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					Selecting and Implementing a Health Care Information System

Why is this important topic?


Information System Life Cycle




Needs Assessment

Important questions to ask
     Do we need to have a health information system?
     Why do we need to have a health information system?
           o Deficiencies
           o Improvements
     Is the system aligned with for our overall goals as an organization?
           o Vision
           o Mission
           o Strategic planning
           o Goals and objectives
     Can we handle the project?
           o Scope
     Do we have the support? Can we get buy-in from the staff members
Form a Steering Committee
      Responsible for the project
      May need subcommittee
      Comprehensive but nimble
      Upper management involvement – IT, administrative, financial and clinical
      Decision making process
      May need to hire a consultant – why?

Understand the current system
      Basis of system requirements
      Methods – interviews, observations, questionnaires
      May need consultants to work on this part.
      Focus on the need of information and optimization of process

Determine System Requirements
      Important – basis of RFP
      Based on the understanding of the current system
      Get a list of “must” and “wants” – like and dislike
      Prioritize the list – steering committee + consultants.
      Establish criteria
           o Technical – architecture, downtime, connectivity, environment, response time, support
                other technology, maintenance, etc.
           o Administrative – regulation, security, privacy, help, data retention, report etc.
           o System specific criteria


SYSTEM SELECTION
      Try to acquire as much information about different systems as possible – CCHIT
      Consider other factors

Request for Information
Simple document asking vendor to provide information about their systems based on the needs of your
organization. Additional questions may ask based on the response.

Request for Proposal
      Single most important document
      Questions need to be precise and well written
      Avoid vagueness – structured questions.

Example:
http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_034278.hcsp?dDocName=bok1
_034278.
Evaluation of Responses
            Score card (sample below)
            Cost-effectiveness analysis

                                          RFP EVALUATION SCORECARD
Before giving to reviewers the Procurement Team Leader should enter each evaluation criteria to be scored in first column and
indicate the priority level under the “multiplier” column. The evaluation criteria with the highest priority will have the highest
multiplier, e.g., “x 10” and the lowest priority criteria will have the lowest multiplier, e.g., “x 1”. Multiply the multiplier by “5”
to obtain the highest number of points for each criteria (since “5” is the highest score).




Reviewers must check one score (0-5) for each criteria. Multiplying the marked score by the multiplier will result in the total
points awarded for that criterion




NAME OF BIDDER:          Score           Score       Score    Score     Score         Score                     Points       Maximum
                                                                                                               Awarded        Points
                     Unsatisfactory   Satisfactory   Good     Very     Excellent   Outstanding    Multiplier                 Available
                                                              Good                                               (mark
RFP TITLE:               0 pts                                                                                 score from      (5 x
                                                                                                                (0-5 and     multiplier)
                                          1 pt       2 pts               4 pts        5 pts                     multiply
                                                              3 pts                                                by
NAME OF                                                                                                        multiplier)
REVIEWER:




  EVALUATION
CRITERIA LISTING

EXAMPLE - 1                                                                            XX           (x 5)          25            25

EXAMPLE - 2                                                    XX                                   (x 2))         6             10

EXAMPLE - 3                                           XX                                            (x 1)          2             5

                                                                                                    (x __)
1.

                                                                                                    (x __)
2.

                                                                                                    (x __)
3.

                                                                                                    (x __)
4.

                                                                                                    (x __)
5.

                                                                                                    (x __)
6.
                                                                                         (x __)
7.

                                                                                         (x __)
8.

                                                                                         (x __)
9.

                                                                                         (x __)
10.

Comments on individual score selections or general comments during review of response:




Site Visit
         Both vendor and clinical site.
         Ask specific questions

Negotiation
Implementing an Health Information System


IMPLEMENTATION

Form an implementation committee
   Technical staff
   Informatics staff
   Clinical staff
   Vendor staff
   Page 203 – characteristics of committee



Plan the installation
   Work breakdown structure (WBS) – page 204
   Get familiar with the systems
   Go over system requirements
   Decision on customization – how much?
   Need of data and workflow optimization
   Test the system


Analyze hardware and telecommunication environment

Develop Procedures and Documentation
   Use the system implantation as an opportunity to introduce workflow optimization
   Risk assessment
   Backup plan
   User guide – scenario based

Testing
   Routine operation
   Scenario based
   Evaluation – usability

Training
   Separate training environment
   Knowledge retention – close to go live data.

Go live
   Pick a date
   Big bang vs staggered – determine strategy
   Convert the old system to the new system
   Evaluation after go live

Common mistakes
   Under-planning
   Scope creep
   Over customization
   Oversight of maintenance
   Poor testing
   Insufficient training
   Did not gain enough buy-in
   Focus on one problem a time
   Does not provide continuing evaluation

MAINTENANCE

User Feedback and Support
   Questionnaire
   Help desk
   System Log file
   Communication
   ROI – cost, quality, satisfaction, outcome

System maintenance

Technical maintenance

				
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