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Healthcare Services Industry Business Reference Architecture

Capability maps, value streams, and strategy maps for healthcare services organizations.

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  • 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 Research & Tools

1. Accelerate the strategy design process

Leverage a validated view of the healthcare services business capabilities to realize measurable top-line business outcomes and unlock direct value.

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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.

Photo of Jennifer Jones, Research Director, Healthcare, Info-Tech Research Group.

Jennifer Jones
Research Director, Healthcare
Info-Tech Research Group

Executive Summary

Your Challenge
  • You are a CIO, head of EA, or chief architect who needs to improve your organization’s understanding of business capabilities and how IT can support them.
  • Your organization wants to sharpen its alignment and focus on organizational outcomes and value by using architecture to better inform its IT governance, stakeholder management, and IT strategy capabilities.
  • Before beginning any strategic initiatives, use this blueprint to understand how the organization creates value and the underlying capabilities and processes of the organization.
Common Obstacles
  • You don’t know where or how to begin or how to engage the right people, model the organization, and drive the value of business architecture.
  • The technical environment supporting healthcare provision is rapidly changing with myriad new solutions and platforms that seek to improve patient care.
  • However, as new tech-enabled solutions are introduced into patient care settings, you need a line of sight to ensure the systems offered to providers improve care and are not introducing new vulnerabilities.
Info-Tech’s Approach
  • 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 processes, information, application, and technology support of key capabilities.
  • Adopt capability-based strategy planning by ongoing identification and road mapping of capability gaps.

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.

Logo for Info-Tech Research Group. Logo for iTRG.

Pinwheel diagram of value in the industry context. At the center is 'Value (Revenue, Margin, Assets)' surrounded by a cycle of '1. Build', '2. Define', '3. Assess & Prioritize' and '4. Sustain'. Surround that are categories 'Business', 'Information/Data', 'Applications', and 'Technology'. On the wings of the pinwheel are 'Governance & Risk', 'Business Context', 'Business Strategy', 'IT Strategy', 'Innovation', 'IT Budget', 'Digital Transformation', 'Core Application Rationalization & Modernization', 'IT Service Mgmt', 'Requirements', 'Data', and 'Org Design/ Operating Model'. The entire pinwheel exists within the 'Industry Context'.

Industry Overview: Healthcare Services

Healthcare 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.

Value Chain for the Healthcare Services Industry with 'Prevent Health Challenges' at the top, followed by 'Diagnose Health Needs', 'Treat Patients', and 'Facilitate and Monitor Recovery'.
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 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

Patient Value Matrix with four quadrants defined by an x-axis between 'Improved capabilities' and 'Financial benefit' and a y-axis between 'Inward' and 'Outward'. The four quadrants are 'Patient care (outward, financial benefit)', 'Cost reduction (inward, financial benefit)', 'Service enablement (inward, improved capabilities)', and 'Patient care and market reach (outward, improved capabilities)'.

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.

Example table for determining business capabilities. The first column is 'Business Goals & Outcomes' listing four Business Goals, two of which are color-coded similarly. The second column is 'Business Initiatives' with Initiatives 1 through 10, each color-coded to match the business goal they help to achieve. The third and fourth columns are 'Level 1 / Level 2 Business Capabilities' with capabilities grouped by 'Value Stream', each of which are color-coded to business goals and the business initiatives that create or improve them.

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.

Healthcare services business capability map with the healthcare services industry value chain as column headers, 'Prevent Health Challenges', 'Diagnose Health Needs', 'Treat Patients', 'Facilitate and Monitor Recovery', and row headers 'Defining', 'Shared', and 'Enabling'.

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/ConceptDefinition
Industry Value ChainA high-level analysis of how the industry creates value for the consumer as an overall end-to-end process.
Business Capability MapThe primary visual representation of the organization’s key capabilities. This model forms the basis of strategic planning discussions.
Industry Value StreamsThe specific set of activities an industry player undertakes to create and capture value for and from the end consumer.
Strategic ObjectivesA set of standard strategic objectives that most industry players will feature in their corporate plans.
Industry Strategy MapA visualization of the alignment between the organization’s strategic direction and its key capabilities.
Capability AssessmentsBased on people, process, information, and technology, a heat-mapping effort that analyzes the strength of each key capability.
CapabilityAn 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.
(Source: The Open Group, 2009)

Tools and templates to compile and communicate your reference architecture work

Sample of the Retail Industry Business Reference Architecture Template.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 map2. Use business capabilities to define strategic focus3. Assess key capabilities for planning priorities4. 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
  • Defined and validated value streams specific to your organization
  • A validated Level 1 business capability map
  • Decomposed Level 2 capabilities
  • Identification of Level 1 cost advantage creators
  • Identification of Level 1 competitive advantage creators
  • Defined future state capabilities
  • Identification of capability process enablement
  • Identification of capability data support
  • Identification of capability application and technology support
  • Prioritization of key capability gaps

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
Build your organization’s capability map
Step 1.1Step 1.2

1.1.1 Identify and assemble key stakeholders

1-3 hours

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.

Outline for determining value streams, starting with 'Industry Value Chain', then 'Value Receivers': 'Cusomters' and 'Partners', then 'Value Streams' with 'Capabilities'.

Value stream descriptions for Healthcare Services

Value
Streams
Prevent Health ChallengesDiagnose Health NeedsTreat PatientsFacilitate and Monitor Recovery
  • Preventative healthcare has direct benefits for both individuals and providers; by minimizing demand on the healthcare system, the system is better able to remain affordable and efficient.
  • This value stream includes preventative programs, patient health education, and community health.
  • Diagnosis has important implications for patient care, research, and policy.
  • It can take different forms: a medical diagnosis is the process of determining medical needs based on symptoms and signs, while a nursing diagnosis is based on the human response to actual or potential health problems and life processes.
  • Diagnostic capabilities include admissions, triage, and medical testing and imaging.
  • Treatment comprises the care and management of a patient to combat a disease or disorder following diagnosis.
  • These capabilities include patient transportation, medication prescription management, medication dispensing management, procedure performance, and drug safety management.
  • Facilitating and monitoring recovery comes after the diagnosis and treatment. This includes patients recovering at home or in the hospital.
  • Capabilities include patient monitoring, physical therapy, trauma management, treatment plan compliance, and lifestyle modification.

Determine how the organization creates value

Begin the process by identifying and locating the business mission and vision statements.

Ways to identify and locate 'Business Mission' and 'Business Vision' statements: 'Corporate Websites', 'Business Strategy Documents', and 'Business Executives'.

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 hours

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

Capability maps, value streams, and strategy maps for healthcare services organizations.

About Info-Tech

Info-Tech Research Group is the world’s fastest-growing information technology research and advisory company, proudly serving over 30,000 IT professionals.

We produce unbiased and highly relevant research to help CIOs and IT leaders make strategic, timely, and well-informed decisions. We partner closely with IT teams to provide everything they need, from actionable tools to analyst guidance, ensuring they deliver measurable results for their organizations.

What Is a Blueprint?

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.

Author

Jennifer Jones

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