Description of the Problem
The problem is the inefficiency, complex, and time consuming nature of paper medical records that are used to document patient information. The Patient Admission Department obtains personal information from patients, which is documented before they are allowed to see the physician. Currently, the hospital manages documentation of patient information using paper-based medical records, which are complex and time consuming.
Business Activities and Processes Affected by the Problem
Documentation of patient data; billing; physician-patient relationship.
Actual Performance (e.g., current baseline)
At present, patient documentation process involves recording patient data, peer communication, patient care and other activities. This process requires an average of 30 minutes to complete. Therefore, the process reduces the dedicated time spent on patient consultation and care by nearly 10%.
Target Performance
An achievable target is for patient documentation process to require an average of 10 minutes per patient. There will be an improvement in physician-patient relationship, from a 75% patient satisfaction rating to a targeted rating of 90%. This will help improve the quality of care and billing processes.
Performance Gap
Since the hospital averages 20 patient visits each day, the performance gaps total approximately 10 labor hours per month. This results in an overall 25% decline in productivity.
Organizational KPIs Affected
Return on investments; physician-patient relationship; patient satisfaction ratings.
Principal Stakeholders
Chief Executive Officer; Patient Admission Department; Physicians
Tentative Solution Strategy
Investigate the viability of establishing an easy-to-use, efficient, and commercially-available electronic health record (EHR) that will automate the process documentation of patient information. The system should improve billing processes, patient care delivery processes, management of patient data, and peer communication (exchange of patient data among physicians for better decision-making).
Acquisition Need Confirmation
We/I confirm that this issue can be addressed through the acquisition of IT services (and IT products as needed) from a contractor selected in open competition.
Activity 2 Requirements Development
OBJECTIVE OF THE REQUIREMENTS
Reduce the amount of time required to document patient data and to improve the management of patient information, as stated in the Performance Gap document.
REQUIREMENTS CATEGORY
REQUIREMENTS DEFINITION
1. Stakeholder Considerations that Need to be Reflected in the Solution
Chief Executive Officer seeks increased return on investments and an increase in overall productivity. The Patient Admission Department seeks improvements in the management of patient information. Physicians seek for improved patient care and satisfaction.
2. Factors to Take Into Account Related to the Business Environment (including legal factors, regulations, competition, and business cycles)
Competitors have the capabilities described here since they currently use electronic health records for documentation of patient data.
3. New Capabilities and/or Functionality Required by a Solution (including requirements for ease of use, quality, interoperability, and data sharing)
An electronic health record is required to lessen the time taken by the Patient Admission Department in recording or managing patient information. As a software solution, EHR will help enhance billing and physician-patient relationship.
Must be able to store and support speedy retrieval of patient data, improve peer communication, and enhance billing processes. Must enhance data sharing among clinicians at the facility. The solution must be easy to use, scalable, fast and reliable, and function across platforms. Must operate with existing technology systems.
4. Existing Business Process Shortfalls (why current business process and/or systems cannot meet the needs or be changed to meet the needs)
Current paper-based medical records are cumbersome and time-consuming to prepare. In addition, it takes time to retrieve and share patient data among clinicians. It is error prone, lacks backups, and is likely to create an adverse medical event.
5. Cost Limitations (may be stated in terms of preferred cost range; may specify a maximum cost; cost figures need to include associated overhead costs; may be specified as an annual limit or life cycle limit or both)
The average cost of implementing an electronic health record is $162,000 with additional maintenance of nearly $85,000 in the first year (Quinn, 2016). As a result the total cost of implementation, training, and overhead is expected to range between $170,000 - $240,000.
6. Other Limitations or Constraints (e.g. availability of key personnel, such as subject matter experts, training methods, and time available for training; limitations related to maintenance or to external support)
Since the targeted individuals are hospital personnel, they are readily available for training to use the system. On-the-job training will be used to promote seamless switch from current paper-based records to EHR. The cost of maintenance would be nearly $85,000 in the first year.
7. Safety & Privacy Requirements (any requirements beyond those currently being used by the organization for non-critical and non-sensitive applications)
Since the implementation of EHR will involve switching from the paper-based medical records, the hospital will need to set-up an IT infrastructure to support the new system. A computerized system comprising computers with a processor of at least 2.5GHz, 2GB of RAM, and an internet speed of at least 3 Mb/s is required. The system should support Chrome, Safari, or Microsoft Edge browsers. A comprehensive network security system is also required to safeguard the EHR.
8. Number to be Implemented (e.g. specify the number of places the solution will need to be implemented and whether they are at different geographical locations)
The solution must be provided for the Patient Admission Department, hospital wards/units, and at CEOs office within the facility.
9. Schedule (explain any schedule constraint, whether for financial or non-financial reasons e.g. if the solution be in place as of a certain date, specify the date and why)
Acquire and implement the solution within the next six months February 8, 2022 August 8, 2022.
10. Other Requirements Not Specified Above (e.g. any related to vendors, consultants, partnerships with other entities, unique user interface requirements, documentation needs, special certification requirements)
Requires external/vendor support, especially within the first year of implementation. The implementation process would involve unit and functional...
…monitor backup procedures; create redundancy and resiliency protocol for the system.
Risk Category
Probability
Impact if Occurs
Mitigation Strategy
Approximate Risk Exposure
Risk Priority
Organizational Risk
a. Potential user resistance
b. Probable increase in functionality requirements
a. 20%
b. 15%
a. $20,000 - $50,000
b. $30,000 - $50,000
a. Frequent updates to users; involvement of users in all stages
b. Comprehensive review of requirements; pilot testing; provide training
a. $10,000 - $20,000
b. $20,000 $30,000
M2
Information Security and Privacy Risk
Potential data storage problems
20%
$15,000 - $50,000
Strict internal security policies; training users on security risks and measures
$10,000 - $20,000
M2
Complexity Risk
Potential design challenges
10%
$3,000 $5,500
Thorough review of vendor solutions before adoption; ongoing collaboration with the vendor
$1,500 - $2,000
L
Infrastructure Risk
Probable interoperability issues
15%
$2,000 - $5,000
Provide extensive user training
$1,500 - $3,000
L
External Risk
Cybersecurity threats
5%
$5,000 $10,000
Implement strict cyber security policies and procedures
$1,000 - $1,500
L
Average Probability
14.17%
Total Approximate Risk Exposure
$44,000 - $76,500
Alternative Solution #3 (Tentative Solution Rank Order #2):
Identify a third-party EHR system; establish partnerships with the third-party for use its servers to store patient data.
Risk Category
Probability
Impact if Occurs
Mitigation Strategy
Approximate Risk Exposure
Risk Priority
Organizational Risk
Potential collaboration challenges with the third-party
15%
$5,000 - $10,000
Comprehensive review of third-party history and capabilities during the identification phase; establish proper partnership policies or procedures
$2,000 - $5,000
M
Information Security and Privacy Risk
Potential loss of control of data storage procedures
30%
$15,000 - $50,000
Establish proper collaboration procedures with the third-party; on-going partnership
$5,000 - $10,000
M2
Complexity Risk
Incompatibility issues
25%
$3,000 $5,000
Thorough review of third-party solutions before adoption; ongoing collaboration with the third-party
$1,500 - $2,500
M
Infrastructure Risk
Limited capabilities offered by the third-party
15%
$2,000 - $5,000
Comprehensive review of available solutions and their capabilities
$1,500 - $3,000
L
External Risk
Cybersecurity threats
5%
$5,000 $10,000
Provider comprehensive user training
$1,000 - $3,000
L
Average Probability
18%
Total Approximate Risk Exposure
$11,000 - $23,500
Alternative Solution #4 (Tentative Solution Rank Order #3):
Leverage the capabilities of another facility and establish partnerships for subsidized use of electronic health record.
Risk Category
Probability
Impact if Occurs
Mitigation Strategy
Approximate Risk Exposure
Risk Priority
Organizational Risk
Potential collaboration challenges with the host facility
25%
$5,000 - $7,500
Comprehensive review of third-party history and capabilities during the identification phase; establish proper measures for collaboration
$1,800 - $3,200
M2
Information Security and Privacy Risk
Potential loss of control of data storage procedures
30%
$15,000 - $40,000
Establish proper collaboration procedures with the host facility; on-going partnership
$4,000 - $6,500
M2
Complexity Risk
Incompatibility issues
25%
$3,000 $5,000
Ongoing collaboration with the third-party
$2,000 - $2,500
M
Infrastructure Risk
Limited capabilities offered by the host facility
20%
$2,000 - $5,000
Comprehensive review of host facilitys capabilities
$1,500 - $3,000
L
External Risk
Cybersecurity threats
10%
$5,000 $10,000
Provider comprehensive user training
$3,000 - $5,000
L
Average Probability
22%
Total Approximate Risk Exposure
$12,300 - $20,200
Recommendation: Eliminate Alternatives #2 and #4 and Retain Alternatives #1 and #3
Based on this risk analysis and in consideration of the probable benefits and the Template 4 ratings, Alternative #2 (client-server electronic health record) and #4 (subsidized EHR system) are eliminated from further consideration. Alternative #2 is eliminated principally because of its high costs of implementation and the risk of probable interoperability issues and potential data storage problems. Alternative #4 is eliminated due to the risk of potential loss of data storage processes, incompatibility issues, and potential challenges in collaboration. Alternative #1 and…
