1 / 32

Transforming Healthcare Operations Through Business-Driven Semantics

At the Semtech Summit in San Francisco, Paul Kalis from Westmoreland presents an innovative framework for project and program management in healthcare. Utilizing a "Triangle approach" of Men, Machine, and Method, Kalis discusses effective strategies for navigating complex legislation and high-volume service delivery. The presentation highlights real-world case references, challenges faced in implementing healthcare reform, and ways to restore trust in system operations. Attendees will gain insights into optimizing tax funding, enhancing operational frameworks, and achieving efficiency gains in public services.

everly
Télécharger la présentation

Transforming Healthcare Operations Through Business-Driven Semantics

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. About business driven semantics Summit: Semtech San Francisco July 2012 Speaker: Paul Kalis Company: Westmoreland Project | Programma | Interim

  2. About Westmoreland • Interim | Project | Program management • Triangle approach Men - Machine - Method • Shipping / Banking / Healthcare / Public services • Turn visionintooperation Project | Programma | Interim

  3. Case reference • The centraladministration office forexecution of healthcarelegislation. • Funding of health care andmedicalorganisations. • Identify, calculate, disposeand collect individualdues • Identify, calculate, dispose and submit individual grants • Income politics vs. disease and disability Project | Programma | Interim

  4. Case reference – volumes Public servicesamouts€ x 1.000 # customers National health 24.000.000 25 National health 250.000 350.000 National health 1.500.000 250.000 Localgouvernments 500.000650.000 Nat. government 100.000 2.000.000 Nat. government 750.000 3.100.000 Total 27.100.000 4.300.000 Project | Programma | Interim

  5. Case reference - figures YearFTECustomers Ratio 196815 15.000 1 : 1.000 2004 150 350.000 1 : 2.333 Efficiency leap 42% 2007 400 950.000 1 : 2.375 2008 600 1.500.000 1 : 2.500 2009 700 1.750.000 1 : 2.500 2010 9503.100.000 1 : 3.263 Efficiency leap 30% 2011 1100 4.300.000 1 : 3.909 Efficiency leap 19% Project | Programma | Interim

  6. Case reference - situation • Unprescedented growth due to health system reform • High volume business vs. complicated legislation • Batch driven volume delivery vs. emotion driven demand • Income politics versus illness, disability and healthproblems • Strong political and social playfield • Pressure from politics and national administration • Focus on cut tax spending • Changes in operationalframeworkandliabilities Project | Programma | Interim

  7. Case reference - challenge • Restore trust tax payers, customers, national administration, politics • Changes in legislationtobeimplementedfasteragainstlowercosts • Production customer focussedagainstlowercosts. • Implement new legislation • Find 2.700.000 new customers in various administrations • Mark them chronically ill or disabled, dispose and pay them € 1 billion • Save us 3 billion in efficiency andtaxcuts • Do it within 1 year • Don’t bother residents, avoid hassle Project | Programma | Interim

  8. The problems - organisation • Operational policy makers are incomprehensible • Business wants everything regardless money or time • The productowner wants even more • Business analistst only analyse “ what they want” • IT architects keep changing their minds • Testers keep saying that they only test against the testbase • No knowledge and skills of semantics to operation Project | Programma | Interim

  9. To go short • Demand not able to define • Supply allowed to go complex • Result: • Money drain • Extended planning • No working system • No result GAP between what we defined and what was build Black box Project | Programma | Interim GAP between what de model should do and what the system does

  10. Business driven semantics is not about ICT • The Know • The Businessrule • The Flow • Java • XSLT • Operating • Hardware Business analysts Policy makers Business developers Legislation Ontology Demand Project | Programma | Interim Supply ICT

  11. Supply chain “old school” Project | Programma | Interim

  12. Supply chain “ new school” Project | Programma | Interim

  13. Company ICT “Old school” Grey Box Project | Programma | Interim

  14. Supply chain ICT“Old school” Black box Project | Programma | Interim

  15. Portals Customer Portal CAK-portal Partner-portal Inter change CRM Leg 3 legal Leg 1 Leg 2 Credit & control Business Intel. Verseon Oracle Fin. Enterprise Service Bus Gateway Batch converter Scan facility Output Sub-system TXT TXT TXT Porta Rinis Press Web / CMS GBA FTP Component based platform “New school” Project | Programma | Interim

  16. User process guidance “Old school” Project | Programma | Interim

  17. User proces control “new school” Project | Programma | Interim

  18. Supply chain user process control Project | Programma | Interim

  19. Aboutmodelling Project | Programma | Interim

  20. Human modelling Man experience is aboutmodels Project | Programma | Interim

  21. The family of Know Activities Services Case objects “Phase” and “State” Knowledge instruments Time limits InvolvementrolesArtefacts (lDocuments, Notes, Appointments) Dynamics Pre conditions Post conditions Project | Programma | Interim

  22. Regulartaxonomies of know Project | Programma | Interim

  23. Aboutbusinessrules Project | Programma | Interim

  24. Automation of businessrulesandknow ? Project | Programma | Interim

  25. Create ontology Project | Programma | Interim

  26. The solutions - Demand • Empower intelligence by knowledge modelling • Get productowners out • Demand starts with legislation, operational policy makers and analists • Take time to support business analists in modelling practices • Take time to support policy makers and analists in dealing with leadership and taking decisions • Picture the future world by modelling and refine ongoing • Use strict model patterns compliant with the architecture • Secure the architecture and onthologie before you start • Force automation to stay within the ontology Project | Programma | Interim

  27. The knitting machine Project | Programma | Interim The model is the machine

  28. More problems - supply • Event driven datastorage • Event driven performance • Stabilisation of schedulers • Knowledge and skills of case modellers • Migration Project | Programma | Interim

  29. The solutions - Supply • Do not start without a fixed architecture • Use a CDM / CMM • Invest in case modellers • Process volume data files directlyinto the database, bypass events • Choosethe events you want to store, throw the rest away • Extendregressiontestingto the max. • Createaninitial load mechanismforloading MIS • Split batch and portalprocessing • No migration Project | Programma | Interim

  30. Yield • Insight and synergie in complex legislation operating models • supply chain proces and quality controls • User process guidance and controls • Less human errors in decision management • Event driven dossiers for individual customers • 50% more efficiency in time to operate for development and changes in legislation • 99% STP for main flow processes • 100.000 calls per week in 4 call centers • Customer satisfaction 91% • Compliments by nat. administration, politicsand healthcare associates for low cost of operation. Project | Programma | Interim

  31. Responsibilities Business driven semantics is about more than analysis and requirements. It is about setting a future mode of operation *********Enjoy your calling ******** Project | Programma | Interim

  32. Thankyou Project | Programma | Interim Project | Program | Interim

More Related