ITIL® Misconceptions: The ‘IS’ and ‘IS-NOT’ of ITIL

Do you also think,

  • “ITIL is just Incident, Problem & Change Management. And yes, CMDB!”
  • “ITIL is a rigid set of tools, procedures, and processes and if you don’t follow what’s in the books, it’s not ITIL.”
  • “ITIL is for infrastructure or production only.”
  • “ITIL is only for big organizations, and it requires too many people.”
  • “ITIL doesn’t require any formal training, it is just common sense or a tool that will fix it all.”
  • “You don’t need to worry about culture when adopting the ITIL framework.”

If your answer to any of above is Yes, this article is for you!

Misconception #1: “ITIL is just Incident, Problem & Change Management. And yes, CMDB!”

Well, this misconception is incorrect. In essence, ITIL covers the entire life cycle of a Service/Solution/Product, right from its inception (aka, ‘kick-off,’ ‘initiation,’ ‘envision’) where ‘VALUE’ for the service is created, thereby supporting the complete service/solution/product lifecycle as an approach.

It involves practices such as management of Strategy, Portfolio, Finance, Demand, and Customer Experience function, with purposes of establishing Business Relationship Management for customer collaboration and loyalty.

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Misconception #2: “ITIL is a rigid set of tools, procedures, and processes and if you don’t follow what’s in the books, it’s not ITIL.”

ITIL is sometimes treated as a standard, which it was never meant to be. Businesses enforce this inflexible structure upon their employees, and it is often met with resistance. Despite what some people think there is nothing called an ‘ITIL way’.

As a resource, the very nature of ITIL is ‘adopt and adapt’ mindset which encourages users to tailor the best practices to their needs. If something fits your requirements, great, use it. If it does not, tweak it or do not use it.

Misconception #3: “ITIL is for infrastructure or production only.”

Many people associate ITIL with managing incidents and problems focusing on break/fix scenarios. But practices such as Lean, Agile, DevOps cannot be complete without ITIL for a holistic solution involving SDLC plus warranty.

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Misconception #4: “ITIL is only for big organizations, and it requires too many people.”

I have encountered several people who believe ITIL is not for their organization as they “don’t have and can’t afford to employ 26 process owners”.

Initially, ITIL may seem overwhelming and people think they need a big team to make it work. However, when taking the time to consult the ITIL guidance it is clear organizations of any size can use the framework.

A tailored approach

  • Just because ITIL has 26 processes, and each one must have a Process Owner – that does not mean having 26 different people each doing one of them. The roles can be assigned to existing employees in your organization with relevant skills and experience.
  • You do not need a minimum number of ITIL people to work effectively within a business. But what you do need is senior management buy-in. To get that, you need to communicate the business benefits clearly in a way that will show the tangible, positive changes it will bring to the organization and how ITIL will help with the pain points.
  • Another very common denominator for problems across teams is lack of role clarity: clearly documented ITIL processes can be used by businesses of all sizes to bring clarity to roles and responsibilities.

Misconception #5: “ITIL doesn’t require any formal training, it is just common sense or a tool that will fix it all.”

A lot of people believe that if they implement an ‘ITSM tool’, it will fix all problems in their business. And it is easier to implement a tool than a process.

Unfortunately, both these viewpoints just are not correct!

Often, while IT teams trying to adopt a full ITIL process, they instinctively just change what is possible within their silo, i.e.  going from Tool A to Tool B. While they may end up with a better Incident Management system or have SLAs implemented, it is questionable whether the proposed way of working, or a target is something that the business also requires.

Alongside a change in approaches and practices, ITIL requires a genuine collaborative cultural shift of a whole business. Otherwise, organizations will not achieve the transformation they are aiming for.

Misconception #6: “You don’t need to worry about culture when adopting the ITIL framework.”

Moving from one framework to another should not affect the organization’s culture too drastically but going from home-grown processes and methods to a structured framework can be quite daunting.

There are steps an organization can take to manage the company culture which will help a change initiative run smoothly:

  • Involve employees from the start – Brainstorm what is working and what is not with your employees. The more involved they are, the smoother the change will be. Reassure the most affected that they have value and a voice. By asking them to help shape the change, their worth to the organization is acknowledged.
  • Take the help of ITIL professionals and experts – Take professional advice that allows you to take advantage of each of the recommendations offered by ITIL methodology. An expert can clarify any doubts that may arise and ensure each process is executed properly according to the requirements of the business.
  • Break down larger changes – Larger changes can be broken down into smaller parts, which will make them easier to work through and can make them less daunting for potentially reluctant employees.
  • Embrace the fact that ITIL is not an immediate problem solver – ITIL does not bring with it a recipe for immediate efficiency but represents a transition that depending on the requirements of each business can vary widely in the amount of time needed to be successful. The effective coordination between processes, people and technology can take a considerable period. But there is no doubt that if these best practices are applied correctly, the organization will be able to enjoy the benefits progressively.

About the Author –

Gouri Mahendru

Gouri is part of the Quality Management function at GAVS, handling the Operations and Delivery excellence within ZIF Command Centres. She is passionate about driving business excellence through innovative IT Service Management in the Digital era and always looks for ways to deliver business value.

When she’s not playing with data and pivoting tables, she spends her time cooking, watching dramas and thrillers, and exploring places in and around the city.

Reimagining ITSM Metrics

Rama Periasamy

Rama Vani Periasamy

In an IT Organization, what is measured as success.? Predominantly it inclines towards the Key Performance Indicators, internally focused metrics, SLAs and other numbers. Why don’t we shift our performance reporting towards ‘value’ delivered to our customers along with the contractually agreed service levels? Because the success of any IT operation comes from defining what it can do to deliver value and publishing what value has been delivered, is the best way to celebrate that success.

It’s been a concern that people in service management overlook value as trivial and they often don’t deliver any real information about the work they do . In other words, the value they have created goes unreported and the focus lies only on the SLA driven metrics & contractual obligations. It could be because they are more comfortable with the conventional way of demonstrating the SLA targets achieved. And this eventually prevents a business partner from playing a more strategic role.

“Watermelon reporting” is a phrase used in reporting a service provider’s performance. The SLA reports depict that the service provider has adhered to the agreed service levels and met all contractual service level targets. It looks ’green’ on the outside, just like a watermelon. However, the level of service perceived by the service consumer does not reflect the ’green’ status reported (it might actually be ’red’, like the inside of a watermelon). And the service provider continues to report on metrics that do not address the pain points.  

This misses the whole point about understanding what success really means to a consumer. We tend to overlook valuable data and the one that shows how an organization as a service provider is delivering value and helping the customer achieve his/her business goals.

The challenge here is that often consumers have underdeveloped, ambiguous and conflicting ideas about what they want and need. It is therefore imperative to discover the users’ unarticulated needs and translate them into requirements.

For a service provider, a meaningful way of reporting success would be focused on outcomes rather than outputs which is very much in tandem with ITIL4. Now this creates a demand for better reporting, analysis of delivery, performance, customer success and value created.

Consider a health care provider, the reduced time spent in retrieving a patient history during a surgery can be a key business metric and the number of incidents created, number of successful changes may be secondary. As a service provider, understanding how their services support such business metrics would add meaning to the service delivered and enable value co-creation.

It is vital that a strong communication avenue is established between the customer and the service provider teams to understand the context of the customer’s business. To a large extent, this helps the service provider teams to prioritize what they do based on what is critical to the success of the customer/service consumer. More importantly, this enables the provider become a true partner to their customers.

Taking service desk as an example, the service desk engineers fixes a printer or a laptop, resets passwords. These activities may not provide business value, but it helps to mitigate any loss or disruption to a service consumer’s business activities. The other principal part of service desk activity is to respond to service requests. This is very much an area where business value delivered to customers can be measured using ITSM.

Easier said, but how and what business value is to be reported? Here are some examples that are good enough to get started.

1. Productivity
Assuming that every time a laptop problem is fixed with the SLA, it allows the customer to get back to work and be productive. Value can be measured here by the cost reduction – considering the employee cost per hour and the time spent by the IT team to fix the laptop.

How long does it take for the service provider to provide what a new employee needs to be productive? This measure of how long it takes to get people set up with the required resources and whether this lead-time matches the level of agility the business requires equates to business value. 

2. Continual Service Improvement (CSI)

Measuring value becomes meaningless when there is no CSI. So, measuring the cost of fixing an incident plus the loss of productivity and identifying and providing solutions on what needs to be done to reduce those costs or avoid incidents is where CSI comes into play.

Here are some key takeaways:

  • Make reporting meaningful by demonstrating the value delivered and co-created, uplifting your operations to a more strategic level.
  • Speak to your customers to capture their requirements in terms of value and enable value co-creation as partners.
  • Your report may wind up in the trash, not because you have reported wrong metrics, but it may just be reporting of data that is of little importance to your audience.   

Reporting value may seem challenging, and it really is. But that’s not the real problem. Keep reporting your SLA and metrics but add more insights to it. Keep an eye on your outcomes and prevent your IT service operations from turning into a watermelon!

References –

About the Author –

Rama is a part of the Quality Assurance group, passionate about ITSM. She loves reading and traveling.
To break the monotony of life and to share her interest in books and travel, she blogs and curates at www. kindleandkompass.com

The Hands that Rock the Cradle, also Crack the Code

Sumit Ganguli

On February 18, 2021, I was attending a video conference, with my laptop perched on my standing desk while I was furtively stealing a glance at the TV in my study. I was excitedly keeping up with the Perseverance Rover that was about to land at the Mars. I was mesmerized by space odyssey and was nervous about the ‘seven minutes of terror’ –  when the engineers overseeing the landing would not be able to guide or direct the Perseverance landing as it would take a while to establish or send any communication from Earth to Mars. Hence, the rover would have to perform a landing by itself, with no human guidance involved.

During this time, I thought I saw a masked lady with a ‘bindi’ on her forehead at the NASA control room who was, in her well-modulated American accented voice, giving us a live update of the Rover.

And since that day, Swati Mohan has been all over the news. We have got to know that Mohan was born in Bengaluru, Karnataka, India, and emigrated to the United States when she was one year old. She became interested in space upon seeing Star Trek at age 9. She studied Mechanical and Aerospace Engineering at Cornell University, and did her master’s degree and Ph.D. in Aeronautics and Astronautics at Massachusetts Institute of Technology.

Swati Mohan is the lead for the Navigation and Controls (GN&C) Operations for the Mars project. She led the attitude control system of Mars 2020 during operations and was the lead systems engineer throughout development. She played a pivotal part in the landing which was rather tricky.

This led me to ruminate about women and how they have challenged stereotypes and status quo to blaze the trail, especially in STEM.

I have been fascinated from the time I got to know that the first programmer in the world was a woman, and daughter of the famed poet, Lord Byron, no less. The first Programmer in the World, Augusta Ada King-Noel, Countess of Lovelace nee Byron; was born in 1815 and was the only legitimate child of the poet laureate, Lord Byron, and his wife Annabella. 

As a teenager, Ada’s prodigious mathematical talents, led her to have British mathematician Charles Babbage, as her mentor. Babbage is known as ‘the father of computers’. Ada translated an article on the Analytical Engine, which she supplemented with an elaborate set of notes, simply called Notes. These notes contain what many consider to be the first computer program—that is, an algorithm designed to be carried out by a machine. As a result, she is often regarded as the first computer programmer.

Six women—Francis “Betty” Snyder Holberton, Betty “Jean” Jennings Bartik, Kathleen McNulty Mauchly Antonelli, Marlyn Wescoff Meltzer, Ruth Lichterman Teitelbaum, and Frances Bilas Spence were associated with the programming of the first computer ENIAC. They had no documentation and no schematics to work with. There was no language, no operating system, the women had to figure out what the computer was, and then break down a complicated mathematical problem into very small steps that the ENIAC could then perform.  They physically hand-wired the machine, using switches, cables, and digit trays to route data and program pulses. This might have been a very complicated and arduous task. So, these six women were the programmers for the world’s mainframe computers.

The story goes that on February 14, 1946 The ENIAC was announced as a modern marvel in the US. There was praise and publicity for the Moore School of Electrical Engineering at the University of Pennsylvania, the inventors of ENIAC the first computer, Eckert and Mauchly were heralded as geniuses. However, none of the key programmers, all the women were not introduced in the event. Some of the women appeared in photographs later, but everyone assumed they were just models, perfunctorily placed to embellish the photograph.

One of the six programmers, Betty Holberton went on to invent the first sort routine and help design the first commercial computers, the UNIVAC and the BINAC, alongside Jean Jennings. These were the first commercial mainframe computers in the world.

It behooves us to walk down the pages of history and read about women who had during their time decided to #choosetochallenge and celebrate the likes of Swati Mohan who have grown tall on the shoulders of the first women programmers.

About the Author –

Sumit brings over 20 years of rich experience in the international IT and BPO sectors. Prior to GAVS, he served as a member of the Governing Council at a publicly-traded (NASDAQ) IT and BPO company for over six years, where he led strategic consulting, IP and M&A operations.

He has managed global sales and handled several strategic accounts for the company. He has an Advanced Professional Certificate (APC) in Finance from Stern School of Management, NYU, and is a Post Graduate in Management from IIM. He has attended the Owners President Management Program (OPM 52) at HBS and is pursuing a Doctorate in Business Administration at the LeBow School of Business, Drexel University.

He has served as an Adjunct Professor at Rutgers State University, New Jersey teaching International Business. He speaks at various industry forums and is involved in philanthropic initiatives like Artha Forum.

5 Leadership Lessons from the Pandemic to Kickstart your Technology Career in 2021

Jane Aboyoun, CIO, SCO Family of Services

Life is not without its ironies. While the pandemic turbo-charged our dependence on technology for day-to-day activities like never before, it also clarified the importance as a leader to be thoughtful and strategic – to take a step back before leaping into the fray.  Here are 5 lessons that helped me navigate the COVID crises that I believe we can all benefit from carrying forward into 2021 and beyond.

  1.  Slow Down to Speed Up

The necessity of responding effectively to COVID-19 as a Tech Chief compelled me to use my expertise to quickly identify technology solutions that would have an impact for my clients.  While responsiveness in an uncertain climate is essential, it’s actually a strong technology foundation that allows agility and creates ballast for organizations looking to gain competitive advantage in uncertain times.  

Lesson #1 is therefore that while it may not be as inspiring as the latest app, focusing on the “blocking and tackling” and building a strong technology foundation enables agility and re-invention.  As a CIO, I constantly balance possible change opportunities with the readiness of my clients to accept that change. Knowing how far to push my clients is a key part of my role. Just because a technology is available, doesn’t always mean it’s right for them.  Always consider how a new technology fits within the foundation.

  1. Don’t Reinvent the Wheel

My role as the CTO of the New York Public Library proved to be a great training ground in how to manage the complexity of upgrading infrastructure, moving applications to the cloud, and building a digital repository. I devised a three-part strategy for the transformation. First, I had to upgrade the aging infrastructure. Second, I had to move the infrastructure and the applications into the cloud, to improve our resiliency, security, and functionality. The third was to figure out how to preserve the library’s physical assets which were expiring from age. We decided to digitize the assets to permanently preserve them. Within 5 years, the repository had over a Petabyte of assets in it and was continuing to grow. These resulted in a world-class computing environment, moving a beloved, trusted, public city library into the digital 21st century that can be accessed by future generations.  Lesson # 2 – the secret to our success at NYPL was that the technology platforms and applications we used were all developed by best-of-breed providers.  We recognized that we were in the data business rather than the R&D business, and as such, didn’t build anything ourselves.  Instead, we took pride in working with and learning from industry leaders.

  1. Future-Proof Your Thinking

The pace of change is so much more rapid than it was even five years ago. Being able to recognize that the landscape is evolving, pivot at speed, and adopt new technology within the organization is now an essential skillset for technology leaders.  I am personally excited about the ‘internet of things’ (IoT) and the data that is being collected at the edge which will be enhanced by 5G capabilities. Also, AI and ML are on the cusp of making a ‘next level’ leap. I think there are lots of good applications of it, we just need to figure out how to use them responsibly.  Lesson # 3 is that as a technology leader, we need to be constantly looking around corners and to remain open-minded and curious about what’s next.  It is important for all leaders and aspiring leaders to ask questions; to challenge the status quo. 

  1. The Human Factor Remains a Top Priority

New technology comes with its own set of challenges. I believe the issue of privacy and security to be the most pressing. Data is being collected everywhere and often has proved to be more valuable that the platform it sits on. Hence, it is paramount to understand evolving data and privacy standards, as well as how to secure it and identify breaches. Then there are also moral and ethical issues around AI. While the opportunities are limitless, it is of utmost importance that we maintain our moral and democratic compass and that we apply technology in a way that benefits society. Lesson # 4 is that while it’s challenging to get the balance between innovation, opportunity, and ethics right, it’s a battle worth fighting.

  1. Facts Matter – Strive for Balance

Another issue for me is information overload.  Knowing what is real and what isn’t, has never been more important. This is where go-to trusted news and academic sources come into play. Two influencers I follow are Dan Fagella from EMERJ and Bernard Marr.  Both Dan and Bernard focus on AI and it’s motivating to hear and read what they have to say. I also read the technology review from MIT and listen to several technology podcasts.  Lesson # 5 is that it’s critical to continue to seek knowledge and to make a point of agnostically learning a lot from other technologists, business-people, and vendors.   Doing your own research and triangulation in the age of ‘alternative facts’ ensures that you stay informed, relevant and are able to separate fact from fiction.

In summary, as we enter the ‘Next Normal’, I anticipate that the pace of change will be faster than ever.  However, it’s important to remember that it’s not technology that leads the way, it’s people.  Staying in touch with technology trends and solutions is obviously important, but so is staying in touch with your values and humanity.  At the end of the day, technology is just an enabler and it’s the human values we apply to it that make the difference in how impactful it will be.

About the Author –

Jane Aboyoun is the Chief Information Officer at SCO Family of Services, a non-profit agency that helps New Yorkers build a strong foundation for the future. In this role, Jane is responsible for leading SCO’s technology strategy, and managing the agency’s technology services to support business applications, architecture, data, engineering, and computing infrastructure.

As an accomplished CIO / CTO, Jane has spent 20 years in the C-suite in a variety of senior technology leadership roles for global, world-class brands such as Nestlé Foods, KPMG, Estēe Lauder Companies, Walt Disney Company, and the New York Public Library.

Work Life Balance is Passé – Five Atomic Habits of Women who #ChooseToChallenge

Padma Ravichandran

The goal is not to read a book; the goal is to become a reader. The goal is not to run a marathon, the goal is to become a runner, says James Clear in his book, Atomic Habits. When your identity emerges out of habits, it made me ponder on the atomic habits of working women, especially the ones who say, it is not difficult to have it all.  With the onset of the pandemic, social media saw a surge of people sharing a typical workday in a pandemic – and organizations started recognizing the power of authentic self –what we had attempted to fathom for years, happened seamlessly – work-life integration. But for those, who know how to Lean In and #ChooseToChallenge, have cracked that work-life balance is passé, and have been focusing on atomic habits to create Work-Life Harmony.

As we march into the month of International Women’s Day with this year’s theme of #ChooseToChallenge, here are some conscious habits that I have observed, and got inspired by in Women who Lean In –

  1. Have a vision of what you want to be – and align it with your purpose and values.

Thinking long term to stay in the game, needs focus on values. With the power of visualization, hurdles are easier to surmount, and your mind is aligned to our vision and crosses the challenges that come in the way. Women who #ChooseToChallenge, focus on the traits that make them successful at work, such as organizing skills, team collaboration, transparency, which also helps them be a ‘successful’ parent! Sometimes we must find the model that is aligned with our purpose with some innovation and ask for specifics. This not only helps build trust but also enables one to create an impact.

  1. Know how to focus, when at work.

Women who #ChooseToChallenge always strive to have an internal positive monologue where work brings intrinsic joy. When we structure our day for success, prioritizing automatically falls in place. Knowing how not to take a bad day home, or vice versa takes endurance and unwavering focus. One of the key tips to staying focused is to recharge oneself. Despite the structured rituals and planning, ensuring there are pockets of freedom, where you can invest in your personal development, kindles more innovation.

  1. Understand the power of relationships.

It is not just about understanding and investing in the power of relationships at work – but in all spheres of life. Purpose-driven organizations do not have a command and control approach to work, but focus more on nurturing relationships at work, and encourage everyone to bring one’s most authentic self to work and enable you to find the right anchors and mentors. This allows oneself to ask for direction and keep rebalancing. It can even be collaborating with teachers of the kids, setting meaningful expectations with partners, or having honest conversations with co-workers, in the spirit of respect, and trust, which in turn builds a valued community of support.

  1. Define self-care, more broadly.

When one chooses to challenge, the buck doesn’t stop in taking care of health and fitness, it transcends to emotions, environment, relationships, time, resources, as self-care attributes to enhanced creativity, faster learning, a sharper memory, and of course elevates moods, which has an implication on workplace performance. Self-care at work could be surrounding ourselves with inspiring and supporting people or updating our workspace with inspiring artwork.

  1. Present yourself authentically.

When choosing to challenge, perhaps the status quo, women are mindful that it is not possible to achieve a perfect equilibrium– and know-how and where to get help when one aspect takes the center stage. We all intuitively know our authentic self but sometimes we shield it even from our own selves; it needs the courage to be authentic. Learn to say no respectfully and step away if something is veering you off your authentic self. When we are our authentic selves, it is easy to have conversations with the key stakeholders on where we need help and navigate forward to pursue what we care about the most in every aspect of our life. 

Work, Self, Home, and Community are not separate chambers with different identities. Attempting to integrate the aspects and the different roles we play in each, by focusing on the larger purpose helps us to be more engaged and productive in all the segments of life.

Reference 

www.hbr.org

About the Author –

Padma Ravichandran is part of the Talent Management Team is intrigued by Organization Culture and Behaviours at the workplace that impact employee experience. She is also passionate about driving meaningful initiatives for enabling women to Lean In, along with her fellow Sheroes. She enjoys reading books, journaling, yoga, and learning more about life through the eyes of her 8-year-old son.

Customer Focus Realignment in a Pandemic Economy

Ashish Joseph

Business Environment Overview

The Pandemic Economy has created an environment that has tested businesses to either adapt or perish. The atmosphere has become a quest for the survival of the fittest. On the brighter side, organizations have stepped up and adapted to the crisis in a way that they have worked faster and better than ever before. 

During this crisis, companies have been strategic in understanding their focus areas and where to concentrate on the most. From a high-level perspective, we can see that businesses have focused on recovering the sources of their revenues, rebuilding operations, restructuring the organization, and accelerating their digital transformation initiatives. In a way, the pandemic has forced companies to optimize their strategies and harness their core competencies in a hyper-competitive and survival environment.

Need for Customer Focused Strategies

A pivotal and integral strategy to maintain and sustain growth is for businesses to avoid the churn of their existing customers and ensure the quality of delivery can build their trust for future collaborations and referrals. Many organizations, including GAVS, have understood that Customer Experience and Customer Success is consequential for customer retention and brand affinity. 

Businesses should realign themselves in the way they look at sales funnels. A large portion of the annual budget is usually allocated towards the top of the funnel activities to acquire more customers. But companies with customer success engraved in their souls, believe in the ideology that the bottom of the funnel feeds the top of the funnel. This strategy results in a self-sustaining and recurring revenue model for the business.

An independent survey conducted by the Customer Service Managers and Professionals Journal has found that companies pay 6x times more to acquire new customers than to keep an existing one. In this pandemic economy, the costs for customer acquisition will be much higher than before as organizations must be very frivolous in their spending. The best step forward is to make sure the companies strive for excellence in their customer experience and deliver measurable value to them. A study conducted by Bain and Company titled “Prescription for Cutting Costs” talks about how increasing customer retention by 5% increases profits from 25%-95%. 

The path to a sustainable and high growth business is to adopt customer-centric strategies that yield more value and growth for its customers. Enhancing customer experience should be prime and proper governance must be in place to monitor and gauge strategies. Governance in the world of the customer experience must revolve around identifying and managing resources needed to drive sustained actions, establishing robust procedures to organize processes, and ensuring a framework for stellar delivery.

Scaling to ever-changing customer needs

A research body called Walker Information conducted an independent research on B2B companies focusing on key initiatives that drive customer experiences and future growth. The study included various customer experience leaders, senior executives, and influencers representing a diverse set of business models in the industry. They published the report titled “Customer 2020: A Progress Report” and the following are strategies that best meet the changing needs of customers in the B2B landscape.

AI Devops Automation Service Tools

Over 45% of the leaders highlighted the importance of developing a customer-centric culture that simplifies products and processes for the business. Now the question that we need to ask ourselves is, how do we as an organization scale up to these demands of the market? I strongly believe that each of us, in the different roles we play in the organization, has an impact.

The Executive Team can support more customer experience strategies, formulate success metrics, measure the impact of customer success initiatives, and ensure alignment with respect to the corporate strategy.

The Client Partners can ensure that they represent the voice of the customer, plot a feasible customer experience roadmap, be on point with customer intelligence data, and ensure transparency and communication with the teams and the customers. 

The cross-functional team managers and members can own and execute process improvements, personalize and customize customer journeys, and monitor key delivery metrics.

When all these members work in unison, the target goal of delivery excellence coupled with customer success is always achievable.

Going Above and Beyond

Organizations should aim for customers who can be retained for life. The retention depends upon how much a business is willing to go the extra mile to add measurable value to its customers. Business contracts should evolve into partnerships that collaborate on their competitive advantages that bring solutions to real-world business problems. 

As customer success champions, we should reevaluate the possibilities in which we can make a difference for our customers. By focusing on our core competencies and using the latest tools in the market, we can look for avenues that can bring effort savings, productivity enhancements, process improvements, workflow optimizations, and business transformations that change the way our customers do business. 

After all, We are GAVS. We aim to galvanize a sense of measurable success through our committed teams and innovative solutions. We should always stride towards delivery excellence and strive for customer success in everything we do.

About the Author –

Ashish Joseph is a Lead Consultant at GAVS working for a healthcare client in the Product Management space. His areas of expertise lie in branding and outbound product management.

He runs a series called #BizPective on LinkedIn and Instagram focusing on contemporary business trends from a different perspective. Outside work, he is very passionate about basketball, music, and food.

Patient 360 & Journey Mapping using Graph Technology

Srinivasan Sundararajan

360 Degree View of Patient

With rising demands for quality and cost-effective patient care, healthcare providers are focusing on data-driven diagnostics while continuing to utilize their hard-earned human intelligence. In other words, data-driven healthcare is augmenting human intelligence.

360 Degree View of Patient, as it is called, plays a major role in delivering the required information to the providers. It is a unified view of all the available information about a patient. It could include but is not limited to the following information:

  • Appointments made by the patients
  • Interaction with different doctors
  • Medications prescribed by the doctors
  • Patient’s relationship to other patients within the eco-systems specially to identify the family history related risks
  • Patient’s admission to hospitals or other healthcare facilities
  • Discharge and ongoing care
  • Patient personal wellness activities
  • Patient billing and insurance information
  • Linkages to the same patient in multiple disparate databases within the same hospital
  • Information about a patient’s involvement in various seminars, medical-related conferences, and other events

Limitations of Current Methods

As evident in most hospitals, these information are usually scattered across multiple data sources/databases. Hospitals typically create a data warehouse by consolidating information from multiple resources and try to create a unified database. However, this approach is done using relational databases and the relational databases rely on joining tables across entities to arrive at a complete picture. The RDBMS is not meant to handle relationships which extend to multiple hops and require drilling down to many levels.

Role of Graph Technology & Graph Databases

A graph database is a collection of nodes (or entities typically) and edges (or relationships). A node represents an entity (for example, a person or an organization) and an edge represents a relationship between the two nodes that it connects (for example, friends). Both nodes and edges may have properties associated with them.

While there are multiple graph databases in the market today like, Neo4J, JanusGraph, TigerGraph, the following technical discussions pertain to graph database that is part of SQL server 2019. The main advantage of this approach is that it helps utilize the best RDBMS features wherever applicable, while keeping the graph database options for complex relationships like 360 degree view of patients, making it a true polyglot persistence architecture.

As mentioned above, in SQL Server 2019 a graph database is a collection of node tables and edge tables. A node table represents an entity in a graph schema. An edge table represents a relationship in a graph. Edges are always directed and connect two nodes. An edge table enables users to model many-to-many relationships in the graph. Normal SQL Insert statements are used to create records into both node and edge tables.

While the node tables and edge tables represent the storage of graph data there are some specialized commands which act as extension of SQL and help with traversing between the nodes to get the full details like patient 360 degree data.

MATCH statement

MATCH statement links two node tables through a link table, such that complex relationships can be retrieved. An example,

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SHORTEST_PATH statement

It finds the relationship path between two node tables by performing multiple hops recursively. It is one of the useful statements to find the 360 degree of a patient.

There are more options and statements as part of graph processing. Together it will help identify complex relationships across business entities and retrieve them.

GRAPH processing In Rhodium  

As mentioned in my earlier articles (Healthcare Data Sharing & Zero Knowledge Proofs in Healthcare Data Sharing), GAVS Rhodium framework enables Patient and Data Management and Patient Data Sharing and graph databases play a major part in providing patient 360 as well as for provider (doctor) credentialing data. The below screen shots show the samples from reference implementation.

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Patient Journey Mapping

Typically, a patient’s interaction with the healthcare service provider goes through a cycle of events. The goal of the provider organization is to make this journey smooth and provide the best care to the patients. It should be noted that not all patients go through this journey in a sequential manner, some may start the journey at a particular point and may skip some intermediate journey points. Proper data collection of events behind patient journey mapping will also help with the future prediction of events which will ultimately help with patient care.

Patient 360 data collection plays a major role in building the patient journey mapping. While there could be multiple definitions, the following is one of the examples of mapping between patient 360-degree events and patient journey mapping.

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The below diagram shows an example of a patient journey mapping information.

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Understanding patients better is essential for improving patient outcomes. 360 degree of patients and patient journey mapping are key components for providing such insights. While traditional technologies lack the need of providing those links, graph databases and graph processing will play a major role in patient data management.

About the Author –

Srini is the Technology Advisor for GAVS. He is currently focused on Data Management Solutions for new-age enterprises using the combination of Multi Modal databases, Blockchain and Data Mining. The solutions aim at data sharing within enterprises as well as with external stakeholders.

Zero Knowledge Proofs in Healthcare Data Sharing

Srinivasan Sundararajan

Recap of Healthcare Data Sharing

In my previous article (https://www.gavstech.com/healthcare-data-sharing/), I had elaborated on the challenges of Patient Master Data Management, Patient 360, and associated Patient Data Sharing. I had also outlined how our Rhodium framework is positioned to address the challenges of Patient Data Management and data sharing using a combination of multi-modal databases and Blockchain.

In this context, I have highlighted our maturity levels and the journey of Patient Data Sharing as follows:

  • Single Hospital
  • Between Hospitals part of HIE (Health Information Exchange)
  • Between Hospitals and Patients
  • Between Hospitals, Patients, and Other External Stakeholders

In each of the stages of the journey, I have highlighted various use cases. For example, in the third level of health data sharing between Hospitals and Patients, the use cases of consent management involving patients as well as monetization of personal data by patients themselves are mentioned.

In the fourth level of the journey, you must’ve read about the use case “Zero Knowledge Proofs”. In this article, I would be elaborating on:

  • What is Zero Knowledge Proof (ZKP)?
  • What is its role and importance in Healthcare Data Sharing?
  • How Blockchain Powered GAVS Rhodium Platform helps address the needs of ZKP?

Introduction to Zero Knowledge Proof

As the name suggests, Zero Knowledge Proof is about proving something without revealing the data behind that proof. Each transaction has a ‘verifier’ and a ‘prover’. In a transaction using ZKPs, the prover attempts to prove something to the verifier without revealing any other details to the verifier.

Zero Knowledge Proofs in Healthcare 

In today’s healthcare industry, a lot of time-consuming due diligence is done based on a lack of trust.

  • Insurance companies are always wary of fraudulent claims (which is anyhow a major issue), hence a lot of documentation and details are obtained and analyzed.
  • Hospitals, at the time of patient admission, need to know more about the patient, their insurance status, payment options, etc., hence they do detailed checks.
  • Pharmacists may have to verify that the Patient is indeed advised to take the medicines and give the same to the patients.
  • Patients most times also want to make sure that the diagnosis and treatment given to them are indeed proper and no wrong diagnosis is done.
  • Patients also want to ensure that doctors have legitimate licenses with no history of malpractice or any other wrongdoing.

In a healthcare scenario, either of the parties, i.e. patient, hospital, pharmacy, insurance companies, can take on the role of a verifier, and typically patients and sometimes hospitals are the provers.

While the ZKP can be applied to any of the transactions involving the above parties, currently the research in the industry is mostly focused on patient privacy rights and ZKP initiatives target more on how much or less of information a patient (prover) can share to a verifier before getting the required service based on the assertion of that proof.

Blockchain & Zero Knowledge Proof

While I am not getting into the fundamentals of Blockchain, but the readers should understand that one of the fundamental backbones of Blockchain is trust within the context of pseudo anonymity. In other words, some of the earlier uses of Blockchain, like cryptocurrency, aim to promote trust between unknown individuals without revealing any of their personal identities, yet allowing participation in a transaction.

Some of the characteristics of the Blockchain transaction that makes it conducive for Zero Knowledge Proofs are as follows:

  • Each transaction is initiated in the form of a smart contract.
  • Smart contract instance (i.e. the particular invocation of that smart contract) has an owner i.e. the public key of the account holder who creates the same, for example, a patient’s medical record can be created and owned by the patient themselves.
  • The other party can trust that transaction as long the other party knows the public key of the initiator.
  • Some of the important aspects of an approval life cycle like validation, approval, rejection, can be delegated to other stakeholders by delegating that task to the respective public key of that stakeholder.
  • For example, if a doctor needs to approve a medical condition of a patient, the same can be delegated to the doctor and only that particular doctor can approve it.
  • The anonymity of a person can be maintained, as everyone will see only the public key and other details can be hidden.
  • Some of the approval documents can be transferred using off-chain means (outside of the blockchain), such that participants of the blockchain will only see the proof of a claim but not the details behind it.
  • Further extending the data transfer with encryption of the sender’s private/public keys can lead to more advanced use cases.

Role of Blockchain Consortium

While Zero Knowledge Proofs can be implemented in any Blockchain platform including totally uncontrolled public blockchain platforms, their usage is best realized in private Blockchain consortiums. Here the identity of all participants is known, and each participant trusts the other, but the due diligence that is needed with the actual submission of proof is avoided.

Organizations that are part of similar domains and business processes form a Blockchain Network to get business benefits of their own processes. Such a Controlled Network among the known and identified organizations is known as a Consortium Blockchain.

Illustrated view of a Consortium Blockchain Involving Multiple Other Organizations, whose access rights differ. Each member controls their own access to Blockchain Network with Cryptographic Keys.

Members typically interact with the Blockchain Network by deploying Smart Contracts (i.e. Creating) as well as accessing the existing contracts.

Current Industry Research on Zero Knowledge Proof

Zero Knowledge Proof is a new but powerful concept in building trust-based networks. While basic Blockchain platform can help to bring the concept in a trust-based manner, a lot of research is being done to come up with a truly algorithmic zero knowledge proof.

A zk-SNARK (“zero-knowledge succinct non-interactive argument of knowledge”) utilizes a concept known as a “zero-knowledge proof”. Developers have already started integrating zk-SNARKs into Ethereum Blockchain platform. Zether, which was built by a group of academics and financial technology researchers including Dan Boneh from Stanford University, uses zero-knowledge proofs.

ZKP In GAVS Rhodium

As mentioned in my previous article about Patient Data Sharing, Rhodium is a futuristic framework that aims to take the Patient Data Sharing as a journey across multiple stages, and at the advanced maturity levels Zero Knowledge Proofs definitely find a place. Healthcare organizations can start experimenting and innovating on this front.

Rhodium Patient Data Sharing Journey

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Healthcare Industry today is affected by fraud and lack of trust on one side, and on the other side growing privacy concerns of the patient. In this context, the introduction of a Zero Knowledge Proofs as part of healthcare transactions will help the industry to optimize itself and move towards seamless operations.

About the Author –

Srini is the Technology Advisor for GAVS. He is currently focused on Data Management Solutions for new-age enterprises using the combination of Multi Modal databases, Blockchain, and Data Mining. The solutions aim at data sharing within enterprises as well as with external stakeholders.

Healthcare Data Sharing

Srinivasan Sundararajan

Patient Care Redefined

The fight against the novel coronavirus has witnessed transformational changes in the way patient care is defined and managed. Proliferation of telemedicine has enabled consultations across geographies. In the current scenario, access to patients’ medical records has also assumed more importance.

The journey towards a solution also taught us that research on patient data is equally important. More the sample data about the infected patients, the better the vaccine/remedy. However, the growing concern about the privacy of patient data cannot be ignored. Moreover, patients who provide their data for medical research should also benefit from a monetary perspective, for their contributions.

The above facts basically point to the need for being able to share vital healthcare data efficiently so that patient care is improved, and more lives are saved.

The healthcare industry needs a data-sharing framework, which shares patient data but also provides much-needed controls on data ownership for various stakeholders, including the patients.

Types of Healthcare Data

  • PHR (Personal Health Record): An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
  • EMR (Electronic Medical Record): Health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization. 
  • EHR (Electronic Health Record): Health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed and consulted by authorized clinicians and staff across more than one healthcare organization. 

In the context of large multi-specialty hospitals, EMR could also be specific to one specialist department and EHR could be the combination of information from various specialist departments in a single unified record.

Together these 3 forms of healthcare data provide a comprehensive view of a patient (patient 360), thus resulting in quicker diagnoses and personalized quality care.

Current Challenges in Sharing Healthcare Data

  • Lack of unique identity for patients prevents a single version of truth. Though there are government-issued IDs like SSN, their usage is not consistent across systems.
  • High cost and error-prone integration options with provider controlled EMR/EHR systems. While there is standardization with respect to healthcare interoperability API specifications, the effort needed for integration is high.
  • Conflict of interest in ensuring patient privacy and data integrity, while allowing data sharing. Digital ethics dictate that patient consent management take precedence while sharing their data.
  • Monetary benefits of medical research on patient data are not passed on to patients. As mentioned earlier, in today’s context analyzing existing patient information is critical to finding a cure for diseases, but there are no incentives for these patients.
  • Data stewardship, consent management, compliance needs like HIPAA, GDPR. Let’s assume a hospital specializing in heart-related issues shares a patient record with a hospital that specializes in eye care. How do we decide which portions of the patient information is owned by which hospital and how the governance is managed?
  • Lack of real-time information attributing to data quality issues and causing incorrect diagnoses.

The above list is not comprehensive but points to some of the issues that are plaguing the current healthcare data-sharing initiatives.

Blockchain for Healthcare Data Sharing

Some of the basic attributes of blockchain are mentioned below:

  • Blockchain is a distributed database, whereby each node of the database can be owned by a different stakeholder (say hospital departments) and yet all updates to the database eventually converge resulting in a distributed single version of truth.
  • Blockchain databases utilize a cryptography-based transaction processing mechanism, such that each object stored inside the database (say a patient record) can be distinctly owned by a public/private key pair and the ownership rights carry throughout the life cycle of the object (say from patient admission to discharge).
  • Blockchain transactions are carried out using smart contracts which basically attach the business rules to the underlying data, ensuring that the data is always compliant with the underlying business rules, making it even more reliable than the data available in traditional database systems.

These underlying properties of Blockchain make it a viable technology platform for healthcare data sharing, as well as to ensure data stewardship and patient privacy rights.

GAVS Rhodium Framework for Healthcare Data Sharing

GAVS has developed a framework – ‘Rhodium’, for healthcare data sharing.

This framework combines the best features of multi-modal databases (relational, nosql, graph) along with the viability of data sharing facilitated by Blockchain, to come up with a unified framework for healthcare data sharing.

The following are the high-level components (in a healthcare context) of the Rhodium framework. As you can see, each of the individual components of Rhodium play a role in healthcare information exchange at various levels.

GAVS’ Rhodium Framework for Healthcare

GAVS has also defined a maturity model for healthcare organizations for utilizing the framework towards healthcare data sharing. This model defines 4 stages of healthcare data sharing:

  • Within a Hospital 
  • Across Hospitals
  • Between Hospitals & Patients
  • Between Hospitals, Patients & Other Agencies

The below progression diagram illustrates how the framework can be extended for various stages of the life cycle, and typical use cases that are realized in each phase. Detailed explanations of various components of the Rhodium framework, and how it realizes use cases mentioned in the different stages will be covered in subsequent articles in this space.

Rhodium Patient Date Sharing Journey

Benefits of the GAVS Rhodium Framework for Healthcare Data Sharing

The following are the general foreseeable benefits of using the Rhodium framework for healthcare data sharing.

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Healthcare Industry Trends with Respect to Data Sharing

The following are some of the trends we are seeing in Healthcare Data Sharing:

  • Interoperability will drive privacy and security improvements
  • New privacy regulations will continue to come up, in addition to HIPAA
  • The ethical and legal use of AI will empower healthcare data security and privacy
  • The rest of 2020 and 2021 will be defined by the duality of data security and data integration, and providers’ ability to execute on these priorities. That, in turn, will, in many ways, determine their effectiveness
  • In addition to industry regulations like HIPAA, national data privacy standards including Europe’s GDPR, California’s Consumer Privacy Act, and New York’s SHIELD Act will further increase the impetus for providers to prioritize privacy as a critical component of quality patient care

The below documentation from the HIMSS site talks about maturity levels with respect to healthcare interoperability, which is addressed by the Rhodium framework.

Source: https://www.himss.org/what-interoperability

This framework is in its early stages of experimentation and is a prototype of how a Blockchain + Multi-Modal Database powered solution could be utilized for sharing healthcare data, that would be hugely beneficial to patients as well as healthcare providers.

About the Author –

Srini is the Technology Advisor for GAVS. He is currently focused on Data Management Solutions for new-age enterprises using the combination of Multi-Modal databases, Blockchain, and Data Mining. The solutions aim at data sharing within enterprises as well as with external stakeholders.

Design-led Organization: Creative Thinking as a Practice!

Gogul R G

This is the first article in the series of ‘Design-led organization’ writing about creative thinking as a practice in GAVS. It is the first step for the readers to explore the world of design and creativity. So, let’s get started!

First let’s see what is design thinking is all about

There is a common misconception that design thinking is new. But when you look back, people have applied a human-centric creative process to build meaningful and effective solutions. Design has been practiced for ages to build monuments, bridges, automobiles, subway systems, etc. Design is not only limited to aesthetics, it is more of a mindset to think of a solution. Design thinking is a mindset to iteratively think about a complex problem and come up with a viable solution

Thinking outside of the box can provide an innovative solution to a sticky problem. However, thinking outside of the box can be a real challenge as we naturally develop patterns of thinking that are based on the repetitive activities and commonly accessed knowledge surround ourselves. It takes something to detach away from a situation where we’re too closely involved to be able to find better possibilities.

To illustrate how a fresh way of thinking can create unexpectedly good solutions, let’s look at a famous incident. Some years ago, an incident occurred where a truck driver had tried to pass under a low bridge. But, he failed, and the truck became firmly lodged under the bridge.

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The driver was unable to continue driving through or reverse out. The struck truck caused massive traffic problems, which resulted in emergency personnel, engineers, firefighters, and truck drivers gathering to negotiate various solutions to dislodge the truck.

Emergency workers were debating whether to dismantle parts of the truck or chip away at parts of the bridge. Each of one were looking for a solution with their respective level of expertise. A boy walking by and witnessing the intense debate looked at the truck, at the bridge, then looked at the road and said, “Why not just let the air out of the tires?” to the absolute amazement of all the specialists and experts trying to resolve the issue.

When the solution was tested, the truck could drive with ease, having suffered only the damage caused by its initial attempt to pass underneath the bridge. It symbolizes the struggles we face where often the most obvious solutions are the ones hardest to come by because of the self-imposed constraints we work within.  

“Challenging our assumptions and everyday knowledge is often difficult for us humans, as we rely on building patterns of thinking in order not to have to learn everything from scratch every time.

Let’s come back to our topic “What is Design thinking?” Tim Brown, Executive Chairman of IDEO – an international design and consulting firm quoted design thinking as below.

“Design thinking is a human-centered approach to innovation that draws from the designer’s toolkit to integrate the needs of people, the possibilities of technology, and the requirements for business success.

Now let’s think about our truck example. A boy with his fresh mindset provides a simple solution to address a complex problem. Yeah! this is the sweet spot. Everyone is creative and capable of thinking like a designer, and out of the box, to come up with a solution. This way of inculcating design as a mindset for a solution is known as Design thinking.

Yes, you read it right, everyone is creative…

We forget that back in kindergarten, we were all creative. We all played and experimented with weird things without fear or shame. We didn’t know enough not to. The fear of social rejection is something we learned as we got older. And that’s why it’s possible to regain our creative abilities, even decades later. In the field of design and user experience, there are individuals to stick with a methodology a while, they will end up doing amazing things. They come up with break through ideas or suggestions and work creatively with a team to develop something truly innovative. They surprise themselves with the realization that they are a lot more creative than they had thought. That early success shakes up how they see themselves and makes them eager to do more.

We just need to rediscover what we already have: the capacity to imagine, or build upon, new to the world ideas.  But the real value of creativity doesn’t emerge until you are brave enough to act on those ideas.

Geshe Thupten Jinpa, who has been the Dalai Lama’s chief English translator for more than twenty years, shared an insight about the nature of creativity. Jinpa pointed out that there’s no word in the Tibetan language for ‘creativity’ or ‘being creative’. The closest translation is ‘natural’. In other words, if you want to be more creative, you should be more natural! So…be natural!

At your workplace, the complex problems can be easily sorted out when you find a solution using creativity with the mindset of design thinking. Creativity can be improved by following the below steps.

  1. Go for a walk.
  2. Play your favorite games.
  3. Move your eyes.
  4. Take a break and enjoy yourself.
  5. Congratulate yourself each time you do something well.
  6. Estimate time, distance, and money.
  7. Take a route you never have taken before.
  8. Look for images in mosaics, patterns, textures, clouds, stars…
  9. Try something you have never done before.
  10. Do a creative exercise.
  11. Start a collection (stamps, coins, art, stationery, anything you wish to collect)
  12. Watch Sci-Fi or fantasy films.
  13. Change the way you do things – there are no routine tasks, only routine way of doing things.
  14. Wear a color you do not like.
  15. Think about how they invented equipment or objects you use daily.
  16. Make a list of 10 things you think are impossible to do and then imagine how you could make each one possible.
  17. For every bad thing that happens to you, remember at least 3 good things that happened.
  18. Read something you have not read yet.
  19. Make friends with people on the other side of the world.
  20. When you have an idea, make a note of it, and later check to see if it happened.
  21. Connect a sport with your work.
  22. Try food you never tried before.
  23. Talk to grandparents and relatives and listen to their stories.
  24. Give an incorrect answer to a question.
  25. Find links between people, things, ideas, or facts.
  26. Ask children how to do something and observe their creativity.

Start doing the above-mentioned steps to inculcate a creative mindset and apply it in your day-to-day work. Companies like GE health care, Procter & Gamble, UBER practiced design thinking and implemented in their new product launches and for solving complex problems in their organizations. Be natural to be more creative! When you are more creative, you can apply design thinking for seeking any solution for a complex problem in your work.

This is the first article in the series of Design led Organization in GAVS. Keep watching this space for more articles on design and keep exploring the world of design-thinking!

References:

About the Author –

Gogul is a passionate UX designer with 8+ years of experience into designing experiences for digital channels like Enterprise apps, B2C, B2B apps, Mobile apps, Kiosk, Point of Sale, Endless aisle, telecom products. He is passionate about transforming complex problems into actionable solutions using design.