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HEALTHCARE USE CASE
Enterprise Architecture Driving a Simplified Healthcare App Landscape

Healthcare Use Case - Enterprise Architecture Driving a Simplified Healthcare App Landscap

1. Executive Summary

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In a period of 3 years, this major healthcare organization located in North America has rationalized its active applications from over 2,000 to almost 1,200, a 40% reduction, by eliminating redundancies and implementing enterprise‑scale Oracle Health applications. This major initiative was accomplished by a team of 16 full‑time enterprise architects, operating under the organization’s IT Services. They succeeded in planning this major initiative using architecture from strategy and execution, ensuring high-level consistency and rigorous governance in the transformation.

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2. Background & Challenge

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This healthcare organization supports over 800 facilities and 120,000 employees. Its legacy IT spanned with more than 2,000 active systems, from clinical apps to corporate tools and lab services, many created in silos by zones or service lines. This fragmentation caused poor integration, escalated support costs, and increased risk of clinical and compliance failures. Some functionalities were duplicated up to five or six times per toolset, leading to confusing patient journeys and inefficient workflows.

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3. The Role of the EA Team – 16 Enterprise Architects

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Within the Information Technology Services team, a team of 16 architects formulated the digital transformation roadmap. They managed discovery, rationalization criteria, and vendor coordination. This tight team managed to deliver the following:

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  • Defined “rationalization zones” aligned to clinical, non‑clinical, and support layers.

  • Created a unified application inventory and scoring rubric.

  • Designed a 3‑year wave-based decommissioning and Oracle onboarding plan.

  • Developed governance playbooks adopted across clinical & operations teams.

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4. Governance & Roadmap

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  • Phase 0 (Months 1–6): Discovery & inventory of 2,000 systems; scoring using the EA-developed business‑technical matrix; defined a target architecture that would support only 1,200 apps, including Oracle modules and key retained medical applications.

  • Phase 1–3 (Year 2): Vendor overlay and interface rebuilding; prioritized legacy removal; implemented Oracle healthcare applications and related modules in hospital zones.

  • Phase 4–5 (Year 3): Final wave of decommissioning, and user training ramp‑up.

 

The EA team participated actively in the healthcare organization’s steering committee that included the CIO, the Chief Medical Information Officer, and the Director of Clinical Operations, among others.

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5. Technical & Organizational Approach

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This healthcare organization migrated services onto Oracle Health Cloud, using their Health Clinical Foundation, Lab, Radiology, Scheduling, and Analytics modules, selected for modular flexibility and compliance with government regulations. Legacy data and interfaces remained active in parallel during the transformation. Duplicated patient/clinician records were merged via a robust master data index. APIs and transaction flows were defined to minimize last‑mile disruption.

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Super-users (nurse/physician representatives) in each zone ran part‑time parallel “shadow rollouts” to test the user interface and workflows, validated with real clinical teams before full deployment.

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6. Outcomes & Benefits

 

​The outcomes and benefits of this healthcare rationalization initiative are described in Figure 1 below. 

Figure 1 – Outcomes of this Healthcare Initiative.png

​7. Lessons Learned

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  1. Focused architecture leadership matters. 16 well‑aligned EA staff kept decisions consistent, strategic, and traceable.

  2. Architectural governance ≠ bureaucracy. Given the clear benefit narrative, clinicians and project leaders embraced structured decision-making.

  3. Phased coexistence prevents chaos. Legacy and modern modules ran in parallel until each wave had sufficiently trained super-users and test validation.

  4. Training infrastructure is essential. Onboarding “power users” early de-risked each zone’s go-live.

  5. Dashboards mattered. The EA team tracked “live systems vs disposed systems” along with user adoption, reporting weekly to the steering committee.

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8- Bottom Line

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This was no cascading train wreck of technology implosion. A tightly coordinated team of 16 enterprise architects—embedded in the healthcare organization’s existing architecture services—applied disciplined rationalization, governance, and phased delivery. The result was a leaner, safer, more sustainable application landscape that prioritizes clinical impact and patient outcomes, while delivering measurable savings and preparing the healthcare organization for future digital expansion.

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