Driving Sustainable IT Architecture with Reverse Legacy Thinking

Peter Cranstone, CEO, 3PHealth
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Peter Cranstone, CEO, 3PHealth

Peter Cranstone, CEO, 3PHealth

Having been in the IT industry as an inventor for 25 years, I must admit to falling prey to let IT solutions drive business strategy. All too often, I would be in a meeting stating, how powerful the tech was without listening to the needs of the business folks. Two years ago that changed, as a chance meeting led to a complete reversal of my legacy thinking. I’ll never forget that meeting, as the individual opened up with the words, “Show me the money or there will be no second meeting.” For the first time I had to think differently.

Business is about making money or more importantly sustainable, forecastable, profitable revenue from volume. ITs job is to support that objective. So for two years, I spent my time understanding the core business problem at hand: how to differentiate in a highly competitive business and lower costs. Only when I really understood the magnitude of the problem, could I turn my mind to how to solve it from a technical standpoint. This is where I started.

Two years passed from that initial meeting, and then last November the following headline appeared in the International Business Times: “We cannot sustain these losses,” CEO Stephen Hemsley said on an investor call. The company in question was UnitedHealth Group, and the healthcare industry is now in a financial crisis. In short, UnitedHealth Group and others are now paying out more in claims than they’re taking in from premiums on individual plans.

‚Äč  If one app can effectively navigate the complexity of a billion websites, then surely there must be a solution that solves website chaos 

Within this industry, the crisis-driven opportunity had arrived to align our IT architecture and enable a new business strategy to counter declining margins. In the old days, the CEO would call the IT department and say, “Solve this problem.” IT would fix the problem, typically by responding with the tools at hand. But sadly, this is not enough. There is a myriad of health, fitness and wellness apps in use today, but they haven’t resulted in improved health, care quality, or margins. Current IT architecture is clearly not addressing the root cause of the health industry’s problem.

Begin the Search for a New Set of Tools:

The previous image clearly shows our position–we’re right at the renewal phase and the only way out is for IT to work with business to enable a new services (healthcare) delivery strategy. We must now turn to history to determine where we need to begin the search for a new set of tools that will enable this transformation. I would argue that in the last 30 years or so, we’ve seen three major technical revolutions. Firstly, I choose the PC and Windows GUI; secondly, I propose the Internet and the browser; and finally, I call out the smartphone and mobile operating system. The commonality between all three of them can be boiled down to two things–the user interface and their associated ecosystems. In each case, the inventors took something very complex and made it simple–a concept known as “simplexity”.

So why have the smartphone and all the new health apps and devices not solved Mr. Hemsley’s business problems? In my opinion, it’s mind numbingly complex. There are thousands and thousands of apps to choose from, which only perpetuates the data silo effect that is already prevalent in health care, and adds to the existing complexity. Contrast that with the browser. One app–any website. Imagine if, in order to effectively use the Web, you had to download an app for each website you wanted to visit. With more than a billion websites, you can imagine the chaos. Right here is where IT should start looking. If one app can effectively navigate the complexity of a billion websites, then surely there must be a solution that solves this problem.

In the case of healthcare, we need to dig a little deeper and return to the core business problem–technology (the electronic health record and point solution apps) is driving the current strategy. If we’d let business strategy drive IT architecture, we must enable healthier consumer behavior to offset our current costs, and we’d need to differentiate our services to sustain user adoption. And that last part is where we find our opportunity. 

The windows GUI, the browser, and the mobile operating system are all sustainable technologies that were adopted by billions of people once they reached a level of simplexity supported by a rich ecosystem. We need the same breakthrough if we’re to solve Mr. Hemsley’s (and other business leaders’) problem. Traditional business process improvements are not enough, so traditional thinking won’t suffice. IT is faced with the difficult challenge of how to modify existing infrastructure and technology to support increased levels of privacy and security, enable more flexible and agile services delivery models, and adapt to consumers’ constantly changing needs (and health)–all while driving sustainable adoption? 

Mask Complexity of Underlying Technologies:

History tells us that it starts with a new, simple user interface. It must respond in real time to user needs and mask the complexity of the underlying technologies, while providing intuitive navigation to relevant content and services. Secondly, it should allow users complete control over the collection, flow and use of their private data. Finally, we need support for open, standards-based ecosystem creation (e.g. Internet of Things) that enables profitable interactions in support of your business strategies. Then put it all behind a single pane of glass.

If IT thinks about this correctly, they can leverage all of their existing infrastructure, knowledge bases, and programming languages to solve a complex business problem–the ability to deliver low cost, convenient, affordable, quality services to everyone. It’s a tall order for IT as we don’t control the devices, operating systems or browsers. So here we sit. Mr. Hemsley cannot solve his business problem because the current tools don’t deliver the functionality and agility that he and others need to reverse their declining margins. But what if, as IT professionals, we could overcome these technological limitations to achieve business success? What would you do?

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