Lecture 8
Selecting
a Healthcare Information System
(Chapter 8)
http://www.csun.edu/~dn58412/IS531/IS531_SP16.html
Learning Objectives
1. System Selection Phase in System
Development Life Cycle
2. Requirements Analysis for System
Selection: Steering committee, issues to
consider
3. Selection of System Vendor (RFI, RFP,
RFQ, Gap Analysis)
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Preliminary Considerations
• Technology is the infrastructure of an
organization:
– The competitive advantages associated
with HIS are contingent upon the
technology, the degree to which
technology meets the organization’s
needs, the strength of the information
services staff, and the speed and
method by which the system is
implemented.
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Preliminary Considerations
• The system is contextual: no “right”
choice or “canned” solution for “all”
facilities
• It must be determined by a strategic
goals / plan of a specific institution
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Systems Development
Life Cycle (SDLC)
• Each system has a life time
• SDLC is the process for the selection and
implementation of an information system
• Ongoing process of developing and
maintaining an information system
• Systems Development Process /
Methodology : specific tasks, deliverables
in process
• Four main phases cover the life span of
information systems
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Systems Development
Life Cycle (SDLC)
1. Analysis (needs/ requirements
assessment)
2. Design (system selection)
3. Implementation
4. Maintenance / Support
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SDLC
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Requirements Assessment
• Initiated by someone with a vision of the
future and overseen by steering committee
• Determine the gap between the current
state and the overall needs in light of the
organization’s strategic plan
• Look at segments in the organization and
current workflows for specific needs /
improvements
• SWOT Analysis for issues in financial,
efficiency, quality
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Steering Committee
• Key success factor
• Membership
– Board members (ensure congruence
with organizational strategic plan)
– Representatives from all departments
affected (to decrease possibility of
missing potential problems)
– Must include end users (patients ?)
– Chair should be a member of
administration to champion the project
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Steering Committee Structure
• Large enough to make a good decision but
small enough to be effective and efficient
• Multilevel committee
– Upper level makes final decisions
– Lower level /frontline makes
recommendations
• Need users with functional expertise, good
communication, and computing
background
• May include consultants
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Outside Consultants
• May be used for any part of the selection
or implementation processes
• Effective use requires clear definition of
the contractual relationship and expected
outcomes
• May be used to analyze all available
information and make recommendations
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Understanding the Current
System
• Must determine what information is used,
who uses it, and how it is used
• May use questionnaires, observation, and
interviews
• Must weigh strengths and weaknesses in
light of organization’s needs
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Determining System
Requirements
• User needs (with ranking weights)
– Mandatory / functional : “musts”
– Optional /non-functional : “wants /
desirables”
• Technical issues
• Administrative / general issues
• Functional / departmental issues
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Technical Issues
• Hardware and software needed for the
desired level of system performance
• Type of architecture (compatible with other
system platforms)
• Connectivity (network with other systems)
• Response time
• Availability: Operational vs. downtime
• Test and training environments
• Support for other Information Technologies
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Administrative / General
Issues
• Compliance with regulatory and legal
requirements on confidentiality, security
and integrity (HIPAA)
• Data standards and data exchange
• Data storage (purging, restoring, backup
data)
• Report capabilities: predefined/automated
vs. ad-hoc
• Abilities to integrate with Heath Information
Exchanges
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Functional / Departmental
Issues
•
•
•
•
•
•
Registration
Order entry/CPOE/ Results reporting
Documentation/Billing
Scheduling
Medical records
Accounting
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System Selection
• Survey on certified vendors with certain
specialties
• Trade shows and conferences
• Publications
– Professional organizations
– Trade journals
– User groups
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Request for Information (RFI)
• Brief document sent to vendors that states
plans to purchase and install a system
• Asks the vendor for a description of the
system, its capabilities, and perhaps:
– About the company
– Number of installed sites
– Technical capabilities
– Updates
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Request for Proposal (RFP)
• Formal document sent to vendors to
describe system requirements sought
• Solicits proposals from vendors that
describe their capabilities to meet the
mandatory and optional requirements
• Detailed and precise to facilitate accurate
responses from vendors
• Responses are used to narrow the choices
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Template of RFP
• Description of organization
–
–
–
–
–
Mission and goals
Organizational structure
Type of healthcare facilities
Payer mix
Volume statistics
• System requirements (avoid specific
configurations to open to effective
alternatives)
• Criteria for evaluation of responses
• Deadline for submission
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Analysis of RFP Responses
• Considerations
– Was it submitted by the deadline date?
– Is it a professional effort?
– Were the vendor representatives
responsive?
– Does the proposal address the RFP or is
it a standard bid?
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Request for Quote (RFQ)
• Statement of need focusing upon pricing,
service levels, and contract terms
• Skips marketing hype often received in
response to RFP
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Site Visit
• Visit many sites having installed the
system under consideration
• Ask the same set of questions at each for
comparison purpose
• Ask for a demonstration of the live system
• Interview system users
• Inspect system output
• Contact other institutions have been using
the system for comments and advises
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Gap Analysis
• Evaluate the system finalists
• Gap Analysis: What needed and what
vendor offered
• Feasibility Analysis: Technical,
Operational, Economic, Schedule, Risk
(TOESR)
• Economic analysis: Costs/benefits , return
on investment …
• Award contract to the winner and brief
others
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Contract Negotiation
• After the system selection and
recommendations negotiations are done
through legal and purchasing
representatives
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Concluding Remarks
• The system life cycle is ongoing
(current system will reach its entropy
someday !)
• Each cycle of the system
development process increase the
body of organizational knowledge
base for future choices.
• Increased knowledge also help to
shorten the selection process.
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Additional Materials
• Six steps to implement EHR
http://www.healthit.gov/providersprofessionals/ehr-implementation-steps
• Top EHR
http://www.softwareadvice.com/medical/electr
onic-medical-record-software-comparison/
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