5 Key Enablers You Need to Know

Whether viewed as a business function, IT discipline or organisational blueprint, the purpose of Enterprise Architecture (EA) is to help organisations align their business processes, applications, data and technology to better achieve their strategic goals.  Over time it is common for these layers of the organisation to drift and separate as each deals with its own challenges and set of priorities.  To align these, EA provides organisations with a unique insight into their structure and operation, extending from strategic decision making to the delivery of technology-enabled change.  By understanding current capabilities coupled with business goals,  EA is able to help organisations chart their way to their desired future state. 

EA typically covers the following key aspects (also known as architecture domains) of an organisation.

 

Architecture domains

Architecture Motivation & Strategy
Defines the organisation’s business drivers, goals, resulting strategy and required capablities that the EA must support. 

Business Architecture
Focuses on the internal structure and operations and the external interactions of the organisation.

Application & Data Architecture
Identifies the applications and data needed to support the business, including how systems are connected, what data flows between them, and how the data is stored, managed and accessed.

Technology Architecture
Encompasses the physical hardware, software, networks and other IT infrastructure required to support the applications and data used by the organisation.

Change Delivery
The ultimate aim of EA is to facilitate the effective delivery of technology-enabled business change needed to achieve strategic goals.  In this respect, EA helps to ensure that both business change and technology change are implemented and aligned.  
 

What is MBEA?

Model-Based Enterprise Architecture (MBEA) is the practice of using models as the primary method of analysing, documenting and communicating EA. These models represent the various aspects and elements of the organisation and, just as importantly, the relationships between them.
 
In contrast to traditional document-based EA, which relies on lengthy text documents and static diagrams, MBEA focuses on the creation and use of dynamic, integrated models, built using industry standard notations such as ArchiMate, UML (Unified Modeling Language), SySML (Systems Modelling Language) or BPMN (Business Process Model and Notation).  Together, such models provide an end-to-end view of the current and future state of the organisation in a structured, visual way.
 
MBEA allows a more interactive and flexible approach to EA, where changes can be visualised, tested and understood in real-time.  It also greatly faciliates collaboration by providing stakeholders from the various parts of the organisation - such as the business, IT and operations – with a shared understanding of how the different parts of the organisation fit together.

Benefits of MBEA

The adoption of a MBEA approach provides a wide range of benefits, making it a powerful tool for organisational growth and transformation.
 

Improved decision-making

MBEA offers a holistic, up-to-date view of the organisation’s structure and operations, both at a business level and technically.  By providing a visual and interconnected model, decision-makers can quickly assess the impact of changes to processes, systems or technologies.  This helps organisations make informed decisions and minimise risk by understanding the cascading effects of changes across the enterprise.
 

Better collaboration between teams

MBEA allows for a shared understanding of the organisation’s structure.  With all stakeholders - from business leaders to IT – being able to access the same models, collaboration improves and silos are broken down.  This leads to better alignment between business strategy and IT operations.
 

Faster response to change

The ability to quickly adapt is the difference between success and failure in today’s fast-moving business environment.  MBEA supports this much needed agility by enabling organisations to rapidly analyse and adjust their structure and behaviour in response to new opportunities or challenges.  Whether adapting to regulatory changes or taking advantage of new technology, MBEA makes it easier to plan and implement changes, while minimising risk and disruption.
 

Consistency and accuracy

Models are precise and structured, allowing organisations to document their EA in a consistent and accurate way.  This reduces inconsistencies, duplication of information and errors that can occur in traditional document-based approaches.  With the right tools and approach to governance, changes to the architecture are easily traceable within the model, allowing them to be monitored and controlled more effectively.
 

Efficient use of resources

By having a clear, modelled view of the organisation, inefficiencies and redundances can be identified and eliminated, processes streamlined and automated, and resources focused on adding business value.  This leads to productivity gains, cost savings and more efficient use of staff and technology.

Key enablers of MBEA

Like all transformative initiatives, MBEA needs a number of key enablers to be established early on in order to to achieve success. 
 

1. Buy-in from senior leadership

The first and perhaps most crucial enabler for establishing a successful MBEA is securing the support of your organisation’s senior leadership.  EA spans multiple domains, from business processes to technology platforms, which makes leadership support essential for the practice to be impactful.
 
Without the active endorsement of senior leaders, the initiative is likely to fail due to lack the necessary resources, priority and departmental cooperation.  To succeed, the role of senior management is not only to allocate budget and resources but also to champion MBEA as a cross-deparmental function that all business units should support and align with.
 
Best practices

1. Present a clear business case that outlines the long-term value of MBEA, such as improved decision-making, cost optimisation and risk reduction.
2. Demonstrate quick wins to gain momentum and prove the effectiveness and value of the approach early on.

 

2. Well trained team

MBEA requires a skilled and knowledgeable team capable of analysing complex business processes and technologies, and understanding how to apply MBEA methods and tools to creating models of value to the organisation.
 
A trained team with proficiency in MBEA tools, modelling languages (such as ArchiMate or UML) and best practices is therefore essential. Using their knowledge and skills, the team must be able to create models that accurately reflect the organisation’s current and future state, and be able to communicate these to business and technical stakeholders at all levels within the organisation.
 
Moreover, continuous training and development are needed ensure that the team stays current with evolving MBEA standards, methodologies and tools.
 
Best practices

1. Invest in both formal training programs and on-the-job learning from experts to develop expertise in MBEA.
2. Foster a collaborative learning environment where team members can share knowledge and improve together.
3. Ensure your team is adequately resourced to meet the needs of the organisation.  For large and complex systems in particular, recruit process and technically focused specialists for modelling different aspects of the architecture.

 

3. Defined methodology and standards

A well-defined MBEA methodology and a set of standardised modelling conventions is a commonly overlooked but essential ingredient needed to guarantee production of clear, consistent and accurate models.    
 
A documented MBEA methodology should include instructions on the correct use of modelling standards and tools, and provide best practice guidance extending from stakeholder engagement and requirements discovery, to model creation, verification, validation, use and maintenance. 
 
As with having a well trained team, use of standardised modelling languages, processes and tools is vital for ensuring fit-for-purpose, high quality models that can be used by different teams and departments across the organisation.  Without this enabler, models will quickly become inconsistent, disjointed and impossible to reuse or extend.  With multiple versions of the "truth" emerging and models becoming increasingly difficult to produce or maintain, the organisation will soon learn to stop using them. 
 
Best practices

1. Adopt and tailor an established framework that fits the needs of your organisation.  This could involve utilising a standard EA framework such as TOGAF or Zachman; or following a hybrid approach by tailoring a framework already in use within your organisation, such as Scaled Agile Framework (SAFe) or ITIL, to include MBEA practices.
2. Develop a set of modelling guidelines, covering areas such as naming conventions, use of the modelling notation, visual styles and documentation requirements, as well as goverance processes for model change and version management.   
3. Conduct regular reviews and updates both to improve the methodology and to adapt to evolving business needs and advances in technology.

 

4. Shared centralised model repository

To enable collaboration and ensure that architecture models are accessible and up-to-date, a shared centralised model repository is essential.  As with any centralised data store, the model repository provides users with controlled access to a common source of data for adding and linking content.
 
With a centralised repository, modellers, architects and other users can collaborate in real-time, minimising duplication and inconsistency within the model, and accelerating decision-making and delivery.  Additionally, a centralised repository provides a robust foundation for governance and version control.
 
While modelling can be performed using tools linked to individual user repositories, this is neither a robust nor scalable approach to MBEA. 
 
Best practices

1. Invest in MBEA modelling tools that support real-time collaborative working and version control via a centralised model repository.
2. Pay close attention to defining the repository structure, i.e. how model content is organised.
3. Set clear policies and controls regarding viewing, adding and updating model content.
4. Ensure the tool and repository support model publication in various formats, bulk import and export of model content and, ideally, integration with other tools, such as requirements management systems and asset registers, for model linking and sychronation. 

 

5. Effective change management and comms

Implementing a MBEA function often represents a significant shift in how an organisation operates, particularly in how teams collaborate and make decisions.  This should not be underestimated.  As with any significant organisational change, an effective change management and communication strategy is crucial to help guide transformation and ensure the function is embraced across the organisation.
 
Change management should focus on helping employees understand the value of MBEA and how it will add value that improves their day-to-day work.  Communication and consultation are key in addressing any concerns and ensuring MBEA meets the needs of users and teams across the organisation.
 
Best practices

1. Establish a structured change management plan that includes training, stakeholder consultation, and clear milestones for implementation.
2. Regularly communicate the progress, benefits, and expectations to all stakeholders, especially those directly impacted by the changes.
3. Use stakeholder feedback to continuously improve the adoption process and address challenges at the earliest opportunity.

 

Conclusion

Successfully establishing a MBEA enables organisations to significantly increase alignment between business and IT, improve decision-making and enhance their ability to respond to change.  However, this is contingent on a number of critical enablers, namely, securing leadership buy-in, building a trained and skilled team, defining a clear methodology and standards, enabling centralised collaboration through a shared repository, and managing the transition to MBEA effectively through a well-planned change management and communication strategy.

By putting these foundational elements in place, organisations can significantly enhance their ability to establish a robust and sustainable MBEA function that delivers real business value and equips them to meet business and IT challenges both now and in the future.

Creating a Platform for Digital Growth and Innovation

In the rapidly evolving landscape of digital healthcare, the efficient exchange and utilisation of data are paramount to improving patient outcomes, enhancing operational efficiency and reducing costs.  It is important for healthcare organisations to realise that even when they choose a centralised Electronic Patient Record (EPR) system they will still be left with a multitude of specialist and other systems which will need integrating if they want to create a single view of the patient and streamline services.  Such systems may include specialist departmental applications such as theatre, pharmacy, cardiology or maternity systems; third party order management systems; personal health records; and remote monitoring systems, to mention only a few. 

The two basic approaches of linking any two systems are to enable them to communicate directly – also known as point-to-point – or to link them via a central hub – commonly known as hub and spoke.  Benefits such as improved quality and continuity of care, increased efficiency and reduced costs that information exchange provides are now well recognised by clinicians, healthcare managers and IT specialists alike.  However, the best way of connecting systems to achieve these benefits is not always as well understood.  In this blog post, we will therefore examine the two approaches to understand why hub and spoke integration emerges as the preferred choice. 

 

Point-to-Point Integration

Point-to-point integration involves establishing connections between individual systems so that they are able to exchange data directly with one another.  With this approach, each system requires a specific integration setup with every other system with which it communicates.  While this may seem straightforward initially, it becomes increasingly complex and challenging to manage as the number of systems and connections grows.

 

Advantages of Point-to-Point Integration

• Initial simplicity - point-to-point integration can be relatively simple to set up in the beginning when dealing with a small number of systems
• Direct communication - data flows directly between systems, ensuring real-time data exchange between the endpoints.  
   

Challenges of Point-to-Point Integration

Scalability

As the number of systems increases, the number of connections (integration points) multiplies exponentially, leading to a complex integration landscape that becomes increasingly difficult, expensive and risk-laden to maintain or extend.

Click to enlarge

In reality not every system will need to communicate with every other system.  However, in addition to each system having potentially multiple connections, it must also have knowledge of each and every system to which it connects, such as its network address and data exchange format. This is known as tight coupling and it has several negative impacts that make it challenging to manage any point-to-point integration solution consisting of more than one or two connections.
 

Impact on implementation

The complex network of tightly coupled systems caused by point-to-point integration increases the chance of functionality being duplicated, often inconsistently, in different places rather than being extracted into reusable modules.  Tight coupling and lack of reuse also impacts data standardisation and interoperability (i.e. the ease with which information can be exchanged and understood) as a result of systems having to individually translate between different data formats.   
 

Impact on testing

Tightly integrated systems are typically harder to test.  Testing a component in isolation becomes challenging when it cannot easily be separated from its network of dependencies on other systems. This can result in larger, more complex test cases and increased test effort to provide assurance that data can be exchanged correctly and therefore safely. 
 

Impact on maintenance

Each individual integration point must be configured and maintained in isolation leading to duplication of effort and potential inconsistencies when any changes are made.  Tightly coupled, point-to-point solutions also suffer from increased risk of defects being introduced when adding, modifying or replacing components.  Even small changes to one component might necessitate modifications to several others, leading to unanticipated effects on the network of interdependent systems.   
 

Impact on reliability

Implementation, testing and maintenance issues with point-to-point integration all affect the degree to which the solution is likely to be able to operate as intended without failure.  This also includes the solution’s fault-tolerance, i.e. its ability to handle the failure of one or more of its connected systems. 
 

Impact on growth and innovation

The difficulty in maintaining a complex point-to-point configuration inevitably affects the ease with which the solution can be adapted or extended to meet new or evolving requirements.  This severely impedes organisation’s ability to grow and innovate digitally and to respond quickly to change, the very benefits integration should aim to deliver.

Unless your requirement is to connect two or three systems and you are confident that no other systems will need to be integrated in future, then point-to-point integration should be avoided.

 

Hub and spoke Integration

Hub and spoke integration entails establishing a central integration hub (also known as an integration or interface engine) that acts as a centralised point for data exchange.  The spoke systems connect to the hub, enabling seamless and standardised communication across the healthcare ecosystem.

Most importantly, as a centralised platform for exchanging healthcare data, an integration hub provides a set of core capabilities that address the limitations of point-to-point integration. 
 
 

Advantages of Hub and Spoke Integration

 

Easier to scale

The integration hub provides each connected system with a single integration point.  Adding a new system to communicate with any number of other systems in the network involves adding a new connection to the hub.  This makes hub and spoke integration solutions inherently easier to scale to meet new requirements.  
 

Easier to implement, test and maintain

Most integration hubs provide inbuilt tools that enable new connections to be added, and subsequently managed, by configuration.  Standard functions such as message routing, error handling and logging can be configured, rather than having to be individually coded for each connection.  Reducing the need for bespoke coding accelerates development, simplifies testing and maintenance, reduces downtime, and improves overall quality (including reliability). 
 

Enhanced interoperability

Despite growing adoption of digital healthcare standards, one of the primary technical obstacles to creating a shared view of the patient and joining up care across settings is lack of interoperability among different vendor systems.  Even systems which do adopt common standards such as HL7 are rarely interoperable out-of-the-box because they implement their own refinements (or profiles) of the standard.  Specialist healthcare integration hubs are designed to support digital healthcare standards by default and in addition provide mapping tools and adapters for translating between different data formats.  This allows organisations to achieve true interoperability and connect their systems seamlessly.
 

Support for integration best practices

Many healthcare integration hubs support best practice patterns of healthcare information exchange out-of-the-box, helping to accelerate development and reduce risk.  Such patterns include guaranteed message delivery to aid reliability; automation of common workflows such as patient registration, appointment scheduling and diagnostic requesting to reduce administrative burden; and real-time notifications and alerting to ensure timely clinical intervention and improve patient safety.
 

Improved data management, governance and security

Data management, governance and security are critical aspects of healthcare integration.  Hub and spoke integration enables data quality, privacy and security controls to be implemented centrally to ensure consistent enforcement of data governance and security policies across the entire landscape of connected systems. 
 

Cost-effectiveness

Beyond the need to connect two or three systems, hub and spoke integration has the potential to offer significant cost savings.  Implementing and maintaining point-to-point connections becomes increasingly resource-intensive, costly and risk-prone as the number of systems grows.  By contrast, following the initial setup cost of the hub, the cost of adding and maintaining a new spoke is relatively fixed.  Cost savings become even more apparent in the long-term as the integration solution grows and organisations are able to add new systems without the need for expensive reconfiguration or redevelopment.
 

Conclusion

In the digital era of healthcare, seamless data exchange and interoperability are vital for providing efficient and high-quality care.  While hub and spoke and point-to-point integration both facilitate data exchange, the hub and spoke approach offers distinct advantages with regard to scalability, utility, quality and cost.  Hub and spoke solutions are highly scalable and, in general, easier to implement, test and maintain.  This reduces cost and accelerates delivery.  In addition, centralised monitoring and control provide for effective management, governance and security, while out-of-the-box support for interoperability and best practice enhance the quality and reliability of the solution overall.   

Most importantly, however, hub and spoke integration provides the flexibility and agility to meet the increasing need for healthcare organisations to exchange data seamlessly in their efforts to join up care, improve operational efficiency and harness digital innovation at scale.
 

ODiSI offers medical diagnostic services providers (such as radiology departments and pathology labs) powerful, flexible and cost-effective integration solutions built on the solid Open-Source foundations of NextGen's Mirth Connect integration hub.  Key benefits include:

1. Faster reporting of results leading to improved continuity of care

2. Increased efficiency through reduced manual data input

3. Interoperable data exchange as standard

These are just some of the proven benefits delivered by ODiSI (see our detailed case study).  Improved continuity of care leads to better patient outcomes and experience, while increased efficiency provides cost savings and optimises resource utilisation.  Interoperable data exchange helps to ensure data accessibility making information available to users to improve clinical decision making and reduce clinical risk.

  

Every ODiSI solution consists of:

• Installed production and test instance of integration hub software linking the customer's chosen set of IT systems to allow information to flow seamlessly between them
• Full design, installation, configuration and testing service
• Full design and test documentation
• Option of customer on-premise hosting or secure managed cloud hosting
• Optional solution aftercare service

To understand how ODiSI can be part of your plan to achieve integration success download a free copy of our comprehensive diagnostic imaging systems integration guide here.

As specialists in healthcare integration, Applied Informatics understands how to design and build powerful, flexible and cost-effective integration solutions aimed at increasing efficiency and throughput, reducing costs and improving patient outcomes.

Our track record speaks for itself with customers describing our integration solutions as the “jewel in their IT architecture”, “relentlessly delivering reliability and efficiency benefits throughout, all in a way that matches precisely the nuances of our business requirements.”

Given our extensive experience in diagnostic systems integration, we are thrilled to be able to share with you our new Diagnostic Imaging Systems Integration Guide.  This comprehensive guide discusses diagnostic imaging workflows and systems, provides an overview of integration patterns and standards, and enables readers to understand the key factors in choosing between COTS, open source and bespoke integration hubs.  Finally the guide describes five important steps to achieving integration success.

Learn more by downloading a copy for yourself.

Founded in 1987, Health Level Seven International (HL7 ®) is a not-for-profit, ANSI-accredited standars developing organisation.  HL7 produces the world's most widely used standards for healthcare interoperability.  Most of the leading suppliers use and support the development of HL7 standards across six continents.  HL7 FHIR ® is the current strategic technology for new interfaces from NHS Digital.

HL7 UK is the affiliate organisation to HL7 International within the United Kingdom.

We are delighted to announce that Applied Informatics have become a benefactor member of HL7 UK and consider the success of HL7 as strategically important.  Benefactor membership provides us with a mechanism to support and influence the development of UK-specific versions of the standard.  This is critical to the delivery of our Data Modelling & Design and Integration Architecture & Design services within the healthcare sector.