TOGAF Business Architecture Plan for

AIIMS

Enhancing Patient Care through IT

Key Problem and Proposed Solution

AIIMS faces challenges with outdated IT systems, manual processes, data silos, and
scalability issues, exacerbated by a 2022 ransomware attack. The proposed solution
involves implementing an integrated Electronic Health Record (EHR) system,
automated workflows, and enhanced cybersecurity within an internal server-based
architecture, avoiding cloud dependencies as per AIIMS's preferences.

Summary of Key Findings

• Current State: Manual processes, disconnected systems, and security

vulnerabilities hinder efficiency and patient experience.
• Future State: Streamlined digital processes, integrated systems, and robust
security measures will improve care delivery and operational performance.
• Business Impact: Reduced delays, enhanced patient satisfaction, and cost
savings through automation.

Business Impact

This transformation will position AIIMS as a leader in healthcare delivery, improving

patient outcomes, staff productivity, and resilience against cyber threats, aligning with
strategic goals of operational excellence and patient-centric care.

Introduction

Background

AIIMS, a premier healthcare institution, has initiated digital transformation projects like
the e-Hospital and OPD Transformation initiatives. However, outdated IT infrastructure
(30-40 years without upgrades) and a ransomware attack in 2022 highlight
vulnerabilities. The survey confirms reliance on internal servers and an intranet,
avoiding cloud services due to security and data volume concerns.

Project Objectives and Goals

• Improve IT Infrastructure: Enhance reliability and security of internal server-

based systems.
• Enhance Patient Care: Streamline workflows for faster, accurate service
delivery.
• Increase Efficiency: Automate manual processes to reduce staff workload and
errors.
• Ensure Data Security: Strengthen cybersecurity to protect sensitive patient
data.

Scope of the Project

This Business Architecture Plan focuses on patient registration, clinical workflows,

administrative processes, and emergency services, aligning with AIIMS’s internal
server-based IT strategy and intranet usage.

Research Methodology
• Data Collection: Survey interviews with AIIMS staff, analysis of existing
documentation (e.g., e-Hospital Project reports).
• Framework: TOGAF ADM Phase B for business architecture development.
• Tools: ArchiMate for modeling, Microsoft Teams for collaboration.

Problem Statement

Description of the Problem

AIIMS’s current business processes and IT systems suffer from:

• Disconnected Systems: Data silos impede information sharing.

• Inefficient Processes: Manual tasks cause delays and errors.
• Data Security Risks: Outdated systems are vulnerable to attacks.
• Scalability Issues: Infrastructure struggles with increasing patient loads.
Importance of Solving This Problem

Addressing these issues is critical to improving patient care, ensuring data integrity,
and maintaining AIIMS’s reputation as a healthcare leader.

Stakeholders Involved or Affected

Stakeholder Role/Concern

Director Strategic oversight

Medical Superintendent Operational efficiency

Doctors/Nurses Clinical workflow effectiveness

IT Department System reliability and security

Patients Care quality and wait times

Administrators Process efficiency

Current Challenges with Existing Enterprise Architecture

• Lack of system interoperability.

• Manual process dependencies.
• Security vulnerabilities due to outdated infrastructure.

Current State Analysis

Description of the Current EA in the Organization

AIIMS operates a mix of manual and semi-digital processes supported by an internal

server-based Hospital Management Information System (HMIS) and an intranet. Key
systems include:

• ORS System: Online appointment scheduling, no real-time bed tracking.

• HMIS Modules: Patient registration, billing, lab management, but disconnected.
• IT Infrastructure: Internal servers, no cloud usage, intranet-only connectivity.
Identified Gaps or Issues

• Data Silos: Lab reports delayed due to disconnected LIS/RIS.

• Manual Processes: Paper-based staff attendance and procurement.
• Security Risks: Outdated systems vulnerable to ransomware.
• Scalability: Limited capacity for patient volume growth.

Stakeholder Needs and Expectations

• Patients: Faster service, secure data.

• Staff: Reduced workload, real-time data access.
• Management: Cost efficiency, compliance with security standards.

Impact Assessment

Current inefficiencies lead to long wait times, increased costs, and compromised
patient data security, negatively affecting AIIMS’s operational and reputational
standing.

Business Process Model (Current State - Patient Registration)

[Patient Arrives] --> [Manual Form Filling] --> [Data Entry by Clerk] --> [Queue for
Appointment] --> [Delays]

Key Issues: Manual entry errors, no real-time availability, peak-hour bottlenecks.

Business Capability Map (Current State)

Capability Description Maturity Level

Patient Registration Manual forms, slow processing Low

Appointment Booking Phone/manual, inefficient Low

Medical Records Paper-based, partial digital Medium

Billing & Payments Manual verification, delays Low

Emergency Services Slow triage, fragmented Medium

Organizational Structure Diagram (Current State)

Note: IT Department operates independently, with limited integration into clinical

workflows.

Solution/Approach

Proposed EA Framework

Using TOGAF ADM, we propose a business architecture that enhances internal server-
based systems with:

• Unified EHR System: Centralized data management.

• Automation Tools: Streamlined workflows.
• Cybersecurity Framework: Enhanced protection within intranet constraints.

Future State Architecture Design

Business Process Model (Future State - Patient Registration)

[Patient Pre-Registers Online] --> [Barcode Check-In] --> [Automated Queue

Management] --> [Immediate Service]

Improvements: Reduced manual entry, real-time updates, faster processing.

Business Capability Map (Future State)

Capability Description Target Maturity

Patient Registration Online pre-registration, automated High

 Appointment Booking Online, real-time scheduling High

Medical Records Fully integrated EHR High

Billing & Payments Automated, EHR-linked High

Emergency Services AI-driven triage, real-time alerts High

Organizational Structure Diagram (Future State)

Change: IT integrated with clinical operations, staff roles shift to digital support.

Tools, Technologies, or Methodologies

• ArchiMate: Modeling business processes and capabilities.

• EHR Software: Custom-developed for internal servers (e.g., OpenEHR).
• AI Tools: Predictive analytics for triage and resource management.
• Cybersecurity: Encryption, intrusion detection within intranet.

Rationale

• Internal Servers: Aligns with AIIMS’s security and data volume preferences.
• Intranet Focus: Maintains existing infrastructure while enhancing functionality.
• Automation: Reduces manual effort, addressing scalability and efficiency.

How the Solution Addresses Identified Gaps

• Data Silos: EHR integration ensures seamless data flow.

• Manual Processes: Automation eliminates redundancies.
• Security: Modern cybersecurity mitigates risks within internal systems.
Cost-Benefit Analysis

Aspect Cost (Estimated) Benefit

EHR Implementation $2M Real-time data, reduced errors

Automation Tools $1M Efficiency, staff time savings

Cybersecurity $500K Data protection, trust

Training $200K Staff adoption, effectiveness

Scalability and Flexibility

The solution scales via modular EHR additions and flexible automation workflows,
adaptable to future patient volume increases without cloud dependency.

Implementation Plan

Steps to Implement

1. Phase A - Vision: Stakeholder validation, architecture vision approval.

2. Phase B - Business Architecture: Finalize models, capability maps.
3. Phase C/D - IS/Tech Architecture: Design EHR and cybersecurity systems.
4. Phase E/F - Planning: Develop migration plan, prioritize automation.
5. Phase G - Governance: Monitor implementation, ensure compliance.

Timeline and Key Milestones

Milestone Date Deliverable

Vision Approval Jan 2025 Statement of Work

Business Models Mar 2025 Process/Capability Maps

System Design Jun 2025 EHR/Cybersecurity Specs

Implementation Start Aug 2025 Initial Deployment

Full Rollout Dec 2025 Fully Operational Systems

Resources Required

• People: IT developers, clinical staff trainers, project managers.

• Tools: ArchiMate, EHR software licenses, cybersecurity tools.
• Budget: $3.7M total (as per cost-benefit analysis).

Potential Risks and Mitigation

Risk Mitigation

Staff Resistance Comprehensive training programs

System Downtime Phased rollout, backup systems

Security Breaches Pre-implementation testing

Outcome

Anticipated Outcomes

• Improved Patient Care: Faster access to records, reduced wait times.

• Operational Efficiency: 30% reduction in manual tasks.
• Data Security: Compliance with healthcare standards, no breaches.
• Scalability: Support for 20% patient volume increase.

Hypothetical Results

If implemented, AIIMS could see a 25% improvement in patient satisfaction scores and
$1M annual savings from efficiency gains.

Hypothetical Challenges

• Integration complexity with legacy systems.

• Initial staff learning curve.

Post-Implementation Monitoring

• KPIs: Wait times, error rates, system uptime.

• Regular audits for security and performance.
Conclusion

Summary of Problem and Solution

AIIMS’s outdated systems and manual processes hinder efficiency and security. The
proposed TOGAF-aligned architecture introduces integrated EHR, automation, and
cybersecurity enhancements within an internal server framework.

Key Findings and Insights

• Current inefficiencies stem from data silos and manual dependencies.

• Future state leverages existing infrastructure with modern enhancements.

Recommendations for Future EA Improvements

• Explore hybrid intranet-cloud models as security technologies evolve.

• Continuous capability enhancement via AI and analytics.