Thinking Big, Starting Small, Advancing Fast

From developing enterprise architecture to breaking down silos, Karen Xie is at the forefront of Blue Shield of California’s push to advance how it runs and grows its business

Building a house is a multistep process. Defining needs and wants, planning how to best achieve the needs and wants, and executing the plan are all part of the construction. It’s much the same with enterprise architecture in a business, says Karen Xie, the vice president of enterprise architecture at Blue Shield of California.

Xie describes it in an analogy: In the first stage, the homeowners define what they need or want in a house. In the second stage, architects provide blueprints to the homeowners that detail the future appearance of their house and the construction sequence. In the third stage, the house is built.

“Enterprise architecture for an organization works in a similar manner—bridging stage one, business strategy development—and stage three, strategy execution,” she says. “In stage two—like the framing, plumbing, and wiring home construction blueprints—the enterprise blueprints provide the future-state business capabilities and their interrelationships, such as omnichannels, digital marketing, and customer experience.” Therefore, Xie says, enterprise architecture is the process of transforming business strategies into an effective execution plan for delivering business-aligned holistic systems. This transformation process entails designing an enterprise in its current and future states from people, process, and technology perspectives.

Karen Xie, Blue Shield of California

Xie’s work at Blue Shield of California is her second time defining a company’s enterprise architecture programs. She worked as the vice president of architecture and innovation at Trinity Health, a national nonprofit health system that runs ninety-three hospitals in twenty-two states, for more than sixteen years before joining Blue Shield.

Since joining the company in 2014, one of Xie’s top priorities has been tearing down business silos. “They do nothing but cause chaos and waste,” Xie says. For example, she ensures that business departments throughout Blue Shield are communicating so that no group is purchasing technology solutions when the company already has similar tools with the same capabilities. If various related projects are pursued in a silo, then it can jeopardize the sequence and result in implementation failure.

Xie recognizes that operating in silos is an industry trend. She points to a study about the annual number of radiology tests conducted in hospitals around the country. “About 20 percent of those radiology tests alone are redundant due to patient data silos,” she says. “This 20 percent costs
$20 billion per year.”

Under Xie’s leadership, the company has leveraged the architecture blueprinting process to create an multiyear enterprise road map that guides planning for both the annual strategic budget and human capital. And, under the rigorous enterprise architecture discipline, there are no unnecessary purchases of duplicate technology solutions by various functions of the business.

“Technology solutions at Blue Shield have been rationalized and simplified,” she says. “Therefore, it has reduced rework, waste, and cost caused by silos and improved business efficiency, effectiveness, and agility.”

Although enterprise architecture has become one of the dominant best practices for top-performing organizations, Xie says there isn’t a magic formula or universal method to apply. She cites research from Gartner Inc., which found that among two-thirds of companies with enterprise architecture programs in place, the programs are barely functional and failed within two years.

“There’s not a playbook to follow,” she says. “It requires applying the best practices and lessons learned with the customizations based on the business environment, people’s skill set in the organization, the maturity level of the program, etc.”

In forming the enterprise architecture program for Blue Shield of California, Xie started by creating an operating model that consists of four key elements: governance to guide the architecture decisions; process to streamline the architecture deliverables; framework to provide the methodologies and tool set to help the architects; and operations to manage the service quality and deliver business value.

“In operationalizing the enterprise architecture operating model, I took the approach of thinking big, starting small, and advancing fast,” Xie says.

Now that it has been formed, Blue Shield’s enterprise architecture program consists of four different architecture domains: business architecture, which defines the enterprise business capabilities to help grow the business; information architecture, which defines enterprise data and data integration standards to support efficiency; application architecture, which defines and rationalizes application solutions to manage information across the company; and infrastructure architecture, which defines and rationalizes the infrastructure that supports application technologies.

Xie’s leadership with these architecture programs is only the beginning of her role in the company. Within a year of being hired, she was tasked with establishing a data services program, which reformed the company’s health innovation technology program and transformed quality assurance testing and automation functions. While working on the health innovation technology program, she has also helped create California’s largest health information exchange platform for patient longitudinal records.

Blue Shield of California is also pushing to become the best healthcare provider in California, and Xie is passionately committed to that goal. Under her leadership, Blue Shield of California’s enterprise architecture program has reached a 4.3 out of five on Gartner Inc.’s assessment of architecture maturity model. This is up from 2.3 in 2014 and significantly higher than our industry’s average maturity level, Xie says.

With her work in evolving enterprise architecture and breaking down silos, Xie will be essential to the company’s strategy to become the number one healthcare payer in the state of California.