This is going to change everything

This article is the first in a monthly series introducing the concept of enterprise architecture and how it can be applied to manage and improve the performance of government. The articles will be written by the Industry Advisory Council's Enterprise Architecture Shared Interest Group, a volunteer organization comprised of federal groups, industry and academia that is working to establish a more citizen-involved open government. This article introduces and explains what enterprise architecture is and why officials across government should care.

Belinda, a friend of mine, was stricken by a particularly virulent strain of lupus. When her strength and pocketbook were depleted, she found she fell into a gap in our health care delivery system. She was shuttled from hospitals in Washington to others in Georgia and North Carolina, receiving identical, ineffective treatments. She eventually underwent a new therapy in Kansas City, Mo., which finally stabilized her condition. The process took many months (too many months), and the odyssey required her to rely on the kindness of others, which thankfully she was given. My wife, a registered nurse in a large metropolitan hospital, says our friend's case is not unique.

There are millions of people who have no idea how to negotiate the myriad government health programs to receive assistance. Belinda, an educated woman, cannot comprehend why agencies at the federal, state and local levels "can't just talk with one another" to seamlessly exchange information and organize responsibilities. She does not know, or care, that agencies operate by closely following laws and assume that another agency is responsible for delivering other services that meet her needs. If there is a gap between the way agencies function or communicate, it becomes the responsibility of legislators to fix it. Unfortunately, this process takes too long to help Belinda.

What government needs are storytellers -- people who can articulate the problems millions of patients like Belinda face and provide the options that will result in quick service and improve health care. Folks like these historically have been called ombudsmen. They create a clear picture of the problem and provide rational choices and their implications. Ombudsmen help policymakers and others fix delivery problems quickly, sometimes before they become a problem at all.

Enterprise architecture, or EA as it is more commonly referred to, is a modern form of the ombudsman role. The process started out by mapping how an agency's networks were linked and how information flowed through an organization, but it has become so much more. Now, a key part of the role of an enterprise architect is to understand the basic needs of citizens or other constituent groups and then plot ways participants (public and private) can work together to deliver the best outcome for those needs. Put another way, EA builds a solid foundation for wise choices by simulating the effects of different alternatives, giving decision-makers the ability to visualize the consequences before officials agree on a final course of action.

How would EA help Belinda? Enterprise architecture would inform federal and state policymakers why she was moved from facility to facility and why she continuously received the same ineffective treatments. EA also would provide ways to fix the problem by sharing records and collaborating on solutions. It provides a clear view of security or privacy risks that might occur, offering solutions that can reduce risks. And it would quantify the value of each alternative's outcome, pointing to what might be the best solution.

Enterprise architecture is a blueprint showing how information flows through an organization, or organizations, and who has responsibility for it in a system, in this case the health care system, whether it is across agencies and from federal to state to local governments. EA is holistic, meaning that everyone involved in the health care system -- government agencies and private clinics and providers -- should be considered "actors" in the solution. If the health care system was built on an EA foundation, it would save many billions of dollars. More important, however, citizens like Belinda would quickly receive the care they need.

To unlock the value from enterprise architecture, government will have to become citizen-centered. It must restructure its approach to creating services -- now a top-down exercise -- to one that structures services based on what is right for citizens every time they interact with an agency. Government must decide how to deliver services from the ground up, which means first understanding the public's health care needs and then constructing scenarios -- or rather, stories -- that describe the way citizens interact with government throughout their lives to meet those needs.

You might think this new approach is impossible because there are millions of stories like Belinda's. But as we look deeper into a delivery system that is based on patients' needs, these stories can be classified in terms of how they are structured: Who should be involved? What is needed from each government provider?

Structure provides the methods for all health care participants to simply talk to each other when addressing a medical need. Next, we consider the behaviors required from different government entities -- the actions necessary from government so it can act as a team and provide innovative solutions for citizens.

Behavior and structure are the core elements enterprise architects use to construct patterns that provide solutions. These solution patterns, like any other pattern, can be adjusted and applied in different ways to eliminate redundancies and gaps in care. Policymakers help to shape the patterns, using mandates to alter each set "just enough" to solve problems for groups of citizens who likely face the same issues that Belinda did. Current technology empowers government entities to apply patterns effectively using social collaboration methods. In short, it makes the impossible possible.

The result? Mandates cease to be blunt instruments for compliance and become ways to optimize health care delivery, using the collective voices of constituents as a guide for decision-making.

In future articles, we will present new ideas that dig deeper into enterprise architecture. IAC's aim is to replace the "it can't be done" attitude with an "it can be done" approach. If you are interested in learning more, please contact me at djackson@2md.com. Our only requirements are an open mind and a willingness to do the right thing.

Doug Jackson is the managing partner of 2md, a small enterprise architecture business. He is the communications chair for the Industry Advisory Council and lives in Kansas City, Mo.