ogBOS!

Loren K. BaynesLoren K. Baynes, Director, Global Marketing Communications, joined The Open Group in 2013 and spearheads corporate marketing initiatives, primarily the website, blog and media relations. Loren has over 20 years experience in brand marketing and public relations and, prior to The Open Group, was with The Walt Disney Company for over 10 years. Loren holds a Bachelor of Business Administration from Texas A&M University. She is based in the US.

 

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The Open Group Boston 2014 – Q&A with Proteus Duxbury, Connect for Health Colorado

By The Open Group

The U.S. healthcare industry is undergoing a major sea change right now due in part to the Affordable Care Act, as well as the need to digitize legacy systems that have remained largely paper-based in order to better facilitate information exchange.

Proteus Duxbury, the CTO for the state of Colorado’s health insurance exchange, Connect for Health Colorado, has a wide and varied background in healthcare IT ranging from IT consulting and helping to lead a virtual health medicine group to his current position running the supporting technologies operating the Colorado exchange. Duxbury joined Connect for Health Colorado early 2014 as the exchange was going through its first major enrollment period.

We spoke to Duxbury in advance of his keynote on July 22 at The Open Group Boston 2014 conference about the current state of healthcare IT and how Enterprise Architecture will play an integral part in the Connect for Health Colorado exchange moving forward as the organizations transitions from a start-up culture to a maintenance and run mode.

Below is a transcript of that conversation.

What factors went into making the roll-out of Connect for Health Colorado healthcare exchange a success?

There were three things. The first is we have an exceptional leadership team. The CEO, especially, is a fantastic leader and was able to create a strong vision and have her team rally quickly behind it. The executive team was empowered to make decisions quickly and there was a highly dedicated work force and a powerful start-up culture. In addition, there was a uniformly shared passion to see healthcare reform successfully implemented in Colorado.

The second reason for success was the flexibility and commitment of our core vendor—which is CGI—and their ability to effectively manage and be agile with rapidly changing regulatory requirements and rapidly changing needs. These systems had never been built anywhere else before; it really was a green field program of work. There was a shared commitment to achieving success and very strong contracting in place ensuring that we were fully protected throughout the whole process.

The third is our COTS (Commercial Off-The-Shelf) solution that was selected. Early on, we established an architecture principle of deploying out-of-the-box products rather than trying to build from scratch, so there was minimal customization and development effort. Scope control was tight. We implemented the hCentive package, which is one of the leading health insurance exchange software packages. Best-of-breed solutions were implemented around the edges where it was necessary to meet a niche need, but we try to build as much into the single product as we can. We have a highly resilient and available architecture. The technical architecture scales well and has been very robust and resilient through a couple of very busy periods at the end of open enrollment, particularly on March 31st and toward the end of December, as the deadline for enrollment in 2014 plans approached.

Why are you putting together an Enterprise Architecture for the exchange?

We’re extremely busy right now with a number of critical projects. We’re still implementing core functionality but we do have a bit of a breather on the horizon. Going into next year things will get lighter, and now is the time for a clear roadmap to achieve the IT strategic objectives that I have set for the organization.

We are trying to achieve a reduction in our M&O (maintenance and operations) expense because we need to be self-sustaining from a budgetary point of view. Our federal funding will be going away starting 2015 so we need to consolidate architecture and systems and gain additional efficiencies. We need to continue to meet our key SLAs, specifically around availability—we have a very public-facing set of systems. IT needs to be operationalized. We need to move from the existing start-up culture to the management of IT in a CMM (Capability Maturity Model) or ITIL-type fashion. And we also need to continue to grow and hold on to our customer base, as there is always a reasonable amount of churn and competing services in a relatively uncertain marketplace. We need to continue to grow our customer base so we can be self-sustaining. To support this, we need to have a more operationalized, robust and cost-efficient IT architecture, and we need a clear roadmap to get there. If you don’t have a roadmap or design that aligns with business priorities, then those things are difficult to achieve.

Finally, I am building up an IT team. To date, we’ve been highly reliant on contractors and consultants to get us to where we are now. In order to reduce our cost base, we are building out our internal IT team and a number of key management roles. That means we need to have a roadmap and something that we can all steer towards—a shared architecture roadmap.

What benefits do you expect to see from implementing the architecture?

Growing our customer base is a critical goal—we need to stabilize the foundations of our IT solution and use that as a platform for future growth and innovation. It’s hard to grow and innovate if you haven’t got your core IT platform stabilized. By making our IT systems easier to be maintained and updated we hope to see continued reduction in IT M&O. High availability is another benefit I expect to see, as well as closer alignment with business goals and business processes and capabilities.

Are there any particular challenges in setting up an Enterprise Architecture for a statewide health exchange? What are they?

I think there are some unique challenges. The first is budget. We do need to be self-sustaining, and there is not a huge amount of budget available for additional capital investments. There is some, but it has to be very carefully allocated, managed and spent diligently. We do work within a tightly controlled federal set of regulations and constraints and are frequently under the spotlight from auditors and others.

There are CMS (Center for Medicaid Services) regulations that define what we can and cannot do with our technology. We have security regulations that we have to exist within and a lot of IRS requirements that we have to meet and be compliant with. We have a complex set of partners to work with in Colorado and nationally—we have to work with Colorado state agencies such as the Department of Insurance and Medicaid (HCPF), we have to work very closely with a large number—we’ve currently got 17—of carriers. We have CMS and the federal marketplace (Federal Data Services Hub). We have one key vendor—CGI—but we are in a multi-vendor environment and all our projects involve having to manage multiple different organizations towards success.

The final challenge is that we’re very busy still building applications and implementing functionality, so my job is to continue to be focused on successful delivery of two very large projects, while ensuring our longer term architecture planning is completed, which is going to be critical for our long-term sustainability. That’s the classic Enterprise Architecture conundrum. I feel like we’ve got a handle on it pretty well here—because they’re both critical.

What are some of the biggest challenges that you see facing the Healthcare industry right now?

Number one is probably integration—the integration of data especially between different systems. A lot of EMR (electronic medical record) systems are relatively closed to the outside world, and it can be expensive and difficult to open them up. Even though there are some good standards out there like HL7 and EDI (Electronic Data Interchange), everyone seems to be implementing them differently.

Personal healthcare tech (mHealth and Telehealth) is not going to take off until there is more integration. For example, between whatever you’re using to track your smoking, blood pressure, weight, etc., it needs to be integrated seamlessly with your medical records and insurance provider. And until this data can be used for meaningful analytics and care planning, until they solve this integration nightmare, it’s going to be difficult really to make great strides.

Security is the second challenge. There’s a huge proliferation of new technology endpoints and there’s a lot of weak leaks around people, process and technology. The regulators are only really starting to catch up, and they’re one step behind. There’s a lot of personal data out there and it’s not always technology that’s the weak leak. We have that pretty tightly controlled here because we’re highly regulated and are technology is tightly controlled, but on the provider side especially, it’s a huge challenge and every week we see a new data breach.

The third challenge is ROI. There’s a lot of investment being made into personal health technology but because we’re in a private insurance market and a private provider market, until someone has really cracked what the ROI is for these initiatives, whether it’s tied to re-admissions or reimbursements, it’s never going to really become mainstream. And until it becomes part of the fabric of care delivery, real value is not going to be realized and health outcomes not significantly improved.

But models are changing—once the shift to outcome-based reimbursement takes hold, providers will be more incentivized to really invest in these kind of technologies and get them working. But that shift hasn’t really occurred yet, and I’ve yet to see really compelling ROI models for a lot of these new investments. I’m a believer that it really has to be the healthcare provider that drives and facilitates the engagement with patients on these new technologies. Ultimately, I believe, people, left to their own devices, will experiment and play with something for a while, but unless their healthcare provider is engaging them actively on it, it’s not something that they will persist in doing. A lot of the large hospital groups are dipping their toe in the water and seeing what sticks, but I don’t really see any system where these new technologies are becoming part of the norm of healthcare delivery.

Do you feel like there are other places that are seeing more success in this outside of the US?

I know in the UK, they’re having a lot of success with their Telehealth pilots. But their primary objective is to make people healthier, so it’s a lot easier in that environment to have a good idea, show that there’s some case for improving outcomes and get funding. In the US, proving outcomes currently isn’t enough. You have to prove that there’s some revenue to be made or cost to be saved. In some markets, they’ve experienced problems similar to the US and in some markets it’s probably been easier. That doesn’t mean they’ve had an easy time implementing them—the UK has had huge problems with integration and with getting EMR systems deployed and implemented nationally. But a lot of those are classical IT problems of change management, scope control and trying to achieve too much too quickly. The healthcare industry is about 20 years behind other industries. They’re going through all the pain with the EMR rollouts that most manufacturing companies went through with ERP 20 years ago and most banks went through 40 years ago.

How can organizations such as The Open Group and its Healthcare Forum better work with the Healthcare industry to help them achieve better results?

I think firstly bringing a perspective from other industries. Healthcare IT conferences and organizations tend to be largely made up of people who have been in healthcare most of their working lives. The Open Group brings in perspective from other industries. Also reference architectures—there’s a shortage of good reference architectures in the healthcare space and that’s something that is really The Open Group’s strong point. Models that span the entire healthcare ecosystem—including payers, providers, pharma and exchanges, IT process and especially IT architecture process—can be improved in healthcare. Healthcare IT departments aren’t as mature as other industries because the investment has not been there until now. They’re in a relative start-up mode. Enterprise Architecture—if you’re a large healthcare provider and you’re growing rapidly through M&O (like so many are right now), that’s a classic use case for having a structured Enterprise Architecture process.

Within the insurance marketplace movement, things have grown very quickly; it’s been tough work. A handful of the states have been very successful, and I think we’re not unique in that we’re a start-up organization and it’s going to be several years until we mature to fully functional, well measured l IT organization. Architecture rigor and process is key to achieving sustainability and maturity.

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duxbury_0Proteus Duxbury joined Connect for Health Colorado as Chief Technology Officer in February 2014, directing technology strategy and operations. Proteus previously served at Catholic Health Initiatives, where he led all IT activities for Virtual Health Services, a division responsible for deploying Telehealth solutions throughout the US. Prior to that, Proteus served as a Managing Consultant at the PA Consulting Group, leading technology change programs in the US and UK primarily in the healthcare and life science industry. He holds a Bachelor of Science in Information Systems Management from Bournemouth University.

 

 

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New Health Data Deluges Require Secure Information Flow Enablement Via Standards, Says The Open Group’s New Healthcare Director

By The Open Group

Below is the transcript of The Open Group podcast on how new devices and practices have the potential to expand the information available to Healthcare providers and facilities.

Listen to the podcast here.

Dana Gardner: Hello, and welcome to a special BriefingsDirect Thought Leadership Interview coming to you in conjunction with The Open Group’s upcoming event, Enabling Boundaryless Information Flow™ July 21-22, 2014 in Boston.

GardnerI’m Dana Gardner, Principal Analyst at Interarbor Solutions and I’ll be your host and moderator for the series of discussions from the conference on Boundaryless Information Flow, Open Platform 3.0™, Healthcare, and Security issues.

One area of special interest is the Healthcare arena, and Boston is a hotbed of innovation and adaption for how technology, Enterprise Architecture, and standards can improve the communication and collaboration among Healthcare ecosystem players.

And so, we’re joined by a new Forum Director at The Open Group to learn how an expected continued deluge of data and information about patients, providers, outcomes, and efficiencies is pushing the Healthcare industry to rapid change.

WJason Lee headshotith that, please join me now in welcoming our guest. We’re here with Jason Lee, Healthcare and Security Forums Director at The Open Group. Welcome, Jason.

Jason Lee: Thank you so much, Dana. Good to be here.

Gardner: Great to have you. I’m looking forward to the Boston conference and want to remind our listeners and readers that it’s not too late to sign up. You can learn more at http://www.opengroup.org.

Jason, let’s start by talking about the relationship between Boundaryless Information Flow, which is a major theme of the conference, and healthcare. Healthcare perhaps is the killer application for Boundaryless Information Flow.

Lee: Interesting, I haven’t heard it referred to that way, but healthcare is 17 percent of the US economy. It’s upwards of $3 trillion. The costs of healthcare are a problem, not just in the United States, but all over the world, and there are a great number of inefficiencies in the way we practice healthcare.

We don’t necessarily intend to be inefficient, but there are so many places and people involved in healthcare, it’s very difficult to get them to speak the same language. It’s almost as if you’re in a large house with lots of different rooms, and every room you walk into they speak a different language. To get information to flow from one room to the other requires some active efforts and that’s what we’re undertaking here at The Open Group.

Gardner: What is it about the current collaboration approaches that don’t work? Obviously, healthcare has been around for a long time and there have been different players involved. What’s the hurdle? What prevents a nice, seamless, easy flow and collaboration in information that gets better outcomes? What’s the holdup?

Lee: There are many ways to answer that question, because there are many barriers. Perhaps the simplest is the transformation of healthcare from a paper-based industry to a digital industry. Everyone has walked into an office, looked behind the people at the front desk, and seen file upon file and row upon row of folders, information that’s kept in a written format.

When there’s been movement toward digitizing that information, not everyone has used the same system. It’s almost like trains running on a different gauge track. Obviously if the track going east to west is a different gauge than going north to south, then trains aren’t going to be able to travel on those same tracks. In the same way, healthcare information does not flow easily from one office to another or from one provider to another.

Gardner: So not only do we have disparate strategies for collecting and communicating health data, but we’re also seeing much larger amounts of data coming from a variety of new and different places. Some of them now even involve sensors inside of patients themselves or devices that people will wear. So is the data deluge, the volume, also an issue here?

Lee: Certainly. I heard recently that an integrated health plan, which has multiple hospitals involved, contains more elements of data than the Library of Congress. As information is collected at multiple points in time, over a relatively short period of time, you really do have a data deluge. Figuring out how to find your way through all the data and look at the most relevant for the patient is a great challenge.

Gardner: I suppose the bad news is that there is this deluge of data, but it’s also good news, because more data means more opportunity for analysis, a better ability to predict and determine best practices, and also provide overall lower costs with better patient care.

So it seems like the stakes are rather high here to get this right, to not just crumble under a volume or an avalanche of data, but to master it, because it’s perhaps the future. The solution is somewhere in there too.

Lee: No question about it. At The Open Group, our focus is on solutions. We, like others, put a great deal of effort into describing the problems, but figuring out how to bring IT technologies to bear on business problems, how to encourage different parts of organizations to speak to one another and across organizations to speak the same language, and to operate using common standards and language. That’s really what we’re all about.

And it is, in a large sense, part of the process of helping to bring healthcare into the 21st Century. A number of industries are a couple of decades ahead of healthcare in the way they use large datasets — big data, some people refer to it as. I’m talking about companies like big department stores and large online retailers. They really have stepped up to the plate and are using that deluge of data in ways that are very beneficial to them, and healthcare can do the same. We’re just not quite at the same level of evolution.

Gardner: And to your point, the stakes are so much higher. Retail is, of course, a big deal in the economy, but as you pointed out, healthcare is such a much larger segment and portion. So just making modest improvements in communication, collaboration, or data analysis can reap huge rewards.

Lee: Absolutely true. There is the cost side of things, but there is also the quality side. So there are many ways in which healthcare can improve through standardization and coordinated development, using modern technology that cannot just reduce cost, but improve quality at the same time.

Gardner: I’d like to get into a few of the hotter trends, but before we do, it seems that The Open Group has recognized the importance here by devoting the entire second day of their conference in Boston, that will be on July 22, to Healthcare.

Maybe you could give us a brief overview of what participants, and even those who come in online and view recorded sessions of the conference at http://new.livestream.com/opengroup should expect? What’s going to go on July 22nd?

Lee: We have a packed day. We’re very excited to have Dr. Joe Kvedar, a physician at Partners HealthCare and Founding Director of the Center for Connected Health, as our first plenary speaker. The title of his presentation is “Making Health Additive.” Dr. Kvedar is a widely respected expert on mobile health, which is currently the Healthcare Forum’s top work priority. As mobile medical devices become ever more available and diversified, they will enable consumers to know more about their own health and wellness. A great deal of data of potentially useful health data will be generated. How this information can be used–not just by consumers but also by the healthcare establishment that takes care of them as patients, will become a question of increasing importance. It will become an area where standards development and The Open Group can be very helpful.

Our second plenary speaker, Proteus Duxbury, Chief Technology Officer at Connect for Health Colorado,will discuss a major feature of the Affordable Care Act—the health insurance exchanges–which are designed to bring health insurance to tens of millions of people who previously did not have access to it. Mr. Duxbury is going to talk about how Enterprise Architecture–which is really about getting to solutions by helping the IT folks talk to the business folks and vice versa–has helped the State of Colorado develop their Health Insurance Exchange.

After the plenaries, we will break up into 3 tracks, one of which is Healthcare-focused. In this track there will be three presentations, all of which discuss how Enterprise Architecture and the approach to Boundaryless Information Flow can help healthcare and healthcare decision-makers become more effective and efficient.

One presentation will focus on the transformation of care delivery at the Visiting Nurse Service of New York. Another will address stewarding healthcare transformation using Enterprise Architecture, focusing on one of our Platinum members, Oracle, and a company called Intelligent Medical Objects, and how they’re working together in a productive way, bringing IT and healthcare decision-making together.

Then, the final presentation in this track will focus on the development of an Enterprise Architecture-based solution at an insurance company. The payers, or the insurers–the big companies that are responsible for paying bills and collecting premiums–have a very important role in the healthcare system that extends beyond administration of benefits. Yet, payers are not always recognized for their key responsibilities and capabilities in the area of clinical improvements and cost improvements.

With the increase in payer data brought on in large part by the adoption of a new coding system–the ICD-10–which will come online this year, there will be a huge amount of additional data, including clinical data, that become available. At The Open Group, we consider payers—health insurance companies (some of which are integrated with providers)–as very important stakeholders in the big picture..

In the afternoon, we’re going to switch gears a bit and have a speaker talk about the challenges, the barriers, the “pain points” in introducing new technology into the healthcare systems. The focus will return to remote or mobile medical devices and the predictable but challenging barriers to getting newly generated health information to flow to doctors’ offices and into patients records, electronic health records, and hospitals data keeping and data sharing systems.

We’ll have a panel of experts that responds to these pain points, these challenges, and then we’ll draw heavily from the audience, who we believe will be very, very helpful, because they bring a great deal of expertise in guiding us in our work. So we’re very much looking forward to the afternoon as well.

Gardner: It’s really interesting. A couple of these different plenaries and discussions in the afternoon come back to this user-generated data. Jason, we really seem to be on the cusp of a whole new level of information that people will be able to develop from themselves through their lifestyle, new devices that are connected.

We hear from folks like Apple, Samsung, Google, and Microsoft. They’re all pulling together information and making it easier for people to not only monitor their exercise, but their diet, and maybe even start to use sensors to keep track of blood sugar levels, for example.

In fact, a new Flurry Analytics survey showed 62 percent increase in the use of health and fitness application over the last six months on the popular mobile devices. This compares to a 33 percent increase in other applications in general. So there’s an 87 percent faster uptick in the use of health and fitness applications.

Tell me a little bit how you see this factoring in. Is this a mixed blessing? Will so much data generated from people in addition to the electronic medical records, for example, be a bad thing? Is this going to be a garbage in, garbage out, or is this something that could potentially be a game-changer in terms of how people react to their own data and then bring more data into the interactions they have with care providers?

Lee: It’s always a challenge to predict what the market is going to do, but I think that’s a remarkable statistic that you cited. My prediction is that the increased volume of person- generated data from mobile health devices is going to be a game-changer. This view also reflects how the Healthcare Forum members (which includes members from Capgemini, Philips, IBM, Oracle and HP) view the future.

The commercial demand for mobile medical devices, things that can be worn, embedded, or swallowed, as in pills, as you mentioned, is growing ever more. The software and the applications that will be developed to be used with the devices is going to grow by leaps and bounds. As you say, there are big players getting involved. Already some of the pedometer type devices that measure the number of steps taken in a day have captured the interest of many, many people. Even David Sedaris, serious guy that he is, was writing about it recently in ‘The New Yorker’.

What we will find is that many of the health indicators that we used to have to go to the doctor or nurse or lab to get information on will become available to us through these remote devices.

There will be a question, of course, as to reliability and validity of the information, to your point about garbage in, garbage out, but I think standards development will help here This, again, is where The Open Group comes in. We might also see the FDA exercising its role in ensuring safety here, as well as other organizations, in determining which devices are reliable.

The Open Group is working in the area of mobile data and information systems that are developed around them, and their ability to (a) talk to one another and (b) talk to the data devices/infrastructure used in doctors’ offices and in hospitals. This is called interoperability and it’s certainly lacking in the country.

There are already problems around interoperability and connectivity of information in the healthcare establishment as it is now. When patients and consumers start collecting their own data, and the patient is put at the center of the nexus of healthcare, then the question becomes how does that information that patients collect get back to the doctor/clinician in ways in which the data can be trusted and where the data are helpful?

After all, if a patient is wearing a medical device, there is the opportunity to collect data, about blood sugar level let’s say, throughout the day. And this is really taking healthcare outside of the four walls of the clinic and bringing information to bear that can be very, very useful to clinicians and beneficial to patients.

In short, the rapid market dynamic in mobile medical devices and in the software and hardware that facilitates interoperability begs for standards-based solutions that reduce costs and improve quality, and all of which puts the patient at the center. This is The Open Group’s Healthcare Forum’s sweet spot.

Gardner: It seems to me a real potential game-changer as well, and that something like Boundaryless Information Flow and standards will play an essential role. Because one of the big question marks with many of the ailments in a modern society has to do with lifestyle and behavior.

So often, the providers of the care only really have the patient’s responses to questions, but imagine having a trove of data at their disposal, a 360-degree view of the patient to then further the cause of understanding what’s really going on, on a day-to-day basis.

But then, it’s also having a two-way street, being able to deliver perhaps in an automated fashion reinforcements and incentives, information back to the patient in real-time about behavior and lifestyles. So it strikes me as something quite promising, and I look forward to hearing more about it at the Boston conference.

Any other thoughts on this issue about patient flow of data, not just among and between providers and payers, for example, or providers in an ecosystem of care, but with the patient as the center of it all, as you said?

Lee: As more mobile medical devices come to the market, we’ll find that consumers own multiple types of devices at least some of which collect multiple types of data. So even for the patient, being at the center of their own healthcare information collection, there can be barriers to having one device talk to the other. If a patient wants to keep their own personal health record, there may be difficulties in bringing all that information into one place.

So the interoperability issue, the need for standards, guidelines, and voluntary consensus among stakeholders about how information is represented becomes an issue, not just between patients and their providers, but for individual consumers as well.

Gardner: And also the cloud providers. There will be a variety of large organizations with cloud-modeled services, and they are going to need to be, in some fashion, brought together, so that a complete 360-degree view of the patient is available when needed. It’s going to be an interesting time.

Of course, we’ve also looked at many other industries and tried to have a cloud synergy, a cloud-of-clouds approach to data and also the transaction. So it’s interesting how what’s going on in multiple industries is common, but it strikes me that, again, the scale and the impact of the healthcare industry makes it a leader now, and perhaps a driver for some of these long overdue structured and standardized activities.

Lee: It could become a leader. There is no question about it. Moreover, there is a lot Healthcare can learn from other companies, from mistakes that other companies have made, from lessons they have learned, from best practices they have developed (both on the content and process side). And there are issues, around security in particular, where Healthcare will be at the leading edge in trying to figure out how much is enough, how much is too much, and what kinds of solutions work.

There’s a great future ahead here. It’s not going to be without bumps in the road, but organizations like The Open Group are designed and experienced to help multiple stakeholders come together and have the conversations that they need to have in order to push forward and solve some of these problems.

Gardner: Well, great. I’m sure there will be a lot more about how to actually implement some of those activities at the conference. Again, that’s going to be in Boston, beginning on July 21, 2014.

We’ll have to leave it there. We’re about out of time. We’ve been talking with a new Director at The Open Group to learn how an expected continued deluge of data and information about patients and providers, outcomes and efficiencies are all working together to push the Healthcare industry to rapid change. And, as we’ve heard, that might very well spill over into other industries as well.

So we’ve seen how innovation and adaptation around technology, Enterprise Architecture and standards can improve the communication and collaboration among Healthcare ecosystem players.

It’s not too late to register for The Open Group Boston 2014 (http://www.opengroup.org/boston2014) and join the conversation via Twitter #ogchat #ogBOS, where you will be able to learn more about Boundaryless Information Flow, Open Platform 3.0, Healthcare and other relevant topics.

So a big thank you to our guest. We’ve been joined by Jason Lee, Healthcare and Security Forums Director at The Open Group. Thanks so much, Jason.

Lee: Thank you very much.

 

 

 

 

 

 

 

 

 

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The Open Group Boston 2014 to Explore How New IT Trends are Empowering Improvements in Business

By The Open Group

The Open Group Boston 2014 will be held on July 21-22 and will cover the major issues and trends surrounding Boundaryless Information Flow™. Thought-leaders at the event will share their outlook on IT trends, capabilities, best practices and global interoperability, and how this will lead to improvements in responsiveness and efficiency. The event will feature presentations from representatives of prominent organizations on topics including Healthcare, Service-Oriented Architecture, Security, Risk Management and Enterprise Architecture. The Open Group Boston will also explore how cross-organizational collaboration and trends such as big data and cloud computing are helping to make enterprises more effective.

The event will consist of two days of plenaries and interactive sessions that will provide in-depth insight on how new IT trends are leading to improvements in business. Attendees will learn how industry organizations are seeking large-scale transformation and some of the paths they are taking to realize that.

The first day of the event will bring together subject matter experts in the Open Platform 3.0™, Boundaryless Information Flow™ and Enterprise Architecture spaces. The day will feature thought-leaders from organizations including Boston University, Oracle, IBM and Raytheon. One of the keynotes is from Marshall Van Alstyne, Professor at Boston University School of Management & Researcher at MIT Center for Digital Business, which reveals the secret of internet-driven marketplaces. Other content:

• The Open Group Open Platform 3.0™ focuses on new and emerging technology trends converging with each other and leading to new business models and system designs. These trends include mobility, social media, big data analytics, cloud computing and the Internet of Things.
• Cloud security and the key differences in securing cloud computing environments vs. traditional ones as well as the methods for building secure cloud computing architectures
• Big Data as a service framework as well as preparing to deliver on Big Data promises through people, process and technology
• Integrated Data Analytics and using them to improve decision outcomes

The second day of the event will have an emphasis on Healthcare, with keynotes from Joseph Kvedar, MD, Partners HealthCare, Center for Connected Health, and Connect for Health Colorado CTO, Proteus Duxbury. The day will also showcase speakers from Hewlett Packard and Blue Cross Blue Shield, multiple tracks on a wide variety of topics such as Risk and Professional Development, and Archimate® tutorials. Key learnings include:

• Improving healthcare’s information flow is a key enabler to improving healthcare outcomes and implementing efficiencies within today’s delivery models
• Identifying the current state of IT standards and future opportunities which cover the healthcare ecosystem
• How Archimate® can be used by Enterprise Architects for driving business innovation with tried and true techniques and best practices
• Security and Risk Management evolving as software applications become more accessible through APIs – which can lead to vulnerabilities and the potential need to increase security while still understanding the business value of APIs

Member meetings will also be held on Wednesday and Thursday, June 23-24.

Don’t wait, register now to participate in these conversations and networking opportunities during The Open Group Boston 2014: http://www.opengroup.org/boston2014/registration

Join us on Twitter – #ogchat #ogBOS

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The Digital Ecosystem Paradox – Learning to Move to Better Digital Design Outcomes

By Mark Skilton, Professor of Practice, Information Systems Management, Warwick Business School

Does digital technologies raise quality and improve efficiencies but at the same time drive higher costs of service as more advanced solutions and capabilities become available demanding higher entry investment and maintenance costs?

Many new digital technologies introduce step change in performance that would have been cost prohibitive in the previous technology generations. But in some industries the technology cost per outcome have be steadily rising in some industries.

In the healthcare market the cost per treatment of health care technology was highlighted in a MIT Technology Review article (1). In areas such as new drugs for treating depression, left-ventricular assistance devices, or implantable defibrillators may be raising the overall cost of health, yet how do we value this if patient quality of life is improving and life extending. While lower cost drugs and vaccines may be enabling better overall patient outcomes

In the smart city a similar story is unfolding where governments and organizations are seeking paths to use digitization to drive improvements in jobs productivity, better lifestyles and support of environmental sustainability. While there are several opportunities to reduce energy bills, improve transport and office spaces exist with savings of 40% to 60% consumption and efficiencies complexity costs of connecting different residential, corporate offices, transport and other living spaces requires digital initiatives that are coordinated and managed. (U-city experience in South Korea (2)).

These digital paradoxes represent the digital ecosystem challenge to maximise what these new digital technologies can do to augment every objects, services, places and spaces while taking account of the size and addressable market that all these solutions can serve.

Skilton1

What we see is that technology can be both a driver of the physical and digital economy through lowering of price per function in computer storage, compute, access and application technology and creating new value; conversely the issues around driving new value is having different degrees of success in industries.

Creating value in the digital economy

The digital economy is at a tipping point, a growing 30% of business is shifting online to search and engage with consumers, markets and transactions taking account of retail , mobile and impact on supply channels (3);  80% of transport, real estate and hotelier activity is processed through websites (4); over 70% of companies and consumers are experiencing cyber-privacy challenges (5), (6) yet the digital media in social, networks, mobile devices, sensors and the explosion of big data and cloud computing networks is interconnecting potentially everything everywhere – amounting to a new digital “ecosystem.

Disruptive business models across industries and new consumer innovation are increasingly built around new digital technologies such as social media, mobility, big data, cloud computing and the emerging internet of things sensors, networks and machine intelligence. (MISQ Digital Strategy Special Issue (7)).

These trends have significantly enhanced the relevance and significance of IT in its role and impact on business and market value at local, regional and global scale.

With IT budgets increasing shifting more towards the marketing functions and business users of these digital services from traditional IT, there is a growing role for technology to be able to work together in new connected ways.

Driving better digital design outcomes

The age of new digital technologies are combining in new ways to drive new value for individuals, enterprise, communities and societies. The key is in understanding the value that each of these technologies can bring individually and in the mechanisms to creating additive value when used appropriately and cost effectively to drive brand, manage cyber risk, and build consumer engagement and economic growth.

Skilton2

Value-in-use, value in contextualization

Each digital technology has the potential to enable better contextualization of the consumer experience and the value added by providers.   Each industry market has emerging combinations of technologies that can be developed to enable focused value.

Examples of these include.

  • Social media networks

o   Creating enhanced co-presence

  • Big data

o   Providing uniqueness profiling , targeting advice and preferences in context

  • Mobility

o   Creating location context services and awareness

  • Cloud

o   Enabling access to resources and services

  • Sensors

o   Creating real time feedback responsiveness

  • Machine intelligence

o   Enabling insight and higher decision quality

Together these digital technologies can build generative effects that when in context can enable higher value outcomes in digital workspaces.

Skilton3

Value in Contextualization

The value is not in whether these technologies, objects, consumers or provider inside or outside the enterprise or market. These distinctions are out-of-context from relating them to the situation and the consumer needs and wants. The issue is how to apply and put into context the user experience and enterprise and social environment to best use and maximise the outcomes in a specific setting context rom the role perspective.

With the medical roles of patient and clinician, the aim in digitization is how mobile devices, wearable monitoring can be used most efficiently and effectively to raise patient outcome quality and manage health service costs. Especially in the developing countries and remote areas where infrastructure and investment costs, how can technologies reach and improve the quality of health and at an effective cost price point.

This phenomena is wide spread and growing across all industry sectors such as: the connected automobile with in-car entertainment, route planning services; to tele-health that offers remote patient care monitoring and personalized responses; to smart buildings and smart cities that are optimizing energy consumption and work environments; to smart retail where interactive product tags for instant customer mobile information feedback and in-store promotions and automated supply chains. The convergence of these technologies requires a response from all businesses.

These issues are not going to go away, the statistics from analysts describe a new era of a digital industrial economy (8). What is common is the prediction in the next twenty to fifty years suggest double or triple growth in demand for new digital technologies and their adoption.

Skilton4

Platforming and designing better digital outcomes

Developing efective digital workspaces will be fundamental to the value and use of these technologies. There will be not absolute winners and losers as a result of the digital paradox. What is at state is in how the cost and inovation of these technologies can be leveraged to fit specific outcomes.

Understanding the architecting practices will be essentuial in realizing the digitel enterprise. Central to this is how to develop ways to contextualize digital technologies to enable this value for consumers and customers (Value and Worth – creating new markets in the digital economy (9)).Skilton5Platforming will be a central IT strategy that we see already emerging in early generations of digital marketplaces, mobile app ecosystems and emerging cross connecting services in health, automotive, retail and others seeking to create joined up value.

Digital technologies will enable new forms of digital workspaces to support new outcomes. By driving contextualized offers that meet and stimulate consumer behaviors and demand , a richer and more effective value experience and growth potential is possible.

Skilton6The challenge ahead

The evolution of digital technologies will enable many new types of architect and platforms. How these are constructed into meaningful solutions is both the opportunity and the task ahead.

The challenge for both business and IT practitioners is how to understand the practical use and advantages as well as the pitfalls and challenges from these digital technologies

  • What can be done using digital technologies to enhance customer experience, employee productivity and sell more products and services
  • Where to position in a digital market, create generative reinforcing positive behavior and feedback for better market branding
  • Who are the beneficiaries of the digital economy and the impact on the roles and jobs of business and IT professionals
  • Why do enterprises and industry marketplaces need to understand the disruptive effects of these digital technologies and how to leverage these for competitive advantage.
  • How to architect and design robust digital solutions that support the enterprise, its supply chain and extended consumers, customers and providers

References

  1. http://www.technologyreview.com/news/518876/the-costly-paradox-of-health-care-technology/.
  2. http://www.kyoto-smartcity.com/result_pdf/ksce2014_hwang.pdf.
  3. http://www.smartinsights.com/digital-marketing-strategy/online-retail-sales-growth/
  4. http://www.statisticbrain.com/internet-travel-hotel-booking-statistics/
  5. http://www.fastcompany.com/3019097/fast-feed/63-of-americans-70-of-milennials-are-cybercrime-victims
  6. https://www.kpmg.com/Global/en/IssuesAndInsights/ArticlesPublications/Documents/cyber-crime.pdf
  7. http://www.misq.org/contents-37-2
  8. http://www.gartner.com/newsroom/id/2602817
  9. http://www2.warwick.ac.uk/fac/sci/wmg/mediacentre/wmgnews/?newsItem=094d43a23d3fbe05013d835d6d5d05c6

 

Skilton7Digital Health

As the cost of health care, the increasing aging population and the rise of medical advances enable people to live longer and improved quality of life; the health sector together with governments and private industry are increasingly using digital technologies to manage the rising costs of health care while improve patient survival and quality outcomes.

Digital Health Technologies

mHealth, TeleHealth and Translation-to-Bench Health services are just some of the innovative medical technology practices creating new Connected Health Digital Ecosystems.

These systems connect Mobile phones, wearable health monitoring devices, remote emergency alerts to clinician respond and back to big data research for new generation health care.

The case for digital change

UN Department of Economic and Social Affairs

“World population projected to reach 8.92 billion for 2050 and 9.22 Million in 2075. Life expectance is expected to range from 66 to 97 years by 2100.”

OECD Organization for Economic Cooperation and Development

The cost of Health care in developing countries is 8 to 17% of GDP in developed countries. But overall Health car e spending is falling while population growth and life expectancy and aging is increasing.

 

Skilton8Smart cities

The desire to improve buildings, reduce pollution and crime, improve transport, create employment, better education and ways to launch new business start-ups through the use of digital technologies are at the core of important outcomes to drive city growth from “Smart Cities” digital Ecosystem.

Smart city digital technologies

Embedded sensors in building energy management, smart ID badges, and mobile apps for location based advice and services supporting social media communities, enabling improved traffic planning and citizen service response are just some of the ways digital technologies are changing the physical city in the new digital metropolis hubs of tomorrow.

The case for digital change

WHO World Health Organization

“By the middle of the 21st century, the urban population will almost double globally, By 2030, 6 out of every 10 people will live in a city, and by 2050, this proportion will increase to 7 out of 10 people.”

UN Inter-governmental Panel on Climate Change IPCC

“In 2010, the building sector accounted for around 32% final energy use with energy demand projected to approximately double and CO2 emissions to increase by 50–150% by mid-century”

IATA International Air Transport Association

“Airline Industry Forecast 2013-2017 show that airlines expect to see a 31% increase in passenger numbers between 2012 and 2017. By 2017 total passenger numbers are expected to rise to 3.91 billion—an increase of 930 million passengers over the 2.98 billion carried in 2012.”

Mark Skilton 2 Oct 2013Professor Mark Skilton,  Professor of Practice in Information Systems Management , Warwick Business School has over twenty years’ experience in Information Technology and Business consulting to many of the top fortune 1000 companies across many industry sectors and working in over 25 countries at C level board level to transform their operations and IT value.  Mark’s career has included CIO, CTO  Director roles for several FMCG, Telecoms Media and Engineering organizations and recently working in Global Strategic Office roles in the big 5 consulting organizations focusing on digital strategy and new multi-sourcing innovation models for public and private sectors. He is currently a part-time Professor of practice at Warwick Business School, UK where he teaches outsourcing and the intervention of new digital business models and CIO Excellence practices with leading Industry practitioners.

Mark’s current research and industry leadership engagement interests are in Digital Ecosystems and the convergence of social media networks, big data, mobility, cloud computing and M2M Internet of things to enable digital workspaces. This has focused on define new value models digitizing products, workplaces, transport and consumer and provider contextual services. He has spoken and published internationally on these subjects and is currently writing a book on the Digital Economy Series.

Since 2010 Mark has held International standards body roles in The Open Group co-chair of Cloud Computing and leading Open Platform 3.0™ initiatives and standards publications. Mark is active in the ISO JC38 distributed architecture standards and in the Hubs-of-all-things HAT a multi-disciplinary project funded by the Research Council’s UK Digital Economy Programme. Mark is also active in Cyber security forums at Warwick University, Ovum Security Summits and INFOSEC. He has spoken at the EU Commission on Digital Ecosystems Agenda and is currently an EU Commission Competition Judge on Smart Outsourcing Innovation.

 

 

 

 

 

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The Open Group Summit Amsterdam 2014 – Day Two Highlights

By Loren K. Baynes, Director, Global Marketing Communications, The Open Group

On Tuesday, May 13, day two of The Open Group Summit Amsterdam, the morning plenary began with a welcome from The Open Group President and CEO Allen Brown. He presented an overview of the Forums and the corresponding Roadmaps. He described the process of standardization, from the initial work to a preliminary standard, including review documents, whitepapers and snapshots, culminating in the final publication of an open standard. Brown also announced that Capgemini is again a Platinum member of The Open Group and contributes to the realization of the organization’s objectives in various ways.

Charles Betz, Chief Architect, Signature Client Group, AT&T and Karel van Zeeland, Lead IT4IT Architect, Shell IT International, presented the second keynote of the morning, ‘A Reference Architecture For the Business of IT’.  When the IT Value Chain and IT4IT Reference Architecture is articulated, instituted and automated, the business can experience huge cost savings in IT and significantly improved response times for IT service delivery, as well as increasing customer satisfaction.

AmsterdamPlenaryKarel van Zeeland, Charles Betz and Allen Brown

In 1998, Shell Information Technology started to restructure the IT Management and the chaos was complete. There were too many tools, too many vendors, a lack of integration, no common data model, a variety of user interfaces and no standards to support rapid implementation. With more than 28 different solutions for incident management and more than 160 repositories of configuration data, the complexity was immense. An unclear relationship with Enterprise Architecture and other architectural issues made the case even worse.

Restructuring the IT Management turned out to be a long journey for the Shell managers. How to manage 1,700 locations in 90 countries, 8,000 applications, 25,000 servers, dozens of global and regional datacenters,125,000 PCs and laptops, when at the same time you are confronted with trends like BYOD, mobility, cloud computing, security, big data and the Internet of Things (IoT).  According to Betz and van Zeeland, IT4IT is a promising platform for evolution of the IT profession. IT4IT however has the potential to become a full open standard for managing the business of IT.

Jeroen Tas, CEO of Healthcare Informatics Solutions and Services within Philips Healthcare, explained in his keynote speech, “Philips is becoming a software company”. Digital solutions connect and streamline workflow across the continuum of care to improve patient outcomes. Today, big data is supporting adaptive therapies. Smart algorithms are used for early warning and active monitoring of patients in remote locations. Tas has a dream, he wants to make a valuable contribution to a connected healthcare world for everyone.

In January 2014, Royal Philips announced the formation of Healthcare Informatics Solutions and Services, a new business group within Philips’ Healthcare sector that offers hospitals and health systems the customized clinical programs, advanced data analytics and interoperable, cloud-based platforms necessary to implement new models of care. Tas, who previously served as the Chief Information Officer of Philips, leads the group.

In January of this year, The Open Group launched The Open Group Healthcare Forum whichfocuses on bringing Boundaryless Information Flow™ to the healthcare industry enabling data to flow more easily throughout the complete healthcare ecosystem.

Ed Reynolds, HP Fellow and responsible for the HP Enterprise Security Services in the US, described the role of information risk in a new technology landscape. How do C-level executives think about risk? This is a relevant and urgent question because it can take more than 243 days before a data breach is detected. Last year, the average cost associated with a data breach increased 78% to 11.9 million dollars. Critical data assets may be of strategic national importance, have massive corporate value or have huge significance to an employee or citizen, be it the secret recipe of Coca Cola or the medical records of a patient. “Protect your crown jewels” is the motto.

Bart Seghers, Cyber Security Manager, Thales Security and Henk Jonkers, Senior Research Consultant of BiZZdesign, visualized the Business Impact of Technical Cyber Risks. Attacks on information systems are becoming increasingly sophisticated. Organizations are increasingly networked and thus more complex. Attacks use digital, physical and social engineering and the departments responsible for each of these domains within an organization operate in silos. Current risk management methods cannot handle the resulting complexity. Therefore they are using ArchiMate® as a risk and security architecture. ArchiMate is a widely accepted open standard for modeling Enterprise Architecture. There is also a good fit with other EA and security frameworks, such as TOGAF®. A pentest-based Business Impact Assessment (BIA) is a powerful management dashboard that increases the return on investment for your Enterprise Architecture effort, they concluded.

Risk Management was also a hot topic during several sessions in the afternoon. Moderator Jim Hietala, Vice President, Security at The Open Group, hosted a panel discussion on Risk Management.

In the afternoon several international speakers covered topics including Enterprise Architecture & Business Value, Business & Data Architecture and Open Platform 3.0™. In relation to social networks, Andy Jones, Technical Director, EMEA, SOA Software, UK, presented “What Facebook, Twitter and Netflix Didn’t Tell You”.

The Open Group veteran Dr. Chris Harding, Director for Interoperability at The Open Group, and panelists discussed and emphasized the importance of The Open Group Open Platform 3.0™. The session also featured a live Q&A via Twitter #ogchat, #ogop3.

The podcast is now live. Here are the links:

Briefings Direct Podcast Home Page: http://www.briefingsdirect.com/

PODCAST STREAM: http://traffic.libsyn.com/interarbor/BriefingsDirect-The_Open_Group_Amsterdam_Conference_Panel_Delves_into_How_to_Best_Gain_Business_Value_From_Platform_3.mp3

PODCAST SUMMARY: http://briefingsdirect.com/the-open-group-amsterdam-panel-delves-into-how-to-best-gain-business-value-from-platform-30

In the evening, The Open Group hosted a tour and dinner experience at the world-famous Heineken Brewery.

For those of you who attended the summit, please give us your feedback! https://www.surveymonkey.com/s/AMST2014

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Filed under ArchiMate®, Boundaryless Information Flow™, Certifications, Enterprise Architecture, Enterprise Transformation, Healthcare, Open Platform 3.0, RISK Management, Standards, TOGAF®, Uncategorized

The Open Group Summit Amsterdam 2014 – Day One Highlights

By Loren K. Baynes, Director, Global Marketing Communications, The Open Group

The Open Group Summit Amsterdam, held at the historic Hotel Krasnapolsky, began on Monday, May 12 by highlighting how the industry is moving further towards Boundaryless Information Flow™. After the successful introduction of The Open Group Healthcare Forum in San Francisco, the Governing Board is now considering other vertical Forums such as the airline industry and utilities sector.

The morning plenary began with a welcome from Steve Nunn, COO of The Open Group and CEO of the Association of Enterprise Architects (AEA). He mentioned that Amsterdam has a special place in his heart because of the remembrance of the 2001 event also held in Amsterdam, just one month after the 9/11 attacks which shocked the world. Today, with almost 300 registrations and people from 29 different countries, The Open Group is still appealing to a wide range of nationalities.

Allen Brown, President and CEO of The Open Group, took the audience on a journey as he described the transformation process that The Open Group has been on over the last thirty years from its inception in 1984. After a radically financial reorganization and raising new working capital, The Open Group is flourishing more than ever and is in good financial health.

It is amazing that 40 percent of the staff of 1984 is still working for The Open Group. What is the secret? You should have the right people in the boat with shared values and commitment. “In 2014, The Open Group runs a business, but stays a not-for-profit organization, a consortium”, Brown emphasized. “Enterprise Architecture is not a commercial vehicle or a ‘trendy’ topic. The Open Group always has a positive attitude and will never criticize other organizations. Our certification programs are a differentiator compared to other organizations. We collaborate with other consortia and standard bodies like ISO and ITIL”, Brown said.

Now the world is much more complex. Technology risk is increasing. A common language based on common standards is needed more than ever. TOGAF®, an Open Group standard, was in its infancy in 1998 and now it is the common standard for Enterprise Architects all over the world. In 1984, the UNIX® platform was the first platform of The Open Group. The Open Group Open Platform 3.0™, launched last year, focuses on new and emerging technology trends like mobility, big data, cloud computing and the Internet of Things converging with each other and leading to new business models and system designs. “The Open Group is all about building relationships and networking”, Brown concluded.

Leonardo Ramirez, CEO of ARCA SG and Chair of AEA Colombia, talked about the role of interoperability and Enterprise Architecture in Latin America. Colombia is now a safe country and has the strongest economy in the region. In 2011 Colombia promoted the electronic government and TOGAF was selected as the best choice for Enterprise Architecture. Ramirez is determined to stimulate social economic development projects in Latin America with the help of Enterprise Architecture. There is a law in Colombia (Regulation Law 1712, 2014) that says that every citizen has the right to access all the public information without boundaries.

Dr. Jonas Ridderstråle, Chairman, Mgruppen and Visiting Professor, Ashridge (UK) and IE Business Schools (Spain), said in his keynote speech, “Womenomics rules, the big winners of the personal freedom movement will be women. Women are far more risk averse. What would have happened with Lehman Brothers if it was managed by women? ‘Lehman Sisters’ probably had the potential to survive. Now women can spend 80 percent of their time on other things than just raising kids.” Ridderstråle continued to discuss life-changing and game-changing events throughout his presentation. He noted that The Open Group Open Platform 3.0 for instance is a good example of a successful reinvention.

“Towards a European Interoperability Architecture” was the title of one of the afternoon sessions led by Mr. R. Abril Jimenez. Analysis during the first phase of the European Interoperability Strategy (EIS) found that, at conceptual level, architecture guidelines were missing or inadequate. In particular, there are no architectural guidelines for cross-border interoperability of building blocks. Concrete, reusable interoperability guidelines and rules and principles on standards and architecture are also lacking. Based on the results achieved and direction set in the previous phases of the action, the EIA project has moved into a more practical phase that consists of two main parts: Conceptual Reference Architecture and Cartography.

Other tracks featured Healthcare, Professional Development and Dependability through Assuredness™.

The evening concluded with a lively networking reception in the hotel’s Winter Garden ballroom.

For those of you who attended the summit, please give us your feedback!  https://www.surveymonkey.com/s/AMST2014

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Filed under Boundaryless Information Flow™, Conference, Dependability through Assuredness™, Enterprise Architecture, Enterprise Transformation, Healthcare, Open Platform 3.0, Professional Development, Standards, TOGAF®, Uncategorized

Improving Patient Care and Reducing Costs in Healthcare

By Jason Lee, Director of Healthcare and Security Forums, The Open Group

Recently, The Open Group Healthcare Forum hosted a tweet jam to discuss IT and Enterprise Architecture (EA) issues as they relate to two of the most persistent problems in healthcare: reducing costs and improving patient care. Below I summarize the key points that followed from a rather unique discussion. Unique how? Unique in that rather than address these issues from the perspective of “must do” priorities (including EHR implementation, transitioning to ICD-10, and meeting enhanced HIPAA security requirements), we focused on “should do” opportunities.

We asked how stakeholders in the healthcare system can employ “Boundaryless Information Flow™” and standards development through the application of EA approaches that have proven effective in other industries to add new insights and processes to reduce costs and improve quality.

Question 1: What barriers exist for collaboration among providers in healthcare, and what can be done to improve things?
• tetradian: Huge barriers of language, terminology, mindset, worldview, paradigm, hierarchy, role and much more
• jasonsleephd: Financial, organizational, structural, lack of enabling technology, cultural, educational, professional insulation
• jim_hietala: EHRs with proprietary interfaces represent a big barrier in healthcare
• Technodad: Isn’t question really what barriers exist for collaboration between providers and patients in healthcare?
• tetradian: Communication b/w patients and providers is only one (type) amongst very many
• Technodad: Agree. Debate needs to identify whose point of view the #healthcare problem is addressing.
• Dana_Gardner: Where to begin? A Tower of Babel exists on multiple levels among #healthcare ecosystems. Too complex to fix wholesale.
• EricStephens: Also, legal ramifications of sharing information may impede sharing
• efeatherston: Patient needs provider collaboration to see any true benefit (I don’t just go to one provider)
• Dana_Gardner: Improve first by identifying essential collaborative processes that have most impact, and then enable them as secure services.
• Technodad: In US at least, solutions will need to be patient-centric to span providers- Bring Your Own Wellness (BYOW™) for HC info.
• loseby: Lack of shared capabilities & interfaces between EHRs leads to providers w/o comprehensive view of patient
• EricStephens: Are incentives aligned sufficiently to encourage collaboration? + lack of technology integration.
• tetradian: Vast numbers of stakeholder-groups, many beyond medicine – e.g. pharma, university, politics, local care (esp. outside of US)
• jim_hietala: Gap in patient-centric information flow
• Technodad: I think patents will need to drive the collaboration – they have more incentive to manage info than providers.
• efeatherston: Agreed, stakeholder list could be huge
• EricStephens: High-deductible plans will drive patients (us) to own our health care experience
• Dana_Gardner: Take patient-centric approach to making #healthcare processes better: drives adoption, which drives productivity, more adoption
• jasonsleephd: Who thinks standards development and data sharing is an essential collaboration tool?
• tetradian: not always patient-centric – e.g. epidemiology /public-health is population centric – i.e. _everything_ is ‘the centre’
• jasonsleephd: How do we break through barriers to collaboration? For one thing, we need to create financial incentives to collaborate (e.g., ACOs)
• efeatherston: Agreed, the challenge is to get them to challenge (if that makes sense). Many do not question
• EricStephens: Some will deify those in a lab coat.
• efeatherston: Still do, especially older generations, cultural
• Technodad: Agree – also displaying, fusing data from different providers, labs, monitors etc.
• dianedanamac: Online collaboration, can be cost effective & promote better quality but must financially incented
• efeatherston: Good point, unless there is a benefit/incentive for provider, they may not be bothered to try
• tetradian: “must financially incented” – often other incentives work better – money can be a distraction – also who pays?

Participants identified barriers that are not atypical: financial disincentives, underpowered technology, failure to utilize existing capability, lack of motivation to collaborate. Yet all participants viewed more collaboration as key. Consensus developed around:
• The patient (and by one commenter, the population) as the main driver of collaboration, and
• The patient as the most important stakeholder at the center of information flow.

Question 2: Does implementing remote patient tele-monitoring and online collaboration drive better and more cost-effective patient care?
• EricStephens: “Hell yes” comes to mind. Why drag yourself into a dr. office when a device can send the information (w/ video)
• efeatherston: Will it? Will those with high deductible plans have ability/understanding/influence to push for it?
• EricStephens: Driving up participation could drive up efficacy
• jim_hietala: Big opportunities to improve patient care thru remote tele-monitoring
• jasonsleephd: Tele-ICUs can keep patients (and money) in remote settings while receiving quality care
• jasonsleephd: Remote monitoring of patients admitted with CHF can reduce rehospitalization w/i 6 months @connectedhealth.org
• Dana_Gardner: Yes! Pacemakers now uplink to centralized analysis centers, communicate trends back to attending doctor. Just scratches surface
• efeatherston: Amen. Do that now, monthly uplink, annual check in with doctor to discuss any trends he sees.
• tetradian: Assumes tele-monitoring options even exist – very wide range of device-capabilities, from very high to not-much, and still not common.
• tetradian: (General request to remember that there’s more to the world, and medicine, than just the US and its somewhat idiosyncratic systems?)
• efeatherston: Yes, I do find myself looking through the lens of my own experiences, forgetting the way we do things may not translate
• jasonsleephd: Amen to point about our idiosyncrasies! Still, we have to live with them, and we can do so much better with good information flow!
• Dana_Gardner: Governments should remove barriers so more remote patient tele-monitoring occurs. Need to address the malpractice risks issue.
• TerryBlevins: Absolutely. Just want the information to go to the right place!
• Technodad: . Isn’t “right place” someplace you & all your providers can access? Need interoperability!
• TerryBlevins: It requires interoperability yes – the info must flow to those that must know.
• Technodad: Many areas where continuous monitoring can help. Improved IoT (internet of things) sensors e.g. cardio, blood chemistry coming. http://t.co/M3xw3tNvv3
• tetradian: Ethical/privacy concerns re how/with-whom that data is shared – e.g. with pharma, research, epidemiology etc
• efeatherston: Add employers to that etc. list of how/who/what is shared

Participants agreed that remote patient monitoring and telemonitoring can improve collaboration, improve patient care, and put patients more in control of their own healthcare data. However, participants expressed concerns about lack of widespread availability and the related issue of high cost. In addition, they raised important questions about who has access to these data, and they addressed nagging privacy and liability concerns.

Question 3: Can a mobile strategy improve patient experience, empowerment and satisfaction? If so, how?
• jim_hietala: mobile is a key area where patient health information can be developed/captured
• EricStephens: Example: link blood sugar monitor to iPhone to MyFitnessPal + gamification to drive adherence (and drive $$ down?)
• efeatherston: Mobile along with #InternetOfThings, wearables linked to mobile. Contact lens measuring blood sugar in recent article as ex.
• TerryBlevins: Sick people, or people getting sick are on the move. In a patient centric world we must match need.
• EricStephens: Mobile becomes a great data acquisition point. Something as simple as SMS can drive adherence with complication drug treatments
• jasonsleephd: mHealth is a very important area for innovation, better collaboration, $ reduction & quality improvement. Google recent “Webby Awards & handheld devices”
• tetradian: Mobile can help – e.g. use of SMS for medicine in Africa etc
• Technodad: Mobile isn’t option any more. Retail, prescription IoT, mobile network & computing make this a must-have. http://t.co/b5atiprIU9
• dianedanamac: Providers need to be able to receive the information mHealth
• Dana_Gardner: Healthcare should go location-independent. Patient is anywhere, therefore so is care, data, access. More than mobile, IMHO.
• Technodad: Technology and mobile demand will outrun regional provider systems, payers, regulation
• Dana_Gardner: As so why do they need to be regional? Cloud can enable supply-demand optimization regardless of location for much.
• TerryBlevins: And the caregivers are also on the move!
• Dana_Gardner: Also, more machine-driven care, i.e. IBM Watson, for managing the routing and prioritization. Helps mitigate overload.
• Technodad: Agree – more on that later!
• Technodad: Regional providers are the reality in the US. Would love to have more national/global coverage.
• Dana_Gardner: Yes, let the market work its magic by making it a larger market, when information is the key.
• tetradian: “let the market do its work” – ‘the market’ is probably the quickest way to destroy trust! – not a good idea…
• Technodad: To me, problem is coordinating among multi providers, labs etc. My health info seems to move at glacial pace then.
• tetradian: “Regional providers are the reality in the US.” – people move around: get info follow them is _hard_ (1st-hand exp. there…)
• tetradian: danger of hype/fear-driven apps – may need regulation, or at least regulatory monitoring
• jasonsleephd: Regulators, as in FDA or something similar?
• tetradian: “Regulators as in FDA” etc – at least oversight of that kind, yes (cf. vitamins, supplements, health-advice services)
• jim_hietala: mobile, consumer health device innovation moving much faster than IT ability to absorb
• tetradian: also beware of IT-centrism and culture – my 90yr-old mother has a cell-phone, but has almost no idea how to use it!
• Dana_Gardner: Information and rely of next steps (in prevention or acute care) are key, and can be mobile. Bring care to the patient ASAP.

Participants began in full agreement. Mobile health is not even an option but a “given” now. Recognition that provider ability to receive information is lacking. Cloud viewed as means to overcome regionalization of data storage problems. When the discussion turned to further development of mHealth there was some debate on what can be left to the market and whether some form of regulatory action is needed.

Question 4: Does better information flow and availability in healthcare reduce operation cost, and free up resources for more patient care?
• tetradian: A4: should do, but it’s _way_ more complex than most IT-folks seem to expect or understand (e.g. repeated health-IT fails in UK)
• jim_hietala: A4: removing barriers to health info flow may reduce costs, but for me it’s mostly about opportunity to improve patient care
• jasonsleephd: Absolutely. Consider claims processing alone. Admin costs in private health ins. are 20% or more. In Medicare less than 2%.
• loseby: Absolutely! ACO model is proving it. Better information flow and availability also significantly reduces hospital admissions
• dianedanamac: I love it when the MD can access my x-rays and lab results so we have more time.
• efeatherston: I love it when the MD can access my x-rays and lab results so we have more time.
• EricStephens: More info flow + availability -> less admin staff -> more med staff.
• EricStephens: Get the right info to the ER Dr. can save a life by avoiding contraindicated medicines
• jasonsleephd: EricStephens GO CPOE!!
• TerryBlevins: @theopengroup. believe so, but ask the providers. My doctor is more focused on patient by using simple tech to improve info flow
• tetradian: don’t forget link b/w information-flows and trust – if trust fails, so does the information-flow – worse than where we started!
• jasonsleephd: Yes! Trust is really key to this conversation!
• EricStephens: processing a claim, in most cases, should be no more difficult than an expense report or online order. Real-time adjudication
• TerryBlevins: Great point.
• efeatherston: Agreed should be, would love to see it happen. Trust in the data as mentioned earlier is key (and the process)
• tetradian: A4: sharing b/w patient and MD is core, yes, but who else needs to access that data – or _not_ see it? #privacy
• TerryBlevins: A4: @theopengroup can’t forget that if info doesn’t flow sometimes the consequences are fatal, so unblocked the flow.
• tetradian: .@TerryBlevins A4: “if info doesn’t flow sometimes the consequences are fatal,” – v.important!
• Technodad: . @tetradian To me, problem is coordinating among multi providers, labs etc. My health info seems to move at glacial pace then.
• TerryBlevins: A4: @Technodad @tetradian I have heard that a patient moving on a gurney moves faster than the info in a hospital.
• Dana_Gardner: A4 Better info flow in #healthcare like web access has helped. Now needs to go further to be interactive, responsive, predictive.
• jim_hietala: A4: how about pricing info flow in healthcare, which is almost totally lacking
• Dana_Gardner: A4 #BigData, #cloud, machine learning can make 1st points of #healthcare contact a tech interface. Not sci-fi, but not here either.

Starting with the recognition that this is a very complicated issue, the conversation quickly produced a consensus view that mobile health is key, both to cost reduction and quality improvement and increased patient satisfaction. Trust that information is accurate, available and used to support trust in the provider-patient relationship emerged as a relevant issue. Then, naturally, privacy issues surfaced. Coordination of information flow and lack of interoperability were recognized as important barriers and the conversation finally turned somewhat abstract and technical with mentions of big data and the cloud and pricing information flows without much in the way of specifying how to connect the dots.

Question 5: Do you think payers and providers are placing enough focus on using technology to positively impact patient satisfaction?
• Technodad: A5: I think there are positive signs but good architecture is lacking. Current course will end w/ provider information stovepipes.
• TerryBlevins: A5: @theopengroup Providers are doing more. I think much more is needed for payers – they actually may be worse.
• theopengroup: @TerryBlevins Interesting – where do you see opportunities for improvements with payers?
• TerryBlevins: A5: @theopengroup like was said below claims processing – an onerous job for providers and patients – mostly info issue.
• tetradian: A5: “enough focus on using tech”? – no, not yet – but probably won’t until tech folks properly face the non-tech issues…
• EricStephens: A5 No. I’m not sure patient satisfaction (customer experience/CX?) is even a factor sometimes. Patients not treated like customers
• dianedanamac: .@EricStephens SO TRUE! Patients not treated like customers
• Technodad: . @EricStephens Amen to that. Stovepipe data in provider systems is barrier to understanding my health & therefore satisfaction.
• dianedanamac: “@mclark497: @EricStephens issue is the customer is treat as only 1 dimension. There is also the family experience to consider too
• tetradian: .@EricStephens A5: “Patients not treated like customers” – who _is_ ‘the customer’? – that’s a really tricky question…
• efeatherston: @tetradian @EricStephens Trickiest question. to the provider is the patient or the payer the customer?
• tetradian: .@efeatherston “patient or payer” – yeah, though it gets _way_ more complex than that once we explore real stakeholder-relations
• efeatherston: @tetradian So true.
• jasonsleephd: .@tetradian @efeatherston Very true. There are so many diff stakeholders. But to align payers and pts would be huge
• efeatherston: @jasonsleephd @tetradian re: aligning payers and patients, agree, it would be huge and a good thing
• jasonsleephd: .@efeatherston @tetradian @EricStephens Ideally, there should be no dividing line between the payer and the patient!
• efeatherston: @jasonsleephd @tetradian @EricStephens Ideally I agree, and long for that ideal world.
• EricStephens: .@jasonsleephd @efeatherston @tetradian the payer s/b a financial proxy for the patient. and nothing more
• TerryBlevins: @EricStephens @jasonsleephd @efeatherston @tetradian … got a LOL out of me.
• Technodad: . @tetradian @EricStephens That’s a case of distorted marketplace. #Healthcare architecture must cut through to patient.
• tetradian: .@Technodad “That’s a case of distorted marketplace.” – yep. now add in the politics of consultants and their hierarchies, etc?
• TerryBlevins: A5: @efeatherston @tetradian @EricStephens in patient cetric world it is the patient and or their proxy.
• jasonsleephd: A5: Not enough emphasis on how proven technologies and architectural structures in other industries can benefit healthcare
• jim_hietala: A5: distinct tension in healthcare between patient-focus and meeting mandates (a US issue)
• tetradian: .@jim_hietala A5: “meeting mandates (a US issue)” – UK NHS (national-health-service) may be even worse than US – a mess of ‘targets’
• EricStephens: A5 @jim_hietala …and avoiding lawsuits
• tetradian: A5: most IT-type tech still not well-suited to the level of mass-uniqueness inherent in the healthcare context
• Dana_Gardner: A5 They are using tech, but patient “satisfaction” not yet a top driver. We have a long ways to go on that. But it can help a ton.
• theopengroup: @Dana_Gardner Agree, there’s a long way to go. What would you say is the starting point for providers to tie the two together?
• Dana_Gardner: @theopengroup An incentive other than to avoid lawsuits. A transparent care ratings capability. Outcomes focus based on total health
• Technodad: A5: I’d be satisfied just to not have to enter my patient info & history on a clipboard in every different provider I go to!
• dianedanamac: A5 @tetradian Better data sharing & Collab. less redundancy, lower cost, more focus on patient needs -all possible w/ technology
• Technodad: A5: The patient/payer discussion is a red herring. If the patient weren’t there, rest of the system would be unnecessary.
• jim_hietala: RT @Technodad: The patient/payer discussion is a red herring. If the patient weren’t there, rest of system unnecessary. AMEN

Very interesting conversation. Positive signs of progress were noted but so too were indications that healthcare will remain far behind the technology curve in the foreseeable future. Providers were given higher “grades” than payers. Yet, claims processing would seemingly be one of the easiest areas for technology-assisted improvement. One discussant noted that there will not be enough focus on technology in healthcare “until the tech folks properly face the non-tech issues”. This would seem to open a wide door for EA experts to enter the healthcare domain! The barriers (and opportunities) to this may be the topic of another tweet jam, or Open Group White Paper.
Interestingly, part way into the discussion the topic turned to the lack of a real customer/patient focus in healthcare. Not enough emphasis on patient satisfaction. Not enough attention to patient outcomes. There needs to be a better/closer alignment between what motivates payers and the needs of patients.

Question 6: As some have pointed out, many of the EHR systems are highly proprietary, how can standards deliver benefits in healthcare?
• jim_hietala: A6: Standards will help by lowering the barriers to capturing data, esp. for mhealth, and getting it to point of care
• tetradian: .@jim_hietala “esp. for mhealth” – focus on mhealth may be a way to break the proprietary logjam, ‘cos it ain’t proprietary yet
• TerryBlevins: A6: @theopengroup So now I deal with at least 3 different EHR systems. All requiring me to be the info steward! Hmmm
• TerryBlevins: A6 @theopengroup following up if they shared data through standards maybe they can synchronize.
• EricStephens: A6 – Standards lead to better interoperability, increased viscosity of information which will lead to lowers costs, better outcomes.
• efeatherston: @EricStephens and greater trust in the info (as was mentioned earlier, trust in the information key to success)
• jasonsleephd: A6: Standards development will not kill innovation but rather make proprietary systems interoperable
• Technodad: A6: Metcalfe’s law rules! HC’s many providers-many patients structure means interop systems will be > cost effective in long run.
• tetradian: A6: the politics of this are _huge_, likewise the complexities – if we don’t face those issues right up-front, this is going nowhere

On his April 24, 2014 post at www.weblog.tetradian.com, Tom Graves provided a clearly stated position on the role of The Open Group in delivering standards to help healthcare improve. He wrote:

“To me, this is where The Open Group has an obvious place and a much-needed role, because it’s more than just an IT-standards body. The Open Group membership are mostly IT-type organisations, yes, which tends to guide towards IT-standards, and that’s unquestionably of importance here. Yet perhaps the real role for The Open Group as an organisation is in its capabilities and experience in building consortia across whole industries: EMMM™ and FACE are two that come immediately to mind. Given the maze of stakeholders and the minefields of vested-interests across the health-context, those consortia-building skills and experience are perhaps what’s most needed here.”

The Open Group is the ideal organization to engage in this work. There are many ways to collaborate. You can join The Open Group Healthcare Forum, follow the Forum on Twitter @ogHealthcare and connect on The Open Group Healthcare Forum LinkedIn Group.

Jason Lee headshotJason Lee, Director of Healthcare and Security Forums at The Open Group, has conducted healthcare research, policy analysis and consulting for over 20 years. He is a nationally recognized expert in healthcare organization, finance and delivery and applies his expertise to a wide range of issues, including healthcare quality, value-based healthcare, and patient-centered outcomes research. Jason worked for the legislative branch of the U.S. Congress from 1990-2000 — first at GAO, then at CRS, then as Health Policy Counsel for the Chairman of the House Energy and Commerce Committee (in which role the National Journal named him a “Top Congressional Aide” and he was profiled in the Almanac of the Unelected). Subsequently, Jason held roles of increasing responsibility with non-profit organizations — including AcademyHealth, NORC, NIHCM, and NEHI. Jason has published quantitative and qualitative findings in Health Affairs and other journals and his work has been quoted in Newsweek, the Wall Street Journal and a host of trade publications. He is a Fellow of the Employee Benefit Research Institute, was an adjunct faculty member at the George Washington University, and has served on several boards. Jason earned a Ph.D. in social psychology from the University of Michigan and completed two postdoctoral programs (supported by the National Science Foundation and the National Institutes of Health). He is the proud father of twins and lives outside of Boston.

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Filed under Boundaryless Information Flow™, Data management, Enterprise Architecture, Enterprise Transformation, Healthcare, Professional Development, Standards

Improving Patient Care and Reducing Costs in Healthcare – Join The Open Group Tweet Jam on Wednesday, April 23

By Jason Lee, Director of Healthcare and Security Forums, The Open Group

On Wednesday, April 23 at 9:00 am PT/12:00 pm ET/5:00 pm GMT, The Open Group Healthcare Forum will host a tweet jam to discuss the issues around healthcare and improving patient care while reducing costs. Many healthcare payer and provider organizations today are facing numerous “must do” priorities, including EHR implementation, transitioning to ICD-10, and meeting enhanced HIPAA security requirements.

This tweet jam will focus on opportunities that healthcare organizations have available to improve patient care and reduce costs associated with capturing, maintaining, and sharing patient information. It will also explore how using Enterprise Architectural approaches that have proven effective in other industries will apply to the healthcare sector and dramatically improve both costs and patient care.

In addition to the need for implementing integrated digital health records that can be shared across health organizations to maximize care for both patients who don’t want to repeat themselves and the doctors providing their care, we’ll explore what other solutions exist to enhance information flow. For example, did you know that a new social network for M.D.s has even emerged to connect and communicate across teams, hospitals and entire health systems? The new network, called Doximity, boasts that 40 percent of U.S. doctors have signed on. Not only are doctors using social media, they’re using software specifically designed for the iPad that roughly 68 percent of doctors are carrying around. One hospital even calculated its return on investment of utilizing a an iPad in just nine days!

We’ll be talking about how many healthcare thought leaders are looking at technology and its influence on online collaboration, patient telemonitoring and information flow.

We welcome The Open Group members and interested participants from all backgrounds to join the discussion and interact with our panel of thought-leaders including Jim Hietala, Vice President of Security; David Lounsbury, CTO; and Dr. Chris Harding, Forum Director of Open Platform 3.0™ Forum. To access the discussion, please follow the hashtag #ogchat during the allotted discussion time.

Interested in joining The Open Group Healthcare Forum? Register your interest, here.

What Is a Tweet Jam?

The Open Group tweet jam, approximately 45 minutes in length, is a “discussion” hosted on Twitter. The purpose of the tweet jam is to share knowledge and answer questions on relevant and thought-provoking issues. Each tweet jam is led by a moderator and a dedicated group of experts to keep the discussion flowing. The public (or anyone using Twitter interested in the topic) is encouraged to join the discussion.

Participation Guidance

Whether you’re a newbie or veteran Twitter user, here are a few tips to keep in mind:

Have your first #ogchat tweet be a self-introduction: name, affiliation, occupation.

Start all other tweets with the question number you’re responding to and add the #ogchat hashtag.

Sample: Q1 What barriers exist for collaboration among providers in healthcare, and what can be done to improve things? #ogchat

Please refrain from product or service promotions. The goal of a tweet jam is to encourage an exchange of knowledge and stimulate discussion.

While this is a professional get-together, we don’t have to be stiff! Informality will not be an issue.

A tweet jam is akin to a public forum, panel discussion or Town Hall meeting – let’s be focused and thoughtful.

If you have any questions prior to the event or would like to join as a participant, please contact Rob Checkal (@robcheckal or rob.checkal@hotwirepr.com). We anticipate a lively chat and hope you will be able to join!

Jason Lee headshotJason Lee, Director of Healthcare and Security Forums at The Open Group, has conducted healthcare research, policy analysis and consulting for over 20 years. He is a nationally recognized expert in healthcare organization, finance and delivery and applies his expertise to a wide range of issues, including healthcare quality, value-based healthcare, and patient-centered outcomes research. Jason worked for the legislative branch of the U.S. Congress from 1990-2000 — first at GAO, then at CRS, then as Health Policy Counsel for the Chairman of the House Energy and Commerce Committee (in which role the National Journal named him a “Top Congressional Aide” and he was profiled in the Almanac of the Unelected). Subsequently, Jason held roles of increasing responsibility with non-profit organizations — including AcademyHealth, NORC, NIHCM, and NEHI. Jason has published quantitative and qualitative findings in Health Affairs and other journals and his work has been quoted in Newsweek, the Wall Street Journal and a host of trade publications. He is a Fellow of the Employee Benefit Research Institute, was an adjunct faculty member at the George Washington University, and has served on several boards. Jason earned a Ph.D. in social psychology from the University of Michigan and completed two postdoctoral programs (supported by the National Science Foundation and the National Institutes of Health). He is the proud father of twins and lives outside of Boston.

 

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Filed under Boundaryless Information Flow™, Enterprise Architecture, Healthcare, Tweet Jam

The Financial Incentive for Health Information Exchanges

By Jim Hietala, VP, Security, The Open Group

Health IT professionals have always known that interoperability would be one of the most important aspects of the Affordable Care Act (ACA). Now doctors have financial incentive to be proactive in taking part in the process of exchange information between computer systems.

According to a recent article in MedPage Today, doctors are now “clamoring” for access to patient information ahead of the deadlines for the government’s “meaningful use” program. Doctors and hospitals will get hit with fines for not knowing about patients’ health histories, for patient readmissions and unnecessary retesting. “Meaningful use” refers to provisions in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which authorized incentive payments through Medicare and Medicaid to clinicians and hospitals that use electronic health records in a meaningful way that significantly improves clinical care.
Doctors who accept Medicare will find themselves penalized for not adopting or successfully demonstrating meaningful use of a certified electronic health record (EHR) technology by 2015. Health professionals’ Medicare physician fee schedule amount for covered professional services will be adjusted down by 1% each year for certain categories.  If less than 75% of Eligible Professionals (EPs) have become meaningful users of EHRs by 2018, the adjustment will change by 1% point each year to a maximum of 5% (95% of Medicare covered amount).

With the stick, there’s also a carrot. The Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.

According to HealthIT.Gov, interoperability is essential for applications that interact with users (such as e-prescribing), systems that communicate with each other (such as messaging standards) information processes and management (such as health information exchange) how consumer devices integrate with other systems and applications (such as tablet, smart phones and PCs).

The good news is that more and more hospitals and doctors are participating in data exchanges and sharing patient information. On January 30th, the eHealth Exchange, formerly the Nationwide Health Information Network, and operated by Healtheway, reported a surge in network participation numbers and increases in secure online transactions among members.

According to the news release, membership in the eHealth Exchange is currently pegged at 41 participants who together represent some 800 hospitals, 6,000 mid-to-large medical groups, 800 dialysis centers and 850 retail pharmacies nationwide. Some of the earliest members to sign on with the exchange were the Veterans Health Administration, Department of Defense, Kaiser Permanente, the Social Security Administration and Dignity Health.

While the progress in health information exchanges is good, there is still much work to do in defining standards, so that the right information is available at the right time and place to enable better patient care. Devices are emerging that can capture continuous information on our health status. The information captured by these devices can enable better outcomes, but only if the information is made readily available to medical professionals.

The Open Group recently formed The Open Group Healthcare Forum, which focuses on bringing  Boundaryless Information Flow™ to the healthcare industry enabling data to flow more easily throughout the complete healthcare ecosystem.  By leveraging the discipline and principles of Enterprise Architecture, including TOGAF®, an Open Group standard, the forum aims to develop standardized vocabulary and messaging that will result in higher quality outcomes, streamlined business practices and innovation within the industry.

62940-hietalaJim Hietala, CISSP, GSEC, is the Vice President, Security for The Open Group, where he manages all IT security, risk management and healthcare programs and standards activities. He participates in the SANS Analyst/Expert program and has also published numerous articles on information security, risk management, and compliance topics in publications including The ISSA Journal, Bank Accounting & Finance, Risk Factor, SC Magazine, and others.

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Q&A with Allen Brown, President and CEO of The Open Group

By The Open Group

Last month, The Open Group hosted its San Francisco 2014 conference themed “Toward Boundaryless Information Flow™.” Boundaryless Information Flow has been the pillar of The Open Group’s mission since 2002 when it was adopted as the organization’s vision for Enterprise Architecture. We sat down at the conference with The Open Group President and CEO Allen Brown to discuss the industry’s progress toward that goal and the industries that could most benefit from it now as well as The Open Group’s new Dependability through Assuredness™ Standard and what the organization’s Forums are working on in 2014.

The Open Group adopted Boundaryless Information Flow as its vision in 2002, and the theme of the San Francisco Conference has been “Towards Boundaryless Information Flow.” Where do you think the industry is at this point in progressing toward that goal?

Well, it’s progressing reasonably well but the challenge is, of course, when we established that vision back in 2002, life was a little less complex, a little bit less fast moving, a little bit less fast-paced. Although organizations are improving the way that they act in a boundaryless manner – and of course that changes by industry – some industries still have big silos and stovepipes, they still have big boundaries. But generally speaking we are moving and everyone understands the need for information to flow in a boundaryless manner, for people to be able to access and integrate information and to provide it to the teams that they need.

One of the keynotes on Day One focused on the opportunities within the healthcare industry and The Open Group recently started a Healthcare Forum. Do you see Healthcare industry as a test case for Boundaryless Information Flow and why?

Healthcare is one of the verticals that we’ve focused on. And it is not so much a test case, but it is an area that absolutely seems to need information to flow in a boundaryless manner so that everyone involved – from the patient through the administrator through the medical teams – have all got access to the right information at the right time. We know that in many situations there are shifts of medical teams, and from one medical team to another they don’t have access to the same information. Information isn’t easily shared between medical doctors, hospitals and payers. What we’re trying to do is to focus on the needs of the patient and improve the information flow so that you get better outcomes for the patient.

Are there other industries where this vision might be enabled sooner rather than later?

I think that we’re already making significant progress in what we call the Exploration, Mining and Minerals industry. Our EMMM™ Forum has produced an industry-wide model that is being adopted throughout that industry. We’re also looking at whether we can have an influence in the airline industry, automotive industry, manufacturing industry. There are many, many others, government and retail included.

The plenary on Day Two of the conference focused on The Open Group’s Dependability through Assuredness standard, which was released last August. Why is The Open Group looking at dependability and why is it important?

Dependability is ultimately what you need from any system. You need to be able to rely on that system to perform when needed. Systems are becoming more complex, they’re becoming bigger. We’re not just thinking about the things that arrive on the desktop, we’re thinking about systems like the barriers at subway stations or Tube stations, we’re looking at systems that operate any number of complex activities. And they bring an awful lot of things together that you have to rely upon.

Now in all of these systems, what we’re trying to do is to minimize the amount of downtime because downtime can result in financial loss or at worst human life, and we’re trying to focus on that. What is interesting about the Dependability through Assuredness Standard is that it brings together so many other aspects of what The Open Group is working on. Obviously the architecture is at the core, so it’s critical that there’s an architecture. It’s critical that we understand the requirements of that system. It’s also critical that we understand the risks, so that fits in with the work of the Security Forum, and the work that they’ve done on Risk Analysis, Dependency Modeling, and out of the dependency modeling we can get the use cases so that we can understand where the vulnerabilities are, what action has to be taken if we identify a vulnerability or what action needs to be taken in the event of a failure of the system. If we do that and assign accountability to people for who will do what by when, in the event of an anomaly being detected or a failure happening, we can actually minimize that downtime or remove it completely.

Now the other great thing about this is it’s not only a focus on the architecture for the actual system development, and as the system changes over time, requirements change, legislation changes that might affect it, external changes, that all goes into that system, but also there’s another circle within that system that deals with failure and analyzes it and makes sure it doesn’t happen again. But there have been so many evidences of failure recently. In the banks for example in the UK, a bank recently was unable to process debit cards or credit cards for customers for about three or four hours. And that was probably caused by the work done on a routine basis over a weekend. But if Dependability through Assuredness had been in place, that could have been averted, it could have saved an awfully lot of difficulty for an awful lot of people.

How does the Dependability through Assuredness Standard also move the industry toward Boundaryless Information Flow?

It’s part of it. It’s critical that with big systems the information has to flow. But this is not so much the information but how a system is going to work in a dependable manner.

Business Architecture was another featured topic in the San Francisco plenary. What role can business architecture play in enterprise transformation vis a vis the Enterprise Architecture as a whole?

A lot of people in the industry are talking about Business Architecture right now and trying to focus on that as a separate discipline. We see it as a fundamental part of Enterprise Architecture. And, in fact, there are three legs to Enterprise Architecture, there’s Business Architecture, there’s the need for business analysts, which are critical to supplying the information, and then there are the solutions, and other architects, data, applications architects and so on that are needed. So those three legs are needed.

We find that there are two or three different types of Business Architect. Those that are using the analysis to understand what the business is doing in order that they can inform the solutions architects and other architects for the development of solutions. There are those that are more integrated with the business that can understand what is going on and provide input into how that might be improved through technology. And there are those that can actually go another step and talk about here we have the advances and the technology and here are the opportunities for advancing our competitiveness and organization.

What are some of the other key initiatives that The Open Group’s forum and work groups will be working on in 2014?

That kind question is like if you’ve got an award, you’ve got to thank your friends, so apologies to anyone that I leave out. Let me start alphabetically with the Architecture Forum. The Architecture Forum obviously is working on the evolution of TOGAF®, they’re also working with the harmonization of TOGAF with Archimate® and they have a number of projects within that, of course Business Architecture is on one of the projects going on in the Architecture space. The Archimate Forum are pushing ahead with Archimate—they’ve got two interesting activities going on at the moment, one is called ArchiMetals, which is going to be a sister publication to the ArchiSurance case study, where the ArchiSurance provides the example of Archimate is used in the insurance industry, ArchiMetals is going to be used in a manufacturing context, so there will be a whitepaper on that and there will be examples and artifacts that we can use. They’re also working on in Archimate a standard for interoperability for modeling tools. There are four tools that are accredited and certified by The Open Group right now and we’re looking for that interoperability to help organizations that have multiple tools as many of them do.

Going down the alphabet, there’s DirecNet. Not many people know about DirecNet, but Direcnet™ is work that we do around the U.S. Navy. They’re working on standards for long range, high bandwidth mobile networking. We can go to the FACE™ Consortium, the Future Airborne Capability Environment. The FACE Consortium are working on their next version of their standard, they’re working toward accreditation, a certification program and the uptake of that through procurement is absolutely amazing, we’re thrilled about that.

Healthcare we’ve talked about. The Open Group Trusted Technology Forum, where they’re working on how we can trust the supply chain in developed systems, they’ve released the Open Trusted Technology Provider™ Standard (O-TTPS) Accreditation Program, that was launched this week, and we already have one accredited vendor and two certified test labs, assessment labs. That is really exciting because now we’ve got a way of helping any organization that has large complex systems that are developed through a global supply chain to make sure that they can trust their supply chain. And that is going to be invaluable to many industries but also to the safety of citizens and the infrastructure of many countries. So the other part of the O-TTPS is that standard we are planning to move toward ISO standardization shortly.

The next one moving down the list would be Open Platform 3.0™. This is really exciting part of Boundaryless Information Flow, it really is. This is talking about the convergence of SOA, Cloud, Social, Mobile, Internet of Things, Big Data, and bringing all of that together, this convergence, this bringing together of all of those activities is really something that is critical right now, and we need to focus on. In the different areas, some of our Cloud computing standards have already gone to ISO and have been adopted by ISO. We’re working right now on the next products that are going to move through. We have a governance standard in process and an ecosystem standard has recently been published. In the area of Big Data there’s a whitepaper that’s 25 percent completed, there’s also a lot of work on the definition of what Open Platform 3.0 is, so this week the members have been working on trying to define Open Platform 3.0. One of the really interesting activities that’s gone on, the members of the Open Platform 3.0 Forum have produced something like 22 different use cases and they’re really good. They’re concise and they’re precise and the cover a number of different industries, including healthcare and others, and the next stage is to look at those and work on the ROI of those, the monetization, the value from those use cases, and that’s really exciting, I’m looking forward to peeping at that from time to time.

The Real Time and Embedded Systems Forum (RTES) is next. Real-Time is where we incubated the Dependability through Assuredness Framework and that was where that happened and is continuing to develop and that’s really good. The core focus of the RTES Forum is high assurance system, and they’re doing some work with ISO on that and a lot of other areas with multicore and, of course, they have a number of EC projects that we’re partnering with other partners in the EC around RTES.

The Security Forum, as I mentioned earlier, they’ve done a lot of work on risk and dependability. So they’ve not only their standards for the Risk Taxonomy and Risk Analysis, but they’ve now also developed the Open FAIR Certification for People, which is based on those two standards of Risk Analysis and Risk Taxonomy. And we’re already starting to see people being trained and being certified under that Open FAIR Certification Program that the Security Forum developed.

A lot of other activities are going on. Like I said, I probably left a lot of things out, but I hope that gives you a flavor of what’s going on in The Open Group right now.

The Open Group will be hosting a summit in Amsterdam May 12-14, 2014. What can we look forward to at that conference?

In Amsterdam we have a summit – that’s going to bring together a lot of things, it’s going to be a bigger conference that we had here. We’ve got a lot of activity in all of our activities; we’re going to bring together top-level speakers, so we’re looking forward to some interesting work during that week.

 

 

 

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Q&A with Jim Hietala on Security and Healthcare

By The Open Group

We recently spoke with Jim Hietala, Vice President, Security for The Open Group, at the 2014 San Francisco conference to discuss upcoming activities in The Open Group’s Security and Healthcare Forums.

Jim, can you tell us what the Security Forum’s priorities are going to be for 2014 and what we can expect to see from the Forum?

In terms of our priorities for 2014, we’re continuing to do work in Security Architecture and Information Security Management. In the area of Security Architecture, the big project that we’re doing is adding security to TOGAF®, so we’re working on the next version of the TOGAF standard and specification and there’s an active project involving folks from the Architecture Forum and the Security Forum to integrate security into and stripe it through TOGAF. So, on the Security Architecture side, that’s the priority. On the Information Security Management side, we’re continuing to do work in the area of Risk Management. We introduced a certification late last year, the OpenFAIR certification, and we’ll continue to do work in the area of Risk Management and Risk Analysis. We’re looking to add a second level to the certification program, and we’re doing some other work around the Risk Analysis standards that we’ve introduced.

The theme of this conference was “Towards Boundaryless Information Flow™” and many of the tracks focused on convergence, and the convergence of things Big Data, mobile, Cloud, also known as Open Platform 3.0. How are those things affecting the realm of security right now?

I think they’re just beginning to. Cloud—obviously the security issues around Cloud have been here as long as Cloud has been over the past four or five years. But if you look at things like the Internet of Things and some of the other things that comprise Open Platform 3.0, the security impacts are really just starting to be felt and considered. So I think information security professionals are really just starting to wrap their hands around, what are those new security risks that come with those technologies, and, more importantly, what do we need to do about them? What do we need to do to mitigate risk around something like the Internet of Things, for example?

What kind of security threats do you think companies need to be most worried about over the next couple of years?

There’s a plethora of things out there right now that organizations need to be concerned about. Certainly advanced persistent threat, the idea that maybe nation states are trying to attack other nations, is a big deal. It’s a very real threat, and it’s something that we have to think about – looking at the risks we’re facing, exactly what is that adversary and what are they capable of? I think profit-motivated criminals continue to be on everyone’s mind with all the credit card hacks that have just come out. We have to be concerned about cyber criminals who are profit motivated and who are very skilled and determined and obviously there’s a lot at stake there. All of those are very real things in the security world and things we have to defend against.

The Security track at the San Francisco conference focused primarily on risk management. How can companies better approach and manage risk?

As I mentioned, we did a lot of work over the last few years in the area of Risk Management and the FAIR Standard that we introduced breaks down risk into what’s the frequency of bad things happening and what’s the impact if they do happen? So I would suggest that taking that sort of approach, using something like taking the Risk Taxonomy Standard that we’ve introduced and the Risk Analysis Standard, and really looking at what are the critical assets to protect, who’s likely to attack them, what’s the probably frequency of attacks that we’ll see? And then looking at the impact side, what’s the consequence if somebody successfully attacks them? That’s really the key—breaking it down, looking at it that way and then taking the right mitigation steps to reduce risk on those assets that are really important.

You’ve recently become involved in The Open Group’s new Healthcare Forum. Why a healthcare vertical forum for The Open Group?

In the area of healthcare, what we see is that there’s just a highly fragmented aspect to the ecosystem. You’ve got healthcare information that’s captured in various places, and the information doesn’t necessarily flow from provider to payer to other providers. In looking at industry verticals, the healthcare industry seemed like an area that really needed a lot of approaches that we bring from The Open Group—TOGAF and Enterprise Architecture approaches that we have.

If you take it up to a higher level, it really needs the Boundaryless Information Flow that we talk about in The Open Group. We need to get to the point where our information as patients is readily available in a secure manner to the people who need to give us care, as well as to us because in a lot of cases the information exists as islands in the healthcare industry. In looking at healthcare it just seemed like a natural place where, in our economies – and it’s really a global problem – a lot of money is spent on healthcare and there’s a lot of opportunities for improvement, both in the economics but in the patient care that’s delivered to individuals through the healthcare system. It just seemed like a great area for us to focus on.

As the new Healthcare Forum kicks off this year, what are the priorities for the Forum?

The Healthcare Forum has just published a whitepaper summarizing the workshop findings for the workshop that we held in Philadelphia last summer. We’re also working on a treatise, which will outline our views about the healthcare ecosystem and where standards and architecture work is most needing to be done. We expect to have that whitepaper produced over the next couple of months. Beyond that, we see a lot of opportunities for doing architecture and standards work in the healthcare sector, and our membership is going to determine which of those areas to focus on, which projects to initiate first.

For more on the The Open Group Security Forum, please visit http://www.opengroup.org/subjectareas/security. For more on the The Open Group Healthcare Forum, see http://www.opengroup.org/getinvolved/industryverticals/healthcare.

62940-hietalaJim Hietala, CISSP, GSEC, is the Vice President, Security for The Open Group, where he manages all IT security, risk management and healthcare programs and standards activities. He participates in the SANS Analyst/Expert program and has also published numerous articles on information security, risk management, and compliance topics in publications including The ISSA Journal, Bank Accounting & Finance, Risk Factor, SC Magazine, and others.

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Filed under Cloud/SOA, Conference, Data management, Healthcare, Information security, Open FAIR Certification, Open Platform 3.0, RISK Management, TOGAF®, Uncategorized

Facing the Challenges of the Healthcare Industry – An Interview with Eric Stephens of The Open Group Healthcare Forum

By The Open Group

The Open Group launched its new Healthcare Forum at the Philadelphia conference in July 2013. The forum’s focus is on bringing Boundaryless Information Flow™ to the healthcare industry to enable data to flow more easily throughout the complete healthcare ecosystem through a standardized vocabulary and messaging. Leveraging the discipline and principles of Enterprise Architecture, including TOGAF®, the forum aims to develop standards that will result in higher quality outcomes, streamlined business practices and innovation within the industry.

At the recent San Francisco 2014 conference, Eric Stephens, Enterprise Architect at Oracle, delivered a keynote address entitled, “Enabling the Opportunity to Achieve Boundaryless Information Flow” along with Larry Schmidt, HP Fellow at Hewlett-Packard. A veteran of the healthcare industry, Stephens was Senior Director of Enterprise Architects Excellus for BlueCross BlueShield prior to joining Oracle and he is an active member of the Healthcare Forum.

We sat down after the keynote to speak with Stephens about the challenges of healthcare, how standards can help realign the industry and the goals of the forum. The opinions expressed here are Stephens’ own, not of his employer.

What are some of the challenges currently facing the healthcare industry?

There are a number of challenges, and I think when we look at it as a U.S.-centric problem, there’s a disproportionate amount of spending that’s taking place in the U.S. For example, if you look at GDP or percentage of GDP expenditures, we’re looking at now probably 18 percent of GDP [in the U.S.], and other developed countries are spending a full 5 percent less than that of their GDP, and in some cases they’re getting better outcomes outside the U.S.

The mere fact that there’s the existence of what we call “medical tourism, where if I need a hip replacement, I can get it done for a fraction of the cost in another country, same or better quality care and have a vacation—a rehab vacation—at the same time and bring along a spouse or significant other, means there’s a real wide range of disparity there. 

There’s also a lack of transparency. Having worked at an insurance company, I can tell you that with the advent of high deductible plans, there’s a need for additional cost information. When I go on Amazon or go to a local furniture store, I know what the cost is going to be for what I’m about to purchase. In the healthcare system, we don’t get that. With high deductible plans, if I’m going to be responsible for a portion or a larger portion of the fee, I want to know what it is. And what happens is, the incentives to drive costs down force the patient to be a consumer. The consumer now asks the tough questions. If my daughter’s going in for a tonsillectomy, show me a bill of materials that shows me what’s going to be done – if you are charging me $20/pill for Tylenol, I’ll bring my own. Increased transparency is what will in turn drive down the overall costs.

I think there’s one more thing, and this gets into the legal side of things. There is an exorbitant amount of legislation and regulation around what needs to be done. And because every time something goes sideways, there’s going to be a lawsuit, doctors will prescribe an extra test, and extra X-ray for a patient whether they need it or not.

The healthcare system is designed around a vicious cycle of diagnose-treat-release. It’s not incentivized to focus on prevention and management. Oregon is promoting these coordinated care organizations (CCOs) that would be this intermediary that works with all medical professionals – whether it was physical, mental, dental, even social worker – to coordinate episodes of care for patients. This drives down inappropriate utilization – for example, using an ER as a primary care facility and drives the medical system towards prevention and management of health. 

Your keynote with Larry Schmidt of HP focused a lot on cultural changes that need to take place within the healthcare industry – what are some of the changes necessary for the healthcare industry to put standards into place?

I would say culturally, it goes back to those incentives, and it goes back to introducing this idea of patient-centricity. And for the medical community, to really start recognizing that these individuals are consumers and increased choice is being introduced, just like you see in other industries. There are disruptive business models. As a for instance, medical tourism is a disruptive business model for United States-based healthcare. The idea of pharmacies introducing clinical medicine for routine care, such as what you see at a CVS, Wal-Mart or Walgreens. I can get a flu shot, I can get a well-check visit, I can get a vaccine – routine stuff that doesn’t warrant a full-blown medical professional. It’s applying the right amount of medical care to a particular situation.

Why haven’t existing standards been adopted more broadly within the industry? What will help providers be more likely to adopt standards?

I think the standards adoption is about “what’s in it for me, the WIIFM idea. It’s demonstrating to providers that utilizing standards is going to help them get out of the medical administration business and focus on their core business, the same way that any other business would want to standardize its information through integration, processes and components. It reduces your overall maintenance costs going forward and arguably you don’t need a team of billing folks sitting in an doctor’s office because you have standardized exchanges of information.

Why haven’t they been adopted? It’s still a question in my mind. Why would a doctor not want to do that is perhaps a question we’re going to need to explore as part of the Healthcare Forum.

Is it doctors that need to adopt the standards or technologies or combination of different constituents within the ecosystem?

I think it’s a combination. We hear a lot about the Affordable Care Act (ACA) and the health exchanges. What we don’t hear about is the legislation to drive toward standardization to increase interoperability. So unfortunately it would seem the financial incentives or things we’ve tried before haven’t worked, and we may simply have to resort to legislation or at least legislative incentives to make it happen because part of the funding does cover information exchanges so you can move health information between providers and other actors in the healthcare system.

You’re advocating putting the individual at the center of the healthcare ecosystem. What changes need to take place within the industry in order to do this?

I think it’s education, a lot of education that has to take place. I think that individuals via the incentive model around high deductible plans will force some of that but it’s taking responsibility and understanding the individual role in healthcare. It’s also a cultural/societal phenomenon.

I’m kind of speculating here, and going way beyond what enterprise architecture or what IT would deliver, but this is a philosophical thing around if I have an ailment, chances are there’s a pill to fix it. Look at the commercials, every ailment say hypertension, it’s easy, you just dial the medication correctly and you don’t worry as much about diet and exercise. These sorts of things – our over-reliance on medication. I’m certainly not going to knock the medications that are needed for folks that absolutely need them – but I think we can become too dependent on pharmacological solutions for our health problems.   

What responsibility will individuals then have for their healthcare? Will that also require a cultural and behavioral shift for the individual?

The individual has to start managing his or her own health. We manage our careers and families proactively. Now we need to focus on our health and not just float through the system. It may come to financial incentives for certain “individual KPIs such as blood pressure, sugar levels, or BMI. Advances in medical technology may facilitate more personal management of one’s health.

One of the Healthcare Forum’s goals is to help establish Boundaryless Information Flow within the Healthcare industry you’ve said that understanding the healthcare ecosystem will be a key component for that what does that ecosystem encompass and why is it important to know that first?

Very simply we’re talking about the member/patient/consumer, then we get into the payers, the providers, and we have to take into account government agencies and other non-medical agents, but they all have to work in concert and information needs to flow between those organizations in a very standardized way so that decisions can be made in a very timely fashion.

It can’t be bottled up, it’s got to be provided to the right provider at the right time, otherwise, best case, it’s going to cost more to manage all the actors in the system. Worst case, somebody dies or there is a “never event due to misinformation or lack of information during the course of care. The idea of Boundaryless Information Flow gives us the opportunity to standardize, have easily accessible information – and by the way secured – it can really aide in that decision-making process going forward. It’s no different than Wal-Mart knowing what kind of merchandise sells well before and after a hurricane (i.e., beer and toaster pastries, BTW). It’s the same kind of real-time information that’s made available to a Google car so it can steer its way down the road. It’s that kind of viscosity needed to make the right decisions at the right time.

Healthcare is a highly regulated industry, how can Boundarylesss Information Flow and data collection on individuals be achieved and still protect patient privacy?

We can talk about standards and the flow and the technical side. We need to focus on the security and privacy side.  And there’s going to be a legislative side because we’re going to touch on real fundamental data governance issue – who owns the patient record? Each actor in the system thinks they own the patient record. If we’re going to require more personal accountability for healthcare, then shouldn’t the consumer have more ownership? 

We also need to address privacy disclosure regulations to avoid catastrophic data leaks of protected health information (PHI). We need bright IT talent to pull off the integration we are talking about here. We also need folks who are well versed in the privacy laws and regulations. I’ve seen project teams of 200 have up to eight folks just focusing on the security and privacy considerations. We can argue about headcount later but my point is the same – one needs some focused resources around this topic.

What will standards bring to the healthcare industry that is missing now?

I think the standards, and more specifically the harmonization of the standards, is going to bring increased maintainability of solutions, I think it’s going to bring increased interoperability, I think it’s going to bring increased opportunities too. We see mobile computing or even DropBox, that has API hooks into all sorts of tools, and it’s well integrated – so I can integrate and I can move files between devices, I can move files between apps because they have hooks it’s easy to work with. So it’s building these communities of developers, apps and technical capabilities that makes it easy to move the personal health record for example, back and forth between providers and it’s not a cataclysmic event to integrate a new version of electronic health records (EHR) or to integrate the next version of an EHR. This idea of standardization but also some flexibility that goes into it.

Are you looking just at the U.S. or how do you make a standard that can go across borders and be international?

It is a concern, much of my thinking and much of what I’ve conveyed today is U.S.-centric, based on our problems, but many of these interoperability problems are international. We’re going to need to address it; I couldn’t tell you what the sequence is right now. There are other considerations, for example, single vs. multi-payer—that came up in the keynote. We tend to think that if we stay focused on the consumer/patient we’re going to get it for all constituencies. It will take time to go international with a standard, but it wouldn’t be the first time. We have a host of technical standards for the Internet (e.g., TCP/IP, HTTP). The industry has been able to instill these standards across geographies and vendors. Admittedly, the harmonization of health care-related standards will be more difficult. However, as our world shrinks with globalization an international lens will need to be applied to this challenge. 

Eric StephensEric Stephens (@EricStephens) is a member of Oracle’s executive advisory community where he focuses on advancing clients’ business initiatives leveraging the practice of Business and Enterprise Architecture. Prior to joining Oracle he was Senior Director of Enterprise Architecture at Excellus BlueCross BlueShield leading the organization with architecture design, innovation, and technology adoption capabilities within the healthcare industry.

 

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What I learnt at The Open Group Bangalore Conference last weekend

By Sreekanth Iyer, Executive IT Architect, IBM

It was quite a lot of learning on a Saturday attending The Open Group conference at Bangalore. Actually it was a two day program this year. I could not make it on Friday because of other work commitments. I heard from the people who attended that it was a great session on Friday. At least I knew about a fellow IBMer Jithesh Kozhipurath’s presentation on Friday. I’d the chance to look at that excellent material on applying TOGAF® practices for integrated IT Operations Enterprise Architecture which was his experience sharing of the lab infra optimization work that he was leading.

I started bit late on Saturday, thinking it was happening at the Leela Palace which was near to my home (Ah.. that was in 2008) Realized late that it was at the Philips Innovation Campus at Manyata. But managed to reach just on time before the start of the sessions.

The day started with an Architecture as a Service discussion. The presentation was short but there were lot of interesting questions and interactions post the session.  I was curious know more about the “self-service” aspect on that topic.

Then we had Jason Uppal of ClinicialMessage Inc. on stage (see picture below) , who gave a wonderful presentation on the human touch to the architecture and how to leverage EA to make disruptive changes without disrupting the working systems.

Jason bangaloreLots of take-aways from the session. Importantly the typical reasons why certain Architectures can fail… caused many a times we have a solution already in our mind and we are trying to fit that into the requirement. And most of these times if we look at the Requirements artifact we will be see that the problems are not rightly captured. Couldn’t agree more with the good practices that he discussed.

Starting with  “Identifying the Problem Right” – I thought that is definitely the first and important step in Architecture.  Then Jason talked about significance of communicating and engaging people and stakeholders in the architecture — point that he drove home with a good example from the health care industry. He talked about the criticality of communicating and engaging the stakeholders — engagement of course improves quality. Building the right levers in the architecture and solving the whole problem were some of the other key points that I noted down. More importantly the key message was as Architects, we have to go beyond drawing the lines and boxes to deliver the change, may be look to deliver things that can create an impact in 30 days balancing the short term and long term goals.

I got the stage for couple of minutes to update on the AEA Bangalore Chapter activities. My request to the attendees was to leverage the chapter for their own professional development – using that as a platform to share expertise, get answers to queries, connect with other professionals of similar interest and build the network. Hopefully will see more participation in the Bangalore chapter events this year.

On the security track, had multiple interesting sessions. Began with Jim Hietala of The Open Group discussing the Risk Management Framework. I’ve been attending a course on the subject. But this one provided a lot of insight on the taxonomy (O-RT) and the analysis part – more of taking a quantitative approach than a qualitative approach. Though the example was based on risks with regard to laptop thefts, there is no reason we can’t apply the principles to real issues like quantifying the threats for moving workloads to cloud. (that’s another to-do added to my list).

Then it was my session on the Best practices for moving workloads to cloud for Indian Banks. Talked about the progress so far with the whitepaper. The attendees were limited as there was Jason’s EA workshop happening in parallel. But those who attended were really interested in the subject. We did have a good discussion on the benefits, challenges and regulations with regard to the Indian Banking workloads and their movement to cloud.  We discussed few interesting case studies. There are areas that need more content and I’ve requested the people who attended the session to participate in the workgroup. We are looking at getting a first draft done in the next 30 days.

Finally, also sat in the presentation by Ajit A. Matthew on the security implementation at Intel. Everywhere the message is clear. You need to implement context based security and security intelligence to enable the new age innovation but at the same time protect your core assets.

It was a Saturday well spent. Added had some opportunities to connect with few new folks and understand their security challenges with cloud.  Looking to keep the dialog going and have an AEA Bangalore chapter event sometime during Q1. In that direction, I took the first step to write this up and share with my network.

Event Details:
The Open Group Bangalore, India
January 24-25, 2014

Sreekanth IyerSreekanth Iyer is an Executive IT Architect in IBM Security Systems CTO office and works on developing IBM’s Cloud Security Technical Strategy. He is an Open Group Certified Distinguished Architect and is a core member of the Bangalore Chapter of the Association of Enterprise Architects. He has over 18 years’ industry experience and has led several client solutions across multiple industries. His key areas of work include Information Security, Cloud Computing, SOA, Event Processing, and Business Process management. He has authored several technical articles, blogs and is a core contributor to multiple Open Group as well as IBM publications. He works out of the IBM India Software Lab Bangalore and you can follow him on Twitter @sreek.

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The Open Group London – Day Two Highlights

By Loren K. Baynes, Director, Global Marketing Communications

We eagerly jumped into the second day of our Business Transformation conference in London on Tuesday October 22nd!  The setting is the magnificent Central Hall Westminster.

Steve Nunn, COO of The Open Group and CEO of Association of Enterprise Architects (AEA), started off the morning introducing our plenary based on Healthcare Transformation.  Steve noted that the numbers in healthcare spend are huge and bringing Enterprise Architecture (EA) to healthcare will help with efficiencies.

The well-renowned Dr. Peter Sudbury, Healthcare Specialist with HP Enterprise Services, discussed the healthcare crisis (dollars, demand, demographics), the new healthcare paradigm, barriers to change and innovation. Dr. Sudbury also commented on the real drivers of healthcare costs: healthcare inflation is higher intrinsically; innovation increases cost; productivity improvements lag other industries.

IMG_sudburyDr. Peter Sudbury

Dr. Sudbury, Larry Schmidt (Chief Technologist, HP) and Roar Engen (Head of Enterprise Architecture, Helse Sør-Øst RHF, Norway) participated in the Healthcare Transformation Panel, moderated by Steve Nunn.  The group discussed opportunities for improvement by applying EA in healthcare.  They mentioned that physicians, hospitals, drug manufacturers, nutritionists, etc. should all be working together and using Boundaryless Information Flow™ to ensure data is smoothly shared across all entities.  It was also stated that TOGAF® is beneficial for efficiencies.

Following the panel, Dr. Mario Tokoro (Founder & Executive Advisor of Sony Computer Science Laboratories, Inc. Japanese Science & Technology Agency, DEOS Project Leader) reviewed the Dependability through Assuredness™ standard, a standard of The Open Group.

The conference also offered many sessions in Finance/Commerce, Government and Tutorials/Workshops.

Margaret Ford, Consult Hyperion, UK and Henk Jonkers of BIZZdesign, Netherlands discussed “From Enterprise Architecture to Cyber Security Risk Assessment”.  The key takeaways were: complex cyber security risks require systematic, model-based risk assessment; attack navigators can provide this by linking ArchiMate® to the Risk Taxonomy.

“Applying Service-Oriented Architecture within a Business Technology Environment in the Finance Sector” was presented by Gerard Peters, Managing Consultant, Capgemini, The Netherlands. This case study is part of a white paper on Service-Oriented Architecture for Business Technology (SOA4BT).

You can view all of the plenary and many of the track presentations at livestream.com.  And for those who attended, full conference proceedings will be available.

The night culminated with a spectacular experience on the London Eye, the largest Ferris wheel in Europe located on the River Thames.

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Filed under ArchiMate®, Cloud/SOA, Enterprise Architecture, Enterprise Transformation, Healthcare, Professional Development, Service Oriented Architecture, TOGAF®

Gaining Dependability Across All Business Activities Requires Standard of Standards to Tame Dynamic Complexity, Says The Open Group CEO

By Dana Gardner, Interarbor Solutions

Listen to the recorded podcast here

Hello, and welcome to a special BriefingsDirect Thought Leadership

Interview series, coming to you in conjunction with The Open Group Conference on July 15, in Philadelphia.

88104-aaadanaI’m Dana Gardner, Principal Analyst at Interarbor Solutions, your host and moderator throughout these discussions on enterprise transformation in the finance, government, and healthcare sector.

We’re here now with the President and CEO of The Open Group, Allen Brown, to explore the increasingly essential role of standards, in an undependable, unpredictable world. [Disclosure: The Open Group is a sponsor of BriefingsDirect podcasts.]

Welcome back, Allen.

Allen Brown: It’s good to be here, Dana. abrown

Gardner: What are the environmental variables that many companies are facing now as they try to improve their businesses and assess the level of risk and difficulty? It seems like so many moving targets.

 Brown: Absolutely. There are a lot of moving targets. We’re looking at a situation where organizations are having to put in increasingly complex systems. They’re expected to make them highly available, highly safe, highly secure, and to do so faster and cheaper. That’s kind of tough.

Gardner: One of the ways that organizations have been working towards a solution is to have a standardized approach, perhaps some methodologies, because if all the different elements of their business approach this in a different way, we don’t get too far too quickly, and it can actually be more expensive.

Perhaps you could paint for us the vision of an organization like The Open Group in terms of helping organizations standardize and be a little bit more thoughtful and proactive towards these changed elements?

Brown: With the vision of The Open Group, the headline is “Boundaryless Information Flow.” That was established back in 2002, at a time when organizations were breakingdown the stovepipes or the silos within and between organizations and getting people to work together across functioning. They found, having done that, or having made some progress towards that, that the applications and systems were built for those silos. So how can we provide integrated information for all those people?

As we have moved forward, those boundaryless systems have become bigger

and much more complex. Now, boundarylessness and complexity are giving everyone different types of challenges. Many of the forums or consortia that make up The Open Group are all tackling it from their own perspective, and it’s all coming together very well.

We have got something like the Future Airborne Capability Environment (FACE) Consortium, which is a managed consortium of The Open Group focused on federal aviation. In the federal aviation world they’re dealing with issues like weapons systems.

New weapons

Over time, building similar weapons is going to be more expensive, inflation happens. But the changing nature of warfare is such that you’ve then got a situation where you’ve got to produce new weapons. You have to produce them quickly and you have to produce them inexpensively.

So how can we have standards that make for more plug and play? How can the avionics within a cockpit of whatever airborne vehicle be more interchangeable, so that they can be adapted more quickly and do things faster and at lower cost.

After all, cost is a major pressure on government departments right now.

We’ve also got the challenges of the supply chain. Because of the pressure on costs, it’s critical that large, complex systems are developed using a global supply chain. It’s impossible to do it all domestically at a cost. Given that, countries around the world, including the US and China, are all concerned about what they’re putting into their complex systems that may have tainted or malicious code or counterfeit products.

The Open Group Trusted Technology Forum (OTTF) provides a standard that ensures that, at each stage along the supply chain, we know that what’s going into the products is clean, the process is clean, and what goes to the next link in the chain is clean. And we’re working on an accreditation program all along the way.

We’re also in a world, which when we mention security, everyone is concerned about being attacked, whether it’s cybersecurity or other areas of security, and we’ve got to concern ourselves with all of those as we go along the way.

Our Security Forum is looking at how we build those things out. The big thing about large, complex systems is that they’re large and complex. If something goes wrong, how can you fix it in a prescribed time scale? How can you establish what went wrong quickly and how can you address it quickly?

If you’ve got large, complex systems that fail, it can mean human life, as it did with the BP oil disaster at Deepwater Horizon or with Space Shuttle Challenger. Or it could be financial. In many organizations, when something goes wrong, you end up giving away service.

An example that we might use is at a railway station where, if the barriers don’t work, the only solution may be to open them up and give free access. That could be expensive. And you can use that analogy for many other industries, but how can we avoid that human or financial cost in any of those things?

A couple of years after the Space Shuttle Challenger disaster, a number of criteria were laid down for making sure you had dependable systems, you could assess risk, and you could know that you would mitigate against it.

What The Open Group members are doing is looking at how you can get dependability and assuredness through different systems. Our Security Forum has done a couple of standards that have got a real bearing on this. One is called Dependency Modeling, and you can model out all of the dependencies that you have in any system.

Simple analogy

A very simple analogy is that if you are going on a road trip in a car, you’ve got to have a competent driver, have enough gas in the tank, know where you’re going, have a map, all of those things.

What can go wrong? You can assess the risks. You may run out of gas or you may not know where you’re going, but you can mitigate those risks, and you can also assign accountability. If the gas gauge is going down, it’s the driver’s accountability to check the gauge and make sure that more gas is put in.

We’re trying to get that same sort of thinking through to these large complex systems. What you’re looking at doing, as you develop or evolve large, complex systems, is to build in this accountability and build in understanding of the dependencies, understanding of the assurance cases that you need, and having these ways of identifying anomalies early, preventing anything from failing. If it does fail, you want to minimize the stoppage and, at the same time, minimize the cost and the impact, and more importantly, making sure that that failure never happens again in that system.

The Security Forum has done the Dependency Modeling standard. They have also provided us with the Risk Taxonomy. That’s a separate standard that helps us analyze risk and go through all of the different areas of risk.

Now, the Real-time & Embedded Systems Forum has produced the Dependability through Assuredness, a standard of The Open Group, that brings all of these things together. We’ve had a wonderful international endeavor on this, bringing a lot of work from Japan, working with the folks in the US and other parts of the world. It’s been a unique activity.

Dependability through Assuredness depends upon having two interlocked cycles. The first is a Change Management Cycle that says that, as you look at requirements, you build out the dependencies, you build out the assurance cases for those dependencies, and you update the architecture. Everything has to start with architecture now.

You build in accountability, and accountability, importantly, has to be accepted. You can’t just dictate that someone is accountable. You have to have a negotiation. Then, through ordinary operation, you assess whether there are anomalies that can be detected and fix those anomalies by new requirements that lead to new dependabilities, new assurance cases, new architecture and so on.

The other cycle that’s critical in this, though, is the Failure Response Cycle. If there is a perceived failure or an actual failure, there is understanding of the cause, prevention of it ever happening again, and repair. That goes through the Change Accommodation Cycle as well, to make sure that we update the requirements, the assurance cases, the dependability, the architecture, and the accountability.

So the plan is that with a dependable system through that assuredness, we can manage these large, complex systems much more easily.

Gardner: Allen, many of The Open Group activities have been focused at the enterprise architect or business architect levels. Also with these risk and security issues, you’re focusing at chief information security officers or governance, risk, and compliance (GRC), officials or administrators. It sounds as if the Dependability through Assuredness standard shoots a little higher. Is this something a board-level mentality or leadership should be thinking about, and is this something that reports to them?

Board-level issue

Brown: In an organization, risk is a board-level issue, security has become a board-level issue, and so has organization design and architecture. They’re all up at that level. It’s a matter of the fiscal responsibility of the board to make sure that the organization is sustainable, and to make sure that they’ve taken the right actions to protect their organization in the future, in the event of an attack or a failure in their activities.

The risks to an organization are financial and reputation, and those risks can be very real. So, yes, they should be up there. Interestingly, when we’re looking at areas like business architecture, sometimes that might be part of the IT function, but very often now we’re seeing as reporting through the business lines. Even in governments around the world, the business architects are very often reporting up to business heads.

Gardner: Here in Philadelphia, you’re focused on some industry verticals, finance, government, health. We had a very interesting presentation this morning by Dr. David Nash, who is the Dean of the Jefferson School of Population Health, and he had some very interesting insights about what’s going on in the United States vis-à-vis public policy and healthcare.

One of the things that jumped out at me was, at the end of his presentation, he was saying how important it was to have behavior modification as an element of not only individuals taking better care of themselves, but also how hospitals, providers, and even payers relate across those boundaries of their organization.

That brings me back to this notion that these standards are very powerful and useful, but without getting people to change, they don’t have the impact that they should. So is there an element that you’ve learned and that perhaps we can borrow from Dr. Nash in terms of applying methods that actually provoke change, rather than react to change?

Brown: Yes, change is a challenge for many people. Getting people to change is like taking a horse to water, but will it drink? We’ve got to find methods of doing that.

One of the things about The Open Group standards is that they’re pragmatic and practical standards. We’ve seen’ in many of our standards’ that where they apply to product or service, there is a procurement pull through. So the FACE Consortium, for example, a $30 billion procurement means that this is real and true.

In the case of healthcare, Dr. Nash was talking about the need for boundaryless information sharing across the organizations. This is a major change and it’s a change to the culture of the organizations that are involved. It’s also a change to the consumer, the patient, and the patient advocates.

All of those will change over time. Some of that will be social change, where the change is expected and it’s a social norm. Some of that change will change as people and generations develop. The younger generations are more comfortable with authority that they perceive with the healthcare professionals, and also of modifying the behavior of the professionals.

The great thing about the healthcare service very often is that we have professionals who want to do a number of things. They want to improve the lives of their patients, and they also want to be able to do more with less.

Already a need

There’s already a need. If you want to make any change, you have to create a need, but in healthcare, there is already a pent-up need that people see that they want to change. We can provide them with the tools and the standards that enable it to do that, and standards are critically important, because you are using the same language across everyone.

It’s much easier for people to apply the same standards if they are using the same language, and you get a multiplier effect on the rate of change that you can achieve by using those standards. But I believe that there is this pent-up demand. The need for change is there. If we can provide them with the appropriate usable standards, they will benefit more rapidly.

Gardner: Of course, measuring the progress with the standards approach helps as well. We can determine where we are along the path as either improvements are happening or not happening. It gives you a common way of measuring.

The other thing that was fascinating to me with Dr. Nash’s discussion was that he was almost imploring the IT people in the crowd to come to the rescue. He’s looking for a cavalry and he’d really seemed to feel that IT, the data, the applications, the sharing, the collaboration, and what can happen across various networks, all need to be brought into this.

How do we bring these worlds together? There is this policy, healthcare and population statisticians are doing great academic work, and then there is the whole IT world. Is this something that The Open Group can do — bridge these large, seemingly unrelated worlds?

Brown: At the moment, we have the capability of providing the tools for them to do that and the processes for them to do that. Healthcare is a very complex world with the administrators and the healthcare professionals. You have different grades of those in different places. Each department and each organization has its different culture, and bringing them together is a significant challenge.

In some of that processes, certainly, you start with understanding what it is you’re trying to address. You start with what are the pain points, what are the challenges, what are the blockages, and how can we overcome those blockages? It’s a way of bringing people together in workshops. TOGAF, a standard of The Open Group, has the business scenario method, bringing people together, building business scenarios, and understanding what people’s pain points are.

As long as we can then follow through with the solutions and not disappoint people, there is the opportunity for doing that. The reality is that you have to do that in small areas at a time. We’re not going to take the entire population of the United States and get everyone in the workshop and work altogether.

But you can start in pockets and then generate evangelists, proof points, and successful case studies. The work will then start emanating out to all other areas.

Gardner: It seems too that, with a heightened focus on vertical industries, there are lessons that could be learned in one vertical industry and perhaps applied to another. That also came out in some of the discussions around big data here at the conference.

The financial industry recognized the crucial role that data plays, made investments, and brought the constituencies of domain expertise in finance with the IT domain expertise in data and analysis, and came up with some very impressive results.

Do you see that what has been the case in something like finance is now making its way to healthcare? Is this an enterprise or business architect role that opens up more opportunity for those individuals as business and/or enterprise architects in healthcare? Why don’t we see more enterprise architects in healthcare?

Good folks

Brown: I don’t know. We haven’t run the numbers to see how many there are. There are some very competent enterprise architects within the healthcare industry around the world. We’ve got some good folks there.

The focus of The Open Group for the last couple of decades or so has always been on horizontal standards, standards that are applicable to any industry. Our focus is always about pragmatic standards that can be implemented and touched and felt by end-user consumer organizations.

Now, we’re seeing how we can make those even more pragmatic and relevant by addressing the verticals, but we’re not going to lose the horizontal focus. We’ll be looking at what lessons can be learned and what we can build on. Big data is a great example of the fact that the same kind of approach of gathering the data from different sources, whatever that is, and for mixing it up and being able to analyze it, can be applied anywhere.

The challenge with that, of course, is being able to capture it, store it, analyze it, and make some sense of it. You need the resources, the storage, and the capability of actually doing that. It’s not just a case of, “I’ll go and get some big data today.”

I do believe that there are lessons learned that we can move from one industry to another. I also believe that, since some geographic areas and some countries are ahead of others, there’s also a cascading of knowledge and capability around the world in a given time scale as well.

Gardner: Well great. I’m afraid we’ll have to leave it there. We’ve been talking about the increasingly essential role of standards in a complex world, where risk and dependability become even more essential. We have seen how The Open Group is evolving to meet these challenges through many of its activities and through many of the discussions here at the conference.

Please join me now in thanking our guest, Allen Brown, President and CEO of The Open Group. Thank you.

Brown: Thanks for taking the time to talk to us, Dana.

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The Open Group Philadelphia – Day Two Highlights

By Loren K. Baynes, Director, Global Marketing Communications at The Open Group.

philly 2.jpgDay 2 at The Open Group conference in the City of Brotherly Love, as Philadelphia is also known, was another busy and remarkable day.

The plenary started with a fascinating presentation, “Managing the Health of the Nation” by David Nash, MD, MBA, Dean of Jefferson School of Population Health.  Healthcare is the number one industry in the city of Philadelphia, with the highest number of patients in beds in the top 10 US cities. The key theme of his thought-provoking speech was “boundaryless information sharing” (sound familiar?), which will enable a healthcare system that is “safe, effective, patient-centered, timely, equitable, efficient”.

Following Dr. Nash’s presentation was the Healthcare Transformation Panel moderated by Allen Brown, CEO of The Open Group.  Participants were:  Gina Uppal (Fulbright-Killam Fellow, American University Program), Mike Lambert (Open Group Fellow, Architecting the Enterprise), Rosemary Kennedy (Associate Professor, Thomas Jefferson University), Blaine Warkentine, MD, MPH and Fran Charney (Pennsylvania Patient Safety Authority). The group brought different sets of experiences within the healthcare system and provided reaction to Dr. Nash’s speech.  All agree on the need for fundamental change and that technology will be key.

The conference featured a spotlight on The Open Group’s newest forum, Open Platform 3.0™ by Dr. Chris Harding, Director of Interoperability.  Open Platform 3.0 was formed to advance The Open Group vision of Boundaryless Information Flow™ to help enterprises in the use of Cloud, Social, Mobile Computing and Big Data.  For more info; http://www.opengroup.org/getinvolved/forums/platform3.0

The Open Group flourishes because of people interaction and collaboration.  The accolades continued with several members being recognized for their outstanding contributions to The Open Group Trusted Technology Forum (OTTF) and the Service-Oriented Architecture (SOA) and Cloud Computing Work Groups.  To learn more about our Forums and Work Groups and how to get involved, please visit http://www.opengroup.org/getinvolved

Presentations and workshops were also held in the Healthcare, Finance and Government vertical industries. Presenters included Larry Schmidt (Chief Technologist, HP), Rajamanicka Ponmudi (IT Architect, IBM) and Robert Weisman (CEO, Build the Vision, Inc.).

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The Open Group Philadelphia – Day One Highlights

By Loren K.  Baynes, Director, Global Marketing Communications at The Open Group.

PhillyOn Monday, July 15th, we kicked off our conference in Philadelphia. As Allen Brown, CEO of The Open Group, commented in his opening remarks, Philadelphia is the birthplace of American democracy.  This is the first time The Open Group has hosted a conference in this historical city.

Today’s plenary sessions featured keynote speakers covering topics ranging from an announcement of a new Open Group standard, appointment of a new Fellow, Enterprise Architecture and Transformation, Big Data and spotlights on The Open Group forums, Real-time Embedded Systems and Open Trusted Technology, as well as a new initiative on Healthcare.

Allen Brown noted that The Open Group has 432 member organizations with headquarters in 32 countries and over 40,000 individual members in 126 countries.

The Open Group Vision is Boundaryless Information Flow™ achieved through global interoperability in a secure, reliable and timely manner.  But as stated by Allen, “Boundaryless does not mean there are no boundaries.  It means that boundaries are permeable to enable business”

Allen also presented an overview of the new “Dependability Through Assuredness™ Standard.  The Open Group Real-time Embedded Systems Forum is the home of this standard. More news to come!

Allen introduced Dr. Mario Tokoro, (CEO of Sony Computer Systems Laboratories) who began this project in 2006. Dr. Tokoro stated, “Thank you from the bottom of my heart for understanding the need for this standard.”

Eric Sweden, MSIH MBA, Program Director, Enterprise Architecture & Governance\National Association of State CIOs (NASCIO) offered a presentation entitled “State of the States – NASCIO on Enterprise Architecture: An Emphasis on Cross-Jurisdictional Collaboration across States”.  Eric noted “Enterprise Architecture is a blueprint for better government.” Furthermore, “Cybersecurity is a top priority for government”.

Dr. Michael Cavaretta, Technical Lead and Data Scientist with Ford Motor Company discussed “The Impact of Big Data on the Enterprise”.  The five keys, according to Dr. Cavaretta, are “perform, analyze, assess, track and monitor”.  Please see the following transcript from a Big Data analytics podcast, hosted by The Open Group, Dr. Cavaretta participated in earlier this year. http://blog.opengroup.org/2013/01/28/the-open-group-conference-plenary-speaker-sees-big-data-analytics-as-a-way-to-bolster-quality-manufacturing-and-business-processes/

The final presentation during Monday morning’s plenary was “Enabling Transformation Through Architecture” by Lori Summers (Director of Technology) and Amit Mayabhate (Business Architect Manager) with Fannie Mae Multifamily.

Lori stated that their organization had adopted Business Architecture and today they have an integrated team who will complete the transformation, realize value delivery and achieve their goals.

Amit noted “Traceability from the business to architecture principles was key to our design.”

In addition to the many interesting and engaging presentations, several awards were presented.  Joe Bergmann, Director, Real-time and Embedded Systems Forum, The Open Group, was appointed Fellow by Allen Brown in recognition of Joe’s major achievements over the past 20+ years with The Open Group.

Other special recognition recipients include members from Oracle, IBM, HP and Red Hat.

In addition to the plenary session, we hosted meetings on Finance, Government and Healthcare industry verticals. Today is only Day One of The Open Group conference in Philadelphia. Please stay tuned for more exciting conference highlights over the next couple days.

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