Course Code: IT112 Course Description: System Analysis and Design Activity Title: Focusing on Reliable Pharmaceutical Service

Reliable Pharmaceutical Service Is a privately held company incorporated in 1975 in Albuquerque, New Mexico. It provides pharmacy services to health-care delivery organizations that are too small to have their own inhouse pharmacy. By the late 1980s its client included two dozen nursing homes three residential rehabilitation facilities two small psychiatric hospitals four small specialty medical hospitals Service Area Albuquerque Santa Fe New service areas: Las cruces Gallup RPS Personnel and Staff Albuquerque and Sta. Fe Services area employs 12 delivery personnel 20 pharmacists assistance 6 licensed pharmacists 10 office and clerical staff Las Cruses and Gallup 15 employees Management team 6 people for company owners The RPS PROCESS Personnel at each health care facility submit patient prescription order by telephone. Orders are logged into the computer as they received. The computer generates cases manifest for each floor or wing of each client facility. The shift supervisor assigns the case manifests who, in turn assign tasks to pharmacy assistants. Pharmacists supervise and coordinate the PAs work. Reliable uses a combination of Excel spreadsheets and Access database and antiquated custom developed billing software running on personal computers. The system has become increasingly unwieldy as facility contracts Medicare and Medicaid reimbursement procedures have become more complex. All drugs for single patient are collected in one plastic drawer of a locking case. Each case is marked with the institutions name, floor number, and wing number. Each drawer is marked with the patients name and room number. Dividers are inserted within a drawer to separate multiple prescriptions for the same patients. When all the individual components of an order have been assembled, pharmacists makes a final check of the contents, sign each page manifest, and places two copy of manifest in the bottom of the case, one copy in a mail basket for billing. When all cases have been assembled, they are loaded onto a truck and delivered to the health-care facilities. MANUAL AND COMPUTER ASSISTED METHODS Order-entry Reliable uses a combination of Excel spreadsheets and Access database and antiquated custom developed billing software running on personal computers. PAs uses custom-developed billing software to enter orders received by telephone and to produce case manifests. Billing health-care facilities insurance companies Medicare & Medicaid patients

Inventory management It is done manually In 2001, reliable revenues leveled off at $40 million and profits plateaued at 5.5 million. By 2005, revenue was declining approximately 4% per year profit was declining at over 8% per year Several reasons for the decline: Price controls in both Medicare and Medicaid reimbursements are contracts with facilities managed by health maintenance organizations (HMOs) and large national health-care companies Increasing competition from national retail pharmacy chains such as Walgreens and in-house pharmacies at large local hospitals Inefficient operating procedures, which havent received a comprehensive review or overhaul in almost two decades Question #1: How many information systems staff members do you think Reliable can reasonably afford to employ? What mix of skills would they require? How flexible would they have be in terms of the work they do each day? Answer: 8 delivery personnel 16 pharmacist assistants (PAs) 9 Licensed and pharmacists 15 office and clerical staff 4 information staff 1 system analysts 1 software engineer 2 programmer o Total of 56 members Skills: o Computer skills for pharmacists and PAs o Costumer accommodation skills o Problem solving skills o Web-based application skills They should more flexible to their work since they do many manual works. Question #2: What impact would Web technology have on the way Reliable deploys its systems? Would the Web change the way Reliable does business? Answer: o Web technology would make their work easier. o Yes, web technology can change the way RPS does business for it will cost them less effort for recording their order instead of doing it manually. Clients can also order online. Question #3: Create an application plan and a technology architecture plan for Reliable Pharmaceutical Service to follow for the next five years. What system projects come firs in your plan? What system projects come later? Answer: Technology Architecture Plan Web based technology Inventory management, billing and order entry Connect client facilities with reliable Strategic business process through internet Application Architecture Plan Supply chain Management: include customer order order processing

inventory customer services Customer Support System Time Management Reliable Pharmaceutical Service

Reliable Pharmaceutical Services Five-year information system plan Management has placed a high priority on developing a web-based application to connect client facilities with Reliable Before the web component can be implemented, Reliable must automate more of the basic information it handles about patients, health-care facilities, and prescriptions. Reliable must develop an initial informational web site, which will ultimately evolve into an extranet through which Reliable will share information and link its processes closely with its clients and suppliers. Requirement of extranet: compliance with Health Insurance Portability and Accountability Act of 1996 (HIPAA) HIPAA requires health-care providers and their contractors to protect patient data from unauthorized disclosure. After basic processes are automated and the extranet web site is place The system should enable clients to add patient information and place orders through the web streamline processes for both Reliable and its clients provide useful query and patient management capabilities includes drug interaction and overdose warnings, automated validation of prescriptions with insurance reimbursement policies, and drug and patient cost data summaries Question #1: One approach to system development that Reliable might take is to start one large project that uses waterfall approach to the SDLC thoroughly plan the project, analyze all requirements in detail, design every component, and then implement the entire system, with all phases completed sequentially. What planning and management difficulties would this approach entail? Answer: Programmers, system analysts, and designers and other information system staff would find some difficulties when the client change their minds in terms of the requirements after the projects is finalized. Question #2: Another approach to system development might be to start with the first required component and get it working. Later, other project could be undertaken to work on the other identified capabilities. What planning and management difficulties would this approach entail? Answer: The Modified Waterfall Approach with overlapping, their will be a delayed of project because they will have to wait until it works and they will have to make sure that every phase is working. Question #3: A third approach to system development might be to define one large project that will use an initiative approach to SDLC. Briefly, what you would include in each iteration. Describe how incremental development might apply to this project. How would an iterative approach decrease project risks compared with the first approach? What are some risks the iterative approach might add the project? Answer: Even though in the iteration there is a repetition of works activities but there is a possibility that we can assume that we get the right solution in the first time. Iteration also saves time, because even though the first activity is still on process, you can still continue to the next activity, but some difficulties occur during the process. Testing and integrating will be included in each iteration. Question #1: Create an event table that lists information about system requirements based on the following specific system processing: When a nursing home needs to fill prescriptions for its patients, it provides order details to Reliable. Reliable immediately records information about the order and prescriptions. Prescription orders come in from all of

Reliable nursing-home clients throughout the day. At the start of each 12-hour shift, Reliable prepares a case manifest, detailing all recent orders, which is given to one of the pharmacists. When the pharmacist has assembled the orders for each client, the pharmacist records the order fulfillment. (Review the Reliable case description at the end of Chapter 1 for more details.) In addition, the system needs to add or update patient information, add or update drug inventory information, produce purchase orders to replenish the drug inventory, record inventory adjustments, and generate various management reports. For now, ignore any billing, payments, or insurance processing. Answer:
EVENT Order and prescription information Time to fill prescription Time to replenish inventory Drug Shipment Drug shipment packaging slip Pharmacist information Client unit information changes Update pharmacist data Update client data Client health care organization Maintain Human Resources Manufacturer Record drug shipment receipt Maintain Reliable Start of each 12hour shift Reorder point Produce purchase order TRIGGERS Prescription data SOURCE PATIENTS USE CASE Inventory Management and Maintain Fill Orders Client Health Organization Manufacturer Case Manifest Purchase Order DESTINATION RESPONSE

Question #2: Create an entity-relationship diagram that shows the data storage requirements for the following portion of the system: Add a few attributes to each data entity and show minimum and maximum cardinality. To process the prescription order, Reliable needs to know about the patients, the nursing home, and the nursing-home unit where each patient resides. Each nursing home has at least one, but possibly many, units. A patient is assigned to a specific unit. An order consists of one or more prescriptions, each for one specific drug and for one specific patient. An order, therefore, consists of prescriptions for more than one patient. Careful tracking and record keeping is obviously crucial. In addition, each patient has many prescriptions. One pharmacist fills each order. Answer:
Client Health-Care Organization Name Address Order Date StartTime EndTime Pharmacist LicenceNumber Name

OrderItem PatientName RoomNumber ChemicalName Manufacturer UnitType UnitDosage Quantity Frequency SpecialInstructions Price DrugItemPackage UPC PackageType PackageQuantity BrandName Price Manufacturer Name Address

Client Unit Name Address Floor Wing

Patient Number Name DateOfBirth Sex RoomNumber

Prescription StartDate StartTime EndDate EndTime Quantity Frequency SpecialInstructions

DrugItem UnitType UnitDosage QuantityOnHand ReorderPoint ReorderQuantity Price Drug ChemicalName

Question #3: Create a domain model class diagram for the object-oriented approach that shows the same requirements as described in step 2. Include a few attributes for each class and show minimum and maximum multiplicity. Be sure to identity any association classes and use the correct notation. Answer:
Client Health-Care Organization -name -address 1..* Order -date -startTime -endTime Pharmacist -licenseNumber -name 0..* 1

1 1..* Manufacturer -name -address 1..* Client Unit -name -address -floor -wing OrderItem -patientName -roomNumber -chemicalName -manufacturer -unitType -unitDosage -quantity -frequency -specialInstructions

0..*

DrugItemPackage -upc -packageType -packageQuantity -brandName -price

0..* 1..* 0..* Prescription Patient -number -address -dateOfBirth -sex -roomNumber -startDate -startTime -endDate -endTime -quantity -frequency -specialInstructions DrugItem -unitType -unitDosage -quantityOnHand -reorderPoint -reorderQuantity -price Drug -chemicalName 1..* 1

0..*

0..*

Question #4: How important is it to understand that each order includes prescriptions for more than one patient? Is that the type of information that is difficult to sort out at first? Did you see the implications initially, or did you have to work through the model until it made sense to you? Discuss Answer: It is important to understand that each order includes prescription for more than one patient to have documentation and define the order correctly. It is important to consider the patient experience not to analyzed. Group Members: Alisan, Wenalyn M. Bohol, Ashel Dela Real, Ma. Fe S. Mamac, Kristine L. Miano, Judith Pearl T Pabalate, Jo-ann M.