unit5 - Learning Objectives Healthcare Software • Types...

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Unformatted text preview: Learning Objectives Healthcare Software • Types of Software • Configurations of Software Healthcare Software, System Acquisition, and Implementation System Acquisition: • Explain the process a HCO generally goes through in selecting a HCIS. • Describe the SDLC and its four major stages. • Discuss the various stages for acquiring a HCIS and pros and cons of each. • Discuss the purpose and content of a RFI and RFP in the system acquisition process. • Gain insight into the problems that may occur during system acquisition. . • Gain an understanding of the health care IT industry. Unit 5: Chapters 6 & 7 February 2, 2011 System Implementation: • • • • Tonight’s Focus Discuss the process that a HCO typically goes through in implementing a HCIS. Appreciate the organizational factors that can affect system acceptance and strategies for managing change. Develop a sample system implementation plan. Gain insight into the things that can go wrong during implementation & strategies managers can employ to alleviate problems. Discuss factors important to system support and evaluation. evaluation. . February 2, 2011 2 Overview of AHS 435 Topics Learning Objectives • AHS 435 - Survey of Clinical & Administrative Information Systems AHS 435 - Survey of Clinical & Administrative Information Systems 3 IT Operations Management . AHS 435 - Survey of Clinical & Administrative Information Systems 4 1 Programming Languages Programming Languages Generation 1 (1950’s) (1950’s) The detailed set of instructions and algorithms used to provide commands and instructions for computers in order to generate useful output. Machine Language (1’s and 0’s) Generation 2 (1960’s) (1960’s) Assembly Language (Commands: Add, Repeat) The original language was called “Machine The original language was called Machine Language” Language” composed of 1’s and 0’s. All All software is designed by some type of language. There There have been Five Generations of Programming Language Generation 3 (1960’s – 1980’s) (1960’s Procedural Systems (FORTRAN, COBOL) (FORTRAN COBOL) Generation 4 (1980’s) User defines problem; computer determines process Generation 5 (1990 - 2010) (1990 Artificial Intelligence, fuzzy logic, neural networks, search engines, queries. Uses Visual keys to program. . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems Generation 6? 5 MACHINE LANGUAGE – FIRST GENERATION 6 FORTRAN PROGRAM – THIRD GENERATION Robert Underwood is a real estate broker in Austin, Texas. C AREA OF A TRIANGLE - HERON'S FORMULA AREA C INPUT - CARD READER UNIT 5, INTEGER INPUT C OUTPUT - LINE PRINTER UNIT 6, REAL OUTPUT C INPUT ERROR DISPAY ERROR OUTPUT CODE 1 IN JOB CONTROL LISTING INTEGER A,B,C INTEGER A,B,C READ(5,501) A,B,C 501 FORMAT(3I5) IF(A.EQ.0 .OR. B.EQ.0 .OR. C.EQ.0) STOP 1 S = (A + B + C) / 2.0 AREA = SQRT( S * (S - A) * (S - B) * (S - C)) WRITE(6,601) A,B,C,AREA 601 FORMAT(4H A= ,I5,5H B= ,I5,5H C= ,I5,8H AREA= ,F10.2,12HSQUARE UNITS) STOP END In binary code, it would be represented as follows: 01010010 01010010 01101111 01100010 01100101 01110010 01110100 00100000 01010101 01101110 01100100 01100101 01110010 01110111 01101111 01101111 01100100 00100000 01101001 01110011 00100000 01100001 00100000 01110010 01100101 01100001 01101100 00100000 01100101 01110011 01110100 01100001 01110100 01100101 00100000 01100010 01110010 01101111 01101011 01100101 01110010 00100000 01101001 01101110 00100000 01000001 01110101 01110011 01110100 01101001 01101110 00101100 00100000 01010100 01100101 01111000 01100001 01110011 00101110 The 58 characters in the sentence require 464 . Bites of data. AHS 435 - Survey of Clinical & Administrative Information Systems AHS 435 - Survey of Clinical & Administrative Information Systems Programming Languages Programming Languages February 2, 2011 February 2, 2011 . . 7 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 8 2 Programming Languages Programming Languages C++ FOURTH GENERATION Visual Basic – Fifth Generation . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 9 Healthcare Software February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 10 HIT Operating Systems System Management Software Proprietary Proprietary Systems Operating Operating Systems Developed Developed and sold by private companies for a profit; protected by copyright Examples: Examples: Microsoft Windows, Apple OS Proprietary Proprietary Open Open Source Utility Utility Programs Virus Scanning Programs Virus Encryption Encryption Programs Open Source Systems Open Source Systems Developed Developed by volunteers and source code (programming) is made available to anyone free of charge Examples: Examples: Linux, Symbian Applications Software Administrative Administrative Supports Supports Business Functions of the organization Clinical Clinical . . Supports Supports the Care Functions of the organization February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 11 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 12 3 HIT Operating Systems HIT Operating Systems Example of a UNIX Screen: UNIX Systems Developed Developed in 1969 by AT&T Used Used extensively in early Physician Practice systems All All interface with the user was through th th the the keyboard Very Very simple to learn and use Limited Limited capabilities . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 13 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 14 HIT Operating Systems HIT Operating Systems Graphical User Interface Systems (GUI) Example of a GUI Screen: Originally Originally developed by Xerox; commandeered by Microsoft Graphical Graphical User Interfaces allow the user to interact more efficiently with the computer information by using graphical rather than by keyboard entries only using graphical rather than by keyboard entries only Data Data entry can be accomplished using: Windows W indows PullPull-Down Menus Buttons Buttons Scroll Scroll Bars Icon Icon Images Wizards W izards And, And, of course, the Mouse February 2, 2011 . AHS 435 - Survey of Clinical & Administrative Information Systems . 15 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 16 4 Applications Software Applications Software Administrative Systems Administrative Systems Patient Management Module Registration Registration (ADT): Admission-Discharge-Transfer Admission-DischargeAutomated Automated Registration Documentation System (ARDS) Patient Patient Accounting Health Health Information Management (HIM): Medical Records/DRG/Transcription/Record Records/DRG/Transcription/Record Management Master Master Patient Index/Community Patient Index Digital Digital Signature Capture Electronic Electronic File Management Document Document Scanning Quality Quality Improvement Contract Contract Management . Financial Accounting Modules General General Ledger Accounts Accounts Payable Payroll/Personnel Payroll/Personnel Human Human Resources Time Time & Attendance Fixed Fixed Assets Material Material Management (Purchasing) Budgeting Budgeting Executive Executive Information (Scorecards, Dashboards February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 17 Applications Software February 2, 2011 18 Applications Software Clinical Systems Clinical Systems Patient Care Modules Point Point of Care Systems Order Order Entry/ Results Reporting (CPOE) Medication Medication Administration Verification (MAR) Care Care Plans Patient Patient Acuity Resident Resident Assessment Instruments Inpatient Inpatient Rehabilitation Facility Core Core Measures Systems/CMS Reporting Patient Patient Education Clinical Modules Laboratory Laboratory Information System (LIS) Anatomic Anatomic Pathology Radiology Radiology Information System (RIS) Imaging Management – Picture Archiving Communications Pi System (PACS) Physical Physical Therapy Cardiopulmonary Cardiopulmonary Pharmacy Pharmacy Pharmacy Pharmacy Clinical Monitoring Operating Operating Room Management . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems AHS 435 - Survey of Clinical & Administrative Information Systems . 19 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 20 5 Applications Software Selecting Software Clinical Systems Q. There are many vendors who sell the same type of application. How should I choose between all these options? these options? A. Physician Modules Medical Medical Practice EMR Charting Charting Software Voice Voice Recognition Physician PACS Links Physician PACS Links Choose between Best of Breed and a Fully Integrated System. . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 21 Selecting Software February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 22 Selecting Software Best Best of Breed (BOB) Best Best of Breed (BOB) Best of breed (BOB) means using a specific software program or package for each specific application or requirement. These are selected based upon their ability to meet the organization’s specific needs better than any other available program. They may be from several vendors vendors and may not be the low-cost package. low- To share information between the applications, the information is either printed out from one package and manually input to the next or the packages are linked either either by the vendor or using a third party "middleware" package or interface system. While the program does an excellent job in meeting the needs, it may not be able to communicate with other applications the organization is using. . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 23 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 24 6 Selecting Software Selecting Software Fully Fully Integrated System (FIS) Choosing Choosing between BOB and FIS Fully Integrated Software (FIS) is a software package with a number of integrated modules or applications that cover a range of functions and requirements. Each application may not fully meet the needs of the organization but works well with the other applications organ th from the vendor. This is also called a “Single Vendor Solution” or “Monolithic Solution.” Consider: The The time, cost and resources for implementation Degree Degree of fit Simplicity Simplicity of use Implementation Implementation management . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 25 Selecting Software February 2, 2011 26 Enterprise Software Describes Describes a collection of computer programs with common or general business applications (rather than personal or organizationorganization-specific applications). Can Can be used in many organizations. May May contain tools for modeling how the entire organization works, and development tools for building applications unique to the organization to the organization. The The software is intended to solve an enterprise-wide problem enterprise(rather than a personal or departmental problem) Enterprise Enterprise level software aims to improve the enterprise's productivity and efficiency by providing business logic support functionality. Examples Examples include HR, Accounting, or Purchasing software. BOB BOB gives you best degree of fit and may be the simplest to use but interfacing runs up the costs and time to implement. FIS FIS is usually the least costly and time consuming and will normally be implemented quicker. BOB BOB allows spreading costs over a period of time. . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems AHS 435 - Survey of Clinical & Administrative Information Systems . 27 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 28 7 System Acquisition The The process that occurs from the time the decision is made to select a new system (or replace an existing system) until the time existing system) until the time a contract contract has been negotiated and signed. Chapter 6 System System Acquisition Acquisition . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 29 February 2, 2011 Systems Development Life Cycle AHS 435 - Survey of Clinical & Administrative Information Systems 30 SDLC Blueprint Blueprint to aid in the planning, selection, implementation, and support of a health care information system. Phases— Phases— Planning and Analysis Planning and Analysis System Acquisition Design Design Implementation Implementation Support Support and Evaluation . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 31 February February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 32 8 Overview of System Acquisition Process Prior to System Acquisition Health Health care executive team should Engage Engage in strategic information systems planning Identify Identify goals and strategies and how IT will be employed to aid the organization in be employed to aid the organization in achieving achieving them Establish Establish IT priorities Gain Gain budgetary approval and institutional support . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 33 The System Acquisition Process February 2, 2011 Determine Determine system goals What What does the organization hope to accomplish by implementing the proposed system? What is it looking for in a system? Goals Goals should be specific and measurable and congruent with the strategic goals of the organization Size Size and composition Knowledge Knowledge and skills Define Define project objectives and scope of analysis Determine Determine and prioritize system requirements Decide Decide what you hope to achieve as a steering committee . AHS 435 - Survey of Clinical & Administrative Information Systems 34 The System Acquisition Process Establish Establish project steering committee and appoint project manager February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 35 February February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 36 9 COMPONENTS TO A GOOD RFI The System Acquisition Process Statement Statement of Perceived Needs General General Information about Healthcare Organization Description Description of Facility Description Description of General Area where system is needed Current Current HIS and other related systems Develop Develop a request for information (RFI) Specific Specific System Needs General General System Needs Expected Expected Components Capacity Capacity expectations Identify Identify several vendors that appear to offer systems with features in line with the compiled services and features that the management group has developed. Expected Expected Schedule for Acquisition Timeline Timeline for RFI Timeline Timeline for RFP Desired Desired Installation Dates Vendor Information Vendor Information Description Description of Vendor Organization Contact Contact Information Financial Financial Status Current Current Products Current Current Installations References References Potential Potential Site Visits Poll Poll other healthcare administrators about experiences with specific vendors and systems. Information Information Needed Interface Interface Capabilities Technical Technical Capabilities Research Research products via internet searches Select Select a small number of vendors to contact . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 37 The System Acquisition Process When do I use an RFI instead of an RFP? And what’s the difference between them? A RFI requests only information about systems, RFI not pricing. A RFP requests both information and a detailed and binding price quotation. A RFI is used when there is a high level of RFI variation and options in the systems desired. A RFP is used when there is little variation and the basic requirements of the system are known. A RFP is also used when there are time constraints. A RFI must be followed by a RFP. . RFI February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 39 February 2, 2011 Databases Databases Network Network Connectivity Hardware Hardware . Web W eb Access Software Software Security Security AHS 435 - Survey of Clinical & Administrative Information Systems 38 Typical Components of an RFP Instructions Instructions for vendors Organization Organization objectives Background Background of the organization System System goals and requirements Vendor qualifications Vendor qualifications Proposed Proposed solutions Criteria Criteria for evaluating proposals General General contractual requirements Pricing Pricing and support . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 40 10 Example Contents for PACS RFP Table Table of Contents 1.0 1.0 Statement of Work Purpose Purpose Coverage Coverage & Participation 2.0 2.0 General Information Original Original RFP Document The The Organization 3.0 3.0 Schedule of Events 4.0 4.0 Proposal Preparation Instructions Vendor’s Vendor’s Understanding of RFP Good Good Faith Statement Communication Communication Proposal Proposal Submission Method Method of Award Selection Selection and Notification . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 41 Example Contents for PACS RFP February February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 42 Example Contents for PACS RFP Table Table of Contents (cont.) 5.0 5.0 Scope General General Criteria Volumes Volumes RFP RFP Objectives The The Technology Environment 6.0 6.0 PACS Specifications 6.1 6.1 System Components 6.2 6.2 Network 6.3 6.3 Database 6.4 6.4 Storage System 6.5 6.5 Archive System 6.6 6.6 External Information System Interfaces 6.7 6.7 Image Acquisition Systems 6.8 6.8 Image Display Workstation 6.9 6.9 Film Printers 6.10 6.10 Web Services and Web Workstations 6.11 6.11 General Specification Questions 6.12 6.12 Interface Requirements 6.13 6.13 Technical Requirements February 2, 2011 . Table Table of Contents (cont.) 7.0 7.0 Vendor Information Vendor Vendor Performance Vendor Vendor Experience 8.0 8.0 Implementation and Post-Implementation Post9.0 Financial Costs Financial Costs Basic Basic Costs Five Five Year Total Cost Summary 10.0 10.0 Deployment Models 11.0 11.0 Other Vendor Requirements 12.0 12.0 Vendor Certification . AHS 435 - Survey of Clinical & Administrative Information Systems . 43 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 44 11 Evaluate RFP The System Acquisition Process Explore Explore other options for acquiring system Contract Contract with Application Service Provider (ASP) Contract Contract with a system developer or build ininhouse Evaluate Evaluate vendor proposals Develop Develop evaluation criteria Hold Hold vendor demonstrations Make Make site visits and check references Prepare Prepare vendor analysis . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 45 February February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 46 The System Acquisition Process Conduct costConduct a cost-benefit analysis Identify Identify acquisition and support costs Identify Identify and evaluate potential benefits of each option Prepare Prepare a summary report and recommendations Recommend Recommend having at least 2-3 vendors in 2final ranking Conduct Conduct contract negotiations . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 47 February February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 48 12 Project Repository Sample Gantt chart . . February February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 49 February 2, 2011 Despite the best made plans, things can and do go wrong… Important Important to effectively manage system acquisition process Key Key tasks that generally occur Importance and composition of Im project repository Things Things that can derail the acquisition process . AHS 435 - Survey of Clinical & Administrative Information Systems 50 Chapter 6 Summary Failure Failure to manage vendor access to organization leadership Failure Failure to keep the process objectives (getting caught up in the vendor razzle-dazzle) razzleOverdoing or underdoing the RFP th RFP Failure Failure to involve the leadership team and users extensively during the system selection Turning Turning negotiations into a blood sport February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 51 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 52 13 System implementation As As defined here, process begins once organization has acquired the system and continues through the early stages following the gothe early stages following the go live date. Requires Requires high level support and sufficient staff, time and resources. Chapter 7 System System Implementation Implementation . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 53 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 54 Sample Composition of Implementation Team System Implementation Process Organize Organize implementation team and identify system champion Composition Composition and size of implementation team Primary Primary role and functions of implementation team Role Role of system champion Nurse Mgr Physician CIO Radiology Director . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems Business Manager 55 February 2, 2011 IT Analyst . AHS 435 - Survey of Clinical & Administrative Information Systems 56 14 System Champion System Implementation Process Characteristics— Characteristics— Determine Determine project scope and expectations Well Well respected, knowledgeable Strong Strong communication skills, interpersonal skills, good listening skills Leadership skills—has clout and can make Leadershi things happen What What are the goals of the project? What is the project’s scope? What does the organization hope to achieve What does the organization hope to achieve as as a result of the new system? How will it measure its success? What What are the risks of failing to define project goals and scope? And system goals? Role Role and functions Sees Sees system as necessary to organization’s achievement of goals Serves Serves as advocate . Assumes Assumes leadership role in gaining buy-in buyFebruary February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 57 February 2, 2011 System Implementation Process Conduct Conduct workflow and process analysis Install Install system components Plan, Plan, conduct, and evaluate staff training Convert Convert data and test system Communication Communication progress or status Prepare Prepare for go-live date go- Major Major activities and tasks Major Major milestones Estimated Estimated duration of each activity Any dependencies among activities Any dependencies among activities Resources Resources and budget Individual Individual or members responsible for completing each task Target Target dates Measures Measures for evaluating completion and success . AHS 435 - Survey of Clinical & Administrative Information Systems 58 Implementation Plan Establish Establish project plan – key components include February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 59 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 60 15 Strategies for managing project… and anticipating things that can go wrong Create Create an environment where expectations are defined, met and managed Do Do not underestimate use resistance Allocate Allocate sufficient resources, including technical support staff and IT infrastructure Provide Provide adequate initial and ongoing training Manage Manage unintended consequences . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 61 February 2, 2011 After Implementation… Important Important to adequately plan for system implementation— implementation—need right set of people, skills, and resources Things Things can and do go wrong, so it’s also important to address organizational aspects of implementing new system Process Process doesn’t end when new system is installed; critical that system continually updated, supported and maintained Discuss what went right and what Discuss what went right and what went went wrong. . AHS 435 - Survey of Clinical & Administrative Information Systems 62 Chapter 7 Summary Ensure Ensure that the system is sufficiently maintained and supported. February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems . 63 February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 64 16 QUESTIONS? . February 2, 2011 AHS 435 - Survey of Clinical & Administrative Information Systems 65 17 ...
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