EHospital HospitalInformationSystems

Hospital
Information Systems

E-Hospital
Hospital Information Systems

Part 3

Punang Amaripuja
p_amaripuja@yahoo.com

Hospital
Information Systems

IT and
Organizational Change

MMRUMY 1
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Hospital
Information Systems

Structural Organizational Changes

Enabled by IT
1. Automation
Increasesefficiency
Replacesmanualtasks

2. Rationalizationofprocedures
Streamlines
Streamlinesstandardoperatingprocedures
standard operating procedures
Oftenfoundinprogramsformakingcontinuousquality
improvements
Totalqualitymanagement(TQM)
Sixsigma

Hospital
Information Systems

Structural Organizational Changes

Enabled by IT
3 Businessprocessredesign
3. Business process redesign
Analyze,simplify,andredesignbusinessprocesses
Reorganizeworkflow,combinesteps,eliminaterepetition

4. Paradigmshifts
Rethinknatureofbusiness
Rethink nature of business
Definenewbusinessmodel
Changenatureoforganization

MMRUMY 2
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Hospital
Information Systems

Organizational Change
Risks and Rewards

Themostcommonformsof
organizationalchangeare
automationandrationalization.
Theserelativelyslowmoving
andslowchangingstrategies
presentmodestreturnsbut
littlerisk.Fasterandmore
comprehensivechangesuch
as redesign and paradigm
asredesignandparadigm
shiftscarrieshighrewardsbut
offerssubstantialchancesof
failure.

FIGURE131

Hospital
Information Systems

Business Process Management

Businessprocessmanagement(BPM)
Varietyoftools,methodologiestoanalyze,design,
optimizeprocesses
Usedbyfirmstomanagebusinessprocessredesign
StepsinBPM
1. Identifyprocessesforchange
2 Analyzeexistingprocesses
2. A l i ti
3. Designthenewprocess
4. Implementthenewprocess
5. Continuousmeasurement

MMRUMY 3
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Hospital
Information Systems

ASISBUSINESSPROCESSFORPURCHASINGABOOKFROMAPHYSICALBOOKSTORE

FIGURE132

Purchasingabookfromaphysicalbookstorerequiresmanystepstobeperformedby
boththesellerandthecustomer.

Hospital
Information Systems

REDESIGNEDPROCESSFORPURCHASINGABOOKONLINE

FIGURE133

UsingInternettechnologymakesitpossibletoredesigntheprocessforpurchasinga
booksothatitrequiresfewerstepsandconsumesfewerresources.

MMRUMY 4
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Hospital
Information Systems

Tools for BPM

Identifyanddocumentexistingprocesses
Identifyinefficiencies
Createmodelsofimprovedprocesses
Captureandenforcebusinessrulesforperforming
processes
Integrateexistingsystemstosupportprocess
i
improvements t
Verifythatnewprocesseshaveimproved
Measureimpactofprocesschangesonkeybusiness
performanceindicators

Hospital
Information Systems

Review:
IT and Organizational Change
The Spectrum of Org Change: (lowtohighrisk&return)
TheSpectrumofOrgChange: (lowtohigh risk & return)
AutomationRationalizationReengineeringParadigm Shift
ITvs.OrganizationalChange
GlobalNetwork Internationaldivisionoflabor
Enterprisenetworks collaborativeworkandteamwork
Distributedcomputing Empowerment
P t bl ti Virtualorganizations
Portablecomputing Vi t l i ti
GraphicalUserInterface Accessibility
ITCapabilitiesthathasorganizationalimpacts
Transactional,geographical,automation,analytical,
informational,sequential,knowledgemanagement,tracking,
disintermediation

MMRUMY 5
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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 6
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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
canbebroken
b b k
downintosixcore
activities.

FIGURE134

MMRUMY 7
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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
Faulty requirements analysis is leading cause of
systemsfailureandhighsystemsdevelopmentcost

MMRUMY 8
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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 PROCESSING DOCUMENTATION
Medium Computations Operations documentation
Content Program modules Systems documents
Timing Required reports User documentation
Timing of outputs
INPUT CONVERSION
Origins MANUAL PROCEDURES Transfer files
Flow What activities Initiate new procedures
Data entry Who performs them Select testing method
When Cut over to new system
USER INTERFACE
How
Simplicity TRAINING
Where
Efficiency Select training techniques
Logic CONTROLS Develop training modules
Feedback Input controls (characters, limit, reasonableness) Identify training facilities
Errors Processing controls (consistency,
( record counts))
ORGANIZATIONAL CHANGES
Output controls (totals, samples of output)
DATABASE DESIGN Task redesign
Procedural controls (passwords, special forms)
Logical data model Job redesign
Volume and speed SECURITY Process design
requirements Access controls Organization structure design
File organization and Catastrophe plans Reporting relationships
design Audit trails
Record specifications

MMRUMY 9
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Hospital
Information Systems

Programming & Testing

Programming:
Systemspecificationsfromdesignstagearetranslated
intosoftwareprogramcode
Testing
Ensuressystemproducesrightresults
Unittesting:Testseachprograminsystemseparately
S t t ti T t f ti i
Systemtesting:Testfunctioningofsystemasawhole
f t h l
Acceptancetesting:Makessuresystemisreadytobe
usedinproductionsetting
Testplan:Allpreparationsforseriesoftests

Hospital
Information Systems

Sample test plan to test a record change

Whendevelopingatestplan,itisimperativetoincludethevariousconditionstobetested,the
requirementsforeachconditiontested,andtheexpectedresults.Testplansrequireinputfrom
bothendusersandinformationsystemsspecialists.
FIGURE135

MMRUMY 10
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Hospital
Information Systems

Conversion
Processofchangingfromoldsystemtonewsystem
Fourmainstrategies
1. Parallelstrategy
2. Directcutover
3. Pilotstudy
4. Phasedapproach
Requires
Requiresend
enduser
usertraining
training
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
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Hospital
Information Systems

SUMMARY OF SYSTEMS DEVELOPMENT ACTIVITIES

CORE ACTIVITY DESCRIPTION
Systems analysis Identify problem(s)
Specify solutions
Establish information requirements
Systems design Create design specifications

Programming Translate design specifications into

code

Testing Unit test

Systems test
A
Acceptance
t ttestt
Conversion Plan conversion
Prepare documentation
Train users and technical staff
Production and Operate the system
maintenance Evaluate the system
Modify the system

Hospital
Information Systems

IT Project Management

MMRUMY 12
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Hospital
Information Systems

CURRENT
SITUATION GOALS

Hospital
Information Systems

New
Developments

NOW THEFUTURE

New
Developments

MMRUMY 13
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Hospital
Information Systems

The Importance of
Project Management
Runawayprojectsandsystemfailure
Runaway projects and system failure
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
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Hospital
Information Systems

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

Hospital
Information Systems

The Project Constraints Matrix

PRIORITIES MaxorMin
Max or Min Constrain Accept
MEASURESOF
SUCCESS
Cost
Rp100.000.000,
X

Schedule
6months
X

Scopeand/orQuality
Max.customerservice
Min.operationalcost X

MMRUMY 15
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Hospital
Information Systems

The Information Systems Plan

1. PurposeofthePlan
Overview,strategic&managementplan
, g g p
2. StrategicBusinessPlan
Currentsituation&organization,changingenvironment,major
goals
3. CurrentSystems
Systems~businessfunction,capabilities,system~business
requirements,futuredemands
4. NewDevelopments
Newsystemsprojects,newcapabilitiesrequirement
5
5. Management Strategy
ManagementStrategy
Acquisition,schedule, realignment,reorganization,controls,
training,personnel
6. ImplementationPlan
Anticipateddifficultiesinimplementation,progressreport
7. BudgetRequirements
Requirements,potentialsavings,financing,acquisitioncycle

Hospital
Information Systems

Simplified Information System Proposal

1. PurposeoftheInformationSystem
Overview ofcompanyandinformationsystemneeds
of company and information system needs
Major goals
2. StrategicContext
Currentsituation&organization
Changingenvironment
Benefits
3. SystemDescription
Mainfunctions
Systemusers(departments,individual)
Systemtype
4. ImplementationPlan
DevelopmentProcessandApproaches
Anticipateddifficultiesinimplementation

MMRUMY 16
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Hospital
Information Systems

Core Systems Development Activities

SystemsAnalysis:
Identifyproblemsandopportunities,specifysolution,information
Identif problems and opport nities specif sol tion information
requirements
SystemsDesign
Createlogical&physicaldesignspecs,managetechnical
realization
Programming(daesign specs programcode)
Testing
Unittest,systemstest,acceptancetest
Unit test systems test acceptance test
Conversion
Planconversion,preparedocs,trainusersandtechnicalstaff
Production&Maintenance
Operatesystem,evaluatesystem,modifysystem

Hospital
Information Systems

Estimating Information Requirements

EnterpriseAnalysis
O
Organization
i ti wideandcomprehensiveIRanalysis;
id d h i IR l i
Intermsoforgunitsfunctionsprocessesvs.dataelements;
Helpsidentifykeyentitiesandattributes.
Steps:largesurveyofmanagers aggregated(asabove)
datacreatorsorusers

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

MMRUMY 17
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Hospital
Information Systems

Systems-Development
Approaches

1. SystemsDevelopmentLifecycle
2. Prototyping
3. Applicationsoftwarepackage
4
4. End user development
Enduserdevelopment
5. 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 Definition Project proposal report

Systems study System proposal report

Design Design specifications

Programming Program specs code

Installation System performance tests

Post-implement. Post-implementation audit

Project Design Design Production
Initiation decision spec decision OPERATIONS
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
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Hospital
Information Systems

SystemsDevelopmentApproaches

Prototyping
Identify
y
basic req.

Develop
prototype

Use the
Prototype

Yes User
satisfied?
No

Operational Revise &

prototype 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
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Hospital
Information Systems

SystemsDevelopmentApproaches

Examples of
Application Software Packages
Accounts receivables Healthcare
Bond & stock management Hotel Management
Computer-aided design Inventory control
Document imaging Library systems
E-mail
Order processing
Enterprise Resource
Planning (ERP) Payroll
Groupware 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
Users control system
y development
p
Saves development time & cost
Reduce applications backlog

Disadvantages
Can proliferate uncontrolled IS and data
Not always meet Quality Assurance

MMRUMY 21
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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 (1/2)

A
Approach
h Ch
Characteristics
t i ti Ad
Advantages
t Di d
Disadvantages
t
Systems Sequential, formal Necessary for Slow & expensive
Lifecycle Written specs and large complex Discourages changes
approvals systems and Massive paperwork
Limited user role projects

Proto- Dynamic reqs by Rapid & Not for large,

typing experiment inexpensive complex systems
Rapid, informal, For uncertain Can gloss over
iterative reqs or end-user analysis,
Cont. user- interface focus documentation, &
prototype interaction Promotes user testing
part.

MMRUMY 22
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Hospital
Information Systems

Systems-Development Approaches (2/2)

Approach Characteristics Advantages Disadvantages

Application Eliminates needs for Reduces design, prog., May not meet orgorgss
software internally dev. s/w install., and maint. req.
package Can save time & cost May not perform
(for common bus.apps) bus.functions well
Reduces int. IS Extensive customi-
resource zation raises cost
End-user Created by end-users Users control sys.dev. Can proliferate
development w/ 4G s/w tools Saves dev. time & cost uncontrolled IS and
Rapid
p & informal Reduce apps backlog data
Min. sys.spec. role Not always meet
Quality Assurance

Out-sourcin Built (& operated) by Can reduce/control cost Losses control over
ext. vendor When internal IS functions
resources are limited Dependence on
external vendors

Hospital
Information Systems

IS Stakeholders

MMRUMY 23
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Hospital
Information Systems

People Perspectives for Systems Development

Focuson Systems
PEOPLE
INFORMATIONSYSTEMBUILDINGBLOCKS Development

Stakeholders AN INFORMATION SYSTEM

ANINFORMATIONSYSTEM Activities

S ISSCOPE
System
Y
Owner
S Purpose&vision Goalsandobjectives Costsandbenefits
T
E
M System ISREQUIREMENTS
S Users
Whatthesystemis:andmustdoindependentof
Systems
A technology Analysis
N System IS DESIGN
ISDESIGN and
A Designers Design
L Howthesystemwillbeimplementedusingtechnology Methods
Y
S ISCOMPONENTS
System
T Builders
S Actual,technicalimplementationofthesystem

Vendors &
INFORMATION TECHNOLOGY & ARCHITECTURE
Consultants

Hospital
Information Systems

SystemOwners
ISsponsorsandchiefadvocates
Fundingtodevelop,operate,andmaintaintheIS
SystemUsers/Clients
RegularlyuseoraffectedbytheIS
Capture,validate,enter,respond,store,exchangeData
&Information
Alwaysright,andultimatelypaysfortheIS
1)
1)Internalusers:clerical&serviceworkers;technical&
l l i l& i k h i l&
professionalstaff;knowledgeworkers;supervisors,
middlemanagers,andexecutivemanagers.
2)Remoteandmobileusers
3)Externalusers

MMRUMY 24
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Hospital
Information Systems

SystemDesigners
Translatessystemusersbusinessrequirementsand
constraints into technical solutions.
constraintsintotechnicalsolutions.
Designscomputerfiles,databases,inputs,outputs,
screen,networks,andprograms
SystemBuilders
ConstructsIScomponentsbasedondesign
specifications
SystemsAnalysts
Systems Analysts
Facilitates thedevelopmentofISandcomputer
applications
System System System System
Owner Users Designers Builders

SYSTEMS ANALYSTS

Hospital
Information Systems

Skills of a Successful
Systems Analyst
Analyticalskills
Understandingoforganizations.
Problemsolvingskills
Systemthinking
Abilitytoseeorganizationsandinformationsystemsassystems
Technicalskills
T h i l kill
Understandingofpotentialandlimitationsoftechnology.

MMRUMY 25
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Hospital
Information Systems

Skills of a Successful
Systems Analyst

Managerialskills
Abilitytomanageprojects,resources,riskandchange

Interpersonalskills
Effectivewrittenandoralcommunicationskills
Helpyouworkwithenduseraswellasothersystemanalysts
andprogrammers

MMRUMY 26