Health and Medical
Practice Insurance Pte Ltd
Sharing of MOHH Approach to EA
Dang Minh Duc
First Up, Organization Context - Singapore …
Confidential to MOH Holdings Pte Ltd.
2
The Healthcare Services
Primary Care
Acute &
Intermediate Care
Long-Term Care
Community
Hospital
Nursing Home
Polyclinics
Palliative
Care
Restructured
Hospital
Screening &
Preventation
General
Practitioners
Home Care
Rehab &
Support
Services
Public sector
Private sector
Confidential to MOH Holdings Pte Ltd.
People sector
3
At The 30,000 Feet…
CH
NH
Polyclinics
Screening &
Prevention
Palliative
Care
RH
Home
Care
FPs
Rehab &
support
services
CH
CH
NH
Polyclinics
Screening &
Prevention
RH
Home
Care
FPs
CH
NH
Polyclinics
Screening &
Prevention
Palliative
Care
RH
Rehab &
support
services
RH
Palliative
Care
Home
Care
FPs
Rehab &
support
services
Polyclinics
NH
Polyclinics
NH
General
Practitioners
Screening &
Prevention
Palliative
Care
Home
Care
Rehab &
support
services
CH
CH
Polyclinics
RH
FPs
Rehab &
support
services
Screening &
Prevention
Screening &
Prevention
Home
Care
FPs
NH
Polyclinics
Palliative
Care
Palliative
Care
RH
Home
Care
FPs
Rehab &
support
services
Community
Hospital
Confidential to MOH Holdings Pte Ltd.
Nursing
Home
4
Fun & Challenges For EA
Chain of 9
polyclinics
Chain of 9
polyclinics
Confidential to MOH Holdings Pte Ltd.
5
Organization Structure
Health Eco System
Confidential to MOH Holdings Pte Ltd.
6
Driving An Ambitious National IT Strategy
Goal
Outcomes
To accelerate sectoral transformation through an Infocomm-enabled
personalised healthcare delivery system to achieve high quality clinical care,
service excellence, cost-effectiveness and strong clinical research
Well-Integrated
Quality
Healthcare
Cost-effective
Healthcare
Services
Strategic
Thrusts
Enable integrated healthcare services
Strategies
Health Information
Exchange - e-Enable
seamless and secured
information exchange in
the healthcare value
chain
Greater ability of
public to manage
their health
Enable integration between
healthcare and advances in
biomedical science
Integrated Healthcare
Continuum - e-Enable
processes and linkages
across the healthcare
value chain
Confidential to MOH Holdings Pte Ltd.
Strong clinical
and health
services research
Translating Biomedical
Research to Healthcare
Delivery - integrate
clinical and biomedical
research data
7
At MOHH, The Alternative paths for Architecture
?
Confidential to MOH Holdings Pte Ltd.
8
Reflecting back…
Gartner Research, 10 Feb, 2010
Case Study: Understanding the Impact of Emergent Strategy on Enterprise Architecture
Confidential to MOH Holdings Pte Ltd.
9
Enterprise Architecture – Value Approach
Confidential to MOH Holdings Pte Ltd.
10
And Some of The Architecture Work
3Q
‘08
4Q
’08
1Q
’09
2Q
’09
3Q
’09
4Q
’09
1Q
’10
Value
NEHRA
From
Strategy to
Program
focus
NEHR
NEHR POC
NHISA
NEHR RFP
2Q
‘10
4Q
’10
1Q
’11
2Q
’11
3Q
’11
4Q
’11
NEHR
detailed
design
Value
Design
Assurance
NHIS
Scoping
Value
3Q
‘10
ESB
From problem to
innovation:
Deep dive into a
tricky problem space
& take opportunity to
innovate.
Repository
Value
Data/Doc
Service Catalog
IIA
CIC & PHM
Interop Specs
Extending to new
Business Areas
CIC & PHM
Architecture
Confidential to MOH Holdings Pte Ltd.
11
Developing The Maturity Model to Assess The current state of CIC /
PHM
iN2015 Strategic Framework
From iN2015 Healthcare and
Biomedical Sciences Report
Goal
Outcomes
Strategic
Thrusts
Strategies
… suggests a journey
summarised by …
To accelerate sectoral transformation through an
Infocomm-enabled personalised healthcare delivery
system to achieve high quality clinical care, service
excellence, cost-effectiveness and strong clinical
research
WellIntegrated
Quality
Healthcare
Costeffective
Healthcare
Services
Enable integrated
healthcare services
Health
Information
Exchange - eEnable seamless
and secured
information
exchange in the
healthcare value
chain
Booz & Company
DATE
Greater
ability of
public to
manage
their health
Strong
clinical and
health
services
research
Enable integration
between healthcare and
advances in biomedical
science
Integrated
Healthcare
Continuum - eEnable
processes and
linkages across
the healthcare
value chain
Translating
Biomedical
Research to
Healthcare
Delivery integrate clinical
and biomedical
research data
Optimized
• Visibility of supply, demand, costs
and care pathways
• Well populated clinical database
• Patients have visibility of their health
journey and available options
Integrated
• Manage ‘cases’ across care settings
using defined care pathways
• Enable interconnection of clinicians,
carers and patients in support of
integrated care
• Shared use of common services and
effective right-siting
Connected
• Connection of core health systems
to support electronic transactions
initiated across settings
• For example - PHR / NEHR for
access to an individuals common
health record, eReferrals, or ePrescriptions
Adopted
12
Integrated and Self Managed
Care Maturity Model
• Adoption of Health Infocomm
technologies across all care settings
• System adopted are core health
systems such as EMR, NEHR, PAS,
RADT, PHR
A current State Assessment
Assessment on the functionality provided and coverage within and across care settings
Integrated and
Self Managed
Care Maturity
Model
Personal
Health
Management
Promotion
Prevention
&
Protection
Family
Physician
Polyclinics
Community
Hospitals
Rehab &
Support
Services
Nursing
Homes
Palliative
Care
Home
Care
Optimized
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
AIC Web /
AIC 2.0
Integrated
• Limited Connectivity
today esp. in ILTC
• Significant
dependency on NEHR,
but not all interfaces
planned in P1
Connected
PHR Plan
NEHR I/F,
PHR
CLEO NEHR
I/F,PHR
NEHR
I/F,PHR
CHIC NEHR
I/F
Adopted
PHR
Established
Fully mature capabilities
Screening
systems
CLEO
platform
Well developed capabilities with minor gaps
Limited capabilities, substantial gaps
Undeveloped capabilities
Booz & Company
DATE
Existing base CHIC Platform
Developed capabilities with some gaps
Committed Projects
13
• AIC 2.0 plan to be
agreed and fleshed
out
• Limited data available
today
• Connectivity &
integration are key
prerequisites
• NEHR
P1 omits
Referrals and Care
Plans
• No Common Services
Local
IngoT roll out
starting
IngoT
IngoT
• CLEO scope only 50
GPs in P1
• Gaps in Nursing
Homes and Rehab &
Support
Current State includes the committed projects CLEO, CHIC, NEHR
Extending The Business Capability Map
Confidential to MOH Holdings Pte Ltd.
14
Extending The Architecture Framework
Confidential to MOH Holdings Pte Ltd.
15
Updating The Information Exchange Requirements
Updating The Info Exchanges Access Patterns
Confidential to MOH Holdings Pte Ltd.
17
Benefits From Earlier Works.
e.g.
Integration
Services
Infrastructure
Security
Administration
Interoperability Specifications
Interoperability Specifications
– Understand EHR information in a
consistent manner.
Integration Services
– Reuses & Refine capabilities EHR needs
to provide
Security
– Apply information classification and ensure
and conformance
Administration
– Adapts/adopts administration and
operations
Our Building Blocks Through Opportunities
“Operationalise” the EA practice
3Q
‘08
4Q
’08
1Q
’09
2Q
’09
3Q
’09
4Q
’09
1Q
’10
2Q
‘10
Value
NEHRA
From
Strategy to
Program
focus
NEHR
NEHR POC
NHISA
NEHR RFP
4Q
’10
1Q
’11
2Q
’11
3Q
’11
4Q
’11
NEHR
detailed
design
Value
Design
Assurance
NHIS
Scoping
Value
3Q
‘10
ESB
From problem to
innovation:
Deep dive into a
tricky problem space
& take opportunity to
innovate.
Repository
Value
Data/Doc
Service Catalog
IIA
Extending to new
Business Areas
CIC & PHM
EA Ops &
Gov
Interop Specs
Implementing operation &
governance only when
needed.
Tooling: EA
Repository
CIC & PHM
Architecture
Content
population
Confidential to MOH Holdings Pte Ltd.
Gov & Operation
20
Collaborative EA Governance
Implementation
Projects
ARB
5
Senior Management Stewardship
Architecture & Solution
Governace
Architecture Office
3
Principal
Enterprise
Architect
Architecture
Change
Management
EA –Project
Engagement
(Interaction
Points)
Inception
Elaboration
Simplified
Interaction
2
Realization
1
Guidance
4
Architects
(Enterprise & Domain)
7
An Accessible
Reference Library
EA Repository & Content Mgmt System
Processes
Architecture &
Solutions Blocks
Architecture
Decisions
Current state of
application
IT Roadmap
6
Confidential to MOH Holdings Pte Ltd.
21
Processes, Tool & Repository
1
4
Demand Log
Arch Repository
Arch Position Log
Artefact Master File
2
3
Confidential to MOH Holdings Pte Ltd.
22
EA Repository Meta Model
Architecture Principles, Vision & Requirements
D Architecture
Principles
D
D
Architecture Requirements Repository
Requirements | Constraints | Assumptions | Gaps
Business Architecture
Architecture Vision
Business strategy | Business Principles Objectives & Drivers | Stakeholders | Technology Strategy
Application Architecture
D
Data Architecture
Technology Architecture
Alfabet Content Meta Model
A
Enterprise’s Architecture landscape (Baseline and to-be)
supported Business Domains/Organizations (Business Support) - which IT systems provides which Capabilities to which Organizations.
A
Program/Project’s Architecture landscape (Implementation Programs/projects )
View of affected Architecture components and/or architecture Components dependencies/overlap
A
A
Organization
A
Application
A Application
Capability
A Component
A
Releases
A Process*
A
Glossary
D Architecture
Decision Log
D
D
Standard
Components
A Business
Services
Data (Physical)
A Standard
Information Flow
Other References
Processes
Architecture
Position Statement
A Components /
Object (LIM)
Platform
A
(Attachment)
A Business
Module
D
Staff
Contact list
D Deliverable's
D
PARCI
D
Toolkits
Specifications?
A
A
Adapted from TOGAF 9
Confidential to MOH Holdings Pte Ltd.
Managed in
Alfabet repository
D
Managed in a
Directory repository
23
Overview of EA Repository’s Meta Model
What’s Cooking…
3Q
‘08
4Q
’08
1Q
’09
2Q
’09
3Q
’09
4Q
’09
1Q
’10
2Q
‘10
Value
NEHRA
From
Strategy to
Program
focus
NEHR
NEHR POC
NHISA
NEHR RFP
4Q
’10
1Q
’11
2Q
’11
3Q
’11
4Q
’11
NEHR
detailed
design
Value
Design
Assurance
NHIS
Scoping
Value
3Q
‘10
ESB
From problem to
innovation:
Deep dive into a
tricky problem space
& take opportunity to
innovate.
Repository
Value
NEHRA next
iteration
Data/Doc
Service Catalog
IIA
Extending to new
Business Areas
CIC & PHM
EA Ops &
Gov
Interop Specs
Implementing operation &
governance only when
needed.
Tooling: EA
Repository
CIC & PHM
Architecture
Content
population
Confidential to MOH Holdings Pte Ltd.
Gov & Operation
25
NEHR Architecture Refresh Approach
Gap analysis of current NEHR system
Gap analysis
of current
NEHR
system
Items from
current target
architecture
Integration
analysis of
current
systems
New business
services and
applications
Options analysis
Goal state architecture
List all application architecture components
from original requirements (baseline business
architecture)
Are there any
components that
were not delivered
as planned?
What does feedback
from early use say
about success of any
services?
Are there any nonfunctional issues to
address that could
affect technology
architecture
NEHR Architecture Refresh Approach
Gap analysis
of current
NEHR
system
Integration
analysis of
current
systems
Gap analysis of current NEHR system
Items from
current target
architecture
New business
services and
applications
Options analysis
Goal state architecture
Assess each artefact from the goal state
Are there any
artefact types
/ views
missing?
What else
does TOGAF
suggest?
Are there any
redundant
views?
Can the
presentation
approach be
improved?
What would
be the next
level of
detail?
NEHR Architecture Refresh Approach
Integration analysis of current systems
Gap analysis
of current
NEHR
system
Items from
current target
architecture
Integration
analysis of
current
systems
New business
services and
applications
Options analysis
Goal state architecture
List all current systems and interfaces
Assess success
of any phase 1
integration
Review current
interface list
from MOHH
Any inputs from
business
architecture
work?
Select any
appropriate
next phase
improvements
Are there any
potential
improvements
to the way data
is shared?
Select best
integration
technology.
NEHR Architecture Refresh Approach
New business services and applications
Gap analysis
of current
NEHR
system
Items from
current target
architecture
Integration
analysis of
current
systems
New business
services and
applications
Options analysis
Goal state architecture
List all potential new services and applications
(from workshops and consultations)
Are there any
new
requirements
from clinical
community?
What new
technologies are
achievable now
that were not in
2009?
Input from phase
1 results
Select any
appropriate next
phase
improvements
Do these align to
MOHH business
drivers?
Any missing
‘services’ now
recognised as
required?
Solidifying EA Process
1
4
Demand Log
Arch Repository
Arch Position Log
Artefact Master File
2
3
Confidential to MOH Holdings Pte Ltd.
30
Health and Medical
Practice Insurance Pte Ltd
Thank you