Dependable Nursing Information Systems

At the end of this unit, the students are expected to: Cognitive: 1. Identify the need for dependable systems in healthcare 2. Enumerate guidelines for dependable systems 3. Review clinical information systems (CIS) 4. Understand the process of designing, implementing and upgrading clinical information Systems Affective: 1. Listen attentively during class discussions 2. Demonstrate tact and respect when challenging other people’s opinions and ideas 3. Accept comments and reactions of classmates on one’s opinions openly and graciously. Psychomotor: 1. Participate actively during class discussions and group activities 2. Express opinion and thoughts in front of the class

System Reliability

the system consistently behaves the same way

Service Availability

required services are present and usable when they are needed.

Confidentiality

sensitive information is disclosed only to those who authorized to see it.

Data Integrity

data are not corrupted or destroyed.

Responsiveness

the system responds to user input within an expected and acceptable time period.

Safety

the system does not cause harm.

five (5) Fundamental Guidelines that can help increase the dependability of healthcare systems

Architect for Dependability

Anticipate Failures

Anticipate Success

Hire Meticulous Managers

Don’t be Adventurous

Architect for Dependability

an enterprise system architecture should be developed from the bottom up so that no critical component is dependent on a component less trustworthy that itself.

Anticipate Failures

features that are transparent to software applications should be implemented to detect faults, to fail over to redundant components when faults are detected, and to recover from failures before they become catastrophic.

Anticipate Success

the systems planning process should anticipate business success and the consequential need for larger networks, more systems, new applications and additional integration

Hire Meticulous Managers

good system administrators should meticulously monitor and manage system and network performance

Don’t be Adventurous

an organization must use only proven methods, tools, technologies and products that have been in production, under conditions, at a scale similar to the intended environment

eight (8) phases of designing

The Planning Phase

The System Analysis Phase

The System Design Phase

The Development Phase

The Testing Phase

The Training Phase

The Implementation Phase

The Evaluation Phase

Architect for Dependability

should be developed from the bottom up so that no critical component is dependent on a component less trustworthy that itself.

Anticipate Failures

applications should be implemented to detect faults, to fail over to redundant components when faults are detected, and to recover from failures before they become catastrophic.

Anticipate Success

the systems planning process should anticipate business success and the consequential need for larger networks, more systems, new applications and additional integration

Hire Meticulous Managers

good system administrators should meticulously monitor and manage system and network performance

Don’t be Adventurous

an organization must use only proven methods, tools, technologies and products that have been in production, under conditions, at a scale similar to the intended environment.

The Planning Phase

t begins once an organization has determined that an existing need or problem may be filled or solved by the development or implementation of a CIS or application.

Definition of the Problem

description of the how the system will be evaluated

Feasibility Study

s a preliminary analysis to determine if the proposed problem can be solved by the implementation of a CIS or component application

Feasibility Study project areas:

Statement of Objectives

Environmental Assessment

Determination of Information Needs

Determination of Scope

Documentation and Negotiation of Project Scope Agreement

s drafted by the project team and submitted to the project’s steering committee for acceptance.

Allocation of Resources

A firm commitment of resources for development of the entire CIS project scope agreement is needed before the system can fulfill its stated objectives.

The System Analysis Phase

provides the data for development of an overview of the nursing problem and/or stated goal defined in the project scope agreement.

Data Collection

the first step in the system analysis phase.

Workflow document

assimilates the data collected into logical sequencing of tasks and subtasks perform by the end users for each goal or problem area.

Data Analysis

provides the data for development of an overview of the nursing problem and/or stated goal defined in the project scope agreement.

tools used in the development of the workflow and functional design documents:

o Data flowchart

o Grid chart

o Decision table

o Organizational Chart

o Model

Data Review

focuses on resolving the problems and/or attaining the goals defined in the feasibility study based on the methods or pathways derived from the workflow documents and the functional design.

Benefits Identification

reflect the resolution of the identified problem, formulated and stated in quantifiable terms.

System Proposal Development

submission to the project’s steering committee for review and approval.

Functional design

overview of the statement of how the new system will work.

The System Design Phase

the design details of the system and the detailed plans for implementing the system are developed for both the functional and the technical components of the system.

Functional Specifications

builds on the design by formulating a detailed description of all system inputs, outputs and processing logic required to complete the scope of the project.

Technical Specifications

Dedicated technical manager is required

four major areas of detailed technical specification to be developed

o Hardware

o Application Software

o Interface Software

o Conversions

Implementation Planning

establishment of a detailed work plan.

The Development Phase

If the project steering committee decides to develop its own system programs, the project staff must proceed with this

includes hardware selection, software development, test system and document system.

The Testing Phase

The system, whether newly developed or commercially available, must be tested to ensure all data are processed correctly and the desired outputs are generated.

verifies that the computer programs are written correctly and ensures that when implemented in the production (live) environment, the system will function as planned.

The Training Phase

It is essential to train the end users on how to use the system properly. A CIS will function only as well as its users understand its operation and the operation streamline the work. All users of the new system or application must receive training.

The Implementation Phase

organizes all steps into a detailed plan describing the series of events required to begin using the system or application in the production or live environment

This phase ensures that once the system is installed in the live environment, the system and the delivery of healthcare in the organization will run smoothly.

The Evaluation Phase

describes and assesses, in detail, the new system’s performance. Using the criteria established in the planning and system design phases

summarizes the entire system, identifying both the strengths and weaknesses of the implementation process.

often leads to system revisions and, ultimately, a better system