Healthcare Services Industry Business Reference Architecture
Capability maps, value streams, and strategy maps for healthcare services organizations.
- Healthcare Services organizations are a central component of the healthcare system and interact with providers and other points of care across the healthcare continuum.
- The business and IT often focus on a project, ignoring the holistic impact and value of an overarching value stream and business capability view.
- 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 potential for increased use of technology to improve patient care.
- The technical environment supporting healthcare service provision is rapidly changing with myriad new solutions and platforms with both patient-centric and practitioner-centric views.
Our Advice
Critical 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 organization, but more significantly, to enabling measurable top-line organizational outcomes and the unlocking of direct value.
Impact and Result
- Demonstrate the value of IT’s role in supporting your hospital organization’s capabilities while highlighting the importance of proper alignment between organizational and IT strategies.
- Apply reference architecture techniques such as strategy maps, value streams, and capability maps to design usable and accurate blueprints of your hospital operations.
- Assess your initiatives and priorities to determine if you are investing in the right capabilities. Conduct capability assessments to identify opportunities and to prioritize projects.
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 |
Executive Summary
Your Challenge
| Common Obstacles
| Info-Tech’s Approach
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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 InsightUsing 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. |
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Industry Overview: Healthcare ServicesHealthcare service organizations are outpatient providers and aim to serve a diverse population of patients presenting with different conditions; they represent a part of an integrated web of healthcare delivery that includes preventative, diagnostic, and curative services. Broadly, healthcare services represent a diverse range of healthcare practitioners, including primary care providers, rehabilitation specialists, dental service providers, outpatient surgery providers, optometrists, mental health practitioners, diagnostic services, home care, nursing services, etc. Many of the locations of care provision offer direct care or facilitate access to other healthcare services including specialist physicians. Healthcare service providers operate on a marginal profit based on industry scales and, as a result, may have limited ability to upgrade to the latest technology or may incur costs to more fully integrate with the acute care infrastructure or between peer services. Additionally, healthcare service providers are remunerated through a combination of out-of-pocket payment, workplace health insurance plans, and/or a government provided service such as Medicare, Medicaid, or provincial healthcare schemes. Service providers form a core part of the patient journey, yet interoperability of a patient’s clinical records continues to be a challenge for providers. Holistic patient records are not consistently shared across all healthcare services. |  Figure above: Value Chain for the Healthcare Services Industry |
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 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:
| Term/Concept | Definition |
| Industry Value Chain | A high-level analysis of how the industry creates value for the consumer as an overall end-to-end process. |
| Business Capability Map | The primary visual representation of the organization’s key capabilities. This model forms the basis of strategic planning discussions. |
| Industry Value Streams | The specific set of activities an industry player undertakes to create and capture value for and from the end consumer. |
| Strategic Objectives | A set of standard strategic objectives that most industry players will feature in their corporate plans. |
| Industry Strategy Map | A visualization of the alignment between the organization’s strategic direction and its key capabilities. |
| Capability Assessments | Based on people, process, information, and technology, a heat-mapping effort that analyzes the strength of each key capability. |
| Capability | 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. |
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
| 1. Build your organization’s capability map | 2. Use business capabilities to define strategic focus | 3. Assess key capabilities for planning priorities | 4. Adopt capability based strategy planning | |
| Phase Steps | 1.1 Define the Organization’s Value Stream 1.2 Develop a Business Capability Map | 2.1 Define the Organization's Key Capabilities 2.2 Develop a Strategy Map | 3.1 Business Process Review 3.2 Information Assessment 3.3 Technology Opportunity Identification | 4.1 Consolidate and Prioritize Capability Gaps |
| Phase Outcomes |
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Info-Tech offers various levels of support to best suit your needs
DIY Toolkit | Guided Implementation | Workshop | Consulting |
| "Our team has already made this critical project a priority, and we have the time and capability, but some guidance along the way would be helpful." | "Our team knows that we need to fix a process, but we need assistance to determine where to focus. Some check-ins along the way would help keep us on track." | "We need to hit the ground running and get this project kicked off immediately. Our team has the ability to take this over once we get a framework and strategy in place." | "Our team does not have the time or the knowledge to take this project on. We need assistance through the entirety of this project." |
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?
Phase 1 | Phase 2 | Phase 3 | Phase 4 | |
| Call #1: Introduce Info-Tech’s Industry reference architecture methodology. | Call #2: Define and create value streams. Call #3: Model Level 1 business capability maps. | Call #4: Map value streams to business capabilities. Call #5: Model Level 2 business capability maps. | Call #6: Create a strategy map. Call #7: Introduce Info-Tech's capability assessment framework. | Call #8: Review capability assessment map(s). Call #9: Discuss and review prioritization of key capability gaps and plan next steps. |
Healthcare Service Industry Business Reference Architecture
Phase 1
Build your organization’s capability map
| Phase 1 1.1 Define the Organization’s Value Stream 1.2 Develop a Business Capability Map | Phase 2 2.1 Define the Organization’s Key Capabilities 2.2 Develop a Strategy Map | Phase 3 3.1 Business Process Review 3.2 Information Assessment 3.3 Technology Opportunity Identification | Phase 4 4.1 Consolidate and Prioritize Capability Gaps |
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
| Step 1.1 | Step 1.2 |
1.1.1 Identify and assemble key stakeholders
1-3 hoursInput: 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.
- 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.
- Consider:
- Who are the decision makers and key influencers?
- Who will impact the business capability work? Who has a vested interest in the success or failure of the outcome?
- Who has the skills and competencies necessary to help you be successful?
- Avoid:
- Don’t focus on the organizational structure and hierarchy. Often stakeholder groups don’t fit the traditional structure.
- 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
Value | Prevent Health Challenges | Diagnose Health Needs | Treat Patients | Facilitate and Monitor Recovery |
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Determine how the organization creates value
| Begin the process by identifying and locating the business mission and vision statements.
| What is Business Context? “The business context encompasses an understanding of the factors impacting the business from various perspectives, including how decisions are made and what the business is ultimately trying to achieve. The business context is used by IT to identify key implications for the execution of its strategic initiatives.” (Source: Business Wire, 2018) |
1.1.2 Determine how the organization creates value
1-3 hoursThe first step of delivering value is defining how it will happen.
- 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.
- Consider:
- Who are your customers?
- What tasks are your customers looking to accomplish?
- How does your organization’s set of products and services help customers accomplish that?
- What are the benefits the organization delivers to customers?
- Avoid:
- 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
About Info-Tech
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A blueprint is designed to be a roadmap, containing a methodology and the tools and templates you need to solve your IT problems.
Each blueprint can be accompanied by a Guided Implementation that provides you access to our world-class analysts to help you get through the project.
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Guided Implementation 1: Model
- Call 1: Introduce Info-Tech’s Industry reference architecture methodology.
- Call 2: Define and create value streams.
- Call 3: Model Level 1 business capability maps.
- Call 4: Map value streams to business capabilities.
- Call 5: Create a strategy map.
Guided Implementation 2: Drive
- Call 1: Introduce Info-Tech's capability assessment framework.
- Call 2: Review capability assessment map(s).
- Call 3: Discuss and review prioritization of key capability gaps and plan next steps.