Peachtree has grown rapidly and are facing problems with its IT infrastructure. It needs to look for a better solution. There are two options proposed to solve the issue whether to use a monolithic enterprise software system which is a single set of systems and applications and completes consistency across all of the hospitals but lack of flexibility for doctors and costly or to implement SOA which is a modular system with flexibility to go after selective standardization but risky as new technology. To select the new approach, Peachtree need to consider some criteria in respect to business, IT and medical perspectives such as costs vs. benefits, health care environment, desired outcomes, system implementations, IT support, and efficiency. SOA is recommended because it is more flexible and suitable for health care work environment. The risk of unpredictable outcomes and costs due to new technology could be overcome by conducting research and analysis and well-planned system implementation and training. Current situation
Peachtree has grown rapidly in the past 12 years through mergers from a teaching hospital into a regional network of 11 large and midsize institutions and each institution has its unique doctor-dominated identity and own proud history and culture. Peachtree is now under a pressure to standardize its systems and processes because it is believed that standardization is more competitive and better in a long run. In addition, Peachtree is facing major IT infrastructure problems. Its current information system does not meet its requirement to achieve the company’s objective of having quality, consistency, and continuity of care across the entire network and delivering all that with the highest levels of efficacy, economy, and respect for patients and staff. There was a meltdown of the information system at one of its facilities. The problem could cause safety hazards to patients because the system is unreliable. Also, the current IT infrastructure has high maintenance costs. There are two proposals presented to address the current IT problems and to achieve the company’s objectives: using a monolithic enterprise software system which will standardize the processes across the network for all of the hospitals but is not flexible and comes with higher costs or adopting SOA which will be more flexible for selective standardization but is new to the market and unpredictable. Criteria
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Business perspective:
* Cost/benefit analysis: compare cost over time
* Health care environment
* Company’s mission and objectives
* Desired outcome
IT perspective:
* System implementation
* IT services and support
* Immediate and practical solutions
* Response to constant change
Medical perspective:
* Life or death
* Efficiency
Alternatives and recommendation
Alternatives
1. Keep the current system
Pros: * Keep the status quo * No cost| Cons: * Does not solve the current problem * Does not meet the mission and objectives|
2. Implement a monolithic enterprise software system
Pros: * Create homogeneous infrastructure * Complete interoperability and consistency * Unify patient records database| Cons: * Cost 500 million to a billion or more (5-7 years) * Need to redesign of every business process
3. Adopt SOA
Pros: * Provide flexibility to go after selective standardization * Provide agility * Can try on a limited scale and move forward in small steps to lower risk * Is flexible on price because of immature market| Cons: * Is new to the market * Has no industry track record * Is unpredictable in term of reliability, cost, estimate time to achieve the progress, desired outcome.|
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Recommendation
Based on the analysis of current situation, the recommendation is for Peachtree to adopt alternative #3. The recommendation is to adopt SOA to improve its IT infrastructure. Standardization of all medical processes may not be a right thing to do because standardization may not be suitable for medical environment. Each institution of Peachtree has its own idiosyncratic so it would be difficult to persuade doctors to change to a rigid rule to do their works. SOA will enable selective standardization. Even though the SOA market is not mature yet, Peachtree could start from small steps to reduce risk and gradually replace its existing systems with SOA. The immature market also allows Peachtree to negotiate the price of the system.
Risk management plan
Some of the actions may include:
* Research more about SOA. Since SOA is new and untested to the health care work environment and no other health care has used SOA so the risk of negative outcomes is high and for patients it could be life or death. Peachtree should conduct more research about SOA. It could review the use of SOA in similar work environment. * Conduct cost/benefit analysis. Peachtree is at risk for incurring high system implementation and maintenance costs due to unpredictable implementation timeline and outcomes. It should analyze all effects and gather data about costs and benefits of SOA. * Develop an overall implementation plan. If SOA is considered being adopted, Peachtree should replace its existing system with SOA by using phased implementation strategy. Direct implementation would be too risky if the new system does not work and too difficult to train users. It should test the system on a small scale to reduce the risk. Peachtree should get inputs from all of its relevant users including both routine and non-routine staff. * Train the users. The users should be trained the new system for each phase as it is introduced.
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