By Amirth Ramakrishnan

In these tough economic times, companies are looking to leverage their existing assets to cut costs and grow their businesses. These assets include physical, human and informational assets. Physical assets include plants, machinery and buildings. Human assets (people) use these physical assets to deliver products and services to their customers.

In recent years, companies have generated huge amounts of data in the process of creating, developing and delivering products and services to customers. The data is resident in companies’ information systems, often in enterprise resource planning systems. As companies mature, they face formidable challenges in managing this growing mountain of data. Over time, many corporate strategies evolve as a result of changing business climate and issues, resulting in strategies that are often reactive and suboptimal.

Businesses can adopt a comprehensive approach to effectively leverage information in ERP systems for competitive advantage. The approach outlined in this article serves as a useful starting point for adopting an effective EIM strategy or to validate an existing EIM strategy.

Strategy Overview

Companies need to pursue the following elements of a four-dimensional strategy to ensure a comprehensive approach to EIM. This strategy takes a “lifecycle” approach to EIM, i.e., it is based on how data is acquired, managed, secured and disposed of in an organization. Most of the other approaches are based on classifying data based on its type (for example, into master data, transaction data, metadata, etc.) but they do not provide insight into how an EIM strategy should be initiated and deployed within an organization. 

EIM Governance: The core of the strategy is based on the right governance structure for managing EIM initiatives within the company. First, the governance team should establish the policies and procedures to launch EIM projects based on long-term business strategy and return on investment. ROI places a quantitative value on the business benefit of the program or project that leverages the information resident within the company. The governance team should consist of both providers (e.g., the order management team which is the source of transactional data) and consumers (e.g., the business intelligence team which uses transactional data to provide reports or inputs to senior management).

The governance team plays a pivotal role in ensuring the right projects are accepted. In the initial stages of the company’s EIM roadmap, focus should be placed on projects that help companies acquire information.

Acquire: Companies acquire information through internal (transactional as well as other operational systems) and external systems during the course of running their business. The process for validating, accepting and managing this information is an important part of the EIM strategy. Typically, enterprise-wide standards have to be implemented to ensure the correct level of information is captured during these interactions to enable a cohesive EIM strategy.

Share: One of the major problems that enterprises face is that organizational information is in silos and there is not a single view of customers, suppliers, partners or even employees. These problems multiply when companies acquire, merge, disinvest or spin off divisions or geographical units. Projects and initiatives that enable enterprise information to be transparent and readily available to business leadership and other stakeholders fall under this category. These initiatives (for example, data warehouse, reporting, etc.) thus enable quick decision-making and help senior leadership to understand how different businesses and geographies have performed. BI and data warehouse tools are typically used to enable these initiatives.

Improve: The quality of information available within a company’s systems is dependent on innumerable factors, some of which are beyond enterprise control. Companies receive feeds and data from suppliers, partners and customers, and there is high likelihood of inconsistent data quality. These problems become apparent during software upgrades and migrations or ERP implementations. IT leadership should measure the information quality through various metrics (such as error rates in order or service fulfillment, invoicing and billing errors, etc.) and target specific improvements through focused projects that improve information quality.

Secure: Every enterprise has to zealously guard their informational assets against willful or accidental breach of security. The potential hit on company’s business makes it imperative for IT leadership to ensure security of information. Projects and processes to ensure the right level of access and security need to be implemented to ensure a strong and secure informational infrastructure that business leadership can rely on to make tactical and strategic decisions. Projects that help ensure security of information are typically run in parallel to other programs that acquire, share and improve the enterprise information infrastructure.

Evolution of EIM Strategy

Tailor the EIM strategy based on specific company needs. Startups and young companies typically focuses on acquisition of information programs and projects that will help them generate leads and opportunities to sell their products and services. Companies that are more established tend to focus on improving the quality and transparency of the available information. Lastly, companies in highly regulated and competitive industries (for example, government, health care and financial services) invest a significant portion of their IT budgets in information security initiatives.

EIM Building Blocks

Some of the technology building blocks supporting a successful EIM strategy involve a service-oriented architecture that will enable improvements to ensure companies can acquire, share, improve and secure their information assets. In addition, companies need to standardize on tools, processes and standards to ensure their EIM strategy is understood and implemented at all levels of the organization. Further, given the global nature of the business, IT leadership should evaluate their systems, processes and tools that can adapt to global and virtual teams.In the coming years, enterprises will increasingly face challenges relating to unstructured information like emails, text messages, tweets, blogs as well as internal portals and other content management tools. The strategic elements to manage these streams of information remain the same. However, software tools and applications will continue to evolve and help achieve a unified lifecycle-based EIM strategy.

About the author: Amirth Ramakrishnan is a senior account manager with Sierra Atlantic Inc. with more than 14 years of experience in the global IT services industry. He works with customers to define and implement IT strategies and solutions for the extended enterprise by using the Global Delivery Model. He is based out of Austin, Texas and can be reached at Amirth.Ramakrishnan@sierraatlantic.com

As the heated debate continues about ways to decrease the costs of our healthcare system while simultaneously improving its quality, it is critical to consider the most appropriate place to start – which depends on who you are. Much has been made about the advantages of clinical alerts especially with their use in areas high on the national radar like quality of care, medication use and allergic reactions, and adverse events.   Common sense, though, says walk before you run; in this case its crawl before you run. 

Clinical alerts are most often electronic messages sent via email, text, page, and even automated voice to notify a clinician or group of clinicians to conduct a course of action related to their patient care based on data retrieved in a Clinical Decision Support System (CDSS) designed for optimal outcomes. The rules engine that generates alerts is created specifically for various areas of patient safety and quality like administering vaccines to children, core measure compliance, and preventing complications like venous thromboembolism (VTE) (also a core measure). The benefits of using clinical alerts in various care settings are obvious if the right people, processes, and systems are in place to consume and manage the alerts appropriately. Numerous studies have been done highlighting the right and wrong ways of implementing and utilizing alerts. The best criteria I’ve seen used consider 5 major themes when designing alerts: Efficiency, Usefulness, Information Content, User Interface, and Workflow (I’ve personally confirmed each of these from numerous discussions with clinicians ranging from ED nurses to Anesthesiologists in the OR to hospitalists on the floors). And don’t forget one huge piece of the alerting discussion that often gets overlooked…….the patient! While some of these may be obvious, all must be considered as the design and implementation phases of the alerts progress.

OK, Now Back to Reality

A discussion about how clinical alerting can improve the quality of care is one limited to the very few provider organizations that already have the infrastructure setup and resources to implement such an initiative. This means that if you are seriously considering such a task, you should already have:

• an Enterprise Data Strategy and Roadmap that tells you how alerts tie into the broader mission;
• Data Governance  to assign ownership and accountability for the quality of your data and implement standards (especially when it comes to clinical documentation and data entry);
• standardized process flows that identify points for consistent, discrete data collection;
• surgeon, physician, anesthesiology, nursing, researcher, and hospitalist champions to gather support from various constituencies and facilitate education and buy-in; and
•  oh yeah, the technology and skilled staff to support a multi-system, highly integrated, complex rules-based environment that will likely change over time and be more scrutinized………

◊◊Or a strong relationship with an experienced consulting partner capable of handling all of these requirements and transferring the necessary knowledge along the way.◊◊

I must emphasize the second bullet for just a moment; data governance is critical to ensure that the quality of the data being collected passes the highest level of scrutiny, from doctors to administrators. This is of the utmost importance because the data is what forms the basis of the information that decision makers act on. The quickest way to lose momentum and buy in to any project is by putting bad data in front of a group of doctors and clinicians; trust me when I say it is infinitely more difficult to win their trust back once you’ve made that mistake. On the other hand, if they trust the data and understand the value of it in near real time across their spectrum of care, you turn them quickly into leaders willing to champion your efforts. And now you have a solid foundation for any healthcare analytics program.    

If you are like the majority of healthcare organizations in this country, you may have some pieces to this puzzle in various stages of design, development, deployment or implementation. In all likelihood, though, you are at the early stages of the Clinical Alerts Maturity Model

and with all things considered, should have alerting functionality in the later years of your strategic roadmap. Though, there are many  projects with low cost, fast implementations, quick ROIs, and ample examples to glean lessons learned from like, Computerized Physician Order Entry (CPOE), electronic nursing and physician documentation, Picture Archiving System (PACS), and a clinical data repository (CDR) to use alerting as a prototype or proof of concept to demonstrate the broader value proposition. Clinical alerting, to start, should be incorporated alongside projects that have proven impact across the Clinical Alerts Maturity Model before they are rolled out as stand-alone initiatives.

Hey healthcare providers! Yeah you the “little guy”, the rural community hospital; or you the “average Joe”, the few-hundred bed hub hospital with outpatient clinics, an ED, and some sub-specialties; or you the “behemoth”, the one with the health plan, physician group, outpatient, inpatient, and multi-discipline, multi-care setting institution. Is your EMR really just an electronic filing cabinet? Do nursing and physician notes, standard lab and imaging orders, registration and other critical documents just get scanned into a central system that can’t be referenced later on to meet your analytic needs? Don’t worry, you’re not alone…

Recently, I blogged about some of the advantages of Microsoft’s new Amalga platform; I want to emphasize a capability of Amalga Life Sciences that I hope finds its way into the range of healthcare provider organizations mentioned above, and quick! That is, the ability to create a standard ontology for displaying and navigating the unstructured information collected by providers across care settings and patient visits (see my response to a comment about Amalga Life Science utilization of UMLS for a model of standardized terminology). I don’t have to make this case to the huge group of clinicians already too familiar with this process in hospitals across the country; but the argument (and likely ROI) clearly needs to be articulated for those individuals responsible for transitioning from paper to digital records at the organizations who are dragging their feet (>90%). The question I have for these individuals is, “why is this taking so long? Why haven’t you been able to identify the clear cut benefits from moving from paper-laden manual processes to automated, digital interfaces and streamlined workflows?” These folks should ask the Corporate Executives at hospitals in New Orleans after Hurricane Katrina whether they had hoped to have this debate long before their entire patient population medical records’ drowned; just one reason why “all paper” is a strategy of the past.   

Let’s take one example most provider organizations can conceptualize: a pneumonia patient flow through the Emergency Department. There are numerous points throughout this process that could be considered “data collection points”. These, collectively and over time, paint a vivid picture of the patient experience from registration to triage to physical exam and diagnostic testing to possible admission or discharge. With this data you can do things like real or near-real time clinical alerting that would improve patient outcomes and compliance with regulations like CMS Core Measures; you can identify weak points or bottlenecks in the process to allocate additional resources; you can model best practices identified over time to improve clinical and operational efficiencies. Individually, though, with this data written on a piece of paper (and remember 1 piece of paper for registration, a separate piece for the “Core Measure Checklist”, another for the physician exam, another for the lab/X-ray report, etc.) and maybe scanned into a central system, this information tells you very little. You are also, then, at the mercy of the ability to actually read a physicians handwriting and analyze scanned documents of information vs. delineated data fields that can be trended over time, summarized, visualized, drilled down to, and so on.

Vulnerabilities and Liabilities from Poor Documentation

Relying on poor documentation like illegible penmanship, incomplete charting and unapproved abbreviations burdens nurses and creates a huge liability. With all of the requirements and suggestions for the proper way to document, it’s no wonder why this area is so prone to errors. There are a variety of consequences from performing patient care based on “best guesses” when reading clinical documentation. Fortunately, improving documentation directly correlates with reduced medical errors. The value proposition for improved data collection and standardized terminology for that data makes sense operationally, financially, and clinically.   

So Let’s Get On With It, Shall We?

Advancing clinical care through the use of technology is seemingly one component of the larger healthcare debate in this country centered on “how do we improve the system?” Unfortunately, too many providers want to sprint before they can crawl. Moving off of paper helps you crawl first; it is a valuable, achievable goal across that the majority of organizations burdened with manual processes and their costs and if done properly, the ROI can be realized in a short amount of time with manageable effort. Having said this, the question quickly then becomes, “are we prepared to do what it takes to actually make the system improve?” Are you?

In these troubling times, everyone is being asked to do more with less, keep costs down or take them out, determine how close to the bone to go before the business completely collapses and other such painful and difficult questions. In the end, business people are expected to rationalize big decisions that will impact the lives of employees, customers, suppliers and partners. These questions are not to be taken lightly and definitely benefit from fact based business insight. Business Intelligence tools can be useful to analyze, explore and present the findings but this is a domain challenging to most business people. IT professionals are doing everything they can to help but the parties frequently find themselves traveling on two different roads running parallel to one another trying to communicate by yelling out the window.  For anyone who has tried to communicate this way, and we all have at some point in life, it is not very effective.

Given the speed at which we need to move these days to answer life and jobs related questions, the time required to get the answer must be short and the quality of the result must be sound. For an approach that will alter the traditional path to obtaining the answer, take a look at my new approach to BI at www.beyenetwork.com/view/10421.

Few things are as embarassing (cool double entendre) as having your pants pulled down in public.  While it is great fun to see it done figuratively to someone else (real world on the grade school playground), it can really cramp both careers and management practice in the corporate world.

Just when you have the fought for budget money to put into some cool analytics or reporting…the project is up and running, you’re day dreaming about keeping your job (maybe a raise!). Then, the project status rolls across your desk: bad data, instant project over-run.  The problem is worst-case scenario; bad data tends to be discovered just as the project goes live with no quiet opportunity to fix it.  The money is gone and everybody is looking (yep, just like second grade, lunch money is gone and…).

Don’t you just love going back to the C-Suite for more  project budget (feel like you’ve just been pantsed?)  Ouch!  This one needs to be avoided at all costs.  How to do it is the tough part.  Does anybody really want to go into the C-Suite and say, “Our corporate data may not be, uh, kosher?”  There is a real career enhancer for any CIO.  So you need to do what any red-blooded CIO would do, bury the cost in another part of the project.  No one wants to champion a project entitled “Fixing Corporate Data Assets”.  How did they get messed-up in the first place?  Guess who gets blamed?

No one wants to hear about legacy code and budget reductions.  There is no wide-eyed fascination regarding aging databases suffering from too many corporate mergers and grafted on must-have emergency applications.  Well, if they don’t want to hear about that, why go through it.  Don’t tell me problems, get me solutions!  Well, here you go, as requested.

Instead, early in an analytics or reporting initative, put in a sub-task to test existing data for proper compliance to the stated information delivery  goals (see that doesn’t feel scary, just numbing).  Overall match to corporate data governance and meta data management standards can be tested at the same time, who could argue with that?  Just a little bit of testing, call it project (career)  insurance.

The next step should be obvious, even to a CIO.  Slide one of these sub-tasks in each project initative (they go togther like “sliders, beer, and baseball”!).  Before you know it the Corporate Data Assets are in tip top shape, without the nasty embarassment of a major budget line item.

There seems to have been an interruption in the fabric of the Business Intelligence marketplace!  It seems a prominent vendor, SAS, has attempted to re-brand, rename and/or reposition their products by declaring death by commoditization of the Business Intelligence category of products. They have outlined for all why the SAS product is really Business Analytics….different from Business Intelligence products.

I have long held that people frequently confuse the name with the thing itself. Look at very visible proof like Kleenex, Xerox and Coke used to describe a category of things. After all, a soft, absorbent tissue for wiping one’s nose is not always a Kleenex despite the ubiquitous use of the term to ask for said soft, absorbent tissue. A similar phenomenon is happening in the case of Gaurav Verma, Global Marketing Manager for Business Analytics at SAS who recently suggested that Business Analytics is something different than Business Intelligence. When you order a Coke at a shop where Pepsi is sold, you still get a brown carbonated liquid full of sugar and food coloring! When does the name become the thing itself?

I believe there is a higher road we can take. My recommendation is that we not confuse what we are trying to achieve with the labels invented by vendors and consultants to differentiate and sell!  I think we should give Gaurav a break and ask him to explain what new functional difference or new value proposition emerged out of the shift from Business Intelligence to Business Analytics. 

Prompted by the outrage of the name game being played, others have suggested that Decision Support, Decision Intelligence and variations of that theme are better labels for the BI industry.  I think those all work just as well. I think we should call it whatever we can to capture the interest of the people most impacted by what we business intelligence practitioners and vendors are trying to achieve.

That said, I would much prefer that we debate how we deliver on the promise of the category of enabling practices and technologies most commonly known as Business Intelligence.  In my view, there is tremendous opportunity still available to those who dare. What if we shifted our discussion to helping business people achieve business objectives for which a rear view mirror, a magnifying glass and a windshield are useful tools?

What’s in a name anyway? But then again, many people are talking about it and looking at SAS products in the process. What’s that old Hollywood saying? There’s no such thing as bad publicity?

Bernard Marr must be a believer in my theory that catchy headlines promote increased readership.  How else to explain that the long-time performance management guru resorted to the titillating title “Performance Anxiety” for an otherwise solid article on the potential perils of poorly implemented performance systems?

Bernard observes that “performance management initiatives were often so mechanistic and number-focused that it prevented organisations from achieving the desired improvements. It could even lead to unintended behaviour.” Indeed.  Remember the story of the hospital that kept patients in ambulances outside the emergency room so that they could improve their ‘waiting time limit’ KPI?

As I’ve frequently observed, the problem with the phrase “what gets measures, gets done” is that people invariably measure the wrong thing.  They measure what’s easy to collect or mandated by others.  Bernard’s survey finds that 92% of the respondents admitted that many of their KPIs were neither relevant nor meaningful.   Cue my favorite line: “not everything that can be counted, counts, and not everything that counts can be counted.”

It gets worse.  The survey also reports that more than 70% participants admitted that people in their organizations occasionally fabricated their performance data. Talk about a lack of trusted information!  I suppose I should feel better that they only occasionally fabricated data but I have a sneaky suspicion that they weren’t turning green KPIs to red.

Bernard does cite some organizations who are using performance management properly and even suggests some best practices.  I’ve seen similar exemplary deployments but, sadly, they seem to be the exception, rather than the rule.

That really does give me anxiety.

This week at SAPPHIRE Orlando I was deep in conversation with a customer about how to make scorecards more actionable when he said something like:

I understand that I should focus on KPIs that are red and trending down but, honestly, I don’t trust the data.

This is perhaps the true Achilles Heel of Performance management.  If end users don’t trust the information they receive, they are unlikely to take any actions – and performance won’t improve.

The customer isn’t unique.  A survey of C-level executives by the Economist Intelligence Unit showed that less than 1 in 10 believes they have the information they need to make critical business decisions and only 1 in 2 believe the information they do have is reliable. The result is management by intuition rather than management by facts.

Turning raw data into trusted information is the domain of Enterprise Information Management (EIM).  True EIM is more than just data integration and data warehousing.  True EIM focuses on three areas:

• Lifecycle management – from source, to consumption, to retirement
• Unified information – structured transactional data typically associated with BI but also unstructured data like text in call center notes and master data typically associated with customer or products
• Data lineage – exposing the user of information to where it came from, how it was computed, and when it was updated 

Adopting EIM can help with lots more than just having executives trust their scorecards.  It allows everyone in the organization to make better business decisions.  For example, imagine a PC manufacturer that receives an order from a consumer for a disk drive that is out of stock.  With trusted information, they can compare the fully-loaded cost of back-ordering the drive (including the cost of a separate shipment) with the cost of delivering a larger drive without charging more to the consumer. In many cases, the second option is financially preferable, even though the raw material is more expensive.

It may be counter-intuitive but it’s good business.  And probably helps with customer satisfaction.  Performance Management needs trusted information.   Welcome to the family, EIM.

What to learn more about EIM?

http://www.eiminstitute.org/

Here is an extract from the website – ABOUT EIMI

About EIMI

The Enterprise Information Management Institute (EIMI)’s purpose is to provide data management professionals with the most comprehensive knowledge portal and access to the industry’s most respected thought leaders on managing enterprise information assets. EIMI features a monthly electronic magazine, EIMInsight, including regular monthly columns by David Marco, John Zachman, Sid Adelman, Len Silverston, Anne Marie Smith, Larrisa Moss, Mike Jennings, and Richard Wang, with contributions by Bill Inmon.

These days successful deployment of Content Management (CM) is fraught with hyper-change, increased user sophistication, ubiquitous communication and interaction, regulatory pressure and financial constraint.  The explosive growth in people’s willingness to share content and collaborate, as demonstrated by the success of Facebook, MySpace, Plaxo, Visible Path and other social networks, requires unprecedented degrees of responsiveness and adaptation in one’s content management strategy. This is why a comprehensive content strategy that anticipates and incorporates an approach specifically designed to meet such challenges is more important than ever. 

Defining an Enterprise Content Management (ECM) strategy is a real challenge for many companies. Customarily, organizations tend to focus their attention on particular areas of pain, using CM applications to improve specific business processes.  These are commonly referred to as Point Solutions, and tend to address short-term concerns but inadvertently increase overall cost of ownership for all solutions. According to a new report by Datamonitor, an independent market analyst, four in five companies on average are deploying some form of basic content management strategy, choosing to spend what resources they have addressing specific content management challenges, such as records management, collaboration, web publishing, or document management.  While these solutions can be very valuable and successful, if they are not deployed within the context of a comprehensive strategy or roadmap, they are often myopic in their design and thereby too inflexible to respond to changes in business requirements.  Support and maintenance of these one-off solutions becomes more expensive than originally estimated to develop and maintain, and in some rare instances, obsolete before ever realizing their anticipated return on investment.

To achieve lasting results requires not only selecting, designing and adapting CM technology to individual organizational needs, but also careful roadmap development and change management that brings technology into the business in a manner the workforce finds acceptable, motivating people to adapt to the necessary changes.  Too often, companies define their content management strategies based on shortsighted pain points instead of focusing on how the business and its people will continue to leverage content to achieve goals and objectives.  Understanding how content is leveraged across the extended value-chain is paramount to successful content management, and requires diligent observation of business processes and workforce behaviors.

In a March 2008 survey conducted by AIIM, nearly 47% of respondents report that today’s content management offerings require too much effort to implement, though half of respondents indicated that they wanted solutions built on top of an ECM platform.  Respondents also noted that integration of disparate technology components and integration with legacy systems accounted for the biggest delays in developing business solutions on top of ECM platforms – 37% and 34% respectively.  Organizations will continue to face significant challenges in realizing the full benefit of content management without first developing a comprehensive strategy that includes change management, governance and linkage to clearly defined business objectives.  Companies that have recognized the close relationship between content management and people, using technology to support them in achieving business objectives, have found content management highly effective in creating a lasting competitive advantage.

As valuable as the above goals are, the implementation continues to be a challenge to all organizations tackling content management.  As internal and external environments change, organizations must be remolded, and sometimes even reinvented, into something that better fulfills the needs and desires of the business.  Understanding the motivation and behavioral characteristics of user groups is critical to developing successful content management strategies. The next few years will represent the beginning of a significant change in how technology is used to empower the aspirations of users, and something every business leader, strategist, and advisor should commit to understanding.  It will not be new technology that drives competitive advantage, but rather new ways of deploying and combining established content management solutions to deliver on end-user expectations and requirements.

Practical steps should be taken to overcome these challenges, turning challenge into opportunity.  First, consider bringing in a third party to assess the current environment.  Third parties bring an objective view, as well as benchmark experiences from similar engagements, which can provide a fresh perspective to what sometimes seem like insurmountable obstacles.  Second, exercise a consistent and real change management campaign from ideation through outcome measurement.  This will ensure committed adoption as opposed to enforced compliance from users, dramatically improving your chances of a successful implementation.  Lastly, take the time to define a practical and concise road map, and then stay the course.  It is true that there are benefits in going through the process of generating a road map, but there are greater benefits in following through.