Childrens Hospital Information System - Case Study Example

Name of student: Course name: Instructors name: Date: Case for the Texas Children’s Hospital Information System Executive Summary Texas Children’s hospital is a well-established international hospital known for caring for children not just in the United States but from other countries as well. According to a World report, Texas children’s hospital was mentioned as the fourth largest best children hospital; established in 1951. The hospital basically deals with primary and tertiary care for children within the hospitals affiliated health plan and practices. The hospital and other affiliate facilities take care over a million children annually[Hosch]. The core principles behind Texas Children’s Hospital success are its commitment to boost the quality of patient care through not only the implementation of evidence- based care guidelines but rather in the measuring and monitoring of the care outcomes. The hospital is committed to the provision of safe, effective, equitable, and patient-focussed, in an efficient and timely manner. Consequently, Texas Children’s Hospital has invested and seeks to continue investing heavily in various information systems that aid in the provision of superior quality, and lower cost to the patient. 1. The current problem, The video highlights some of the challenges the hospital support staff are encountering as a result of lack of proper information within the patients file. At that instance, they have a file with missing signature and name thereby making then unable track the origin. They later get the idea that all their problems can be solved if the hospital adopts an integrated health care management system. 2. Rich picture 3. System Development lifecycle for a Hospital Life cycle The failure to use Health care Information System (HCIS) has been pointed out as a major before barrier to the use of IT in hospitals. Some of the factors pointed out are inadequate management, lack of proper policies, resistance to dynamics and noncompliance by staff, and finally technical failures. In essence the implementation of HCIS seeks to alter significantly the social, technical, cultural, and organizational aspects of a hospital workplace. Since health care is a very intricate, highly dynamic as well as interactive environment, an iterative software implementation procedure such as Software Development lifecycle (SDLC) gives the best approach to the successful HCIS implementation. There are five steps necessary in the development and implementation of SDLC. These are Requirement definition and process planning Analysis Design of new HCIS system Implementation Support and maintenance The purpose of this section is to outline a framework for a successful HCIS implementation in the incorporation of strategies within appropriate SDLC stages. a) Defining the scope and challenges Exploring the existing and possible solutions Conducting the feasibility studies Selecting the probable solutions based on the outcome of the feasibility tests Creating the project schedule Setting aside the necessary resources Launching the project b) Identifying and defining the goals and objectives This is guided by the project deliverable defined in the planning stage. This is critical in the gaining of support and acceptance by the uses. In coming out the goals, it is fundamental for the key clinicians who are vastly familiar with the clinical processes and workflow to be actively involved in both selection and customization process. c) Requirement definition and process planning This is the most critical stage of any project since it gives the direction to the entire project. Any flaws at this stage affect significantly the outcome of the successive stages. The main tasks in the implementation of HCIS d) Collaboration and communication It is imperative for the early engagement of the clinicians through day to day collaboration and communication. By setting out realistic expectations, the clinicians can be better placed to clarify the goals and objectives, formulate perception for benefits and outcomes. This effectively creates a psychological ownership by all stakeholders within the hospital. Their feedback is very instrumental during the adaptive stage of SDLC for HCIS optimization and customization. e) Feasibility determination This provides the platform for the determination of system suitability based on technical functionality, organizational and economic reasons. This is critical in controlling the project from going to over budget, not just in the system implementation, but in the human and financial cost implication. Checks are also carried out to ascertain the interoperability and compatibility of the proposed system with the existing infrastructure, staff level of competence and training needs[USD10]. f) Analysis The key tasks performed during this HCIS implementation phase include: Prioritising the system requirements Generating and evaluating alternatives solution systems proposed Reviewing of organizational policies Providing recommendations to the management g) Design This is usually carried out by an expert preferably from a third party service provider. The stage involves the determination of the necessary architecture and operating system in respect to hardware, software, existing processes, data retrieval, networking, and user interface and use and archive procedures. Such as system, is therefore designed based on system requirements and user needs defined in the earlier stages. It is to insist all the time that the primary purpose and core purpose of all tasks is to improve patient wellbeing. A well designed system should be capable of assisting the users, supporting cognitive processes, and accommodating the existing workflow. h) Establishing communication channels The developed system should have inbuilt communication channel for flow of information, as well as a robust user interface to detect and reduce potential workarounds. i) User Interface This is the most critical element HCIS system design. An effective user interface offers critical task information with direct visibility of all relevant information. It should not only be simple but should include enough information to be termed as complete. A proper HCIS should present a consistent, predictable and easy to navigate. Some of the key attributes of a superior user interface include: Appropriate colour scheme Use of standardized terminology Minimal screen navigation to complete a task Proper font Ability to provide clinical decision support such as reminders and alerts, easy to override and easily noticeable 4. Interviews during establishment of system requirements a. Management How do they feel about the current existing patient information management system? What is their expectation in the new design? How the various departments interlinked and how do information flow amongst the department? Number of staff and their level of education and computer proficiency Description of the process flow and information flow b. IT department System capacity i.e. capacity of available information processing and storage available both hardware and software General information flow within the hospital departments c. Records registry What is nature of records stored? How often are records retrieved and for what purpose? What is the retention period for the documents? What is there view in regards to a health care management system d. Doctors and clinicians What is their view on the existing system and what changes do they desire What kind of challenges do they encounter in their quest for getting patient information What is there view in regards to a health care management system Provide a complete list of all documents referenced Specify the sources from which the references can be obtained 5. System Request Form ELEMENT DESCRIPTION EXAMPLES Project Sponsor The person who initiates the project and who serves as the primary point of contact for the project on the business side CEO, all doctors and Clinicians, Pharmacists, radiographers, patient registry Business need Business-related reasons for initiative the system Iimprove access to information Improved information integrity Simplified access to patient information Minimization of errors generated from information duplication and transcription Enhanced decision support systems for the hospital management Business requirements Business capabilities that the system will provide Provide online access to information Produce patient status reports Seamless integration of people, department and processes Reduction of administrative and clinical transaction costs Business Value Benefits that the system will create for the organisation 12% reduction in data retrieval time $300,000 cost savings from decreased patient pile up $200,000 savings from removal of existing system Special issues or constraints Issues that are relevant to the implementation of the system that need to be known by the approval committee Dissecting the source system to determine the required data, and specific information to be stored The different ways suitable for managing security of patient data and information How to deliver data in a simple to use dynamic information requests rather than just static reports Network system security to assist in setting up of multiple system users 6. Possible Effects For Texas Children’s Hospital (TCH) If Its Information System Project Fails There are three ways in which hospital information system can fail: these include: i. Total failure: this is a case where a system fails to kick off i.e. never implemented or in a case where a new system is launched but abandoned immediately. ii. Partial failure: this is a scenario where major goals established in the feasibility study phase are unachieved or a case where there occurs a significant undesirable outcome. iii. Sustainability failure: this is reported in a case where a system succeeds at the initial stage but then fails over a period of one year or so. iv. Replication failure: this is a scenario where a system can only perform at its pilot location and cannot be replicated in other locations. 7. In a case of TCH, possible failures can be described as follows: Technical: since a HCIS system requires powerful technological infrastructure, this may fail to as a result of inferior existing technological realities within the hospital[Dav98] Information: HCIS system is basically designed to handle process and output a particular pre-determined set of information. However in TCH hospital there are no specific information demand, thus creating a gap between the conception information in the system and the realities on the ground Staffing and skills: a typical HCIS system is relatively difficult to use thereby creating a significant gap between the system expectations and hospital staff expertise. Objectives and values; the HCIS system may fail to match well with the values and objectives of the hospital staff. This may stem out of the belief that human inputs are critical in a health care system and cannot be substituted by technology. Conclusion In essence the implementation of HCIS seeks to alter significantly the social, technical, cultural, and organizational aspects of a hospital workplace. Since health care is a very intricate, highly dynamic as well as interactive environment. A proper HCIS should provide online access to information, Produce patient status reports and offer seamless integration of people, department and processes Bibliography Hosch: , (Hospital), USD10: , (Services, 2010), Dav98: , (Davies, 1998), Read More