Abstract
Healthcare organizations strive for cost effective IT investment therefore it needs strategic planning to meet its future needs especially on minimizing risk and maximizing return on investment In my analysis, assessment, planning and vision are some of the best practices to achieve an effective IT alignment. The integration of technologies combined with strategic planning is the key factor to a successful organization. To evaluate and identify the organization’s current state, assessment on hardware, software, technology, IT support model is vital. The assessment will identify the current problems and will provide recommendations to address them. Planning not only includes a list of projects that support the organization’s existing technology but also includes timeframes, financial sustainability and availability on resources. Develop the actual plan by defining the organization’s vision and primary goals which could provide an overview of what lies ahead. Strategic goals and objectives should be set in line with the business goals. Identify the success and failure of each objective to measure the level of effectiveness. In health care services, patients are required to register or make appointments on websites which requires online access. What about an alternative if a patient is unable to get internet access? Identifying IT gaps and addressing them will provide easier resolution and planning. This is a clear logic of how the use of technology impacts the organization.
Keywords: IT alignment, assessment, planning, vision
The System Development Life Cycle (SDLC) is a software process used to develop information systems used in project management through investigation, analysis, design, implementation and maintenance. It describes the different stages involved in the project. Its main objective is to guarantee high quality system, to provide a firm management control and maximize productivity. The SDLC must assure to generate more functions in high quality with less time and resources, cost effective, improved product variability and a quantitative result of investment. To achieve these objectives, the SDLC must be highly usable, be able to support projects and different types of systems, support technical and management activities and provide training on how to use it. To form the framework of an information system, SDLC developed a variety of approaches such as: waterfall model, rapid application development (RAD), joint application development (JAD), the spiral model, build and fix model, prototyping and synchronize-and-stabilize. The development of the information system involves systems analysts who are trained to analyze and design information systems and technical specialists who are technology experts. With the right input, the SDLC develops phases of process from start to finish.
System Evaluation is the process of gathering information by consulting the users of the program and support personnel to identify the problem.
System Analysis is identifying the cause of the problem and proposes a plan to address the problem.
System design is where the new system is developed that involves Physical construction of the system, hardware, software and data base, telecommunications and procedures that specify its performance.
Programming is the process where the new system is installed.
Testing is the process where the codes are tested to produce the desired results which are done throughout the programming stage.
Implementation is replacing the old system into the new one which is done in three stages: direct conversion is turning on the new system and turning off the old one. Pilot conversion is where system is operational in small areas. Phased conversion is gradual replacement of the system until fully functional.
Operations and Maintenance is where the new system is evaluated to eliminate errors or malfunctions. Choosing an SDLC is a major change for the staff and should be considered as a full time resources project with a high level of expertise thus continuous maintenance and updating the users of the system concerning the latest procedures should be implemented.
The continuous rise of health care cost, problems concerning access to quality care and misappropriation of funds has been the most controversial issues in the past years. To address these problems, the federal government has made revisions concerning the development of new healthcare methods, restructure of organizations, and reform on health care business and clinical procedures. One of its major revisions is the development of a new basic framework of healthcare information which is the integration of existing and new application systems. The framework focuses on patient care with Computer-based patient record (CPR) systems support, network sharing of patient information and access to health care information. Health care information standards are created in order for these programs to work effectively. The types and classification of health care information standards are:
Patient Identifiers need to be ideal but some issues were raised regarding identification fraud and violations of confidentiality. The American Society for Testing and Materials (ASTMs) created the Universal Health Care Identifier (UHID) E1714.95 that outlined the national system properties while Computer- based Patient Record Institute (CPRIs) Codes and Structures Work Group created a Patient Identifier Project Team to address issues on identification.
Provider Identifiers are assigned to health providers and health government agencies. The Healthcare Financing Administration (HCFA) created Universal Physician Identifier Number (UPIN) which is commonly used only to Medicare physicians. The HCFA created the National Provider File (NPF) as a new provider identifier for Medicare and Medicaid programs, caregivers and sites-of care and other government agencies.
Site-of-Care Identifiers is created to identify healthcare facilities, physicians and service providers. The Health Industry Business Communications Council (HIBCC) issued Health Industry Number (HIN).
Product and Supply Labeling Identifiers is to identify medical equipment manufacturers and drug distributors. The HIBCC issued the The Labeler Identification Code (LIC). The Uniform Code Council issued the Universal Product Code (UPC) used to label products sold in retail settings. The National Drug Code (NDC) is also an identifier represented by the Clinical Data Representations section.
Communications (Message Format) Standards are created for patient data information transactions. The committees on Standards Development Organizations (SDOs) developed some standards commonly accepted by users and vendors. One of them is Digital Imaging and Communications (DICOM) which was developed by the American College of Radiology - National Electrical Manufacturers' Association (ACR-NEMA) and identifies the communications standards and message formats for diagnostic and therapeutic images.
Clinical Data Representations (Codes) are widely used for diagnosis and procedures documentation. The International Classification of Diseases (ICD)
Codes, 9th edition (ICD-9) is accepted worldwide and is supported by the World Health Organization (WHO).
Confidentiality, Data Security and Authentication guidelines and standards are created for the development of computer-based patient record systems and confidential healthcare information networks. The Fair Health Information Practices Act (HR 435) supported by Rep. Gary Condit (D-CA) together with The Healthcare Privacy Protection Act supported by Sen. Robert Bennet. These bills were created to address the need for complete federal rules concerning patient’s health information and their rights.
Quality Indicators, Data Sets and Guidelines are created to support the measurement of quality care. Indicator Measurement System (IMSystem) was created by The Joint Commission on Accreditation of Health Care Organizations (JCAHO). This is to facilitate the level of performance for obstetrics, oncology, trauma, and cardiovascular care.
International Standards are organized by The International Organization for Standardization (ISO) which is a worldwide federation of national standards organizations to promote the development of standardization and related activities in the world. ANSI was the U.S. representative and one of the founding members.
Standards Coordination and Promotion Activities are organizational programs created to support and promote the development of health care information standards. The ANSI Healthcare Informatics Standards Planning Panel (HISPP) was the primary organization that worked to coordinate healthcare information standards.
Risks on information security are the common problem in keeping legitimate information on medical records. The need to protect security information is the task of security professionals. Implementing some approaches and features on computer based patient records is the key to accomplish security system.
For healthcare administrators and hospitals, the value of medical information on a computer based system should be protected from external threats. Access control to confidential information should be restricted only to authorized personnel to ensure unauthorized release of protected information. In a computer-based patient record, the information access control feature can help restrict access to those who are not authorized to view records. To ensure protection, access control mechanisms on the computer that process the information should be strongly built. Identification is the basic foundation in building a strong control mechanism. System analysts should use hardware and software solutions to configure strong access control. Verification or authentication is necessary for identification claim of a person by using PIN, s and passwords. Administrative policies and procedures should be enforced on what information or service to access and by whom. The management can create security policy agreements concerning the accompanying responsibilities of having the privilege to access and define the penalties for violating these policies. Failure of privacy and confidentiality is often due to improper behavior of personnel handling the information so they must be held responsible for any inappropriate action.
References:
Choosing aHealthcare Planning, Budgeting and Forecasting System, (March, 2009). IBM. Retrieved from http://www-304.ibm.com/easyaccess/fileserve?contentid=187165
Federal Healthcare Informatics Standards Activities, (December, 1999). Agency forHealthcare Researchand Quality. Retrieved from http://www.ahrq.gov/data/datameet.htm
Rouse, M, (May, 2009),SystemsDevelopment Life Cycle (SDLC). Search Software Quality. Retrieved from http://searchsoftwarequality.techtarget.com/definition/systems-development-life-cycle
