Healthcare Services Industry Business Reference Architecture

Business Capability Maps, Value Streams, and Strategy Maps for the Healthcare Services Industry

Analyst Perspective

In the age of disruption, IT must end misalignment & enable value realization.

An industry business reference architecture helps accelerate your strategy design process and enhances IT’s ability to align people, process, and technology with key business priorities.

Healthcare service providers require a unified and validated view of their business capabilities that aligns initiatives, investments, and strategy in order to provide value to their clients and stakeholders.

Healthcare Services represents a diverse group of outpatient healthcare service provision organizations including primary care, mental health providers, diagnostic service providers, and home health care. Regionalization of services is changing the nature of healthcare service delivery in many areas. There is an opportunity for increased use of technology to improve patient care.

Healthcare Services budgets are under constant strain due to pressures from government budgets, insurers, and staff costs.

The technical environment supporting healthcare service provision is rapidly changing with myriad new solutions and platforms with both patient-centric and practitioner-centric views.

Jennifer Jones Research Director, Healthcare Info-Tech Research Group

Executive Summary

Info-Tech Insight

Using an industry-specific reference architecture is central and has many benefits to organizational priorities. It's critical not only to understanding, modeling, and communicating the operating environment and the direction of the organization, but also, more significantly, to enabling measurable top-line organizational outcomes and the unlocking of direct value.

Reference Architecture Framework

Overarching Insight Using an industry-specific reference architecture is central and has many benefits to organizational priorities. It's critical to understanding, modeling, and communicating the operating environment and the direction of the enterprise, and more significantly, to enabling measurable top-line business outcomes and the unlocking of direct value. Determine your organizational priority. Many organizational priorities are dependent on an understanding of how the organization creates value and the organization's capabilities and processes. Examine organizational opportunities through the lens of business, information/data, applications & technology. Your understanding of your organization's business capabilities, processes (rules & logic), information/data, and architecture will identify organizational opportunities to create value through reduced costs or increased revenues and services. Follow Info-Tech's methodology to enable organizational outcomes and unlock direct value. Your approach indicates the scope of your modernization initiatives. Build your organization's capability map by defining the organization's value stream and validating the industry reference architecture. USe business capabilities to define strategic focus by defining the organization's key capabilities and developing a prioritized strategy map. Assess key capabilities for planning priorities through a review of business processess, information, applications, and technology support of key capabilities. Sustain capability-based strategy planning through ongoing identification and roadmapping of capability gaps.

Patient Value Realization

Patient value defines the success criteria of an organization as manifested through organizational goals and outcomes, and it is interpreted from four perspectives: Patient care: Positive patient care is generated from mature capabilities that are enabled with modern technologies. Cost reduction: Mature capabilities are enabled through well-supported modern technologies. Service enablement: The productivity and efficiency gains of internal operations from products and capabilities enhanced with modern technologies. Patient care and market reach: The improved reach and insights of the organization in existing or new markets.

Patient Value Matrix

Value, goals, and outcomes cannot be achieved without business capabilities

Break down your business goals into strategic and achievable initiatives focused on specific value streams and business capabilities.

Healthcare services business capability map

Business capability map defined…

In business architecture, the primary view of an organization is known as a business capability map.

A business capability defines what a business does to enable value creation, rather than how. Business capabilities:

• Represent stable business functions.
• Are unique and independent of each other.
• Typically will have a defined business outcome.

A business capability map provides details that help the business architecture practitioner direct attention to a specific area of the business for further assessment.

Glossary of Key Concepts

A business reference architecture consists of a set of models to provide clarity and actionable insight and value. Typical techniques and terms used in developing these models are:

Tools and templates to compile and communicate your reference architecture work

The Healthcare Services Industry Business Reference Architecture Template is a place for you to collect all of the activity outputs and outcomes you’ve completed for use in next steps. Download the Healthcare Services Industry Business Reference Architecture Template

Info-Tech’s methodology for Reference Architecture

Info-Tech offers various levels of support to best suit your needs

Diagnostics and consistent frameworks used throughout all four options

Guided Implementation

A Guided Implementation (GI) is a series of calls with an Info-Tech analyst to help implement our best practices in your organization.

A typical GI is between 6 to 9 calls over the course of 1 to 4 months.

What does a typical GI on this topic look like?

Healthcare Service Industry Business Reference Architecture

Phase 1

Build your organization’s capability map

This phase will walk you through the following activities:

• Identify and assemble key stakeholders
• Determine how the organization creates value
• Define and validate value streams
• Determine which business capabilities support value streams
• Accelerate the process with an industry reference architecture
• Validate the business capability map
• Establish Level 2 capability decomposition priorities
• Decompose Level 2 capabilities

This phase involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Step 1.1

Define the Organization’s Value Stream

Activities

• 1.1.1 Identify and assemble key stakeholders
• 1.1.2 Determine how the organization creates value
• 1.1.3 Define and validate value streams

This step involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Outcomes of this step

• Defined and validated value streams specific to your organization

1.1.1 Identify and assemble key stakeholders

Input: List of who is accountable for key business areas and decisions, Organizational chart, List of who has decision-making authority

Output: A list of the key stakeholders, Prioritized list of decision-making support needs, Reference Architecture Template

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Department Executives and Senior Managers

Build an accurate depiction of the business.

1. It is important to make sure the right stakeholders participate in this exercise. The exercise of identifying capabilities for an organization is very introspective and requires deep analysis.
2. Consider:
   1. Who are the decision makers and key influencers?
   2. Who will impact the business capability work? Who has a vested interest in the success or failure of the outcome?
   3. Who has the skills and competencies necessary to help you be successful?
3. Avoid:
   1. Don’t focus on the organizational structure and hierarchy. Often stakeholder groups don’t fit the traditional structure.
   2. Don’t ignore subject-matter experts on either the business or IT side. You will need to consider both.

Download the Reference Architecture Template

Define the organization’s value streams

• Value streams connect business goals to the organization’s value realization activities. They enable an organization to create and capture value in the market place by engaging in a set of interconnected activities. Those activities are dependent on the specific industry segment an organization operates within. Value streams can extend beyond the organization into the supporting ecosystem, whereas business processes are contained within and the organization has complete control over them.
• There are two types of value streams: core value streams and support value streams. Core value streams are mostly externally facing: they deliver value to either an external or internal customer and they tie to the customer perspective of the strategy map. Support value streams are internally facing and provide the foundational support for an organization to operate.
• An effective method for ensuring all value streams have been considered is to understand that there can be different end-value receivers. Info-Tech recommends identifying and organizing the value streams with customers and partners as end-value receivers.

Value stream descriptions for Healthcare Services

Determine how the organization creates value

1.1.2 Determine how the organization creates value

The first step of delivering value is defining how it will happen.

1. Use the organization’s industry segment to start a discussion on how value is created for customers. Working back from the moment value is realized by the customer, consider the sequential steps required to deliver value in your industry segment.
2. Consider:
   1. Who are your customers?
   2. What tasks are your customers looking to accomplish?
   3. How does your organization’s set of products and services help customers accomplish that?
   4. What are the benefits the organization delivers to customers?
3. Avoid:
   1. Don't boil the ocean. Focus on your industry segment and how you deliver value to your partners and customers specifically.

Download the Reference Architecture Template

1.1.2 Determine how the organization creates value

1.1.3 Define and validate value streams

Input: Business strategy, Info-Tech’s industry-specific reference architecture accelerator

Output: List of organizational specific value streams, Detailed value stream definition(s)

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Department Executive and Senior Managers

Unify the organization’s perspective on how it creates value.

1. Write a short description of the value stream that includes a statement about the value provided and a clear start and end for the value stream. Validate the accuracy of the descriptions with your key stakeholders.
2. Consider:
   1. How does the organization deliver benefits?
   2. How does the customer receive the benefits?
   3. What is the scope of your value stream? What will trigger the stream to start and what will the final value be?
3. Avoid:
   1. Don’t start with a blank page. Use Info-Tech’s value stream definitions on the previous slide as a starting point and customize from there.

Download the Reference Architecture Template

Step 1.2

Develop a Business Capability Map

Activities

• 1.2.1 Determine which business capabilities support value streams
• 1.2.2 Accelerate the process with an industry reference architecture
• 1.2.3 Validate the business capability map
• 1.2.4 Establish Level 2 capability decomposition priorities
• 1.2.5 Decompose Level 2 capabilities

This step involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Outcomes of this step

• A validated Level 1 business capability map
• Decomposed Level 2 capabilities

Develop a business capability map – Level 1

• Business architecture consists of a set of techniques to create multiple views of an organization; the primary view is known as a business capability map.
• A business capability defines what a business does to enable value creation and achieve outcomes, rather than how. Business capabilities are business terms defined using descriptive nouns such as “Marketing” or “Research and Development.” They represent stable business functions, are unique and independent of each other, and typically will have a defined business outcome. Business capabilities should not be defined as organizational units and are typically longer lasting than organizational structures.
• A business capability mapping process should begin at the highest-level view of an organization, the Level 1, which presents the entire business on a page.
• An effective method of organizing business capabilities is to split them into logical groupings or categories. At the highest level, capabilities are either “core” (customer-facing functions) or “enabling” (supporting functions). As a best practice, Info-Tech recommends dividing business capabilities into the categories illustrated to the right:

Business Capability Map for Healthcare Services

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

Glossary of Capabilities

A business capability is an ability that an organization, person or system possesses. Capabilities are typically expressed in general and high-level terms and typically require a combination of organization, people, processes, and technology to achieve. Level 1 Healthcare Services capabilities that are used in this reference architecture model are:

Glossary of Capabilities

Glossary of Capabilities

Glossary of Capabilities

Glossary of Capabilities

1.2.1 Determine which business capabilities support value streams

Deconstruct value streams into their component capabilities.

1. Analyze the value streams to identify and describe the organization’s capabilities that support them. This stage requires a good understanding of the business and will be a critical foundation for the business capability map.
2. Consider:
   1. What is the objective of your value stream? This can highlight which capabilities support which value streams.
   2. What are the activities that make up the business?
   3. Segmenting your value stream into individual stages will give you a better understanding of the steps involved in creating value.
3. Avoid:
   1. Don’t do this alone. Make sure the right stakeholders participate. The exercise of identifying capabilities for an organization is very introspective and requires deep analysis. It is challenging to develop a common language that everyone will understand and be able to apply. Don’t waste your efforts building an inaccurate depiction of the business.

Download the Reference Architecture Template

1.2.1 Determine which business capabilities support value streams

1.2.2 Accelerate the process with an industry reference architecture

It’s never a good idea to start with a blank page.

1. The business capability map on the previous slide can be used as an accelerator. Assemble the relevant stakeholders – business unit leads and product/service owners – and modify the business capability map to suit your organization’s context.
2. Consider:
   1. What are the activities that make up your business?
   2. Can these activities be tied to outcomes? If not, they might not apply to your organization.
   3. Are there any capabilities on the map that don’t fit the organization? Deselect them if yes.
3. Avoid:
   1. Don’t repeat capabilities. Capabilities are typically mutually exclusive activities.
   2. Don’t include temporary initiatives. Capabilities should be stable over time. The people, processes, and technologies that support capabilities will change continuously.

Customize generic capability maps with the assistance of our industry analysts.

Download the Reference Architecture Template

1.2.2 Accelerate the process with an industry reference architecture

1.2.3 Validate the business capability map

Input: List of organization-specific capabilities mapped to value streams, Reference Architecture Template

Output: Level-1 business capability map, Reference Architecture Template

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Department Executive and Senior Managers

Crowdsource the capability map validation.

1. Validate the capability map with the executive team (those who were not included) and other key stakeholders. Use validation of your business capability map as an excuse to start a conversation regarding the organization’s overall strategy.
2. Consider:
   • Are there any sensitive areas of the organization that may take this effort the wrong way? Engage them to get their input as early as possible to ensure they don’t feel left out or alienated.
3. Avoid:
   1. Don’t delay validating the maps with top-level executives. Without their support, your architecture practice won’t be taken seriously.
   2. Don’t leave anyone out on the assumption that they won’t be interested. This process will foster alignment between organizational silos.

Download the Reference Architecture Template

Develop a business capability map – Level 2

Level 2 business capabilities define individual Level 1 capabilities at a more granular level of detail. Level 2 capabilities typically represent individual stable business functions that, while unique and independent of each other, typically will have a collection of processes that contribute to and enable the Level 1 capability.

1.2.4 Establish Level 2 capability decomposition priorities

Deconstruct Level 1 capabilities into their component capabilities.

1. Analyze the Level 1 business capabilities to identify and describe at a deeper, more granular level the organization’s capabilities that support them. This stage requires a good understanding of the business and will be a critical foundation for the Level 2 business capability map.
2. Consider:
   1. Which Level 1 capabilities enable the most critical stage of my value stream?
   2. Which Level 1 capabilities enable the most stages of the value stream?
3. Avoid:
   1. Don’t try to cut corners. Although it may seem tempting to jump right to this step and avoid doing your Level 1 mapping, you will run the risk of model pollution. Starting with Level 1 helps ensure you have a unified view of your organization’s capabilities and will help you avoid having to redo the work later.

Download the Reference Architecture Template

1.2.4 Establish Level 2 capability decomposition priorities

1.2.5 Decompose Level 2 capabilities

Input: Prioritized list of Level 1 business capabilities for decomposition, Reference Architecture Template

Output: Level 2 capabilities for areas of interest and focus

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Department Executive and Senior Managers

Deconstruct Level 1 capabilities into their component Level 2 capabilities.

1. Using the Level 1 capability map as a baseline, hold working sessions with the line of business represented for each (or selected) Level 1 capability or set of related capabilities and decompose them.
2. Consider:
   1. Will you want to go deeper to level 3? If so, then confirm if the same team for Level 2 has knowledge of Level 3+ and decompose to Level 3 concurrently.
3. Avoid:
   1. Don’t do this alone. Make sure the right stakeholders participate. The exercise of identifying Level 2+ capabilities for an organization is very introspective and requires deep analysis and understanding of business functions and processes. It is challenging to develop a common language that everyone will understand and be able to apply. Don’t waste your efforts building an inaccurate depiction of the business.

Download the Reference Architecture Template

Level 2 Capability Decomposition

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

Glossary of Capabilities

Level 2 Healthcare Services capabilities (individual stable business function with overall contribution and enablement of Level 1 capabilities) used within this reference architecture are:

Glossary of Capabilities

Healthcare Services Industry Business Reference Architecture

Phase 2

Use business capabilities to define strategic focus

This phase will walk you through the following activities:

• Determine cost advantage creators
• Determine competitive advantage creators
• Define key future-state capabilities
• Identify the strategic objectives for the business
• Map strategic objectives to IT programs
• Validate the strategy map and program prioritization

This phase involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Step 2.1

Define the Organization’s Key Capabilities

Activities

• 2.1.1 Determine cost advantage creators
• 2.1.2 Determine competitive advantage creators
• 2.1.3 Define key future-state capabilities

This step involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Outcomes of this step

• Identification of Level 1 & 2 cost advantage creators
• Identification of Level 1 & 2 competitive advantage creators
• Defined future-state capabilities

Define the organization’s key capabilities

• A discussion about the key or most critical capabilities is an excellent opportunity for IT leaders to review, refresh, and even reset expectations from the business as to what value IT should be providing to the organization. There is often misalignment as to whether, or to what extent, IT should be making strategic investments to help the business enhance its capabilities through technology. Some IT leaders believe they should be transforming the organization, while their CEO wants them to focus on operational efficiencies.
• Depending on the mandate from the business, an IT leader may focus on developing a cost advantage for the organization by directing technology efforts to capabilities that deliver efficiency gains. This is often the case for many IT leaders for whom the primary role for IT is to enable the business to deliver its products/services to the end consumer at the lowest cost possible. These capabilities are known as Cost Advantage Creators.
• Organizations can develop a competitive advantage over their industry counterparts by creating a differentiated experience for the organization’s customers. Increasingly, this is facilitated and made possible through technology. IT can direct investment into capabilities that will improve their organization’s competitive position in its market by delivering unique or enhanced experiences for the organization’s end customers. IT can focus on developing a competitive advantage by directing efforts onto capabilities that are end-customer facing. These are known as the organization’s Competitive Advantage Creators.

Defining key capabilities for Healthcare Services

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

2.1.1 Determine cost advantage creators

Input: Value stream, Level 0 and Level 1 capabilities from previous activities, Reference Architecture Template

Output: Identified cost advantage creating capabilities

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Department Executive and Senior Managers

Focus on capabilities that drive a cost advantage for your organization.

1. If your organization has a cost advantage over competitors, the capabilities that enable it should be identified and prioritized. Highlight these capabilities and prioritize the programs that support them.
2. Consider:
   1. What is the source of your cost advantage? IT should support the capabilities that drive the cost advantage.
   2. Is the industry you operate in sensitive to prices?
3. Avoid:
   1. Don’t focus on capabilities that create an unsustainable cost advantage. Take a long-term perspective and allocate your resources wisely.

Download the Reference Architecture Template

2.1.2 Determine competitive advantage creators

Prioritize capabilities that give your organization an edge over rivals.

1. If your organization does not have a cost advantage over competitors, determine if it can deliver differentiated end-customer experiences. Once you have identified the competitive advantages, understand which capabilities enable them. These capabilities are critical to the success of the organization and should be highly supported.
2. Consider:
   1. Are there any products or services your organization provides that customers consider superior to competitive offerings?
   2. Which capabilities enable the competitive advantage?
   3. How easy is it for competitors to neutralize your competitive advantage? Focus on the capabilities that are difficult to replicate by competitors to create a more sustainable advantage.
3. Avoid:
   1. Don’t determine the competitive advantages alone. Incorporate various perspectives from throughout the organization to truly understand how the organization competes in the marketplace.

Download the Reference Architecture Template

2.1.2 Determine competitive advantage creators

2.1.3 Define key future-state capabilities

Input: Value stream, Level 0 and Level 1 capabilities from previous activities, Cost advantage creators from previous activity, Competitive advantage creators from previous activity, Reference Architecture Template

Output: Identified enhancements to existing or new organizational capabilities

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Department Executive and Senior Managers

Know where you want to go and chart a course to get there.

1. In addition to the current cost and competitive advantage creators, the organization may have the intention to enhance existing or develop new capabilities. Discuss and select the capabilities that will help drive the attainment of future goals.
2. Consider:
   1. Are your competitors doing anything to give them a competitive advantage? Can your organization easily replicate the capabilities needed to neutralize that advantage?
   2. How is the external environment (political, economic, social, or technological) likely going to change in the future? How might these changes impact your current key capabilities?
3. Avoid:
   1. Don’t blindly copy your competitors’ strategies. It is important to understand that each organization is unique; before focusing on key capabilities that might neutralize your competitors’ advantages, ensure they fit well with your overall strategy.

Download the Reference Architecture Template

Step 2.2

Develop a Strategy Map

Activities

• 2.2.1 Identify the strategic objectives for the business
• 2.2.2 Map strategic objectives to IT programs
• 2.2.3 Validate the strategy map and program prioritization

This step involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• CTO, VP Applications, VP Infrastructure
• Portfolio Manager (PMO Director)
• Department Executive and Senior Managers

Outcomes of this step

• Identification of business strategic objectives
• Defined and validated strategy map/goal cascade

2.2 Develop a strategy map

• A strategy map is a tool to help narrow the focus onto what matters most. With ever-changing resources, business strategies, and external environments, the strategy map can ensure IT is consistently providing value through the enhanced prioritization of IT programs.
• Strategy mapping is a technique that helps the executive suite communicate the business strategy to other levels of the organization by visually representing the organizational strategic objectives and mapping each of them to value streams, business capabilities, and ultimately, to specific IT programs. There are five layers to a strategy map: strategic business goals, business initiatives, value streams, business capabilities, and IT programs.
• Strategic business goals are the targets and outcomes that the organization is looking to achieve.
• Value streams enable an organization to create and capture value in the market through interconnected activities that support strategic objectives.
• Business capabilities define what a business does to enable value creation in value streams, rather than how.
• IT programs are actionable descriptions of how the IT department will enable one or multiple business capabilities in its target state.

Figure above: Strategy Map

2.2.1 Identify the strategic goals and outcomes for the business

Knowing the key strategic objectives for the business will drive business-IT alignment.

1. It is important to make sure the right strategic objectives of the organization have been identified and are well understood. Engage the right stakeholders to help identify and document the key strategic objectives for the business.
2. Consider:
   1. What are your targets for the organization?
   2. What are the organization’s strategic investment goals?
   3. What are the goals of the organization over the next 12 months?
   4. What are your top business initiatives over the next 12 months?
   5. Are there external forces that will impact the current strategic objectives?
3. Avoid:
   1. Don’t simply go with the existing documented strategic objectives for the business. Ensure they are up to date, and interview the decision makers to get the most updated objectives if needed.

Download the Reference Architecture Template

2.2.1 Identify the strategic goals and outcomes for the business

Illustrative example of strategic goals and outcomes for Healthcare Services

Acme Care.		1	Exceptional Service	We are committed to promoting healthier communities through our commitment to patient-centered care. We will embrace the latest technology and will pursue community-led strategic alliances.
		2	Patient Care	We will deliver exceptional patient care that will result in positive health outcomes four our patients and our community.
		3	Operational Excellence	We will demonstrate operational efficiency by continuing to provide exceptional patient care while maintaining a highly skilled labor force. We will achieve this by improving and streamlining internal processes.

2.2.2 Map strategic objectives to IT programs

Input: List of IT projects, initiatives, and IT capabilities, Business goals

Output: IT initiatives, Goals cascade

Materials: Whiteboard/Flip Charts, Capability Maps, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Portfolio Manager (PMO Director), Department Executive and Senior Managers

Communicate the business strategy to other levels of the organization visually.

1. Starting with strategic objectives, map the value streams that will ultimately drive them. Next, link the key capabilities that enable each value stream. Finally, map the IT programs supporting those capabilities. This process will help you prioritize IT programs that deliver the most value to the organization.
2. Consider:
   1. Focus on the value streams that truly drive the strategic objectives.
   2. Are there any capabilities that are not tied to outcomes?
   3. Are all strategic objectives supported with IT programs?
3. Avoid:
   1. Don’t be too granular. The audience for a strategy is interested in a higher-level understanding of what IT is doing. As such, keep things at the program level as opposed to the individual projects that programs are composed of.

Download the Reference Architecture Template

Illustrative example of strategy map

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

2.2.3 Validate the strategy map and program prioritization

Crowdsource the strategy map validation.

1. Validate the strategy map in layers. Start with IT and confirm which IT programs enable particular capabilities. Next, work with the business departments to validate the capabilities that support the value streams. Finally, validate the strategic objectives of the organization with the C-suite and communicate the value streams that support them.
2. Consider:
   1. Are all strategic objectives equally important? If not, get a prioritized list of strategic objectives.
   2. Do any of the programs have critical dependencies that influence sequencing?
   3. If there are strategic objectives that do not have any IT programs mapped to them, consider adding new programs. Conversely, reconsider upcoming programs that do not have a connection to strategic objectives.
3. Avoid:
   1. Don’t delay validating the strategic maps with top-level executives. A proactive approach will save you time in terms of rework and maximize alignment.
   2. Don’t leave anyone out on the assumption that they won’t be interested. It is easy to miss key stakeholders – be careful and organized.

Download the Reference Architecture Template

2.2.3 Validate the strategy map and program prioritization

Healthcare Services Industry Business Reference Architecture

Phase 3

Assess key capabilities for planning priorities

This phase will walk you through the following activities:

• Assess process support for capabilities
• Evaluate user adoption of processes for key capabilities
• Prioritize key capabilities process refinement
• Assess how well information supports capabilities
• Evaluate accessibility to data for key capabilities
• Prioritize data improvements for key capabilities
• Assess technology support of capabilities
• Uncover value opportunities for applications
• Compare results with industry research to determine plan of action

This phase involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Step 3.1

Business Process Review

Activities

• 3.1.1 Assess process support for capabilities
• 3.1.2 Evaluate user adoption of processes for key capabilities
• 3.1.3 Prioritize key capabilities process refinement

This step involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Outcomes of this step

• Identification of capability process enablement

Business process review

Use process analysis and assessment to drive collaboration and integration. Organizations undergoing growth, either organically or through M&A, tend to develop in a piecemeal and short-sighted fashion in an attempt to preserve their view of agility. This can lead to the following pains: Duplicated or conflicting business activities. Processes that create bottlenecks by involving too many business units. Manual rekeying of data into multiple systems. Inefficient process for producing standard reports. These organizations are driven by the desire to effectively manage existing business processes while recognizing the need for a faster ability to share data, information, and insight across multiple systems and business units to support increasing demands for more rapid response. A primary goal of a strategy is to provide a framework that enables the current business environment to function as seamlessly as possible, allowing for flexibility when processes need to evolve. Through effective strategy design, IT can provide integration across business units by performing an analysis of how well the organizational capabilities are supported by processes. Specifically, IT should analyze and assess processes on the basis of adherence, enforcement, overlap and on the presence of effective monitoring measures.	Assess how well processes support capabilities
		NONE: No documented process exists.
		LOW: Processes have been documented but have not been effectively communicated and may be in conflict.
		MEDIUM: LOW + processes are explicitly defined and have been formally communicated. There is minimal overlap between processes.
		HIGH: MEDIUM + processes are enforced and regularly monitored for deviations. Employees typically adhere to the process. Figure above: Process Assessment Legend

Business process support of key capabilities

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

3.1.1 Assess process support for capabilities

Input: Reference Architecture Template, Standard operating procedures, Capability maps

Output: Heat mapped capability map

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, Department Executive and Senior Managers

Standardization breeds efficiency.

1. Begin by assessing whether each key capability has documented processes supporting it. Then evaluate whether the documented processes have been communicated and the extent to which there is process overlap.
2. Consider:
   1. What processes are documented?
   2. Have the documented processes been communicated to the business users?
   3. Are some of the processes redundant? Has that been done on purpose, or can you optimize them?
   4. Are there key capabilities that lack processes all together?
3. Avoid:
   1. Don’t waste time. Only evaluate processes that are documented and communicated, and then evaluate them for exclusivity.
   2. Don’t do this in a vacuum. Validate that you have captured all existing processes by speaking to other employees.

Download the Reference Architecture Template

3.1.2 Evaluate user adoption of processes for key capabilities

Having processes is one thing, but are they being adhered to?

1. The next level of analysis involves assessing whether defined processes are being adhered to. Confirm if the organization enforces adherence and that regular monitoring for deviations is occurring.
2. Consider:
   1. Is there regular monitoring for deviations from the defined process? Is this recorded and acted upon?
   2. Are there certain groups of users that are not following the processes in place? Why?
3. Avoid:
   1. Don’t think the lack of process adherence is simply the employees’ fault. In some cases, the processes might not be well designed or are outdated, thus warranting the need for refinement.

Download the Reference Architecture Template

3.1.2 Evaluate user adoption of processes for key capabilities

3.1.3 Prioritize key capabilities process refinement

Use process to drive collaboration and integration.

1. Key capabilities should be well supported by processes. If there are any capabilities that scored medium or below, prioritize delivering effective process support, improving user adoption, and establishing effective process governance.
2. Consider:
   1. Is business process management in your mandated area of influence, responsibility, or accountability? If not, consider who you may need to recruit for support from the business side to drive refinements.
   2. Communicate any new processes or changes to existing ones through a variety of mediums. Make it easy for the users/employees to reference them if needed.
3. Avoid:
   1. Don’t create redundant processes. Ensure there is minimal overlap with existing processes if you are creating a new process.
   2. Don’t forget to think about user adoption and governance when creating new processes. This might be more challenging, but it will ultimately ensure long-term success.

Download the Reference Architecture Template

3.1.3 Prioritize key capabilities process refinement

Step 3.2

Information Assessment

Activities

• 3.2.1 Assess how well information supports capabilities
• 3.2.2 Evaluate accessibility to data for key capabilities
• 3.2.3 Prioritize data improvements for key capabilities

This step involves the following participants:

• Enterprise/Business Architect
• Data Architect
• Organizational Planning & Analysis staff
• Business Analysts
• Business Unit Leads
• CIO
• Department Executive and Senior Managers

Outcomes of this step

• Identification of capability data support

The Data, Reporting & Analytics Diagnostic helps identify information gaps

Assessing how well information supports capabilities is nearly impossible to perform without an honest and thorough understanding of end-user sentiment towards Data, Reporting & Analytics. Develop data-driven insights to help you decide which business capabilities require new or improved reporting and analytics and which opportunities will improve business processes, and by extension, enable the capabilities of the business. The Data, Reporting & Analytics programs will help you: Assess data quality and reporting satisfaction at a glance Evaluate data quality across 9 dimensions of quality Evaluate reporting across 10 dimensions of satisfaction Determine which areas are the most critical Determine effectiveness of analytics tools

Here are some critical insights to extract from the Data, Reporting & Analytics Diagnostic report

Begin with understanding the perception of the information in use in your organization to assess the effectiveness of supporting key business.
	Data and reports that are deemed to be low accuracy, currency, or completeness could hamper strategic business capabilities and should be investigated further regarding the effectiveness of supporting key business capabilities.

Information Assessment

Assess the availability and quality of data in providing information as a business asset. Information is central to every organization’s success and ability to realize its goals. Too often organizations experience the following pains: Duplicated or conflicting data residing in disparate databases. Inadequate controls or edits on data. Manual rekeying of data into multiple systems. Inability to provide executives with reliable and easily accessible information for decision making. Inability of business units to assume “ownership” of data. These organizations are driven by the desire to effectively manage existing business processes while recognizing the need for a faster ability to share data, information, and insight across multiple systems and business units to support increasing demands for more rapid response. A primary goal of a strategy is to provide a framework that enables information to be viewed as a critical business asset, across organizational boundaries, and accessed as seamlessly as possible. Through effective strategy design, IT can provide integration of data across business units by performing an analysis of how well the organizational capabilities are supported by information. Specifically, IT should analyze and assess data on the basis of quality, integrity, and ownership and on the presence of an effective data governance framework.	Assess how well existing information supports capabilities
		NONE: Data is unavailable, unreliable, duplicated, or not of sufficient detail
		LOW: Data is available but not subject to adequate integrity or quality controls. Data ownership is undefined.
		MEDIUM: LOW + Data is available but not fully automated. Data ownership is mostly defined.
		HIGH: MEDIUM + Data is available, of high quality, fully automated, and has clear ownership. Figure above: Information Assessment Legend

Information support of key capabilities

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

3.2.1 Assess how well information supports capabilities

Information is a key business asset.

1. Begin by assessing whether each key capability has data available to support it. Then evaluate the quality and integrity of the data and the extent to which there is clear business unit ownership of the data.
2. Consider:
   1. What data exists to support the capability?
   2. Does the same data exist in various databases?
   3. What controls exist to ensure quality and integrity?
   4. Are there key capabilities that lack automated information all together?
3. Avoid:
   1. Don’t waste time. Only evaluate information holdings that are central to the capability.
   2. Don’t do this in a vacuum. Validate that you have captured all existing data by collaborating with other IT and business unit employees.

Download the Reference Architecture Template

3.2.1 Assess how well information supports capabilities

3.2.2 Evaluate accessibility to data for key capabilities

Having data is one thing, but is it easily accessible and available in a format suitable for decision making?

1. The next level of analysis involves assessing whether data is easily accessible to the main users of the information.
2. Consider:
   1. Is data well integrated so executives do not have to access more than one source for the information they need? Is there a data warehouse capability to bring together data from disparate databases?
   2. Is there an end-user business intelligence (BI) capability? Are users sufficiently trained in its use?
3. Avoid:
   1. Don’t think that the lack of information is the fault of any one IT unit or application. In most cases, there is a lack of a comprehensive approach to enterprise and data architecture at the core of the problem.

Download the Reference Architecture Template

3.2.2 Evaluate accessibility to data for key capabilities

3.2.3 Prioritize data improvements for key capabilities

Use data to institute information as an asset.

1. Key capabilities should be well supported by data. If there are any capabilities that scored Level 2 or below, prioritize establishing an effective data governance framework. Leverage Info-Tech’s blueprint Build a Data Architecture Roadmap for more information.
2. Consider:
   1. Is data management fully in your mandated area of influence, responsibility, or accountability? If not, consider who you may need to recruit for support from the business side to drive refinements.
   2. Effective data governance will require close collaboration between IT and the data owners on the business side.
3. Avoid:
   1. Don’t create redundant data. Ensure there is minimal overlap with existing data elements if you are creating a new application or database process.
   2. Don’t forget to think about end-user access and reporting tools when creating new data holdings. This might be more challenging, but it will ultimately ensure long-term success.

Download the Reference Architecture Template

3.2.3 Prioritize data improvements for key capabilities

Step 3.3

Technology Opportunity Assessment

Activities

• 3.3.1 Assess technology support of capabilities
• 3.3.2 Uncover value opportunities for applications

This step involves the following participants:

• Enterprise/Business Architect
• Business Analysts
• Business Unit Leads
• CIO
• CTO, VP Applications, VP Infrastructure
• Department Executive and Senior Managers

Outcomes of this step

• Identification of capability application and technology support

The Application Portfolio Assessment Diagnostic helps identify application gaps

Application portfolio management is nearly impossible to perform without an honest and thorough understanding of end-user sentiment toward IT software. Develop data-driven insights to help you decide which applications to retire, upgrade, re-train on or maintain to meet demands and, by extension, enable the capabilities of the business. The Application Portfolio Assessment program will help you: Assess the health of the application portfolio Understand the business’ perception of the application in use throughout your business Identify and build core IT processes that automate IT-business alignment Create a plan to address alignment gaps impeding business growth Deliver your plan to demonstrate IT value and progress

Here are some critical insights to extract from the Application Portfolio Assessment report

Begin with understanding the perception of the applications in use in your organization to assess the effectiveness of supporting key business capabilities.

Applications that are deemed as unleveraged, questionable, or contentious should be investigated further regarding the effectiveness of supporting key business capabilities.

Technology opportunity assessment

New technologies can create opportunities for business agility and help develop resilience to changing market conditions. Business agility is essential to stay competitive. However, the application portfolio of many organizations cannot sufficiently support the flexibility and efficiency the business needs because of legacy challenges. Organizations experience application sprawl over time, caused by many factors, that can end up costing more for licenses, operational resources, and maintenance. Organizations are looking for ways to modernize their applications, but they want to develop options without introducing additional risks. Adopting a capability-based approach to assessing applications will enable the IT department to identify opportunities to: Automate tasks through the strategic selection and implementation of applications. Integrate applications that have cross-capability implications. Rationalize the application portfolio. Eliminate redundant or legacy applications that don’t deliver enough value. The market availability for software applications dedicated to supporting a specific capability (or set of capabilities) can serve as an indicator of the presence of legacy challenges. Where there is a lack of application availability, it may be a signal of either custom developed, ad-hoc and makeshift solutions or shadow IT.	Availability of software applications that support each capability
		NONE: Capability is typically unsupported by applications. The likelihood of legacy applications supporting these capabilities is high.
		LOW: Capability is somewhat supported by applications. There is typically a mix of legacy and purchased applications supporting these capabilities.
		MEDIUM: Capability is moderately supported by applications. Organizations do not have to build their own applications; however, there aren’t many solutions to choose from.
		HIGH: Capability is well supported by applications. Organizations can choose from a variety of solutions that will meet or exceed their needs. Figure above: Technology Opportunity Assessment Legend

3.3.1 Assess technology support of capabilities

Input: Reference Architecture Template, Listing of key system of records/transactional system inventory, Capability maps

Output: Heat mapped capability map

Materials: Whiteboard/Flip Charts, Reference Architecture Template

Participants: Enterprise/Business Architect, Business Analysts, Business Unit Leads, CIO, CTO, VP Applications, VP Infrastructure, Department Executive and Senior Managers

Determine how well key capabilities are supported by applications.

1. Perform an application rationalization exercise on the key capabilities to determine how well they are being supported by applications. Applications should be assessed on the basis of flexibility, ease of use, and integration.
2. Consider:
   1. How flexible are the applications?
   2. How well do the applications integrate?
   3. How easy are the applications to learn and use?
   4. Are there overlap, unplanned redundancy, or data quality issues?
3. Avoid:
   1. Don’t perform a complete overhaul. Consider continuity in delivering business services before you rip and replace everything.
   2. Don’t forget about shadow IT. Ask around to get an accurate understanding of what applications are being used to support business capabilities.

Download the Reference Architecture Template

Application support of key capabilities

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

3.3.2 Uncover value opportunities for applications

Make sure the business is leveraging applications wherever it should.

1. Unsupported key capabilities are areas in which IT can deliver high value for the business. The key capabilities that score None or Low in the technology assessment are the ones that require the most attention.
2. Consider:
   1. Prioritize which unsupported key capabilities to focus on based on their importance.
3. Avoid:
   1. Don’t focus on unsupported key capabilities that will require too much investment.
   2. Don’t build an application just because you can. Research existing solutions before deciding to build in-house.

Download the Reference Architecture Template

3.3.2 Uncover value opportunities for applications

Healthcare Services Industry Business Reference Architecture

Phase 4

Adopt capability-based strategy planning

This phase will walk you through the following activities:

• Assess capability gaps via a MoSCoW Analysis

This phase involves the following participants:

• Business Analysts
• Business Unit Leads
• CIO
• CTO, VP Applications, VP Infrastructure
• Department Executive and Senior Managers
• Portfolio Manager (PMO Director)

Step 4.1

Consolidate and Prioritize Capability Gaps

Activities

• 4.1.1 Assess Capability Gaps via a MoSCoW Analysis

This step involves the following participants:

• Enterprise/Business Architect
• Project Managers & Business Analysts
• Business Unit Leads
• CIO
• CTO, VP Applications, and VP Infrastructure
• Department Executive and Senior Managers

Outcomes of this step

• Prioritization of key capability gaps

Consolidate and prioritize capability gaps

Direct strategic IT investments based on the collective output of the capability assessments. When combined with a solid understanding of business priorities and IT’s mandate, a capability assessment can be the driving force that informs a unified perspective on the sequencing of an organization’s strategic IT initiatives. Assessments based on how well a capability is supported by people (via organizational analysis), process (via process review), data (via information assessment), and technology (via application, infrastructure, data, and security improvements) will inform the overall health of a capability, or in other words, the size of a capability gap. This information, when contrasted with the concept of a MoSCoW-based effort to value, forms an enhanced decision-making framework that can be used to determine initiative sequencing on a strategic roadmap. If a capability has a large gap (is poorly supported by people, process, data, or technology), it should be considered as high effort, or difficulty, to address. When the capability is well aligned with business priorities and the IT mandate, the capability gap should be considered as high value to address. See the figure on the right: IT leaders should focus their efforts on the lower-right quadrant (high value, low effort). In the top-right quadrant (high value, high effort), IT should seek business support to drive the initiative. Capability gaps on the right side of the quadrant overall are good candidates for capability outsourcing.

Figure above: MoSCoW Analysis for Business Capabilities

MoSCoW capability gap analysis

	Value to Effort Impact Ratio HE = High Effort LE = Low Effort HV = High Value LV = Low Value
	‹— We are looking to act on low effort, high value

4.1.1 Assess capability gaps via a MoSCoW analysis

Elevate your focus from the IT level to the organization level.

1. Gather and synthesize the priorities from the information, people, process, and technology assessments to develop a consolidated view of IT’s planning responsibilities.
2. Consider:
   1. How big is the difference between current needs and the assessment of the factors that support each capability?
   2. Are there any groups of capabilities that have low scores from the assessments? Consider a root-cause analysis to determine what could be impacting multiple capabilities.
3. Avoid:
   1. Don’t forget about healthy capabilities. Enhance the green (low-gap) capabilities once you have resolved the issues with the red and yellow (large-gap) key capabilities.

Download the Reference Architecture Template

4.1.1 Assess capability gaps via a MoSCoW analysis

MoSCoW analysis for business capabilities

Note: Illustrative Example. To edit and customize this visual please download the corresponding template.

Ranked list of IT implications template

Address key capability gaps

As part of your next-steps checklist, leverage the reference architecture for priorities that drive measurable top-line organizational outcomes and the unlocking of direct value.

Summary of Accomplishment

Problem Solved

• Accelerated the building of your organization’s capability map by defining the organization’s value stream and validating the industry reference architecture.
• Used business capabilities to define strategic focus by defining the organization’s key capabilities and developing a prioritized strategy map.
• Assessed key capabilities for planning priorities through a review of business processes, information, and application and technology support of key capabilities.
• Consolidated and prioritized capability gaps for incorporation into priorities.

If you would like additional support, have our analysts guide you through other phases as part of an Info-Tech workshop.

Contact your account representative for more information.

workshops@infotech.com 1-888-670-8889

Additional Support

If you would like additional support, have our analysts guide you through other phases as part of an Info-Tech workshop.

Contact your account representative for more information. workshops@infotech.com 1-888-670-8889

To accelerate this project, engage your IT team in an Info-Tech workshop with an Info-Tech analyst team.

Info-Tech analysts will join you and your team at your location or welcome you to Info-Tech’s historic Toronto office to participate in an innovative onsite workshop.

The following are sample activities that will be conducted by Info-Tech analysts with your team:

Model Level 1, 2 & 3 business capability maps. Using the business capability map as an accelerator, Info-Tech analysts will work with relevant stakeholders to modify and validate the business capability map to suit your organization’s context.

Review capability assessment map(s). Info-Tech analysts will work with relevant stakeholders to review the various capability assessment maps and identify value opportunities within your organization.

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