Case Study for Assignment 1 & Assignment 2
Designing Hospital Information Systems A Hospital Information System (HIS) basically is a synonym for information management system at use in hospitals. Hospitals generate a wealth of data round the clock, 365 days a year, all of which needs to be well managed to ensure efficient functioning. Patients visit such as establishments for outpatient care in an emergency, or get admitted for either a short stay (a few hours) or long in duration (that may sometimes be indefinite). The recent trend sees a growing emphasis on improving overall efficiency and clinical management. Important HIS Aspects to Consider Requirements Management In the requirements gathering phase, one should undertake an as-is study exercise to perform a comprehensive impact analysis of all business processes in order to identify the ones that will be affected by having the new system in place and the way this will occur. The various business processes that exist, the stakeholders involved and the systems / applications currently being used within the establishment that would be affected, albeit to varying degrees. Once this has been finalised and agreed upon, a requirements analysis followed by documentation needs to be prepared. Once finalised, the software requirement specification and functional design documents should be prepared with proper functional architecture in place. These should be signed-off by the competent authorities on both the customer and the vendor sides. The documents should then be turned over to the system design team for further action to ensure that the required system is delivered as per the specifications. General Requirements– An Overview Generally, the system should be safe and secure from a data management point-of-view. Highly sensitive data is handled by such systems and hence the comfort-level related to privacy and safety issues need to be addressed aggressively. The system should ensure efficient flow of information that provides interdepartmental support to the establishment, functional and process integration, be adaptable and flexible from a user perspective, and last, but not the least, be standards-based to ensure interoperability in terms of syntactic, semantic and process. The following points are that need to be given serious attention in order to build and implement a viable solution that will be able to deliver true value-for-money on a long-term basis: I. Use of a unique patient identifier like UHID (unique health identifier); II. Quick registration in times of emergency – use of “break-the-glass feature”, with due record of who did what, when and why (the reason for this action); III. Data security, patient confidentiality and privacy; IV. User-based-role-based access control with a sound and practical process using password/biometrics; V. Eligibility check of all insurance and ability to accept an upfront deposit to cover the estimated cost of care; VI. E-prescription for outpatients, Computerized Physician Order Entry (CPOE) for others; VII. For investigations, the consultant needs to know the total costs and the individual investigation charges. This would allow them to prioritise the ones that the patients must get done right away irrespective of the costs while leaving the rest later when they can afford them; VIII. The Electronic Medical Record (EMR) needs to be integrated with Laboratory Information System (LIS), Radiology Information System (RIS) and Picture Archiving and Communication System (PACS) to allow all images to be viewed and compared with any archived images; IX. Secured remote access to view information and add notes; X. Checking for Economic Order Quantity (EOQ) and re-order levels and automated listing of near-expiry items at least 90 days prior to expiry; XI. Slow moving materials in the medical stores should be tracked and appropriate alerts should ensure that all stakeholders are aware of the situation; XII. Bar coding for tracking patients, services, material and medication; and XIII. Management Information System (MIS) reports that serve as de facto registers will need to be maintained as per prevailing rules, regulations and legal requirements. A budget of $750,000.00 has been granted to develop the new HIS. This total budget includes development cost, and any other cost you can think of this project will incur. Estimated discount rate of 8% is provided. It is estimated that the new HIS system will help in reducing cost by $26,500 per month. Maintenance cost could be estimated at around $7500.00 per month. Additional Observations A fact that is frequently overlooked, mostly unappreciated and grossly underestimated is that it is the end-user of any IT system that makes or breaks it. It is vital to take them into confidence and actively engage them right at the planning phase itself and continued through each and every stage of the software development life cycle. Otherwise one is, more often than not, left to sincerely rue the decision. The importance of training and retraining of all users can neither be over-stated nor over-emphasised and should not be just one-off. Furthermore, the training needs to be periodic. One-off intense training followed by periodic re-training is vital. Every major upgrade or functionality change that would impact the business process should be considered equivalent to a new implementation. In all such instances, an appropriate training schedule needs to be prepared and rigorously followed to ensure the project’s success.