The US government will start tracking hospital readmission rates. Why? Because we spend some $15B each year treating returning patients. Many of these would not need to return if they followed instructions — which involve meds, follow up out patient visits, diet, and you get the picture. To be fair, it's sometimes not the patient's fault. They often do not get a proper discharge summary and in some cases they are just not together enough to comply. They may lack transportation, communication skills, or the ability to follow instructions. Doesn't it make sense to figure out those at-risk patients and do something a little extra? It does. No question. And translates to real money and better care, and this is where big data comes in — and it's nice to see some real use cases that do not involve monitoring our behavior to sell something. Turns out — no surprise here — the structured EMR patient record, if one exists, is full of holes and gaps — including missing treatments from other providers, billing history, or indicators of personal behavior — that may provide a clue to readmission potential. The larger picture of information —mostly unstructured —can now be accessed and analyzed, and high-risk patients can have mini workflows or case management apps to be sure they are following instructions. IBM is doing some great work in this area with the analytics engine Watson and partners such as Seton. Take a few minutes to read this article.
If you’re trying to build an effective EA program, you’re in trouble from the get-go. I’d like to paint a rosier picture for anyone involved in this strategic, potentially very high-impact practice, but consider the fact that one of our more frequent client inquiries is about how to communicate EA’s value to non-EAers. How can I not say you’re in trouble if so many people doing EA look for outside help to explain to their own stakeholders that what they’re doing on a daily basis is worthwhile? There’s clearly something wrong with this picture.
So, OK, let’s say you want to build an EA practice anyway, despite the poorly understood value proposition — who should you staff it with? Misguided people with a desire to labor away in obscurity? Actually, no, you want your best and brightest. Those few very smart people who know your business very well, have both deep and broad knowledge and great analytical skills, and who display the potential for strategic-, system-, and design-thinking. That's a little challenging.
And then, when you find these people and attract them to your program, how best to organize them for effectiveness? Centralizing EA resources gives you the most control and makes it more likely that EA can deliver on its strategic value proposition. Decentralizing or federating EA resources puts the architects where the action is, making it more likely business and BT stakeholders will perceive value from the effort. But then those federated resources sometimes get so involved with their local — and usually tactical — issues that they go native and they’re not really working on the “E” in EA anymore.
Speed and agility are at the heart of business today — and, unfortunately, those are two areas in which IT is falling short. Two trends — neither of which is going away anytime soon — are impacting this increased need. Consumerization is rapidly changing the expectations of today’s information workers. In too many instances that we care to acknowledge, your employees are using faster, more agile solutions at home than they are at the office. On top of that, businesses are under an increased demand to change.
Enterprise architects are in a unique position to be change agents for their businesses — if they aggressively change the way they work with the business. Join us at our Enterprise Architecture forums — May 3 to 4 in Las Vegas and June 19 to 20 in Paris — for practical guidance on how to connect EA with your business’ bottom line.
You already know it. Technology is completely pervasive in our lives, and in how businesses operate. It’s pervasive in how business execs think — they know that every change they make has a technology aspect to it. As my colleague Randy Heffner says, “It’s no longer enough to say that technology supports business. Today, your business is embodied in its technology.”
You already know it. The pace of change in our highly interconnected and interdependent world is increasing — and along with this are the opportunities and risks which change brings. From emerging markets to new social platforms such as Pinterest, business leaders are finding they can’t assume stable business models and environments anymore. Gone are the days of three-year strategic plans — the mantra now is: “How quickly can we sense and respond to new opportunities and threats? How quickly can we shift our business for these changes?”
In today’s business environment, the pressure to change, and change quickly and often, is growing, thanks to the proliferation of empowered customers, emerging global markets, regulation (and deregulation), and growing social responsibilities. For the past several years, I’ve worked with CIOs from all types of industries as they’ve worked to transform the culture, the tactics, and the technology of their organization to become more agile. The successful ones, like Michael Mathias at Aetna or Glenn Schneider at Discover Financial Services, now sit in organizations where the business leaders look to IT as a key enabler of business agility.
And interestingly, when you speak with these successful CIOs, they often point to their enterprise architecture (and business architecture) as the secret weapon for how they achieve that agility -- the ability to tap new technologies and processes to help their businesses shift and innovate quickly. That’s great news, and shows the potential for high-performance EA practices.
I just saw something that makes a point I covered in a technology trends briefing for a client yesterday. After getting my Sun-dried Ethiopia Harrar (a $3.45 “clover-brewed,” ridiculously priced guilty pleasure – nice marketing job, Starbucks!), I noticed a young woman sitting behind me with her 5x7 notebook out, busily scribbling while bent over a large smartphone. Hmmm, I thought, let’s see what she’s doing. So I made pest of myself by asking a few questions. Here is some of the Q&A (her replies are abbreviated; she was actually quite helpful and not as curt):
Q: Are you a student or is what you are doing for work? A: No, I’m actually working.
Q: So do you have a PC? A: I do, but it’s a bulky 17” laptop that I got when I was a student, and I can do what I need on this.
Q: Is that company-issued phone, or is it yours? A: It’s mine.
Q: Does your company help by paying for any of the service? A: No, I pay it all myself.
Q: Are you doing an official assignment? A: No, nobody told me to do this. I am ...
Q: Do you even have your PC with you? A: No, I didn’t bring it.
We all feel the loss of human connection due to relentless automation, the emerging behavior of Digital Natives (who prefer online interaction to direct human interaction), and the inability of current systems to support “personalization at scale.” So I’ve been wondering whether we will start to see real pushback against the straight-through and self-service procesees we endure daily — what I am calling “faceless” processes. In short, we are starting to see inklings that the pendulum is swinging away from faceless processes and a back toward more personalized human-driven interactions.
There are a few things that seem to point in this direction, such as community banks taking customers from the big guys, or the well-documented hatred of foreign call centers and voicemail hell. An “I’ve had enough” shift is also advanced by more vocal consumer attitudes — witness, for example, the recent consumer pushback on debit card fees. The question is, will we start to see companies start to differentiate based on injecting humans back into the process? Does social have a role to play here? And is there a way to measure whether this is actually happening?
In the first phase of the information age, technology helped us achieve new levels of productivity. In the next phase, technology will shape who we are. Why? Because technology is everywhere – and savvy businesses are paying attention. I did a check on a recent trip and noticed that, on average, 80% of the people around me were nose down in their technology. That’s amazing if you stop and think about it….(pause for thinking)…When you spend that much time using something, it ceases to be a helper and starts to shape who you are.
I think 2012 will be a watershed year for the global business environment as technology moves from being “out there” to “part of us.” In 2020, we will look back on 2012 not as the year the world ended but as the year it changed for good. Check out the TED video We Are All Cyborgs Now. Here are four predictions about business in 2012 that all start with the fusion of business and technology and the impact that it will have on shaping business. I hope will add some new thought food to your mental garden:
My “Stuck in Cement” research is up on Forrester.com today. I have to say, I really wrestled with the title. It’s just incorrect to say “stuck in cement,” because technically cement is only the active ingredient and needs to be mixed with sand and water to make concrete. So it should be “stuck in concrete,” although somehow this doesn’t quite sound right. But really, who but a chemist would lose sleep over this or even catch the distinction? The real issue is whether packaged apps really are a barrier to innovation at this point — or does our research just reflect the high level of frustration that our clients feel trying to manage technology in a world changing so quickly?
The basic idea is that industry-specific or packaged apps — and these are currently mostly on-premises applications — aligned with organizational silos have worked well for well-defined, highly structured processes where volume, scale, and straight-through processing dominate system design. But these apps are difficult to change, appear increasingly less relevant, and form a barrier to innovation for companies in fast-moving industries like energy, healthcare, and financial services now facing advancing consumer technologies that threaten business as usual.
As my first calendar year as an analyst draws to a close, I wanted to thank everybody who has read and commented on my blog and say that I look forward to even more next year. In closing out the year, I turn for a moment away from emerging technology to share an email I wrote to one of our clients in response to some questions he had about the changing nature of EA. In describing the future, I'm going to blatantly pirate a term that Randy Heffner has been using for a while because as I sought to answer this client's questions, I realized how absolutely spot on it is. here is the relevant text of that email:
Happy to answer your questions as outlined below in the inquiry request. We have published a report along similar lines, BT 2020: IT's Future In The Empowered Era, that I recommend for additional ideas. Regarding timing, 2015 will be a stepping stone towards 2020, so I’ll focus answers on 2020, and you can extrapolate to 2015 in terms of the migration that needs to occur.