The Open Group Conference London 2011
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Rapid Business Transformations in Health Care: A Systems Approach

Refaat Shulaiba
Chief Information Officer, Midwest Health Plan, US

Peter Drucker described healthcare organizations as the most complex form of human organization we have ever attempted to manage.

The top two priorities of health care business leaders are to constantly improve the quality of health care while striving to contain and reduce the high cost of health care. The health care industry, similar to all businesses, is motivated to deliver innovative solutions that accelerate business transformation and increase business capabilities.

Business transformation is an initiative to align an organization's business processes with the technology capabilities of the firm. The main contribution of the study is a roadmap for business performance excellence, which provides self-service capabilities to measure and improve the systems incrementally. The case study describes an innovative approach to improve care quality and reduce cost of care by applying a tailored version of the TOGAF to a multi-specialty provider group forming an Accountable Care Organization (ACO).

Refaat Shulaiba, CIO of Midwest Health Plan, has extensive experience applying Enterprise Architecture solutions in healthcare organizations. He has specialized in health care systems, Accountable Care Organizations (ACO), Pay for Performance (P4P), Practice Management Billing Systems, Claim Management Systems, Case Management, Medicare Advantage, NCQA HEDIS, HIPAA regulations, and EDI.

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