INFO 731
Prudence W. Dalrymple, PhD
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In this lecture, we will
define a system, and describe different types of
systems
identify stakeholders and examine how their
views of systems differ from one another
see how the role of the systems analyst as a
problem-solver is similar to that of the
informatician
look at the system development process and
acknoweldge that views of systems differ
according to various roles
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An understanding of systems and how they
work is fundamental to understanding
healthcare informatics
From a systems perspective, almost anything is
a system
Failure to appreciate the inter-relatedness of
various components of health care has led to
inefficiencies, errors, waste and lack of progress
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A system is a group of interrelated components that function
together to achieve a desired result.
An information system (IS) is an arrangement of people, data,
processes, and information technology that interact to collect,
process, store, and provide as output the information needed to
support an organization.
Information technology is a contemporary term that describes
the combination of computer technology (hardware and software)
with telecommunications technology (data, image, and voice
networks).
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During the planning phase, an organization’s total information system needs
are identified, analyzed, prioritized, and arranged.
During the analysis phase, requirements are gathered from users, studied
and organized. Any redundancies are eliminated and a solution
recommended
During the design phase, the description of the recommended solution is
converted into logical and then physical system specifications.
During the implementation phase, the information system is coded, tested,
installed, and supported in the organization.
During the maintenance phase, the system is systematically repaired and
improved.
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Functions:
Input
Processing
Output
Storage
Control
Components:
People
Procedures
Data
Software
Hardware
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A transaction processing system (TPS) is an information system that captures
and processes data about operational transactions. In business, this might be
sales; in healthcare, this is usually administrative data related to patient care
A management information system (MIS) is an information system that
provides for management-oriented reporting based on transaction processing
and operations of the organization.
A decision support system (DSS) is an information system that either helps to
identify decision making opportunities or provides information to help make
decisions. In healthcare, this is usually targeted to support clinical decisions
An executive information system (EISs) is tailored to the unique information
needs of executives.
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An expert system is an information system that captures the
expertise of workers and then simulates that expertise to the
benefit of non-experts. This is exemplified in certain decision
support systems.
A communications and collaboration system is an information
system that enables more effective communications between
the various aspects of healthcare to enhance their ability to
collaborate. For example between physicians and nurses,
pharmacists and clinicians, inpatient and outpatient systems.
An office automation system is an information system that
supports the wide range of office activities that provide for
improved workflow between workers.
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A stakeholder is any person who has an interest in an existing or
proposed information system. Stakeholders can be technical or
non-technical workers. They may also include both internal and
external workers.
Information workers are those workers whose jobs involve the
creation, collection, processing, distribution, and use of
information.
A Systems Analyst is an information worker who is a facilitator
or a coach, who bridges the communication gap between the
non-technical and technical stakeholders. This is also a
responsibility of an informatician or informaticist.
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All information systems have multiple
stakeholders whose job satisfaction,
productivity, accuracy, and motivation are
affected by the information system.
Some of these stakeholders are chief executives,
boards, clinicians, patients, vendors/suppliers,
government agencies and the public
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System designer – a technical specialist who translates
system users’ business requirements and constraints into
technical solution. She or he designs the computer
databases, inputs, outputs, screens, networks, and
software that will meet the system users’ requirements.
System builders – a technical specialist who constructs
information systems and components based on the
design specifications generated by the system designers.
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Informaticians perform many of the functions
customarily handled by systems analysts. They are
expected to bring domain knowledge as well as
systems knowledge to their positions. Thus, they
study the problems and needs of an organization
to determine how people, data, processes, and
information technology can improve the
organization’s ability to achieve its goals. They
generally do not program.
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"Problems" that need solving may be:
Problems, either real or anticipated, that
require corrective action
Opportunities to improve a situation despite
the absence of complaints
Directives to change a situation regardless of
whether anyone has complained about the
current situation
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Working knowledge of information technology
Familiarity with healthcare environment
General problem-solving skills
Good interpersonal communication skills
Good interpersonal relations skills
Flexibility and adaptability
Character and ethics
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Quality Improvement & Patient Safety
Security and Privacy
Need for Data Exchange & Interoperability
Continued Technology Development in Healthcare
Economic Pressures
National Reform Movements
Consumerism
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Understanding clinical workflow is an essential part of information
system design and deployment. Understanding the “before” state
helps identify key components as well ads unnecessary steps, and
how parts of a system are related. During design and
implementation, awareness of the system’s impact on workflow
can help prevent costly and dangerous work-arounds. Workflow
analysis is similar to business process redesign (BPR) because it is
the study, analysis, and redesign of fundamental business
processes to improve quality and efficiency.
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Networks and the Internet
Mobile and Wireless Technologies
Object Technologies
Collaborative Technologies
Enterprise Applications
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System development process – a set of activities,
methods, best practices, deliverables, and
automated tools that stakeholders use to develop
and maintain information systems and software.
It is cyclical, aiming at continuous testing and
evaluation
It requires continual feedback to optimize results
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A general approach to problem-solving
1. Identify the problem.
2. Analyze and understand the problem.
3. Identify solution requirements or expectations.
4. Identify alternative solutions and choose the “best” course
of action.
5. Design the chosen solution.
6. Implement the chosen solution.
7. Evaluate the results. If the problem is not solved, return to
step 1 or 2 as appropriate.
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Simplified System
Development Process
General Problem-Solving Steps
System initiation
1. Identify the problem.
System analysis
2.
3.
Analyze and understand the problem.
Identify solution requirements or
expectations.
System design
4.
Identify alternative solutions and choose the
“best” course of action.
Design the chosen solution.
5.
System implementation
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6.
7.
Implement the chosen solution.
Evaluate the results. If the problem is not
solved, return to step 1 or 2 as appropriate.
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System initiation – the initial planning for a project to define
initial scope, goals, schedule, and budget.
System analysis – the study of a problem to recommend
improvements and specify the requirements and priorities for
the solution.
System design – the specification or construction of a technical,
computer-based solution for the requirements identified in a
system analysis.
System implementation – the construction, installation, testing,
and delivery of a system into production.
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Project management – the activity of defining,
planning, directing, monitoring, and controlling a
project to develop an acceptable system within the
allotted time and budget.
Process management – the ongoing activity that
defines, improves, and coordinates the use of an
organization’s chosen methodology (the “process”)
and standards for all system development projects.
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Clinical information systems support patient care
functions that extend out to the clinical staff
Nursing, pharmacy, lab, radiology
Administrative information systems support internal
business operations of an organization, as well as reach
out to suppliers (of materials, equipment, supplies, and
services).
Human resources
Financial management & billing
Inventory control
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Information systems architecture - a unifying
framework into which various stakeholders with
different perspectives can organize and view the
fundamental building blocks of information
systems.
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Knowledge — consists of raw data that is
processed to create useful information.
Process — the activities (including
management) that carry out the mission of
the organizaiton.
Communication — how the system
interfaces with its users and other
information systems.
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Database technologies that support accumulation and
use of data, information and knowledge
Software technologies that automate and support
information processes and services
Interface technologies that support communication and
collaboration
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System owners’ view
Interested not in raw data but in information that enables process
efficiencies and procductivity, improves patient saftey and
enhances the organization.
Delivers values while controlling costs
Defines scope and vision for project.
System users’ view
Data is something recorded on forms, stored in file cabinets,
recorded in books and spreadsheets, or stored on computer.
Focus on procedures as they pertain to data.
Specify data requirements – system users know the detail about
clinical procedures and policies
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System designers’ view
Translate the systems users’ data requirements into database
design.
Data structures, database schemas, fields, indexes, and constraints
of particular database management system (DBMS).
System builders’ view
Must represent data in database language
DBMS or other data technologies
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System owners’ view
Concerned with high-level processes and functions; not
concerned with process details.
Functions are groups of related processes that support
the organization, such as nursing, housekeeping, supplies,
pharmacy, radiology, billing
A cross-functional information system is a system that
supports relevant business processes from several
functions without regard to departmental boundaries.
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System users’ view
Concerned with processes or “work” that must be
performed to provide the appropriate responses to
business events.
Process requirements – a user’s expectation of the
processing requirements (activities, data flow, work flow)
for a process and its information systems.
Policy – a set of rules that govern a process.
Procedure – a step-by-step set of instructions and logic for
accomplishing a process.
Work flow – the flow of transactions through processes to
ensure appropriate checks and approvals are
implemented.
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System designers’ view
Concerned with which processes to automate
and how to automate them
Constrained by limitations of application
development technologies being used
Software specifications – the technical design
of processes to be automated or supported by
computer programs to be written by system
builders.
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System builders’ view
Concerned with programming logic that implements
automated processes.
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System owners’ view
Who (which units, employees, patients, medical staff
and external partners) must interact with the system?
Where are they located?
What other information systems will the system have
to interface with?
System users’ view
Concerned with the information system’s inputs and
outputs.
Interactions with the system
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System designers’ view
Concerned with the technical design of both the user
and the system-to-system communication interfaces.
Interface specifications – technical designs that
document how system users are to interact with a
system and how a system interacts with other systems.
User dialogue – a specification of how the user moves
from window to window or page to page, interacting
with the application programs to perform useful work.
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System builders’ view
Concerned with the construction, installation,
testing and implementation of user and
system-to-system interface solutions.
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