MANAGEMENT MANAGEMENT COLLEGE OF SOUTHERN AFRICA (MANCOSA) ASSIGNMENT COVER SHEET SURNAME
LOUW
FIRST NAME/S
CLINTON BRIAN
STUDENT NUMBER MODULE NAME
117226 MANAGEMENT INFORMATION SYSTEMS
ASSIGNMENT NUMBER
2
TUTOR'S NAME
Trishana Ramluckan
EXAMINATION VENUE
CAPE TOWN TO BE CONFIRMED
DATE SUBMITTED
18-Apr-11
SUBMISSION ( )
1ST SUBMISSION
RE-SUBMISSION
6 EASTFORD STREET
POSTAL ADDRESS
KNYSNA 6570
E-MAIL
CONTACT NUMBERS
[email protected] WORK:
044 3850310
HOME:
044 3851366
MOBILE: 0823754303
COURSE/ INTAKE
MBA YEAR 1 - JANUARY 2011
DECLARATION I hereby declare that the assignment submitted submitted is an original piece of work produced by myself.
DATE: 18 April 2011 SIGNATURE:
PAGE
TABLEOFCONTENTS LISTOFABBREVIATI VIATIONS ONS
2
QUESTION 1 1.1 CH CHALLENGESFACEDBY METROPOLITA ITAN HOSPIT PITAL 1.1.1 Knowled ledge Management SystemChalle llenge 1.1.2 Ma Management Info Inforrmation ion Systems Challe llenge 1.1.3 Cost of MISand KMSchallenge 1.1.4 Security and Backup Issue Challenge 1.1.5 Challenge persuadingboard members
3 3 3 4 4 4 5
QUESTION 2 2.1 Computer Hardware 2.2 Software 2.3 Connectivity 2.4 Security
7 7 7 8 8
QUESTION 3 3.1 Systems Development Lifecycle 3.1.1 Systems Analysis 3.1.2 SystemDesign 3.1.3 Programming 3.1.4 Testing 3.1.5 Conversion 3.1.6 Production and Maintenance
10 10 11 11 11 12 12 13
QUESTION 4 4.1 Explain how TIMM could solve solve the problems experienced by each department as specified by Grantt in her preliminary investigation 4.2 Discussthe additional additi onal benefit benefits s that each department and and the hospital hospital as a whole coul could d experience by the implementation of the proposed integra integrated ted medical medical management system
15
15
19 22
BIBLIOGRAPHY
2
LISTOF ABBREVIATIONS DBMS EDI IMIS IMS IT KM KMS LAMP MEDINFO MIS MySQL PC RDBMS SDLC SQL TIMM VAN VANS VPN
Data Base Management System ElectronicData Interchange IntegratedManagement InformationSystem IntegratedManagementSystem Information Technology KnowledgeManagement KnowledgeManagement System Linux, Apache, MySQL, PHP/Perl/Python Medical Information Management Information System My StructuredQueryLanguage Personal Computer Relational Data BaseSystem SystemsDevelopmentLifecycle Structured QueryLanguage Totally IntegratedMedical Management Information System Value Added Network Value Added Networks Virtual PrivateNetwork
QUESTION 1 Highlight the challenges faced by Metropolitan Hospital that is also common to many Southern African business enterprises. 1.1
CHALLENGES FACED BY METROPOLITAN HOSPITAL
1.1.1
KNOWLEDGE MANAGEMENT SYSTEM CHALLENGE It is clear from the case study that Metropolitan Hospital has no knowledge management system in place. This does not, however, pertain only to Metropolitan Hospital but to companies in the Southern African region as a whole.
3
The concept of KM is a fairly new one in Southern Africa. Most businesses were only made aware of it since 2000 by business schools and the academic sector by promoting the KM concept in their courses and curricula. According to Laudon et el (2010: p443) knowledge management refers to the set of business processes developed in an organization to create, store, transfer, and apply knowledge. Effective knowledge management reduces the tendency to ‘repeat the mistakes ‘or as others call it, ‘reinventing the wheel’. This is can prove to be very costly and inefficient to Metropolitan Hospital. The application of the wrong treatment to a patient may lead to malpractice lawsuits. Effective knowledge management, therefore, can dramatically improve the quality of services at Metropolitan Hospital. Effective knowledge management will greatly contribute to improved excellence, which is to: •
dramatically reduce costs
•
provide potential to expand and grow
•
increase value and/or profitability
•
improve the quality of products and services
1.1.2 MANAGEMENT INFORMATION SYSTEMS CHALLENGE
An analysis by Sarah Grantt, the new medical director, into the information systems at the various departments revealed the following: •
Almost all departments have some sort of information system except for the Medical department. This is a very perturbing factor because this department is at the core of what Metropolitan Hospital do.
•
Those departments ‘fortunate’ enough to have information systems utilizes IT infrastructure that is obsolete, cumbersome and there is no cohesion between the IT systems of the various departments. The storing of information is unstructured.
4
•
A lack of training for staff members (mainly medical) by the human resources department on how to benefit from the effective use of information systems that can lead to improved productivity.
1.1.3 COST OF MIS AND KMS CHALLENGE
There is no doubt that an improvement or total redesign of a firm’s information system will be costly. The cost of developing, updating and maintaining such a system require significant on-going investment of time and money. The problem with Metropolitan Hospital is that they have a limited budget for making improvements and that money is reserved for another project, namely the opening of a new state-of-the-art cardiac centre. 1.1.4 SECURITY AND BACKUP ISSUE CHALLENGE Backup and security procedures are not simply an IT matter, but are an important part of corporate risk management and control. Backup measures are an important part of assuring that the hospital can continue to do provide health care services in the event of a system failure, and as part of a larger business continuity plan to address loss of capabilities. Some backup and may be left to the local departments; however, the backup of mission critical and corporate systems proves to be more difficult and should be organised as a corporate issue. The best backup and security measures still do not ensure that system malfunction will not take place. The reason for this is the human factor. The people responsible for backup and security at any company are fallible. 1.1.5 CHALLENGE OF PERSUADING BOARD MEMBERS ABOUT MIS AND KMS
This can prove to be one of the most difficult challenges. It is not easy persuading stakeholders or board members to adopt a new management information system. The biggest constraint is the cost involved in such a project. One of the major concerns by board members might be that the cost involved with such a system outweighs the benefits that are generated. The best way for the Metropolitan Hospital to address the challenges would be to design and implement a KMS plan and a MIS plan 5
(i)
KMS plan
A knowledge management plan involves an analysis of corporate objectives and a close examination of the tools, both traditional and technical that is required for attending to the needs of the company. The challenge is to select an IT infrastructure that fits the context of the overall strategic plan of Metropolitan Hospital. The KMS plan basically encompasses the following process: •
Gathering - data entry, ocr and scanning, etc.
•
Organizing – cataloguing, indexing, filtering, linking
•
Refining – contextualizing, collaborating, compacting and data-
mining •
(ii)
Disseminating - flow, sharing, alert and push
MIS plan Laudon et el (2010: p554) describes the information systems plan as a road map indicating the direction of systems development (the purpose of the plan), the rationale, the current systems/situation, new developments
to
consider,
the
management
strategy,
the
implementation plan, and the budget. This plan also describes how the goals of the company can be attained with the support of information technology. The business value of a KMS and MIS plan lies in the benefits that can be generated for Metropolitan Hospital. These benefits can be tangible (increased productivity, reduced facility costs, reduced workforce, etc.) 6
or intangible (improved asset utilization, improved resource control, improved decision making, etc.).
QUESTION 2 Identify and describe the hardware, software, connectivity and security requirements for Milley’s “fantasy medical institution”. Dick Milley’s fantasy medical institution 2.1
COMPUTER HARDWARE
The hardware requirements for Dr. Milley’s fantasy medical institution depend on the type of database that will be used, for example flat model, hierarchical model, network model and relational model. The relational model is the most popular of the databases, because it is relatively easy to create and access and it has the added advantage of being easy to extend.
7
After the original database creation, a new data category can be added without requiring that all existing applications be modified. This database organizes data in tables. Each table contains records of closely related data that may be linked through some common characteristic. The relational database has become the standard model for databases made from products such as
2.2
Access
or
MySQL.
SOFTWARE
SQL often referred to as Structured Query Language, is a database computer language designed for managing data in relational database management systems (RDBMS). MySQL is the most popular open source database, because of its high performance, high reliability and ease of use. It is also the database of choice for a new generation of applications built on the LAMP stack (Linux, Apache, MySQL, PHP / Perl / Python.) Many of the world's largest and fastest-growing organizations including Facebook, Google, Adobe, Alcatel Lucent and Zappos rely on MySQL to save time and money powering their high-volume Web sites, business-critical systems and packaged software. It can also run on many operating platforms such as Linux, Windows, Mac OS, Solaris, HP-UX, and IBM AIX. 2.3
CONNECTIVITY
Connectivity is the ability to connect systems, application programs and people of a company into a single integrated network. Computer networks are the main connectivity instrument for passing data in an electronic environment. A network is composed of several computers connected by a wired or wireless medium so data and other resources can pass through for sharing. According to Dick Milley he wants to be able to access medical information almost anywhere in the hospital. The internet has enabled companies to use internet working standards and web technology to create private networks called intranets and extranets. 8
The advantage of intranets and extranets is that it can create network applications that can run on different types of computers throughout the organization including wireless enabled laptops and smartphones. Security is not a problem because these networks are protected from public visits by firewalls. Extranets will allow the suppliers and customers limited access to its intranet. Intranets and extranets also have a cost benefit, because it reduces operational costs. The following must be considered when using a wired or wireless medium. Wireless connections may not be fast or reliable enough for certain bandwidth-intensive activities for sending or receiving large files. All of the devices connected wirelessly share the approximate equivalent of an Ethernet cable bringing the connection speed considerably down. 2.4
SECURITY
Security in a hospital has become a significant concern. The type of network system used in the hospital is very important from a security perspective. Metropolitan hospital should consider a virtual private network for the following reasons. •
A virtual private network (VPN) is a network that uses the Internet, to provide remote offices or individual users with secure access to the hospital’s network.
VPN’s
will
provide
Metropolitan
Hospital
with
the
same
competencies, but at a much lower cost. •
A VPN is much secured because it works by using the shared public infrastructure while maintaining privacy through security procedures and tunnelling protocols such as the Layer Two Tunnelling Protocol (L2TP).
•
Data are encrypted at the sending end and decrypted at the receiving end, data is send through a "tunnel" that cannot be "entered" by data that is not properly encrypted. An additional level of security involves encrypting not only the data, but also the originating and receiving network addresses.
9
Database security represents the system, processes, and procedures that protect a database from unauthorized activity. DBMSs usually impose security through the following: •
ACCESS CONTROL - manages who can connect to the database through authentication and what they can do through authorization.
•
AUDITING RECORDS - information about database activity: who, what, when, and possibly where.
•
ENCRYPTION - protects data at the lowest possible level by storing and possibly transmitting data in an unreadable form. The DBMS encrypts data when it is added to the database and decrypts it when returning query results. This process can occur on the client side of a network connection.
QUESTION 3 Explain how the TIMM IS team could use the structured systems development lifecycle (SDLC) approach to attain their goal. 3.1
SYSTEMS DEVELOPMENT LIFECYCLE
In order for the TIMM IS of Metropolitan Hospital to attain their goals of integrated medical information system is by means of the structured or predictive systems development lifecycle approach (SDLC). The Systems Development Life Cycle (SDLC) or the Systems Development Process is a type of approach used to describe the process for building information systems, intended to develop information systems in a very calculated, structured and systematic way, reiterating each phase of the life cycle. 10
According to Laudon et el (2010: p515) this life cycle can be broken down into six core activities. Figure 1 gives a visual representation of the systems development process.
PRODUCTION AND MAINTENANCE
CONVERSION
SYSTEMS ANALYSIS
SYSTEMS DEVELOPMEN T
SYSTEM DESIGN
PROCESS
TESTING PROGRAMMIN G
Figure 1: Adapted from source: (Laudon and Laudon, 2010: p516)
It must be stressed that although each of the systems development activities are depicted in a sequential order, some might be repeated or takes place simultaneously. 3.1.1 SYSTEM ANALYSIS The TIMM IS team can use system analysis to understand the details of the system proposed by Dick Milley, such as the IT infrastructure that will be used, which database to use, software, connectivity, etc. A decision on the desirability of the system can then be taken. Therefore, system analysis is a useful tool for the TIMM IS to investigate the proposed system, identify problems, and using the information to implement the system. Before any decision can be made the TIMM IS should conduct a feasibility study to determine whether the solution proposed will be feasible from a financial, technical, and organizational 11
level.
3.1.2 SYSTEM DESIGN Systems design is the process of defining the architecture, components, modules, interfaces, and data for a system to satisfy specified requirements. It serves as the blueprint for the overall plan or model for the integrated medical information system that will be used by Metropolitan Hospital and how the system will fulfil the objectives of the hospital. The purpose of System Design is to create a technical solution that satisfies the operational requirements for Metropolitan Hospital’s proposed system. During the system design process certain design specifications are produced for example, system components, system environment, implementation requirements and time and cost estimates. The specifications should address all the managerial, organizational, and technological components of the chosen system solution. 3.1.3 PROGRAMMING This entails the construction of the new integrated management system for Metropolitan Hospital. During this phase system specifications are translated into software program code. It is not necessary for the TIMM IS team to perform this task because software that meets the requirements for the hospital’s new system can be purchased from a variety of software retailers. This will save metropolitan Hospital a lot of time and money. The suppliers of prewritten, predesigned and pretested software programs also provide on-going maintenance and enhancements to keep the system in line with changing technical and business developments. Other options to consider is outsourcing, an external organization build or operate the information system, and offshore outsourcing, the organization that will build or operate the information is located in another country. The latter is done purely as a means to cut costs. 3.1.4 TESTING The software program code is tested at various levels in software testing to determine whether the system will produce the desired results. These tasks are 12
performed on a regular basis. This is a grey area as many different opinions exist as to what the stages of testing are and how much if any iteration occurs. Following are the types of testing: •
Unit testing is done to test each program individually;
•
System testing involves the testing of the system as a whole;
•
User acceptance testing is the final certification that the system is ready to be implemented.
3.1.5 CONVERSION This phase refers to the changing form the old system to the new system. The following conversion strategies can be utilised:
PARALLEL STRATEGY o
The old and the new system runs concurrently to ascertain whether the new system functions properly. The advantage of this approach is that it is the safest, because in the event of errors the old system can be used as a backup. However, the biggest drawback of this strategy is that it is very expensive to maintain.
DIRECT CUTOVER STRATEGY o
The old information system is replaced entirely with the new system. This is the riskiest of the four strategies because in the event of errors, there is no other system to fall back on. This strategy could prove to be the costliest of them all.
PILOT STUDY APPROACH o
The new system is introduced to a limited area of the hospital, such as the medical department or finance department. Only upon the success of the pilot version will it be installed throughout the hospital.
PHASED APPROACH
13
o
This strategy introduces the new integrated management system in phases, either by functions or by organizational units.
o
In this approach the organization undergoes a kind of "rolling" conversion in which one subsystem after another is changed over from the old to the new system.
o
As an example, patients records can be installed first, followed by accounts,
etc.
Other functions will
come later. Alumni
and
development came at the end. o
The disadvantage can be that it takes a long time to complete the conversion phase, and extra development work is needed.
3.1.6 PRODUCTION AND MAINTENANCE After the installation and conversion of the new integrated management system, it is said to be in production. During this phase the users and technical specialists continually review the system to determine whether the system will be able to attain the performance requirements of Metropolitan Hospital.
The purpose of this phase is to:
Operate, maintain and enhance the system
Certify that the system can process sensitive information
Determine when the system needs to be modernised, replaced or retired.
The TIMM IS team of Metropolitan Hospital must take note of the following with regard to the systems development lifecycle •
Systems development rarely works so effortlessly.
•
There is sometimes a need to revisit the previous phases of the SDLC.
•
Difficulty of recording requirements in a functional way. 14
•
Scheduling and budgeting is challenging especially if Metropolitan Hospital has large SDLC phases.
QUESTION 4 4.1 Explain how TIMM IS could solve the problems experienced by each department as specified by Grantt in her preliminary investigation. MEDICAL DEPARTMENT Problem: Output of medical data always generated on paper, whilst medical procedures are done by computerized equipment. Possible solution: Implementation of the MEDINFO (MEDical INFOrmation) system that is basically a general purpose computer-based information storage, retrieval, and analysis system. It is created for a time sharing, on-line computer system for the speedy and easy creation, maintenance, and analysis of general data files. The MEDINFO system allows for an analysis to be created, a description of the data made, data to be entered and updated into records, and for the data to be displayed or analysed by the investigator without programmer intervention. 15
CLAIMS DEPARTMENT: Problem: Patients’ personal data are still keyed in manually from charts and coded according to insurance and Medicare specifications.
Claims are not using a Web based
medical claims service agency. The claims system is only connected to the accounting system. Possible solution: The purpose of the management information system is to eliminate redundancy. In South Africa the MedEDI system uses Electronic Data Interchange (EDI), which permits healthcare professionals to collect their patient billings now - in real time.
It has some of the following advantages: •
Dramatically reduces calls to medical schemes and simplifying medical scheme claim administration tasks
•
Reducing time spent ‘following up’ and 'chasing debt’
•
Providing an immediate acknowledgment from the medical scheme that they have received the claim from the hospital
•
Eliminating the need for several stand-alone billing applications and EDI (electronic data interchange) systems
•
It is a very affordable system
ACCOUNTING DEPARTMENT: Problem: Accounting is still PC-based and uses an off-the-shelf medical accounting software package, handling all accounts payable and receivable. The accounting system also maintained a full record of all patient personal data. The networking of the
16
accounting and claims departments required changing the types of computers accounting used. Possible solution: Off-The-Shelf medical accounting software might not be sufficient for the accounting needs of the Metropolitan Hospital. There are many accounting software suppliers that provide software that are tailored to the needs of the hospital. The Made To Measure Medical Accounting System is a powerful, flexible software package for managing the many aspects of accounts of Metropolitan Hospital. It often means the integration of many different functions involved in patient care: scheduling, billing, maintenance of electronic medical records, accounting, etc.
PURCHASING DEPARTMENT: Problem: The purchasing department had become part of the accounting department about six months ago, providing an opportunity for the hospital to utilize EDI (electronic data interchange), which is the electronic exchange of business information, such as invoices, payments, and order status information. With only a handful of suppliers large enough to serve Metropolitan Hospital’s needs, the hospital signed a new contract only every two years. Possible solution: The purchasing department should be separated from the accounting department in order for them to function optimally. Web-based EDI, or webEDI, will allow the hospital to network with its suppliers without the worry of implementing a complex EDI infrastructure, such as value-added networks (VANS).
17
Using a friendly web-based interface, EDI transactions can be received, edited and sent as easily as an email. The hospital will also be able to receive EDI documents and send EDI invoices and shipping documents with no software to install. The Internet is making EDI more accessible to all. WebEDI has the added advantages that it is accessible anywhere in the world and you do not need a dedicated IT person to manage any software installation. FINANCE DEPARTMENT: Problem: The finance department ran a packaged program on the hospital’s mainframe. It tracked revenues and expenses by type. The finance and accounting departments transferred data files into each other’s systems. Possible solutions: First of all, the finance and accounting department should be merged. Intranet is the general term for a collection of private computer networks within an organization. An intranet uses network technologies as a tool to simplify communication between people or workgroups to improve the data sharing capability and overall knowledge base of an organization's employees. HUMAN RESOURCES DEPARTMENT Problems: Performance reviews are done online, but none of the medical staff took advantage of that feature. Possible solution: It is important that all staff members must be made aware of the advantages of an online performance review system. It is the task of the human resources department to determine the reason for the medical staff not taking advantage of this feature. LEGAL DEPARTMENT: Problems: 18
The legal department’s staff of three had its own PC client-server network. The server contained all the legal documentation resources, and the department subscribed to an online case database. Possible solution: The outsourcing of the legal services department . The true value of outsourcing must be more than just saving the hospital money. The goal should be to provide a solution to the legal needs of the hospital. Other than cost savings, outsourcing includes the foll owing advantages: 1. Quality: Vendors have expert legal employees along with specialized
processes and technology that ensure better quality of output for the hospital. 2. Flexibility: Outsourcing provides flexibility to the hospital as the buyer and can
change a vendor if required.
4.2
Discuss the additional benefits that each department and the hospital as a whole could experience by the implementation of the proposed integrated medical management system.
Additional benefits to the various departments of Metropolitan Hospital are as follows: MEDICAL DEPARTMENT:
The benefits of IMIS are improved medical examination and treatment and patient service.
Less staff is required to cater for more patients in the same time or less.
Staff can be redeployed to other suitable locations.
Enabled improvement in the response time, because it automates the process of collecting, collating and retrieving patient information.
19
Doctors can spend their precious time more in clinical activities than to put in clerical activities.
Provides an opportunity to enhance patient care.
Records of patients can be retrieved simultaneously using IMS.
CLAIMS DEPARTMENT:
Easily navigational software interfaces save a lot of time from data entry for special jobs only.
Eliminates denials due to lost charges and improves the hospital’s ability to explain charges.
Provides immediate access to patient correspondence associated with encounters and receivables resolution.
ACCOUNTING DEPARTMENT:
Accounting can sometimes become very complex. The integrated medical management system eliminates any such complexity.
Better cash flow and improved accuracy
Simultaneous access to information
Compliance with legal requirements
Resolve matters quickly and efficiently
Conserve time and increase accuracy and accountability within a department
PURCHASING DEPARTMENT:
Purchasing department can use it to control costs and streamline the procurement procedures without sacrificing control 20
It enables purchasing managers to move away from operational, day-to-day tasks and instead focus on managing and negotiating stronger supplier contacts, examining spend and purchase decisions, to ultimately progress the purchasing function from a cost- to a profit-centre.
Better purchasing information with lower overheads
FINANCE DEPARTMENT:
Will enable the hospital to serve the rapidly growing number of health care consumers in a cost-effective manner.
Enhanced Revenue Management
DEVELOPMENT DEPARTMENT:
Increased hospital publicity, means that donations will be much easier to come by.
HUMAN RESOURCES DEPARTMENT:
A much happier workforce because they will not be overwhelmed by multiple cross-references
Improved confidentiality
Information can be accessed centrally.
Authorized staff may retrieve any information at any time
HR is relieved of routine tasks requested, with user permissible access
All personnel documents can be electronically filed and secured for the life of the document
ADDITIONAL BENEFITS OF IMMS TO METROPOLITAN HOSPITAL:
21
Clearly defined roles and responsibilities for managing the integrated management system
Drastically increase productivity in all departments
Highest levels of security protects unauthorised release of protected health information
Improves and develops performance
Simplifies internal operations
Improve administrative efficiency
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Cawthon, N,
Negativity in Automated Performance Appraisals due to Online
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Kinser,
D,
Healthcare
IT
Lessons
Learned,
http://www.ediltd.com/enewsletter/july_newsletter/article2.html
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