Electronic Business: Concepts, Methodologies, Tools, and Applications (4-Volumes) P176 docx

continuedstructure for an e-business starting from NMA competences: data collection, data management, exploitation of new technologies and partner/customer management “ The normal practi

Table 3 continued

structure for an e-business starting from NMA

competences: data collection, data management, exploitation of new technologies and partner/customer management

“ The normal practice would be: you take the external consultancy methodology cookbook and you apply things fr

responsible for the structural change, 2003) “W

Consultants came with a whole series of structural models, they came with the toolkit but didn’

KRZWR¿WLW´6WUDWHJLVW “ Don’

T business case

LGHQWL¿HGZLWKWKHHVWUDWHJ\SURMHFW - Have a multi functional leadership team i.e from sales, marketing and IT -Involve senior management from sales and marketing in the strategy implementation

a very clear vision about what the endgame looks like” (Senior Manager

“ Sales and Marketing senior management buy- in was absolutely fundamental for the pr

Political resistance to change of various stakeholders and managing simultaneously their diverse expectations

“ Consistency of message and purpose is one of the most important success factors in making change happen Crystal-clear purpose, understood by all, including ‘what it means for me’, should be made explicit” (NMA

Table 3 continued

- Communicate consistently with end users, at the beginning to build FRQ¿GHQFH

communicate progress and to get feedback - Use customer relationship management WR

who are confused about who they are actually buying products and services from

and delivery channels for a lengthy period of time Communicating pr

customers, users and clients was essential They demanded honest, consistent and up-to-date information whether the news wer

customers, users and clients that we had a back- up or disaster r

Aligning the objectives of the 21 projects with the overall objectives of the e-business strategy and establishing timelines in place

- People involved in the projects have clear understanding of their roles and responsibilities - Good project management to avoid GXSOLFDWLRQV

comes in and it takes up vast amounts of time and systems space, because of all these critical paths which chunter away

Blending major change with major continuity

with the business strategy and with the core operations from the start

potential changes in course sooner rather than later …” (Senior Marketing manager

agement Team to clearly articulate the vision,

purpose, goals, and values for the organisation

and to communicate them clearly businesswide

It also required pulling together the leadership,

communication, and engagement activity, whilst

ensuring that all existing projects, initiatives, and

everyday activities were aligned and integrated

with this This high level strategic activity was

also about leveraging what was already in place

and, most importantly, maintain consistency

across cultural, behavioural, and leadership

ap-proaches

Second, the case of Britain’s National

Map-ping Agency shows that, in practice, the

transi-tion from government monopoly to commercial

organisation whilst embracing e-business as a

corporate philosophy can be extremely

challeng-ing to achieve Although e-business has enabled

NMA to tap new customers and new revenues and

opened up a space for importation of private sector

practices into NMA, the strong public interest for

its activities was still present Yet the

organisa-tion was expected to operate commercially, cover

its costs, and build up reserves through its own

commercial style operations That situated the

organisation in the intersection of two different

spheres—the public and the private Becoming

an e-business, in this context, required

collabora-tive working not only with commercial partners

but also with different parts of the government

7KH ³LQEHWZHHQ´ VLWXDWLRQ WKXV WHVWHG WR WKH

full extent the capability of the organisation to

lead and manage change, especially in terms of

¿QGLQJWKHSHUIHFWEDODQFHEHWZHHQIXO¿OOLQJLWV

still strategic role as national agency and

provid-ing high-quality services to its customers in a

dynamic marketplace

One of the senior managers interviewed

de-scribed this situation with the following words:

³:H>DVDQRUJDQLVDWLRQ@ZDQWWREHKDYHDVLIZH

were situated in the commercial business

sec-tor, but we cannot escape our origins” (Senior

Manager, 2004)

7KLUGWKHFDVH¿QGLQJVGHPRQVWUDWHWKDWVXF-cessful organisational transformation involving e-business implementation relies on changing some fundamental business processes and attitudes Close cooperation between many different sets

of people—from middle managers to program-mers, and from technical architects to system users within the organisation—is needed This convergence of business process, creative, and technical skills created in NMA a new dimension for teamwork, which in turn shifted the culture RIWKHRUJDQLVDWLRQIURP³NQRZOHGJHLVSRZHU´ WR ³VKDULQJ NQRZOHGJH LV SRZHU´ 7HFKQRORJ\ can be an important enabler but not a driver of knowledge sharing

Finally, one key challenge in NMA was how

to blend major change with major continuity

In this respect, a major lesson learnt from this organisation’s experience was that it is essential

to integrate the e-commerce strategy with the business strategy and with the core operations IURPWKHVWDUW7KLVHFKRHVWKH¿QGLQJVRI'XWWD and Segev (1999) that successes result from close partnerships between commercial and IT man-agers, and that companies making e-commerce central to their organisation do better than those that make it an afterthought

CONCLUSIONS

This article aimed to reveal the processes of strategic and organisational transformation en-gendered by e-business during the implementa-tion of a complex structural and cultural change programme aimed at reshaping a commercialised public sector organisation and rethinking how it provided value to its customers The discussion H[DPLQHGWKHGLOHPPDVDQGFRQVWUDLQWVLGHQWL¿HG

by managers in the interpretation of the e-busi-ness strategy concept and why its implementa-tion in practice could be challenging Whilst the Internet offers a technological solution, the

¿QGLQJVRIWKLVFDVHVWXG\VXJJHVWWKDWWKHVXF-cessful implementation of a wider e-business

strategy depends on managing simultaneously

a number of projects which cross organisational

boundaries and linking together organisational

and technological factors

:KLOVWWKLVUHÀHFWLYHDFFRXQWPD\EHXQLTXH

it does, however, provide pointers to other large

organisations undertaking a similar

e-transforma-WLRQDQGUHÀHFWVRQWKHGHJUHHRIRUJDQLVDWLRQDO

transformation required by traditional

organisa-tions in meeting this imperative and successfully

making the change to e-business In particular,

WKH¿QGLQJVLOOXVWUDWHWKDWDQHEXVLQHVVVWUDWHJ\

is not just about technology It also embraces the

business challenges that result from managing

change in a fast moving environment, as well as the

important issues of people, organisation, culture,

communication, and how an organisation must

create a process for delivering innovation

)XUWKHU HPSLULFDO ¿HOG VWXGLHV LQ RWKHU

VHW-tings would enrich the concepts developed in

WKLVVWXG\DQGZRXOGSURGXFHDGH¿QLWLYHOLVWRI

best practices The case highlights, however, the

complex nature of the notion of e-business in a

public sector context and shows that when

imple-mented successfully, it can transform entirely

these organisations and their capabilities

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Chapter 5.19 From ASP to Web Services:

Identifying Key Performance Areas and

Indicators for Healthcare

Matthew W Guah

Warwick University, UK

Wendy L Currie

Warwick University, UK

ABSTRACT

Value creation from e-business for customers

in healthcare is an important topic in academic

and practitioner circles This chapter reports the

¿QGLQJVIURPDWZR\HDUUHVHDUFKVWXG\ZKLFK

found that disappointing results from the

much-hyped application service provider (ASP) business

model is currently being replaced by perceived

new opportunities from Web services Yet past

failings from ASP do not guarantee future

suc-cess with Web services models, particularly as

evidence shows that accruing value-added

ben-H¿WVIURPHEXVLQHVVLQLWLDWLYHVLVRIWHQIUDXJKW

ZLWKGLI¿FXOW\+HDOWKFDUHLVQRH[FHSWLRQDQGLV

likely to pose more problems given the

complex-ity of the organizational structures, processes,

procedures, and activities within this vertical

sector This research study calls for a more

rigorous approach in identifying and evaluating

key performance areas and indicators from new e-business initiatives involving emerging tech-nologies and platforms such as Web services Yet the measures and metrics used for healthcare may differ from those adopted in other sectors Healthcare professionals will therefore need to GHYHORSFRQWH[WVSHFL¿FNH\SHUIRUPDQFHDUHDV (KPAs) and KPIs, and caution against accepting DW³IDFHYDOXH´WKHYDOXHSURSRVLWLRQGHYLVHGE\ Web service providers

INTRODUCTION

The process of healthcare management modern-ization is maturing in Europe, North America, and

in other developed countries This has resulted

to an exponential increase in demand for rapid business process execution, more accurate and timely information, and additional automated

information systems (IS) Interest in Web services

is emerging in many different guises As subset

of e-business, Web services offer customers

soft-ware as a service The principle of operation is

similar to the application service provision (ASP)

model, priced on a pay-as-you-go, utility model

of business computing (Currie, Desai, & Khan,

2004) Against a background of disappointing

results from ASP (Hagel, 2002), Web services are

designed to resolve problems of poor integration

(interoperability) between software applications

and low customer satisfaction This research study

treats the Web services business model as the

main unit of analysis and seeks to identify how

value is created for customers (Perseid, 2003;

Sleeper & Robins, 2001) Despite the promises

of vendors, Web services have fared poorly in

terms of attracting a large client base (CBDI,

2003) The reasons for this are both technical and

commercial (Hagel, 2002) The fallout from the

ASP market provides some important lessons for

vendors offering software as a service, and for

e-business models more generally

7KLV FKDSWHU SUHVHQWV WKH ¿QGLQJV IURP D

two-year research that examines both the supply

side and customer side of deploying, hosting, and

integrating e-business models, focussing

primar-ily on Web services in the UK health sector The

chapter is structured into three main areas It

begins with a discussion of ASP taxonomies and

argues that the various templates for ASP were

HVVHQWLDOO\ÀDZHGIRUDFRPELQDWLRQRIWHFKQLFDO

or business reasons Within the healthcare sector,

technology vendors failed to develop e-business

models that created value for customers They

adopted a technology push strategy where product

and services are offered to customers without a

clear understanding of their business requirements

(Cassidy, 2002) This section is followed by an

overview of the research study and methods used

for data collection and analysis Next, we

pres-ent the results from a questionnaire survey and

interviews with healthcare professionals Using a

ULVNDVVHVVPHQWIUDPHZRUNZKLFKFDSWXUHV¿YH

key performance areas (KPAs) for evaluating the software-as-a-service business model (which includes both ASP and Web services) (Currie, 2003), this research applies this framework within the healthcare sector Comparing the results from KHDOWKFDUHZLWKWKRVHRI¿YHVHFWRUV&XUULHHW al., 2004), we observe that priorities and prefer-ences vary This suggests that service provider vendors need to identify a more rigorous approach

in developing their value propositions from e-EXVLQHVV IRU VSHFL¿F LQGXVWULDO VHFWRUV VLQFH D

RQHVL]H¿WVDOO approach is inappropriate The

chapter concludes by offering future directions for research on emerging technologies within healthcare

LESSONS FROM THE FIRST PHASE OF THE ASP MODEL

The emergence of the ASP model suggested an DQVZHUWRSUHYDLOLQJTXHVWLRQ³:K\VKRXOGVPDOO businesses and non-IT organizations spend sub-stantial resources on continuously upgrading their IT?” Many believed that application outsourcing, using the ASP model could provide the solution WRHQKDQFLQJ,7HI¿FLHQF\DQGUHGXFLQJWKHto-tal cost of ownership of IT (IDC, 2000) Within the context of healthcare, ASPs could offer both horizontal (business facing) and vertical (sector VSHFL¿FVRIWZDUHVROXWLRQV$QH[DPSOHRIWKH latter could be in the form of electronic patient records (EPR) systems (Guah & Currie, 2004)

An ASP assumes responsibility for buying, host-ing, and maintaining a software application on its own facilities, publishing its user interfaces over the networks, and provides its clients with

a shared access to the published interfaces The customer simply has to subscribe to the service

to receive the application over an Internet or dedicated intranet connection, as an alternative

to hosting the same application in-house (Guah

& Currie, 2004)

The impetus behind ASP was fuelled by the

belief that utility computing offered a new business

model to customers, similar to electricity, gas,

and water The commercialization of the Internet

PHDQWWKDWDVQHWZRUNWUDI¿FLQFUHDVHGLQD¿UP¶V

data centre, IT architecture would trigger other

resources into action, including idle servers,

ap-SOLFDWLRQVRUSRROVRIQHWZRUNVWRUDJH7KH¿UP

would pay only for the amount of time it used the

VHUYLFHV7KXVWKHFRQFHSWRI³VRIWZDUHDVDVHU-vice” was created Accessing IT resources in this

way would result in reduced up-front investment

DQGH[SHQGLWXUHHQDEOLQJ¿UPVWREX\VHUYLFHV

on a variable-price basis (Dewire, 2000) This

fuelled opportunities in the late 1990s for service

providers to offer software applications and IT

infrastructure on a rental, pay-as-you-go pricing

model (Bennet & Timbrell, 2000) An ASP could

be a commercial entity, providing a paid service

to customers (Susarla, Barua, & Whinston, 2003)

RUFRQYHUVHO\DQRWIRUSUR¿WRUJDQL]DWLRQVXS-porting end users (Currie et al., 2004)

In healthcare, an ASP may provide some mix

of application services for laboratory, prescribing,

charting, outpatient visit, coding, and clinician

scheduling, and reporting Some may even offer

clinical alerts normally associated with expensive

institution-based EPR systems, including health

warnings of potential drug reactions Through

the provision of this one-to-many model over the

Internet, an ASP takes patient charts and medical

records and keeps them on a centrally managed

repository, to which a healthcare provider can

gain access from anywhere in the world This

can allow for a physician to review the patient’s

medication lists from all previous encounters and

WKHLUSUHVFULSWLRQ¿OOLQJKDELWVSURYLGHGDOOWKH

OHJDOUHTXLUHPHQWVRISDWLHQWFRQ¿GHQWLDOLW\KDYH

been arranged)

ASP Taxonomies

7D[RQRPLHV UHSUHVHQW ³LGHDOW\SH´ VFHQDULRV

which may not exist in their pure form (Currie et

al., 2004) They are useful for providing a

frame-work for organizing phenomena by attempting

to deconstruct the various components and/or

characteristics Variations exist within

ideal-typical categories, as well as overlap between

FDWHJRULHV 'XULQJ WKH ¿UVW ZDYH RI WKH $63 market, many different types of ASP emerged

Some were concerned to offer a broad,

horizon-tal product and service portfolio, while others

WDUJHWVSHFL¿FYHUWLFDOLQGXVWU\VHFWRUVVXFKDV healthcare Table 10.1 focuses on a horizontal ASP products/services portfolio, and Table 10.2 looks

at the service providers targeting the healthcare vertical sector Each of these categories implies

a different outsourcing relationship between sup-plier and customer

7KH¿UVW$63WD[RQRP\7DEOHGHOLQHDWHV

ASPs into vertical LQGXVWU\VSHFL¿Fhorizontal (across/within business functions); enterprise

(complex software such as ERP and CRM);

pure-play (Web-enabled applications) and infra-structure (data centre, networking, and other

sup-porting technology) (Currie et al., 2004) Whilst many research analysts and pundits suggested that vertical ASPs offered excellent opportunities for business development, they also needed to ad-dress key challenges, such as a limited customer base; potential problems in serving only one sector/subsector; potential overreliance on one Internet service vendor (ISV); and others By restricting their potential customer base, vertical ASPs believed they could offer a high level of service since they marketed themselves as having

an in-depth knowledge of the sector/subsector they served

The second taxonomy (Table 2) of the ASP PDUNHWDGRSWV¿YHFDWHJRULHVASP resellers, ASP developers, ASP aggregators, hosting services, and managed services providers (Hagel, 2002, p 45) Comparing the two ASP taxonomies reveals VLJQL¿FDQWVLPLODULWLHVZLWKFRQVLGHUDEOHRYHUODS between categories and activities of the various

players The ideal-typical categories provided by

different taxonomies offer an illustration of the market/strategic positioning and product/service

portfolios of ASPs, and should not be treated as

rigid categories in their own right Given the

FRQIXVLRQ ZKLFK VXUURXQGHG WKH ¿UVW ZDYH RI

ASPs, attempts to deconstruct the ASP business

model and market into taxonomies is a useful

exercise, which may provide some clarity to the

phenomenon under scrutiny

ASP taxonomies can be further mapped across

the netsourcing stack, which captures a variety of

customer/supplier scenarios “where relationships

in this space are very complicated” (Kern, Lacity,

& Willcocks, 2002, p 115) For example, an ASP

delivering a hosted software application to the end

customer, may subcontract data centre services,

billing, help desk, and other support services to

DGGLWLRQDO¿UPV)XUWKHUPRUHWKH$63PD\QRW

even own or have developed the software, as this

may be the intellectual property of an Internet

service vendor In the case of enterprise ASPs

and ASP resellers, developers, and aggregators, WKHVH¿UPVPD\IRUPFRPSOH[VWUDWHJLFDOOLDQFHV

or partnerships with leading ERP vendors, usually IRUVSHFL¿FWDUJHWFXVWRPHU7DEOH

As a forerunner to the current Web services market, ASP was highly volatile, dynamic, and immature market A recent review of the ASP industry (Susarla et al., 2003) concluded that the technological factors like scalability, speed and focus, and the behavioral aspects of price and ÀH[LELOLW\ZHUHWKHNH\GULYHUVRIWKHPRGHO7KH inhibitors of the model were poor connectivity, lack of trust in the model, reluctance to be locked into long-term contracts with suppliers, lack of customization, poor choice and suitability of software applications from ASPs, and few op-portunities to integrate disparate applications across technology platforms and business environ-ments These factors and others led Hagel (2002)

to conclude that

Table 1 Taxonomy of ASPs based on a horizontal product/service portfolio (Currie et al., 2004)

Type of ASP Description Generic Examples Key Challenges

Mixed/

Vertical

,QGXVWU\VSHFL¿F

KHDOWK¿QDQFH

transportation)

SchlumbergerSema (health) Bloomberg (Finance) S/W for Excellence (Dental)

Limited customer base Reliant upon major vendors Restricted by sector-based economic

(accounting, human resource, travel)

Salesforce.com (HR) Concur (travel) SAGE (accounting)

Low barriers to entry;

Undifferentiated products/services

software (ERP, CRM, supply andlogistics)

SAP Oracle McKesson

Very expensive for small/medium organisations

&KDQQHOFRQÀLFWV

Data security/integrity

Internet/Web-enabled software application (email/

security/disaster recovery)

Graphnet Health iSoft

Mail.com

8QSUR¿WDEOHFRPPRGLW\DSSOLFDWLRQV Reliant upon VC funding;

Unstable/volatile/dynamic market

Infrastructure Technology partners

to ASP (telco, data centre, networking)

Cable andWireless BT

CISCO

Technical inhibitors Over-capacity Severe competition

in other developed countries This has resulted

to an exponential increase in demand for rapid business process execution, more accurate and timely information, and additional