EHospital HospitalInformationSystems

Hospital Information Systems

Hospital Information Systems Part 3

Punang Amaripuja p_amaripuja@yahoo.com

E-Hospital

Hospital Information Systems

IT and Organizational Change

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Structural Organizational Changes Enabled by IT

1. Automation
Increasesefficiency Replacesmanualtasks

2. Rationalizationofprocedures
Streamlinesstandardoperatingprocedures Oftenfoundinprogramsformakingcontinuousquality improvements
Totalqualitymanagement(TQM) Sixsigma

Hospital Information Systems

Structural Organizational Changes Enabled by IT

3 Businessprocessredesign 3.
Analyze,simplify,andredesignbusinessprocesses Reorganizeworkflow,combinesteps,eliminaterepetition

4. Paradigmshifts
Rethinknatureofbusiness Definenewbusinessmodel Changenatureoforganization

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Organizational Change Risks and Rewards

Themostcommonformsof organizationalchangeare automationandrationalization. Theserelativelyslowmoving andslowchangingstrategies presentmodestreturnsbut littlerisk.Fasterandmore comprehensivechangesuch asredesignandparadigm shiftscarrieshighrewardsbut offerssubstantialchancesof failure.

FIGURE131

Hospital Information Systems

Business Process Management

Businessprocessmanagement(BPM)
Varietyoftools,methodologiestoanalyze,design, optimizeprocesses Usedbyfirmstomanagebusinessprocessredesign

StepsinBPM
1. Identifyprocessesforchange 2 Analyze 2. A l existing i ti processes 3. Designthenewprocess 4. Implementthenewprocess 5. Continuousmeasurement

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

ASISBUSINESSPROCESSFORPURCHASINGABOOKFROMAPHYSICALBOOKSTORE

FIGURE132

Purchasingabookfromaphysicalbookstorerequiresmanystepstobeperformedby boththesellerandthecustomer.

Hospital Information Systems

REDESIGNEDPROCESSFORPURCHASINGABOOKONLINE

FIGURE133

UsingInternettechnologymakesitpossibletoredesigntheprocessforpurchasinga booksothatitrequiresfewerstepsandconsumesfewerresources.

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Tools for BPM

Identifyanddocumentexistingprocesses
Identifyinefficiencies

Createmodelsofimprovedprocesses Captureandenforcebusinessrulesforperforming processes Integrateexistingsystemstosupportprocess i improvements t Verifythatnewprocesseshaveimproved Measureimpactofprocesschangesonkeybusiness performanceindicators

Hospital Information Systems

IT and Organizational Change TheSpectrumofOrgChange: (lowtohighrisk&return)

AutomationRationalizationReengineeringParadigm Shift

Review:

ITvs.OrganizationalChange
GlobalNetwork Internationaldivisionoflabor Enterprisenetworks collaborativeworkandteamwork Distributedcomputing Empowerment P t bl computing Portable ti Virtual Vi t lorganizations i ti GraphicalUserInterface Accessibility

ITCapabilitiesthathasorganizationalimpacts
Transactional,geographical,automation,analytical, informational,sequential,knowledgemanagement,tracking, disintermediation

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Modern Business Trends with Implications on IS

TotalQualityManagement(TQM) BusinessProcessRedesign ContinuousProcessImprovement EnterpriseResourcePlanning(ERP) GlobalizationoftheEconomy InformationTechnologyTrendsandDrivers SocialNetworkingandWeb2.0

Hospital Information Systems

Systems Development Life Cycle

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Systemsdevelopment:
Activitiesthatgointoproducinganinformation systemsolutiontoanorganizationalproblemor opportunity 1. Systemsanalysis 2. Systemsdesign 3 Programming 3. 4. Testing 5. Conversion 6. Productionandmaintenance

Hospital Information Systems

The Systems Development Process

Buildingasystem canbe b broken b k downintosixcore activities.

FIGURE134

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Systems Analysis
Analysisofproblemtobesolvedbynewsystem
Definingtheproblemandidentifyingcauses Specifyingsolutions
Systemsproposalreportidentifiesandexaminesalternative solutions

Identifyinginformationrequirements

Includesfeasibilitystudy
Issolutionfeasibleandgoodinvestment? Isrequiredtechnology,skillavailable?

Hospital Information Systems

Systems Analysis (cont.)

Establishinginformationrequirements Whoneedswhatinformation,where,when,and how Defineobjectivesofnew/modifiedsystem Detailthefunctionsnewsystemmustperform Faultyrequirementsanalysisisleadingcauseof systemsfailureandhighsystemsdevelopmentcost

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Systems Design
Describessystemspecificationsthatwilldeliver functionsidentifiedduringsystemsanalysis Shouldaddressallmanagerial,organizational,and technologicalcomponentsofsystemsolution Roleofendusers
Userinformationrequirementsdrivesystembuilding Usersmusthavesufficientcontroloverdesignprocesstoensure systemreflectstheirbusinessprioritiesandinformationneeds Insufficientuserinvolvementindesigneffortismajorcauseofsystem failure

Hospital Information Systems

Specifications of Systems Design

OUTPUT Medium Content Timing INPUT Origins Flow Data entry USER INTERFACE Simplicity Efficiency Logic Feedback Errors DATABASE DESIGN Logical data model Volume and speed requirements File organization and design Record specifications PROCESSING Computations Program modules Required reports Timing of outputs MANUAL PROCEDURES What activities Who performs them When How Where CONTROLS Input controls (characters, limit, reasonableness) Processing controls (consistency, ( record counts) ) Output controls (totals, samples of output) Procedural controls (passwords, special forms) SECURITY Access controls Catastrophe plans Audit trails DOCUMENTATION Operations documentation Systems documents User documentation CONVERSION Transfer files Initiate new procedures Select testing method Cut over to new system TRAINING Select training techniques Develop training modules Identify training facilities ORGANIZATIONAL CHANGES Task redesign Job redesign Process design Organization structure design Reporting relationships

MMRUMY

EHospital HospitalInformationSystems

Hospital Information Systems

Programming & Testing

Programming:
Systemspecificationsfromdesignstagearetranslated intosoftwareprogramcode

Testing
Ensuressystemproducesrightresults Unittesting:Testseachprograminsystemseparately S t testing: System t ti Test T tfunctioning f ti i of fsystem t asawhole h l Acceptancetesting:Makessuresystemisreadytobe usedinproductionsetting Testplan:Allpreparationsforseriesoftests

Hospital Information Systems

Sample test plan to test a record change

Whendevelopingatestplan,itisimperativetoincludethevariousconditionstobetested,the requirementsforeachconditiontested,andtheexpectedresults.Testplansrequireinputfrom bothendusersandinformationsystems specialists.

FIGURE135

MMRUMY

10

EHospital HospitalInformationSystems

Hospital Information Systems

Conversion
Processofchangingfromoldsystemtonewsystem Fourmainstrategies
1. 2. 3. 4. Parallelstrategy Directcutover Pilotstudy Phasedapproach

Requiresendusertraining Finalizationofdetaileddocumentationshowinghow systemworksfromtechnicalandenduser standpoint

Hospital Information Systems

Production and Maintenance

Systemreviewedtodetermineifrevisionsneeded Mayincludepostimplementationauditdocument Maintenance
Changesinhardware,software,documentation,or procedurestoaproductionsystemtocorrecterrors,meet newrequirements,orimproveprocessingefficiency
20%debugging,emergencywork 20%changestohardware,software,data,reporting 60%ofwork:Userenhancements,improvingdocumentation, recodingforgreaterprocessingefficiency

MMRUMY

11

EHospital HospitalInformationSystems

Hospital Information Systems

SUMMARY OF SYSTEMS DEVELOPMENT ACTIVITIES CORE ACTIVITY

Systems analysis

DESCRIPTION
Identify problem(s) Specify solutions Establish information requirements Create design specifications

Systems design

Programming

Translate design specifications into code Unit test Systems test A Acceptance t t test t Plan conversion Prepare documentation Train users and technical staff Operate the system Evaluate the system Modify the system

Testing

Conversion

Production and maintenance

Hospital Information Systems

IT Project Management

MMRUMY

12

EHospital HospitalInformationSystems

Hospital Information Systems

CURRENT SITUATION

GOALS

Hospital Information Systems

New Developments

NOW
New Developments

THEFUTURE

MMRUMY

13

EHospital HospitalInformationSystems

Hospital Information Systems

The Importance of Project Management Runawayprojectsandsystemfailure Runawayprojects:30% 40%ITprojects

Exceedschedule,budget Failtoperformasspecified

Typesofsystemfailure
Failtocaptureessentialbusinessrequirements Failtoprovideorganizationalbenefits Complicated,poorlyorganizeduserinterface Inaccurateorinconsistentdata

Hospital Information Systems

Consequences of Poor Project Management

Withoutpropermanagement,asystemsdevelopment projecttakeslongertocompleteandmostoftenexceedsthe allocatedbudget.Theresultinginformationsystemmost likelyistechnicallyinferiorandmaynotbeableto demonstrateanybenefitstotheorganization.

MMRUMY

14

EHospital HospitalInformationSystems

Hospital Information Systems

Project Management
Activitiesincludeplanningwork,assessingrisk, estimatingresourcesrequired,organizingthe work,assigningtasks,controllingproject execution,reportingprogress,analyzingresults Fivemajorvariables
1. 2. 3. 4. 5. Scope Time Cost Quality Risk

Hospital Information Systems

The Project Constraints Matrix

PRIORITIES MaxorMin MEASURESOF SUCCESS Cost Rp100.000.000, Schedule 6months Scopeand/orQuality Max.customerservice Min.operationalcost

Constrain

Accept

X X

MMRUMY

15

EHospital HospitalInformationSystems

Hospital Information Systems

The Information Systems Plan

1. 2. 3. 4. 5 5. 6. 7.

PurposeofthePlan
Overview, ,strategic g &management g p plan Currentsituation&organization,changingenvironment,major goals Systems~businessfunction,capabilities,system~business requirements,futuredemands Newsystemsprojects,newcapabilitiesrequirement Acquisition,schedule, realignment,reorganization,controls, training,personnel Anticipateddifficultiesinimplementation,progressreport Requirements,potentialsavings,financing,acquisitioncycle

StrategicBusinessPlan CurrentSystems

NewDevelopments ManagementStrategy

ImplementationPlan

BudgetRequirements

Hospital Information Systems

Simplified Information System Proposal

1. 2. PurposeoftheInformationSystem
Overview ofcompanyandinformationsystemneeds Major goals Currentsituation&organization Changingenvironment Benefits Mainfunctions Systemusers(departments,individual) Systemtype DevelopmentProcessandApproaches Anticipateddifficultiesinimplementation

StrategicContext

3.

SystemDescription

4.

ImplementationPlan

MMRUMY

16

EHospital HospitalInformationSystems

Hospital Information Systems

Core Systems Development Activities

SystemsAnalysis:
Identify Identif problemsandopport opportunities, nities specif specifysol solution, tion information requirements

SystemsDesign
Createlogical&physicaldesignspecs,managetechnical realization Programming(daesign specs programcode)

Testing
Unittest, test systemstest, test acceptancetest

Conversion
Planconversion,preparedocs,trainusersandtechnicalstaff

Production&Maintenance
Operatesystem,evaluatesystem,modifysystem

Hospital Information Systems

Estimating Information Requirements

EnterpriseAnalysis
O Organization i ti wide id and dcomprehensive h i IRanalysis; l i Intermsoforgunitsfunctionsprocessesvs.dataelements; Helpsidentifykeyentitiesandattributes. Steps:largesurveyofmanagers aggregated(asabove) datacreatorsorusers

StrategicAnalysis:CriticalSuccessFactors
Smallnumberofeasilyidentifiableorganizationalgoals Shapedbytheindustry,firm,manager,&environment Believedtoensurethesuccessofanorganization

MMRUMY

17

EHospital HospitalInformationSystems

Hospital Information Systems

Systems-Development Approaches
1. 2. 3. 4 4. 5. SystemsDevelopmentLifecycle Prototyping Applicationsoftwarepackage Enduserdevelopment Outsourcing

Hospital Information Systems

SystemsDevelopmentApproaches(1/5)

Systems Development Lifecycle

Characteristics Sequential, formal Written specs and approvals Limited user role Advantages Necessary for large complex systems and projects Disadvantages Slow & expensive Discourages changes Massive paperwork

MMRUMY

18

EHospital HospitalInformationSystems

Systems Hospital Development Information Systems Approaches

Systems Development Lifecycle

Project proposal report System proposal report Design specifications Program specs code System performance tests Post-implementation audit
OPERATIONS

Project Definition Systems study Design Programming Installation Post-implement.

Project Initiation Design Design Production decision spec decision

Year 1

Year 1

3-8 Year Life Span

Hospital Information Systems

SystemsDevelopmentApproaches(2/5)

Prototyping
Characteristics Dynamic requirements by experiment Rapid, informal, iterative Continuous user-prototype interaction Advantages Rapid & inexpensive For uncertain requirements or end end-user user interface focus Promotes user participation Disadvantages Not for large, complex systems Can gloss over analysis, documentation, & testing

MMRUMY

19

EHospital HospitalInformationSystems

Hospital Information Systems

SystemsDevelopmentApproaches

Prototyping
Identify y basic req.

Develop prototype

Use the Prototype Yes

User satisfied?

No Operational prototype Revise & enhance

Hospital Information Systems

SystemsDevelopmentApproaches(3/5)

Application Software Package

Characteristics Eliminates needs for internally developed software Advantages Reduces design, programming, installation, and maintenance Can save time & cost (for common business apps) Reduces internal IS resource Disadvantages May not meet organizations requirements May not perform business functions well Extensive customization raises cost

MMRUMY

20

EHospital HospitalInformationSystems

Hospital Information Systems

SystemsDevelopmentApproaches

Examples of Application Software Packages

Accounts receivables Bond & stock management Computer-aided design Document imaging E-mail Enterprise Resource Planning (ERP) Groupware Healthcare Hotel Management Inventory control Library systems Order processing Payroll Tax accounting

Hospital Information Systems

SystemsDevelopmentApproaches(4/5)

End-User Development
Characteristics Created by end-users with software tools Rapid & informal Minimum system specialist role Advantages y development p Users control system Saves development time & cost Reduce applications backlog Disadvantages Can proliferate uncontrolled IS and data Not always meet Quality Assurance

MMRUMY

21

EHospital HospitalInformationSystems

Hospital Information Systems

SystemsDevelopmentApproaches(5/5)

Outsourcing
Characteristics Built (& operated) by ext. vendor Advantages Can reduce/control cost When internal resources are limited Disadvantages Losses control over IS functions Dependence on external vendors

Hospital Information Systems

Systems-Development Approaches
A Approach h Systems Lifecycle Ch Characteristics t i ti Sequential, formal Written specs and approvals Limited user role Dynamic reqs by experiment Rapid, informal, iterative Cont. userprototype interaction Ad Advantages t Necessary for large complex systems and projects Rapid & inexpensive For uncertain reqs or end-user interface focus Promotes user part.

(1/2)

Di d Disadvantages t Slow & expensive Discourages changes Massive paperwork Not for large, complex systems Can gloss over analysis, documentation, & testing

Prototyping

MMRUMY

22

EHospital HospitalInformationSystems

Hospital Information Systems

Systems-Development Approaches
Approach
Application software package

(2/2)

Characteristics
Eliminates needs for internally dev. s/w

Advantages
Reduces design, prog., install., and maint. Can save time & cost (for common bus.apps) Reduces int. IS resource Users control sys.dev. Saves dev. time & cost Reduce apps backlog

Disadvantages
May not meet org orgs s req. May not perform bus.functions well Extensive customization raises cost Can proliferate uncontrolled IS and data Not always meet Quality Assurance Losses control over IS functions Dependence on external vendors

End-user development

Created by end-users w/ 4G s/w tools Rapid p & informal Min. sys.spec. role Built (& operated) by ext. vendor

Out-sourcin

Can reduce/control cost When internal resources are limited

Hospital Information Systems

IS Stakeholders

MMRUMY

23

EHospital HospitalInformationSystems

Hospital Information Systems

People Perspectives for Systems Development

Focuson PEOPLE

INFORMATIONSYSTEMBUILDINGBLOCKS

Systems Development

Stakeholders
S Y S T E M S A N A L Y S T S
System Owner

ANINFORMATIONSYSTEM

Activities

ISSCOPE
Purpose&vision Goalsandobjectives Costsandbenefits

System Users

ISREQUIREMENTS
Whatthesystemis:andmustdoindependentof technology

System Designers

ISDESIGN

Howthesystemwillbeimplementedusingtechnology

Systems Analysis and Design Methods

System Builders

ISCOMPONENTS
Actual,technicalimplementationofthesystem
INFORMATION TECHNOLOGY & ARCHITECTURE

Vendors & Consultants

Hospital Information Systems

SystemOwners
ISsponsorsandchiefadvocates Fundingtodevelop,operate,andmaintaintheIS

SystemUsers/Clients
RegularlyuseoraffectedbytheIS Capture,validate,enter,respond,store,exchangeData &Information Alwaysright,andultimatelypaysfortheIS 1)Internal lusers:clerical l i l&service i workers; k technical h i l& professionalstaff;knowledgeworkers;supervisors, middlemanagers,andexecutivemanagers. 2)Remoteandmobileusers 3)Externalusers

MMRUMY

24

EHospital HospitalInformationSystems

Hospital Information Systems

SystemDesigners
Translatessystemusersbusinessrequirementsand constraintsintotechnicalsolutions. Designscomputerfiles,databases,inputs,outputs, screen,networks,andprograms

SystemBuilders
ConstructsIScomponentsbasedondesign specifications

SystemsAnalysts
Facilitates thedevelopmentofISandcomputer applications
System Owner System Users System Designers System Builders

SYSTEMS ANALYSTS

Hospital Information Systems

Skills of a Successful Systems Analyst

Analyticalskills
Understandingoforganizations. Problemsolvingskills Systemthinking
Abilitytoseeorganizationsandinformationsystemsassystems

Technical T h i lskills kill

Understandingofpotentialandlimitationsoftechnology.

MMRUMY

25

EHospital HospitalInformationSystems

Hospital Information Systems

Skills of a Successful Systems Analyst

Managerialskills
Abilitytomanageprojects,resources,riskandchange

Interpersonalskills
Effectivewrittenandoralcommunicationskills
Helpyouworkwithenduseraswellasothersystemanalysts andprogrammers

MMRUMY

26