Enterprise Architecture in Hospitals: Resolving Incongruence Issues

Enterprise Architecture allows addressing technologies and processes in a holistic way and mirrors choices related to process standardization and data integration. It has the potential to address long-standing problems in health information systems related to fragmented IT portfolios, immature IT infrastructures, and silo-structured organizing. Nevertheless, uptake of Enterprise Architecture in hospitals has been slow. To understand the issues related to this slow uptake we have undertaken an interview study with architects and managers. The issues identified reveal a level of incongruence between healthcare as a domain and the practice of EA. Specifically, by analyzing the experiences of architects and managers we identified four different areas of such incongruence that create the need to reconcile a) Bottom-up vs. Top-down Planning b) Clinical vs. Systems' Knowledge, c) Local vs. Global Arrangements and d) Patient Safety vs. Patient Privacy. Building on prior related research we propose ways for resolving the incongruence issues identified.