Peachtree Healthcare has been faced with a dilemma. There has been a major IT infrastructure problem within the company for some time now. Since technology has taken over in the healthcare field, it is imperative that Peachtree Healthcare get the technology needed so that they can be trusted and well known within the healthcare industry. Mission The mission of Peachtree Healthcare is to ensure quality, consistency, and continuity of care across the entire network – and to deliver care with the highest levels of efficiency and economy while maintaining respect for patients and staff.
Objectives The hospital needs to decide on what long / short term IT infrastructure system strategies and roadmaps are needed to increase efficiency. The new system should allow sharing of patient records, ensure quality, consistency, and continuity of care across entire network of hospitals and physicians. Key Issues The IT infrastructure is not reliable; therefore, uses are unable to perform their day to day functions including clinical duties. This is impacting quality and safety of patient care. Recommendations
Adopt service oriented architecture (SOA) which will enable selective standardization. CURRENT SITUATION (10) Peachtree Healthcare has major IT infrastructure problems and is struggling to find the right fix. Growth through acquisitions has led to the inheritance of many incompatible legacy systems. Current IT resources are focused on maintaining inefficient processes in order to keep the hospital running. The maintenance costs of the current IT system are so high that further innovation has become a luxury. In addition there have been recent meltdowns of clinical information systems.
IT infrastructure is not reliable; therefore users are unable to perform their day to day functions, including clinical duties. This is impacting quality and safety of patient care. Furthermore there is pressure from the hospital’s board to standardize hospital procedures and practices without fully assessing the need for it. Max Berndt (CEO), Candace Markovich (CIO) and Tom Drane (CFO) are struggling to analyze the current situation subjectively in order to properly manage the pressure to follow competitors. CRITERIA (5)
The hospital needs to decide on what long / short term IT infrastructure system strategies and roadmaps are needed to increase efficiency. The new system should allow sharing of patient records, ensure quality, consistency, and continuity of care across entire network of hospitals and physicians. The system should also ensure “selective” standardization of certain medical procedures across the network but allow sufficient flexibility to individual hospitals and professionals in other areas. Other criteria include:
• Time to value – when will the new system realize value for each business unit • Flexibility – easy to modify, upgrade and customization capabilities • Staff buy-in – ability to convince all staff to give this project a try ALTERNATIVES & RECOMMENDATIONS (15) Alternative 1: Monolithic System (Modular Enterprise System) A monolithic system is single set of systems and applications that will provide consistency across Peachtree’s facilities but may not give doctors enough flexibility. Other pros and cons include:
|Pros |Cons | |Tried and true |Costs 500 million – 1 billion dollars | |Gets the job done |Difficult to estimate true costs | |Creates new consistent infrastructure |Requires redesign of every business process | |Single set of systems that unifies hospitals and patient records |Could render the surgical approach difficult to the point of | | |impossibility | |Peachtree healthcare can become a single institution with multiple |Many doctors are independent professionals and dislike standardization| |sites | | | |There could be many malfunctions | Alternative 2: Service-Oriented Architecture (SOA) System
A servicer-oriented architecture system is modular design that will allow Peachtree to standardize incrementally and selectively but poses certain risks as a newer technology. Other pros and cons include: |Pros |Cons | |System will provide quickness |Technology is not proven and unpredictable | |System will proved flexibility – selective standardization |Immature SOA market / no industry track record | |Can limit scale / move slowly to reduce risk |Risk of becoming victim of ongoing learning curve | |Vendors are willing to be flexible on cost due to immature SOA market |No one else is aggressively adopting SOA | | |Difficult to estimate time to achieve progress | Recommendation:
My recommendation is to crease a strategy of selective standardization using a SOA system. This means assessing and deciding on a SOA architecture standard. Reviewing individual business functions and deciding on an ideal standard for that functional unit then migrating others to it. This will allow Peachtree to standardize incrementally, which Max has wanted most in an IT infrastructure. RISK MANAGEMENT PLAN (15).
Since SOA is a new technology, there are serious risks and consequences involved with this approach. The SOA technology is not mature yet and has not been tested in the long term. As a result there is a lot of unpredictability. To mitigate these risks Peachtree should gradually replace its old system with the SOA System. They should proceed with SOA in stages by piloting smaller projects to quickly provide value to business units. By gradually installing the SOA, Peachtree and its doctors would learn about how the systems worked and they could then master it in a sense as the infrastructure moved further.
By gradually installing the infrastructure, Peachtree would not only minimize risk but also create flexibility and control. With the gradual learning process on the new SOA system, Peachtree and its physicians would allow IT to shift priorities along the way. Peachtree should also create case studies to get other business units and vendors support throughout roll-out process. They should also consider hiring external change management consultants to ensure minimum user disruption and smooth transition into the new system.