Health Records Management System - Business Plan Example

Health Records Management System Introduction System development life cycle, in its nature forms, stands to be one of those oldest and however still vastly applied methods in software development and adoption methods in the field of information technology. Even though it has mutated over several years as a result of ever-changing cases and paradigm shifts concerning to the development or acquiring software, its main tenants are as usable currently as they used to be (Gkoulalas-Divanis, & Loukides, 2013). Life cycle phases have undergone iterations of different number of stages and different names, but at the center the System Development Life Cycle is resilient in its testing and implementation in the business, government and industry architecture. Actually, the System Development Life Cycle has been termed as one of the two dominant application development techniques in today’s world together with prototyping. Thus learning about System Development Life Cycle is still very crucial to students of all centuries. This article outlines System Development Life Cycle application in a real world health care environment entailing a core component of a sectional hospital care facility. The article may be used as pedagogical equipment in system analysis and design course, or even in an upper division or graduate course as a scenario of implementation of the System Development Life Cycle in practical application. Several aspects have been discussed that include the entire System Development Life Cycle in health care setup. Background SDLC has always been part of the information Technology family since the inception of modern digital computers (Wager, Lee, Glaser & Wager, 2009). Systems Analysis and Design course is requisite in various Management Information Systems application programs. Even though such lessons avail an overview of several means of acquiring or developing a software application, at their core such applications still contribute a significant amount of time to System Development Life Cycle as they ought to. As this paper will demonstrate, chronological steps and phases adherence is still an acceptable way of insuring the successful software development. Generally, SDLC has really evolved but at its core it still remains a vast technique used for developing software applications. Early dissertations of the SDLC upheld the arduous delineation of vital steps or stages to adhere to for any type of software development project (Loretz, 2005). The Waterfall Model is one of the common well-recognized forms of development. In this classic architecture, the technique involves seven chronological steps: Planning of the project, feasibility study: Institutes a high-standard picture of the proposed project and establishes its goals and objectives. System analysis, necessities definition: Enhances goals of the project into outlined functionalities and operation of the proposed application Software. Explores the end-user information wants. System design: Defines the desired functionalities and operations in more detailed manner, including screen shots, rules of the business, process illustrations, pseudo-code and other relevant documentation. Implementation phase: Real code is actually written in this phase. Incorporation and testing: collects all the parts in one place into a distinct testing setting, then checks for bugs, errors, and interoperability that may exist in the system. Acceptance, installation, and deployment: This is the final phase of initial development; at this point the software application is set into production and operates the actual business handling that it was designed for. Maintenance: this phase entails all that happens in the entire softwares life: alterations, correction, add-ons, shifts to a different kind of computing platform and excreta. This phase is the least glamorous and maybe the most essential phase of all, proceeds seemingly ever. According to the original description of the Boehm-Waterfall software engineering approach, an interactive back-step exists between each phase rendering the Boehm-Waterfall as a blend of a sequential approach with an interactive back-step. Other initial works were systematically matched after the Waterfall model, with capricious number of stages and not markedly different names for every stage. This article has majored on the use of Waterfall in most of its description. There are several methods and techniques that have been used in the past and present in system development, though due to time and other avoidable factors that can be applied to evade delay of a software application use, Waterfall remains to be the option for this case. Over the past years, “My Town” health clinic has been experiencing challenges in terms of managing patient records with huge number of papers piled in each patient’s file making the cabinet to occupy a lot of space at the facility and at the same time, patient record tracing has been issue since it consumes time and some records are not traced due to file mix up (Carter, & American College of Physicians--American Society of Internal Medicine, 2001). This has made the facility to be rated as one of the clinics that do not meet the standards required in the modern health care set ups. Key Technical Issues Computers have changed the way human beings live in the current world. Initially, computers were only used in offices for storing word and spreadsheet documents, folders, for the purpose of entertainment. The evolution of modern software languages that can be used to customize a software application according to user needs has marked a remarkable step in computing world. When it comes to this evolution, healthcare is not an exemption (Iyer, Levin Shea & Ashton, 2006). The issue of providing quality care is always a priority for any facility that provides healthcare services. The main technical aspect comes into picture when it comes to the process of customization. The health care facility is always concerned about data integrity and patient information confidentiality. The integrity of information given by patients and the way workstations and exam rooms should be secure in such a way that the patient feels free to give information since his or her information remains confidential. Monitoring and evaluation cannot miss in any health care set up. The process of monitoring and evaluation can only be done effectively by use of systems that are in place to easily generate reports that the management can use in key decision making (Klein, 2000). There has to be skilled personnel to aid the end users on how to use the system and can implement further user needs. The infrastructure used in terms of software and hardware also plays a key role in such a system. Currently, the world of computing is facing a threat from hackers all over; this makes it a vital step for the developer to build the system using the most current technologies that are highly secure. Cost and time remains factors to be adhered to when coming up with such a system. Efficient systems such as a medical records system should focus on these two facts due to the way they normally mess an organization’s plans. The EMR After successfully evaluating EMRs and establishing source of funding for implementation at the health facility, EMR software was chosen that would enable care providers to meet the goal of managing a completely paperless EMR. At one point, the technicians decided to install a Practice Partner Patient Records at the facility which has eleven examination rooms, 6 casual faculty physicians, 3 visiting consultants, 6 resident physicians, and 12 full and part times office staff members and cares for approximately 12,000 patient visits annually. After a three months negotiation and a two months bidding process with the vendor, the contract was then signed. The implementation team One of the essentials steps to a successful implementation of the EMR is establishing a team to manage the entire process. The team shall include a designated projector manager and information service department representatives from UWDFM and the clinical practice and other office staff. Due to manager’s need for substantial protected time for the task, a project manager is to be hired at half time to coordinate and track the pre-implementation matters, tasks and decisions. The technical team members comprised of UWDFM’s principal of information services, an application trainer, and an application support specialist. Our team members were also included in the staffing which included a physician under practice with a strong need for success of the project and another physician with experience in the implementation of EMR. In the initial planning phase, project team members managed to visit three practices that had implemented the software recently. High standards users and leaders gave their say regarding their own experience, answered questions and shared documents. Implementation process was also discussed by the team and the vendors’ staff members. The discussion availed a crucial starting point for developing the facility implementation plan. Before its use, staffs meet and communicate via e-mails to refine the entire process of implementation plan and discuss progress. The implementation plan The team shall develop a plan that involves numerous simultaneous implementation activities, that entails workflow analysis and the system redesign, installation of hardware, facility modification, software configuration, keying in old data, developing the backup systems, dealing with paperwork and training. Additionally, another main issue to a successful implementation of EMR is adopting a clear outline of what is expected of the EMR to achieve and settling on decisions in the entire process supporting that specific goal. Having the aim of becoming paperless at the back of the mind, and with the well-known idea of “plan for the worst, hope for the best,” the following is how some of the implementation tasks have been handled. Work-flow analysis and redesign: One of the most important tasks is to analyze each function of each job in order to know how tasks are performed with the old system that is in place. The project team will spend considerable amount of time to analyze the existing work procedures, seeking for opportunities for enhanced efficiency, planning new work flows that maybe be achieved with the available tools in the EMR and coming up with a transition plan. During monthly meetings at the process of implementation, medical staff and office meet to discuss and make plans necessary for changes in flow of work that would apply best use of the EMR system software. For instance, the team decides to substitute paper phone mails with electronic generated ones, and then incorporate resident supervision documentation – an activity that is currently done on paper - into an electronic progress message. In order to avoid major renovation expenses, most practices should fit in the EMR structure into available room space and plans for the floor. Having a complete redesigned workflow, there will be a proper understanding of what is expected from the staff and patients flow in the EMR application in the existing space. This becomes useful for planning purposes as to where to place the new hardware equipment. To have a fully retired paper issue, computers are needed in each location within the facility where the staff would be able to access and input data, and at the same time place enough printers at every location such that staff members have adequate access to printed materials. Once hardware location has been established, additional electrical and networking cables shall be installed where appropriate. Each examination room shall have a keyboard slot, a pull out scribbling surface and a desk drawer used for storing some forms that are in current use. Workstations are designed with the following in place: Design a triangle in between physician, patient and monitor to foster eye contact and enable the physician to be closer to the patient enough for physical examination. Guarantee ergonomically the right keyboard level height, position of the mouse and a height that the monitor can easily be viewed. Elude the clutter as a result of the racks of paper forms on the room walls. Obtain a readily available surface that can be used for writing purpose. Hardware selection and installation: The type of hardware to be used in the networks and the servers basically is steered by the requirements of the vendor and the recommendations. Taking into consideration how drastically these hardware changes over time, vendor’s recommendation are considered before purchasing any item. Considerable debates exist among EMR users concerning one choice of hardware: whether to make use of hardwired desktop machines or portable tablet or notebook devices at the workstations. Hardwired desktop machines were the preferred option to avoid the challenges that come with notebooks such as ever increasing cost, many problems in repairing or even swapping components, partial battery lifespan, possibility of damage as a result of dropping or spills and the required additional technology layer required for wireless connections. With the kind of hardware selected, a small remote test installation server is set up in conjunction with printers, scanners and workstations. Since skilled personnel are from UWDFM staff, it gets easier for them to concentrate on test at their office before it has been brought in the field. Once the system has been tested, several testing takes place that assures the facility of the system usability. This enables staff members who are not computer literate to overview the system and have the needed skills to operate the system before it goes live. Before going live, the exam rooms must be ready and complete. Resource requirement Access to internet and computers Access to cloud storage account Design and development software such as MySQL work bench tool, Dreamweaver and Notepad++ or any other tool that can be used in code editing. Database technical such as PHP, MySQL, Oracle and JavaScript Storage content development Budget Requirements (Direct and Indirect costs) Item Cost Salary : Database planning coordinator $5,600 Salary Database Administrator $22,400 Hardware Upgrades (new work stations, new operating system software) $2,000 Network/Hardware Installation $4,000 Database software/ custom build $5,000 Training $1,000 Total cost $40,000 Technical Specification for health facility data warehouse The new data house will be standard compliant and fully accessible. The overall development of the system will adhere to the following standards: Fast data retrieval Forms available to the end users for opinions or comments that contribute to the necessary adjustment. Integration of meta tags in every web page with specific description to aid in search engine ranking. Cross platform and browser compatibility Oracle and cloud storage compliant Features of the new data house The database will be a multi-user; the facility currently has three database end users on staff and activities being carried out. Every staff member is based in one location but there are instances where either of the staff would require visiting the system at a remote location. Although the current storage capacity is 3000GB, the proposed schema will handle data in terms of Terabytes. The new system should be in a position to efficiently import and export the entire client’s data to enable bulk inclusion of the existing data. Quality Assurance plan In the process of project management, quality shall be maintained by continued review of the overall body work. Usability test will have to be complete at least thirty days prior to the final to the health facility data warehouse launch date to provide a cushion for unplanned and unexpected occurrences. Usability Testing The usability tests will be incorporated into the schedules of deliverables as an integral element in the pre-launch phase. End user will aid in defining whatever worked and whatever did not work and assist in growth process, alter and improved workability. It is always essential to test any software application before launching it to avoid feedbacks that may scare away users from using the application. Training recommendation The database planning coordinator and the database administrator shall be responsible for training the current staff and any that would join the organization regarding the use if the new database software. Both staff members should undergo an appropriate training sessions to give them the necessary skills needed to operate the database in house and its effective use and schedule refresher trainings. Provision of fully sponsored training enables more secure technical support work set up within an organization, thus in the event that the technical administrator is absent the rest can handle the technical problem in a more efficient way without messing up the entire system. References Carter, J. H., & American College of Physicians--American Society of Internal Medicine. (2001). Electronic medical records: A guide for clinicians and administrators. Philadelphia: American College of Physicians-American Society of Internal Medicine. Bonewit-West, K., Hunt, S. A., & Applegate, E. J. (2013). Todays medical assistant: Clinical & administrative procedures. St. Louis, Mo: Elsevier/Saunders. Fordney, M. T., French, L. L., & Follis, J. J. (2008). Administrative medical assisting. Clifton Park, NY: Delmar Cengage Learning. Gkoulalas-Divanis, A., & Loukides, G. (2013). Anonymization of electronic medical records to support clinical analysis. In Kirch, W. (2008). Encyclopedia of Public Health: Set. New York: Springer. Iyer, P. W., Levin, B. J., Shea, M. A., & Ashton, K. (2006). Medical legal aspects of medical records. Tucson, AZ: Lawyers & Judges Pub. Co. Klein, G. O. (2000). Case studies of security problems and their solutions. Amsterdam [u.a.: IOS Press [u.a.. Loretz, L. (2005). Primary care tools for clinicians: A compendium of forms, questionnaires, and rating scales for everyday practice. St. Louis, Mo: Elsevier Mosby. Patel, V. L., Rogers, R., & Haux, R. (2001). Medinfo 2001: Proceedings of the 10th World Congress on Medical Informatics. Amsterdam: IOS Press. Smith, R. P. (2002). The Internet for physicians. New York: Springer. Wager, K. A., Lee, F. W., Glaser, J. P., & Wager, K. A. (2009). Health care information systems: A practical approach for health care management. San Francisco, CA: Jossey-Bass. Zaleski, J., & Siemens Aktiengesellschaft. (2009). Integrating device data into the electronic medical record: A developers guide to design and a practitioners guide to application. Erlangen: Publicis Pub. Read More