Studying at Masters Level and Research Methods - Assignment Example

A HOSPITAL BASED INFORMATION SYSTEM Institute Health issues in care and medication industry pose a number of challenges, not least from administration and record management point of view. Research is important to efficiently handle and deal with the management and more so the management of records. This work investigates the hospital system and tries to document the automation of the hospital processes (Jaypee Brothers, Medical Publishers, and Kumar 2007). Health has emerged as one of the areas that have scanty local content. A lot of information is available, but accessing it means going through a lot of paper work, files and histories. The websites that are there lean heavily on advertisement of the institutions’ but little information is given that would be of immense help to the patient. There are issues that databases should meet in order to ensure productivity in the use of a system. Among them are: persistence, concurrency, availability, distribution, and scalability. All hospital users want their information on first aid, symptoms checkers, and doctor and hospital directories, alert services on subscribed services to be seamlessly accessible, without delays. Introduction Database clustering is needed to make the different components used to create the system to work together. If combined through this application, the system will be free from faults, and will perform highly at a low cost. There are two methods commonly used for clustering relational databases: shared-disk clustering and shared-nothing clustering. In the shared nothing design, each node in the cluster holds one segment of the database, as well as to handle all the processing details in relation to data stored in the particular node. A master server is able to access the process needed to be executed at the moment, breaks it down into various portions, and distributes a portion to each node that contains data to be processed. The scope of any hospital can entirely be illustrated like shown below. The first function of any hospital is to diagnose patients and determine the type of health issues they have. This is done through the various processes of laboratory test, doctor consultations, and nurse temperature and body pressure measurement taking costs (Smith 2007). The hospital is also responsible for giving prescriptions of variously diagnosed conditions. Drug administration is another obligation by the health unit, specifically by the pharmacy. The health unit has the function of providing immunity to the students in various ways such as drug administration, and various programs to sensitize the students about common diseases and their way of prevention costs (Smith 2007). Objectives Database clustering has core attributes among them are: persistence, concurrency, availability, distribution, and scalability. Concurrency refers to the ability of the database to allow multiple users to access the database simultaneously. Persistence, an important property that must at all times be looked at, is the ability to store information in the database and randomly retrieve it with the least effort. Integrity, as the term suggests itself, is the ability of the database to ensure that the data it contains is not corrupt and is never lost at any time. There are measures to ensure database integrity; not a topic for discussion today. Scalability, on the other hand, refers to the performance rating as the size or the number of database users increases. Different database products address different issues (Jaypee Brothers, Medical Publishers, and Kumar 2007). Some database products address only persistence issues and are categorized as persistent databases. These kinds of databases use flat files such as ISAM,VSAm or input/output streaming devices. It is significant to know where most of the database processing occurs. Is it on the client? Is it on the server? Or is it evenly distributed between server and client? Data clustering are of two types; logical, which affects the client-side application directly. Information clustering affects application scalability and performance directly. Both the server and the client utilize clustering models which not only dictates the transportation of information from client to the server but also how the server retrieves information from the disk. The scalability of the application due to the increase in information accessed by the client and increase in database size is affected by how information is directly transported to the client. The transportation of information from the server to the client is determined by the logical clustering of the client-side. Clustering models can have a negative or positive scalability because of the locking model that a particular database is utilizing. Wrongful combination of locking models and the client side clustering can result in immediate and dramatic degradation as the number of database users (Jaypee Brothers, Medical Publishers, and Kumar 2007). How can optimal clustering benefit performance through the improvement of application scalability? First things first, what is clustering? According to the dictionary, clustering is the pooling together of related items. Clustering in databases refers to the pooling together of related things with the aim of improving access productivity and utilization of resources. Typically, clustering can be considered to refer to putting related data together in one physical disk space. When most database processing occurs on the client-side, these databases are client-centric. If most of the database processing occurs at the server-side, the databases are server-centric. When the processing is evenly distributed between the client and the server, the architecture is balanced client-server. Data clustering in relational databases is very straightforward. Rows of a given table are sequentially stored on the same disk page by page. For the case of relational architecture, this is sensual since most of the activities of the database are sequentially accessed. Database performance relies so much on the physical clustering of the database environment. This mainly because RDBMS systems architectures are mostly server-centric which means most of the database processing occurs at the server (Jaypee Brothers, Medical Publishers, and Kumar 2007). The fact that only data from a particular table is stored on a given page allows for optimal disk access. Clustering in Relational Database Management systems are mostly beneficial in the server since the server does a lot of the direct access of virtually all the operations of the database. It is worth noting that, clustering in client operations plays no real part since the data passed from the server is the one requested by the client. RDBMS queries that does not benefit from clustering are slower costs (Smith 2007). Since the only data passed by the server to the client are those that have been requested by the client, clients operations are not affected. The actual pages containing information remain on the server. For instance, the server might only retrieve only one page from the disk in a clustered case where 10 rows would have been returned from a single query. 10 pages may be returned from the disk which may still be running 10 rows only to the client without utilizing clustering. In both cases, data of the same amount is retrieved to the client. The server would however, do more work in a sub-optimal state than it would in an optimal state. Need for: (Justification) The intended system should have capabilities that ease the working and running of hospital processes but not displace the workers. The system should add new users every time a student demands services from the health unit for the first time. It should search for the existing users of the health unit with their corresponding details and health history. The system is intended to provide a form that accepts patients’ symptoms, diagnosis, and prescription, done at the various stages of the process, that is, nurse, lab, doctor, and the pharmacy costs (Smith 2007). It should be able to generate reports from the various procedures. The system should be able to print the generated reports for reference at the various procedures. It should also capture the next visit or referral date. The system may face the following challenges which are normal like most database systems that are developed. These challenges can be discussed in terms of their probabilities and impacts to the users. In my research, I have estimated these to my view and or the rest of the hospital user which could mean any other person. Scheduling is the process of arranging the events of the project in given time ranges. Risk of this occurring can be high only when the developer concentrates on a particular process more than the others. This could result to non-completion, poor product due to hurried process, and ignoring of some crucial procedures in the product’s scope. The probability of this happening is a 2, kind of a low rating, given the involvement of a supervisor that will help the developer keep up to the schedule (Jaypee Brothers, Medical Publishers, and Kumar 2007). Resource allocation is one of the trickiest ventures in any given project. The major resources that could be required in the student projects is travelling to and fro the respectable institutions, and maybe paying up for some services such as SMS servers and hosting services. The risk for this is 4, quite a high probability given the financial situation that students stand. The developer might later realize that the specifications given or found are not exactly comprehensive. Refiguring or restructuring the design to match new specifications is quite tricky. The probability for this happening is 5, given the probability of requirement inflation, usually another risk. This is the worst risk that could be expected in any project, as it would combine each of the other risks as aforementioned. This could only thus be possible if the other risks have a high probability of happening. The probability could thus be the average of each of the other risks (“Integrated Healthcare Information Systems” 2007). This would result with the inadequacy of the Software Requirement Specifications document, usually done after the requirements of a given system have been analyzed. The developer might later realize that the design or rather system requires additional requirements for better functionality (“Integrated Healthcare Information Systems” 2007). This automatically alters the design and thus schedule. The probability for this is 5 given the hurried proposal and SRS development at the initial stages of the software development. Estimate the impact of project if the risk occurs. Using a 1-10 scale, assign it a 1 for little impact and a 10 for huge catastrophic impact. Mark out the rating on the risk impact/probability chart. This is a high impact/low probability in the project (Impact score (x) = 7, Probability score (y) = 2). The high impact is due to the delays and non-delivery that it could cause in case it occurs. This would result to elimination from the project and a force to repeat the whole unit which lasts a whole academic year. It is of low probability given the providence of a project supervisor and coordinator that closely monitor the students. This is a high impact/high probability risk (Impact score (x) = 8, Probability score (y) = 7). Resource availability is key in any project. Lack of it will cause interference with data collection, tool purchase, and other activities as stipulated in the budget. This could completely paralyze the whole project (“Integrated Healthcare Information Systems” 2007). It is of high probability given the condition of the students regarding monetary support, plus needs may arise during the scope of development. This is a low impact/high probability risk (Impact score (x) = 2, Probability score (y) = 7). It is low impact as the scope of the project may not really stray, but rather, just lack some functionalities that the developer didn’t really put to considerations during the Software Requirement Specifications period. It is of high probability given that most students usually ignore the initial stages of acquiring requirements. Most students usually assume the requirements and ignore the fact that they are to visit the actual institution they are directly creating software for. This is a high impact/low probability risk (Impact score (x) = 8, Probability score (y) = 3). In fact it has the highest impact given the initial objective of developing software that aims at deliverables despite all the other processes. It is of low probability though, because it would require the flop of all the other processes for it to follow too. The providence of a supervisor also reduces its probability. This is a low impact/low probability risk (Impact score (x) = 2, Probability score (y) = 2). The low impact refers to the low lack of derailment from the project scope and functionality, apart from just the additional functionalities that would have added to the project final deliverable. The low probability is due to the initial emphasis that might have been put during the initial stages of requirement specifications. With perfect requirement specifications, there is low probability that the requirements will inflate, giving the developer worry or need to add more functionality late in the development stage (“Integrated Healthcare Information Systems” 2007). Risk 3 Risk 5 Risk 1 Risk 2 Risk 4 X-Values Impact (x)/Probability (y) 7 2 8 7 2 3 8 3 2 2 Project objectives Project objectives determine what is to be done and how it is to be done, in order to meet the overall aims of a project. They can affect the quality of a project. If objectives are accurate and explicitly defined, they facilitate in proper execution of all the activities necessary for the production of a quality project product or service. Ambiguous objectives bring about ambiguity and inaccuracy that may bring about a poorly done project costs (Smith 2007). They also provide for strong management of projects. Clearly defined objectives enable clear and easy management of projects. This maximizes the productivity of the project personnel. Cost refers to the budget and financial resources availed for the execution of the project. It determines the support hardware and software that can be purchased by the organization owning the project. Technologically sound hardware and good support software are expensive but if bought, will facilitate the implementation of a sound project (“Integrated Healthcare Information Systems” 2007). Cost also affects the number of personnel that can be involved in a project. A bigger budget means that more personnel can be involved in the project. This in turn means faster execution of the project. If the budget is limited, this will mean working with a smaller number of personnel. This results in slow execution of the project. If the architecture uses the shared-disk clustering, then the nodes on the cluster have equal access to information that is in the information database. Processed information is divided within them but database is not affected at all. The result is a particularly fault tolerant database. Even if one or more servers fail, all of the application data remains available to the other nodes. By comparison, if one node on a shared-nothing database crashes, all of the data stored on that node likewise goes offline, until a failover system can recover from the fault. The software used in the architecture of shared nothing clustering can be used to run all applications in a clustered environment, the database that we are focusing on here. This makes the approach suitable for both commercial and home-use systems. For the shared disk clustering, the software used is able to evaluate a number of clustering solutions, based on the type of application the user wants to run. Cost also affects the expertise that can be hired and used. Experts are expensive to hire. If the project budget is sufficient, experts can be hired. This will ensure that the project execution is under good expertise. Good quality project products can thus be produced. Projects have start dates, schedules and end dates costs (Smith 2007). Time is determined by: start date, task durations, task dependencies, task deadlines, task schedules and end date. Projects must be accorded adequate time if they are to be up to standard. If there is enough time allocated to a project, all the details are executed accordingly (Reiling 2007). This will ensure that the project products are of the required standard. On the other hand, accelerated projects are difficult to implement. They sometimes have unrealistic deadlines and schedules. This causes hurried decision making, which in turn causes unexpected problems in the project implementation. Project scope states the objectives, goals and what must be met so as to achieve the successful implementation of a project. The scope details the range of the project. This includes: parameters of the project, its limitations, what is to be included and what is to be excluded. A project scope must be explicitly defines as it must make clear to all the personnel involved what product or service is to be delivered by the project (Reiling 2007). If it is not explicitly defined, it may bring about scope creep. Scope creep is the incremental expansion of the scope of a project that may include the addition of project requirements that were not there initially, without adjusting the budget and schedule of the project accordingly. A properly described project scope helps in scope creep management in case of scope creep occurrence (Reiling 2007). Proper project scope also helps in planning for the change management strategies that will be needed when change management will be carried out. It also facilitates the identification of potential risks that may affect the project. In this way it also facilitates risk management. A project product is termed to be of good quality if it meets all the pre-set requirements and brings about sufficient customer satisfaction. Quality affects a project. For a project to yield a product of good quality, the following have to be input: a good time schedule, enough cost/budget, enough man-hours, proper expert input, explicitly defined objectives and a properly defined project scope costs (Smith 2007). A good quality project product must have adequate time for implementation, proper expertise input, adequate financial resources, well defined objectives and scope. To permit the construction of an overall distributed, modular and evolutionary framework based on openness criteria and on the adoption of the most adequate architectural, information and technological solutions emerging on the international scenario. This approach permits to optimise the costs, by adopting the hardware and software solutions most adequate to the specific needs, even if developed by different manufacturers. The adoption of a standard and open architecture, independent from individual supplier (both hardware and software) represent the only solution capable of ensuring the achievement of such objectives, allowing the integration of the diverse components of the system through an incremental approach, according to the evolving requirements and securing the investments already done (“Integrated Healthcare Information Systems” 2007). Of all existing applications, data warehousing is the least complicated approach for any clustered database to manage. Most databases that contain the warehousing application are based on an assumption that there is a large amount of data in existence, which is needed to serve many users. However, the software is only functional in a read-only capacity. Most applications rely on SQL-based transaction processing are difficult for any clustered database to manage. On a shared-disk design, where every node accesses the database in turns, business oriented based applications require a resource that is able to disregard all faults. This helps avoid chances of data corruption. This design has reliable integration between its mainframe between its mainframe hardware, operating system, and database software. Overview on Database Clustering Dr. ID, Nurse ID Temp, pressure Patient in Patient ID Patient ID Exit In any given hospital, there is provision of health services to the public. Anybody seeking treatment goes through four (4) main stages which include: At the reception the patient produces an identity card to verify that they are members of the any hospital community and therefore give them the right to use the facility. Using the ID the receptionist retrieves the patient’s medical records from the database. If it is the first time for the patient to seek medical attention at the facility the receptionist activates the patients account on the database. The patient data retrieval automatically activates the patient’s account in the whole health unit. The receptionist allocates the patient a nurse and doctor. Details of the particular patient are immediately reflected to the nurse and doctor allocated to them. At the side of the nurse, the system should enable using of ID to identify the patient after which s/he takes measurements of the patient’s temperature and pressure and enters the data in the system. The doctor should be able to verify the patient’s identity using the ID card, the doctor refers to the data entered by the nurse into the system, looks for vital signs while entering the details in the system. The doctor then makes his diagnosis and prescription(s) and enters them into the system as well. Patient presents ID card for identification in the system. The pharmacist refers to the prescription made by the doctor as indicated in the system. Reduction in labor costs: factors that contribute to cost reductions include a decrease in manual or clerical tasks and streamline the work process of clinicians Conclusion and future steps Based on these assessments, the best advice for now is to undertake clustered databases with caution. Reductions in the need for equipment: Standardization and better inventory management through computerization is beneficial. Improved customer satisfaction: increased customer satisfaction contributes to customer retention. Improved employee satisfaction: the system is to be of service to both customer and employees of the hospital. Once past the learning curve, increased employee satisfaction contributes to employee retention and decreases turnover costs. Enhancements in quality of care: Quality of care improvements, especially if publicized outside the hospital, may lead to physicians steering more patients to the institution. In addition, given the new consumerism in healthcare, the importance of patients feeling comfortable with the quality of care in an institution may further enhance revenue if patients say. Clusters have many advantages over mainframes. The most significant difference is that clusters are cost effective because all is needed is to add low-cost hardware or restructure the hardware that is already in existence. This saves one the cost of having to buy servers which are usually very expensive. It should however, be noted that clustered databases could have hidden costs. For shared-nothing architectures, developing the database may require one to reapportion data across newly added servers. This exercise is done manually. Each approach has gained its converts, and each clustering solution is beginning to see real-world deployment. Clustering is not only beneficial but preferable for even the smallest servers, youll see implementations on a larger scale. Also the structure of the hospital itself is evolving from a vertical, aggregated organization, towards the integration of a set of specialized departments, each of them with its own logistic, organizational and administrative requirements. According to such ultimate organizational goal of the whole structure, also the information systems supporting the individual centers must be structured as a federation of autonomous systems individually optimized according to the specific characteristics of the involved units. Individual systems must be consistent with information and procedural standards, in order to permit the mutual interoperability to provide an effective and efficient support to the co-operation individually provided by each single unit. To support effectively such organizational aspects, the healthcare information systems must be structured as federal of different applications, each of them being autonomous and individually optimized to support the specific characteristics of the involved unit and users. Through this approach it will be ensured the transfer and integration of consistent information across the overall hospital structure, without causing constraints and/ or limitations in the individual units and permitting therefore to achieve the following three primary objectives of an advanced healthcare information system. References Smith Laurence, (2007). Integrated Hospital Information Systems: Hospital Based Systems, North Carolina: Lulu. Com Publishers Jaypee Brothers, Medical Publishers, and Kumar Shakti, (2007). Modern trends in planning and designing of hospitals: Principles and practice, New Delhi: Yaypee Brothers Publishers Integrated Healthcare Information Systems: How to Develop, Design, Program and Implement, (2007), North Carolina: Lulu.com Publishers Reiling John, (2007). Safe by Design: Designing Safety in Health Care Facilities, Processes, and Culture, Oak Brook: Joint Commission Resources. Read More