A way to a services culture

Prevention is better than cure--service-oriented architecture (SOA) helps reduce bottlenecks and raise service levels.

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Long queues and consultation times are common at many of today's clinics and hospitals.

One way IT departments can help overcome such challenges is to adopt a service-oriented architecture (SOA), industry experts say.

Foong Wai Keong, CEO of Ecquaria Technologies, a Singapore-based IT services consultancy, told ZDNet Asia in an interview that the "SOA way" enables today's IT departments to build systems that map closely to the service requirements of organizations.

One benefit of SOA is governance, Foong said. Citing a hypothetical scenario, he explained: "Let's say your contact center's ISO 9000 standard requires an agent to pick up a call after three seconds and the call should last no more than 30 seconds. That's all documented, but that's not good enough."

Even if an organization is IS0 9000 certified, Foong said, most organizations today do not have a way to ensure it meets the standards all the time.

"But with the SOA approach, IT can enforce and make sure the organization adheres to the ISO 9000 standards," he said. "The IT system guides the person and prompts him to pick up the phone call within three rings.

Case study:
Health Promotion Board

In 2006, Singapore's national agency for health promotion and disease prevention implemented a clinical management system that could support its nationwide program to monitor students' medical and dental health.

HPB needed a reliable and integrated system capable of capturing 1 million medical and dental records, as well as 300,000 immunization records, by more than 600 clinicians and field staff across the island.

Developed on Ecquaria Technologies' SOA platform, the system allowed real-time accessing and capturing of student records. The integrated appointment scheduling and queue management system also helped to improve HPB's front-desk services.

Foong Wai Keong, CEO of Developed using Ecquaria Technologies, told ZDNet Asia that it used to be "a mad house" on the third floor of HPB.

"But since we implemented the system, there are more no queues," he said. "That's because HPB is able to optimally spread the patients out across multiple clinics. The system enables HPB to see where the queues are building up and diverts patients to clinics with shorter queues."

"So it is not enough for organizations to say they are ISO 9000 certified. Business processes must be closely mapped to service levels to ensure that standards are met," he added. "And SOA enables that."

Victor Lim, vice president of IDC's Asia-Pacific consulting operations, said that hospitals should "strongly consider" the adoption of SOA when they refresh or replace their information systems.

"This will provide them with the ability to add new services modules, change or upgrade redundant modules, and rationalize their services and IT assets for better efficiency and returns," Lim said.

A well-oiled pipe
To explain the benefits of a process- or services-oriented approach, Foong used the analogy of an oil pipeline, where gas flows from one pipe to another uninterrupted.

"Where you suspect there is a choke point, you put in a probe to see why there is a choke, why the 'service level' is not met. And this is what's important if you're looking to change your organization to become more service-oriented," he noted.

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Thanks to SOA, organizations can employ preemptive measures to address a choke point in real-time.

Foong explained: "In the past, tech could not let you to do that because what you got were quarterly reports which showed that you missed a service level agreement or SLA, but that's based on historical data. What you really want is to know, before things get crowded in the hall, that the queue is building up and how to ease the choke point."

Organizations that use the SOA approach will be in a better position to allocate resources and monitor service delivery for effective inpatient and outpatient management.

"With the SOA approach, IT can enforce and make sure the organization adheres to the ISO 9000 standards."
-- Foong Wai Keong,
Ecquaria Technologies

Citing the example of a healthcare provider offering free health screening, Foong said that it may anticipate a higher turnout at its clinics and deploy two additional staff at the front desk. In most cases, however, deploying additional staff may not necessarily reduce queues and wait times.

"But with SOA, the system monitors the situation in real-time. If queues show to be building up very quickly, then you are notified to put in more resources. So this SOA approach looks at how you can preempt a sudden surge of unexpected events," Foong explained.

"If you want to maintain a consistent level of service, you need a mechanism to help you preempt unexpected events."

Although it is not impossible for an organization to deliver on expected service levels without SOA, Foong said: "Many organizations today tout a service approach. Yes, I would say 70 to 80 percent of the time they are, but they are not able to meet service levels 20 to 30 percent of the time.

"And it is this 20 or 30 percent of the time that people will remember, not the 70 percent when you did meet expected levels," he added.

To be truly service-oriented, a healthcare organization should be able to "offer a commitment" to the patient on how long his clinic visit will take.

"Imagine a clinic that is able to tell every patient that he will get out in, say, 30 minutes. This gives the patient a lot of assurance. But to do that, the IT systems will have to be [designed in a way] that it is able to help you optimally plan the day," said Foong.

Another potential benefit of being service-oriented is the ability to give patients a way to know the wait times at clinics or hospitals.

Noting that most people today tend to visit a clinic that is closer to home or work, Foong said that many do so without knowing that there are other clinics with shorter queues.

"In most cases today, an appointment can take up a whole day," he said. "But imagine how much time you could save if a system on the Web allows you to scan for a clinic with the shortest queue."

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