Modeling a Health Care Enterprise
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The federal government is responsible for the direct or indirect medical care of nearly a million people. It is the fifth largest jurisdiction in Canada. Certain groups, such as members of the military, inmates at federal institutions and First Nations peoples, are either excluded from the Canada Health Care Act or are provided care through a long standing policy decision. The Federal Healthcare Partnership (FHP) is a partnership of 6 major departments responsible for providing the direct or indirect care. The FHP includes the Department of Defence, Correctional Services Canada, Health Canada, the RCMP, Veteran’s Affairs Canada and Citizenship and Immigration Canada. In an effort to benefit from an electronic system, a few of the departments are currently in the planning or implementation phase of a major health information system. In addition to the individual partner departments, the FHP is currently undertaking an Enterprise Architecture Plan to develop an electronic health record, much like that of Canada Health Infoway, to provide a level of interoperability between the partners and the jurisdictions the partners interact with. The internship at the FHP consisted of one month placements at 3 of the 6 departments with the final month at the FHP. The intern was hosted at the Department of Defence, Correctional Service Canada and the First Nations and Inuit Health Branch of Health Canada. The internship’s main object was to observe and participate in the various major health information system projects within each partner department. Each placement yielded different issues and challenges for research as well as the application of some of the theory learned to date in the form of minor projects. These projects included developing questionnaires as well as technical requirement documents. The main benefit from the internship, though, was the opportunity to observe and compare the different departments undertake similar projects at different points of the project life cycle. From this experience was the observation that the knowledge among the project teams about the implementation and maintenance of a health information system varied. One of the objectives of the internship was to maintain a horizontal management perspective in keeping with the mandate of the FHP. In light of the differences of understanding in the necessary elements of health care enterprise, what developed was the start of an enterprise architecture for the health care enterprise that includes not only the health information system but also the governance, people and operational support aspects. In working through an adapted version of the Zachman Framework, the result was a contextual and the start of a conceptual model. The benefit of this effort for the partners and the FHP is to provide a means to not only define the enterprise and the necessary components to function effectively but also to leverage current knowledge resources filling any knowledge gaps the individual partners departments have.