TOGAF or not TOGAF?

When we think of the word architecture, the first thing that comes into mind are buildings. The common meaning of the word is the process of planning, designing, and constructing physical structures. This all reflects the technical, social, environmental and the aesthetic background of the architect and the client.

However, architecture is not just about physical structures. The word has been adapted to different structures, computers, networks, organizations. According to Roger Sessions, enterprise architecture (EA) is described as the “organization of a system (the enterprise/business) embodied in its components, their relationships between each other and the environment and principles guiding its design and evolution.” EA was created to solve problems of the growing complexity of IT systems and aligning them to the business needs. 

So why is this important in Health Information Systems? Isn’t this more suited for private companies so that they can maximize their profits? Well let’s look at it at a different perspective. The HIS’ purpose is to improve health service, meaning it makes it more efficient. Just like anything, it requires resources (such as money, personnel, time) to create and maintain. Like for private corporations, these resources are limited, so we have to make sure that none of them are wasted. So because of both our goal and limitations, efficiency is needed. In that way, the health system and a private company are rather similar. 

So EA’s can help us create an efficient HIS. There are different approaches called “EA methodologies” to develop the system. The assignment for this week is to select one of the four methodologies that could be used to develop the HIS. Before I discuss the four methodologies, we have to look at what the enterprise (the Philippine government health system) looks like. Here is an organizational chart of the functional clusters of our current health system.

Organizational chart from the DOH

As you can see, it is split up to two general clusters, the technical and operation clusters. Technical clusters deal with specific aspects of the health system — finance, diseases of priority, human resources, etc. They are further subdivided to divisions who focus on specific functions of the cluster.

Operation clusters are the regional representatives of the health system across the country. This is made up of centres for health development (CHD). These CHD’s are the most local-level of the units that are directly under the DOH, however there are health units that are more local than them. There are provincial health office (PHO) under the provincial government, and municipal health office (MHO) under the municipal government. Cities not under provinces, such as those in the NCR also have their own MHOs. At the most local level are the barangay health centers and hospitals. Certain specialty hospitals are directly under the DOH, such as the Lung Center of the Philippines, National Kidney and Transplant Institute and Philippine Heart Center.

So how is data gathered, processed, and distributed across these different clusters? Let’s look at a few aspects and link the operation clusters to the technical cluster involved. First, let’s look at human resources. The health Human Resource Development Bureau (HRDB) is in charge of this aspect.

Here are their general functions:

1. Formulates plans, policies, programs and standards related to the production, deployment, utilization and development of human resource for the health sector.
2. Provides relevant training programs for specific categories of health workers and technical assistance and expert services to collaborating and implementing agencies.
3. Develops benefits and compensation packages for health human resource.
4. Conduct studies and researches on health human resource.
5. Advises the Secretary of Health on matters pertaining to the health human resource development.

So, let’s say for function 1, in order to deploy health workers effectively, they have to know the distribution of the different kinds of health workers across the country. What kind of data do they need? They need a list of all health workers working for each of the most local units - the barangay health centers and hospitals. Each one has to list all their health workers, such as doctors, nurses, midwives, etc. Even their specialization have to be listed such as with doctors, they can be general practitioners, pediatricians, obstetricians, etc. These lists then have to collected by the MHO, then collected by the PHO, then the CHD, then finally the central office of the DOH. All these lists can then be used to create a distribution map of health workers (they can create multiple for each type and specialization). The HRDB can now get an idea of which areas that have a greater need for certain specialists, and develop their plans accordingly. These plans then have to be disseminated from HRDB down to CHD, down to the PHO, down to the MHO, and finally to the health centers and hospitals. 

Since we’re talking about the health system as a business, let’s look into finance. Here are the general functions of the Finance Service (FS):

1. Coordinates budget preparation activities
2. Conducts financial planning including program budgeting and review based on national policies, plans and objectives for health
3. Serves as fiscal comptroller of the Department of Health and provides services related to cash management and accounting performance
4. Advises the Secretary of Health on matters pertaining to finance services.

So let’s consider program budgeting of a national health project (because externally supported health projects are under a different group) from function 2. So the FS needs to look at what the total budget is for health, estimated costs for the resources needed to implement the project, and prevalence of the disease concerned with the project.  To get the prevalence, barangay health centers and hospitals make a report of the number of cases of the disease to the MHO, then it is collated by the PHO, and then the CHD, and finally by the central office. The total budget can be retrieved from the central office and the costs of resources from different suppliers are canvassed by the Central Office Bids and Awards Committee (COBAC). Then the budget and supplies for the project are distributed to the local health units to be used for the project. However, they can only take into consideration down to the CHD as the local level. Why? Because financing of health programs in the provincial and municipal level is under the their respective government units. In this respect, they are autonomous from the national government (the DOH). Even in the first example, while information of the HRDB’s plans is spread to the most local levels, it is still up to the MHO and PHO to give it priority and implement it. This is a troubling situation of the central government needing data from the local government, but lacking any real power to apply the knowledge gained from it at the local level.

Ok, now we have an idea of the situation in the organization. Before we look into the EA methodologies, here are a few terms that we have to understand. These are taken from Session’s paper on comparison of Architecture Methodologies:

architectural artifact — A specific document, report, analysis, model, or other tangible that contributes to an architectural description

architectural methodology — A generic term that can describe any structured approach to solving some or all of the problems related to architecture

architectural taxonomy — A methodology for organizing and categorizing architectural artifacts

Now let’s look at the four EA methodologies. Here I’ll list what I think are the strength and weaknesses of each.

Zachman Framework for Enterprise Architecture

Zachman’s framework is not really an architectural framework per se. It is an architectural taxonomy. Zachman classifies architectural artifacts into which individuals in the company would use it and its descriptive focus. So on its own it is not useful in developing an EA because there is no actual process for creating the EA. However, by applying it to another methodology, it can help sharpen the focus of EA artifacts to concerns of each of the major players, but still help them understand that their perspectives are all being considered when creating the EA.

The Open Group Architecture Framework

Also known as TOGAF. Advantages of TOGAF are on the practical side. As you will see in another methodology later, the enterprise will not be locked into a consulting organization. While a TOGAF consultant can be hired to help develop the architecture, another option is to train itself to use it. TOGAF has the most free/inexpensive information available of the methodologies. Another big  advantage is that it guides the enterprise though the process of developing an EA in great detail through its Architecture Development Method. This complements Zachman’s framework as it is what it is lacking. A detailed process is useful especially for an organization that is developing an EA for the first time. 

On the other hand, applying TOGAF is a risk if the organization choses to do it on their own for the first time with no consultant/individuals with experience. This is because TOGAF gives the steps on creating an EA, but not necessarily an effective one. With our goal being to make an efficient information system, this is a problem of possibly wasting resources that could be used elsewhere.

Federal Enterprise Architecture

FEA for short, this methodology’s advantage is its view of enterprise as segments. Segments are lines of functionality in the enterprise. In application to the health system, the national level and the provincial and municipal level health units are split up between its core-mission segments and business services segments instead of different agencies. Because of this segmentation, the autonomy of the local health units are still respected while being part of the greater system. Also, FEA develops and  measures the maturity of each health unit separately. This gives each unit the freedom to implement and use the developed EA for each segment at their own pace.

A big problem of FEA is that it takes time to show results. This is the price of applying EA on various segments at different paces, sometimes even one at a time. As much as I believe in “slow and steady wins the race,” having no results for a long time does not help build confidence and support of the EA from the various stakeholders. 

Gartner

Gartner-Meta is a company that specializes in EA consultation. Their main advantage is that the center of the method unifying all the stakeholders in a common vision and turning it into results. This makes the EA easily acceptable for everyone. Because it prioritizes results, it cuts out all the fat from processes and taxonomies and focuses on how to achieve the enterprise vision. This makes it the fastest to show improvements upon implementing the EA.

However, remember what I said about TOGAF? Opposite to this, Gartner is a company with specialists who develop custom EAs for enterprises. There is no strict process or taxonomy to read up on. If it were to be used, the DOH has no other option but to to hire a consultant from Gartner to help develop the EA, and it would be costly. Also, with the vastness of the entire enterprise, I don’t know if Gartner has the ability to unify all stakeholders in a single vision.

Final Thoughts

I think that the practical aspects really greatly hamper Gartner to be used for the PHIS. FEA complements the current organizational structure, but our culture of demanding quick results will be problematic for acceptance. TOGAF helps advance our own knowledge of EA and is the most practical, the risk here is that if we go with no consultant/experience, it could lead to a EA that doesn’t really improve the entire enterprise. If I were to choose one of these methodologies, it would be a toss up between TOGAF using the Zachman Framework or FEA.

Sources:

1. Finance Service. Retrieved from Department of Health website: http://www.doh.gov.ph/content/finance-service.html.
2. Functional Clusters for Kalusugan Pangkalahatan. (2011). Retrieved from Department of Health website: http://www.doh.gov.ph/sites/default/files/2011-11-24_18-08_KP%20organogram.pdf_0.jpg.
3. Health Human Resource Development Bureau. Retrieved from Department of Health website: http://www.doh.gov.ph/content/health-human-resource-development-bureau.html
4. R. Sessions. A Comparison of the Top Four Enterprise-Architecture Methodologies. (2007). Retrieved from Microsoft Developer Network website:  http://msdn.microsoft.com/en-us/library/bb466232.aspx.