Selecting a Health

Care Information
Chapter
7
System

These four phases

are:
1.Needs

assessment
2.System

selection
3.Implementation

NEEDS ASSESSMENT
This
process
often
initiated when a deficit in
the current method of
manual
or
automated
information handling as
recognized.

NEEDS ASSESSMENT

FIGURE7-1. THE LIFE CYCLE OF AN INFORMATION SYSTEM

The Steering
Committee
The
system
selection
steering
committee
is
an
essential component of the
assessment
and
selection
processes, and leadership as
well as membership of this group
may impact the success or
failure of the project.

Consultants
n

Consultants may be hired for assistance in

any phase of the selection process,
including assessing the current information
system

The effective use of consultants requires

clear definition of the contractual
relationship and expected outcomes as
well as good communication throughout
the association.

Developing a
Common Vision
The needs assessment process
should include an examination of the
vision and mission statements of the
organization, because these should
guide the committee in looking to the
future
and
determining
the
organizations information needs.

Understanding the
Current System
A thorough understanding of how
information is currently collected and
processed is the starting point in
performing a needs assessment.
EXAMPLE:
n Client

name, sex, marital status, and

diagnosis.

Determining System
Requirements
Determination of the system
requirements should address criteria
related to all aspects of system
performance, including technical,
administrative, registration, order
entry, results reporting, medical
records, and accounting criteria.

Sample of Criteria
Defining Musts and
Wants

Charting/Documentation Information Criteria

Must or

______________________________________________________________________Want
Weight
Capable of multidisciplinary charting
Able to chart medications, IVs, and treatments
10

10
M

Has mechanism to remind the user of undocumented activities,

Treatments, medications, and IVs at intervals specified by department
M
10
Automatically calculates charted IV products into intake and output
7
Automatically totals fluid balance by shift and 24- hour period
8

Technical Criteria

Technical
criteria
those
hardware
and
software
components necessary for the
desired
level
of
system
performance.

Areas to consider are

the
following:
Type of architecture.

Architecture refers to the structure of the

central processing unit and is interrelated
elements.
Examples of Criteria
n

Features case of implementation and support

of real-time integration to existing and future
information system.

Amount of downtime.

Downtime refers to the period of time

when an information system is not operational
and available for use.
Examples of Criteria
n

Does not have a history of prolonged or

frequent unscheduled downtimes.

Connectivity standards.

The standards help to maximize the

connectivity between application and information
files, supporting system integration.
Examples of Criteria
n

Provides for HL7-compliant interfaces

Includes the ability to interface from and to

client care instruments such as monitors

Test environment separate from live

environment.

A
separate
environment
for
the
development and testing of updates and
changes to the system must be available, so
that the actual system (live system) can
continue to operate without interference
during these activities.
Examples of Criteria

Response time.

Response time is the amount of time

between a user action and the response from
the information system.
Examples of Criteria
n

Able to continuously track and monitor

response
time
and
provide
reports
containing this information.

Support of electronic technologies.

the information system should support

other technologies that will enhance client
care and business operations..
Examples of Criteria
n

Supports various methods of data entry by

the user, including touch-screen entry and
voice recognition

Allows the use of bar coding and scanning

Administrative/
General criteria.
Administrative criteria describe
how
the
system
may
be
administratively
controlled
for
appropriate and effective use of the
information.

Security levels to comply with

regulatory and legal requirements.

The Joint Commission for Accreditation of

Healthcare
Organizations
(JCAHO),
for
example,
regulates
the
confidentiality,
security, and integrity of hospital systems.
Examples of Criteria
n

Provides an auditing utility to track and

report what information has been accessed

Online help screens

Online help screens display instructions

to asset the user with completing a specific
function.
Examples of Criteria
n

Help screens must be available and easily

accessed by the user

Help screens must be concise and easy to

understand

Purging and restoring data.

It is important to determine how long it is

necessary to maintain online access to client
data before sending it to other storage devices.
Examples of Criteria
n

Includes a flexible client purge process,

allowing both automatic and manual purge
capabilities

Process for restoring data that have been

purged to storage to be extracted from the

Report capabilities.

The system should provide a reportwriting software components that allows

specific types of information to be extracted
from the database and presented in a report..
Examples of Criteria
n

Predefined
reports
to
be
automatically on a set schedule.

produced

Registration Criteria
The registration criteria are essential for
ensuring that the client is properly indentified
for all aspects of information management .
Examples of Criteria
n

Assigns each client a

across the organization

unique

identifier

Provides the ability to change or update

registration information.

Order Entry/Results
Reporting Criteria
These criteria ensure that accurate
entry of physician orders is accomplished in
a timely and effect manner.
Examples of Criteria
n

Supports documentation of medications

and
treatments,
and
relates
this
documentation to the appropriate order.

Medical Records
Criteria
medical records criteria should

The
support the storage of all pertinent client
date obtained from various information
system, allowing the user to access a
longitudinal record of all client activities and
events or visits.
Examples of Criteria
n

Translates diagnosis and procedure

terminology into numeric code.

Produces deficiency lists on demand for

Accounting Criteria
These criteria facilitate reimbursement
for services rendered and help to ensure the
financial stability of the enterprise.
Examples of Criteria
n

Generates summaries or detailed bills

Supports physician billing

Allows the user to enter

insurance verification data.

the

client's

SYSTEM SELECTION

This phase is critical to the success

of the project. The extremely high
purchase, installation, and maintenance
costs associated with new or upgraded
technology men that the decision must
made carefully.

System Selection
Criteria
n

Overall costs

Hardware,
costs

software,

and

Implementation Costs
Support and maintenance cost

network

n Vendor

characteristics

Reputation
Experienced staff and
consultants
Financial status

Software features

Ease of use
Intuitive user interface, requiring minimal
training
Includes all functionality identified as
musts
Supports security requirements
Supports interfaces with other applications

Additional Sources
of Information
n

Trade shows and conferences are

beneficial sources of information.

Other potentially helpful sources of

information
include
weekly
publications, trade newspapers, and
monthly
journals
that
address
information and technology, and local
user group.

Request for
Information
n

An information systems vendor is a

company that designs, develops, sells,
and supports systems.

The request for information (RFI) is often

the initial contract with with vendors.

The purpose of the RFI is to obtain

essential information about the vendors

Request for
Proposal
n

The next step is to evaluate this

information and prepare a formal
document called the Request for
proposal (RFP).

The purpose of this document is to solicit

proposals from many vendors that
describe their capabilities to meet the
wants and needs.

Strategies for a
Successful RFP
All aspects of the document
must be detailed and precise to
facilitate an accurate response from
the vendor.

Strategies for a
Successful RFP
All aspects of the document
must be detailed and precise to
facilitate an accurate response from
the vendor.

RFP Design

Although the actual format of

the RFP may vary from organization
to organization, all RFPs must
contain certain components that are
essential for a complete and
effective document.

The RFP should

include the
following details:

Description of the organization.

The first objective of the RFP should be to familiarize the

vendor with the organization. The RFP must describe the
organizations overall environment, as well as the specific
setting in which the system will function.
The following information should be included:
1.

Mission and goals.

2.

Structure of the organization.

3.

Type of health care facility

4.

Payor mix.

5.

Volume statistics.

System requirements.

When defining system requirements is to avoid

limiting the vendor to specific configurations, such as the
type and number of devices, because the vendor may be
able to suggest better solutions.
n

Criteria for evaluating of responses.

RFP evaluation process may improve the quality of

the vendors response. If the vendors respond in the
expected format, evaluating responses from multiple
vendors can be more easily accomplished, and results
more easily compared.
n

Deadline date.

Site Visits

The use of site visits is very

helpful in selecting a system. Site
visits allow the system to be seen in
action at a location that is
comparable in size and services
provided.

Contract
Negotiations
Once the decision has been made by the
steering committee, the enterprises legal and
purchasing representatives carry out the contract
negotiations. They may request the names of the
three highest ranked vendor, as well as their RFP
responses. The end result will be the selection of
one vendor and a system that will be implemented
in the enterprise. After the contract is signed, the
implementation phase begins.