4 Guys Consulting Team D Gary Fenton, Timothy Glennon, Matthew Powers, Michael White W hite MIS-600-60165: Information Systems Capstone Professor Bill Crumm April 21, 2013
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TABLE OF CONTENTS 1. EXECUTIVE SUMMARY ........................... .......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ .................... ...... 6 2. PROJECT CHARTER .......................... ......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ........................... ............. 9 2.1 OBJECTIVES ........................... ......................................... ............................ ............................ ............................ ............................ ............................ ............................ ............................. ............................. ................ 10 2.2 ASSUMPTIONS ........................... .......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ......................... ........... 10 2.3 CONSTRAINTS ........................... .......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ......................... ........... 10 2.4 COST/FINANCIAL ASSUMPTIONS............................ .......................................... ............................ ............................ ............................ ............................. ............................ ........................ ........... 10 2.5 USER ACCEPTANCE CRITERIA/QUALITY ........................... .......................................... ............................. ............................ ............................ ............................ ........................... ............. 10 2.6 MAJOR R ISKS ........................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ......................... ........... 10 ISKS ............................ 2.7 K EY ......................................... ............................ ............................ ............................ ............................ ............................ ............................ ............................. ................. 11 EY STAKEHOLDERS ........................... 3. PROJECT VALUE STATEMENT ........................... ......................................... ............................ ............................ ............................ ............................ ............................ ............................ ....................... ......... 12 4. PROJECT STRATEGY STATEMENT ........................... ......................................... ............................ ............................ ............................ ............................. ............................. ........................... ................. .... 15 5. PROJECT METHODOLOGY ............................ .......................................... ............................ ............................. ............................. ............................ ............................ ............................ ........................... ............. 15 5.1 PROJECT MANAGEMENT METHODOLOGY ............................ .......................................... ............................ ............................ ............................ ............................ ......................... ........... 16 5.2 SCOPE WBS (SCHEDULE)...................... ).................................... ............................ ............................. ............................. ............................ ............................ ............................ ........................... ............. 17 6. BUSINESS REQUIREMENTS AND RULES ............................ .......................................... ............................ ............................ ............................ ............................. ............................. ...................... ........ 19 6.1 ACTOR GLOSSARY ............................ ........................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ .................. .... 19 6.2 CONTEXT DIAGRAM .......................... ......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ .................. .... 20 6.3 USE CASE GLOSSARY ............................ .......................................... ............................ ............................ ............................ ............................ ............................ ............................ ............................. ................. 21 6.4 USE CASE DIAGRAM .......................... ......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ .................. .... 23 6.5 USE CASE NARRATIVES ............................ ........................................... ............................. ............................ ............................ ............................ ............................ ............................ ......................... ........... 24 7. MS PROJECT PLAN ........................... .......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ......................... ........... 58 8. DATA AND ENTITY MODELS ........................... ......................................... ............................ ............................ ............................ ............................ ............................ ............................ ......................... ........... 61 8.1 CONTEXT DATA FLOW MODEL .......................... ........................................ ............................ ............................ ............................ ............................. ............................. ............................ ................ 61 8.2 KEY-BASED DATA MODEL .......................... ........................................ ............................ ............................ ............................ ............................ ............................ ............................ ....................... ......... 62 8.3. FULLY-ATTIBUTED DATA MODEL .......................... ........................................ ............................ ............................ ............................ ............................. ............................. ...................... ........ 63 9. DATA FLOW DIAGRAMS ............................ .......................................... ............................ ............................ ............................ ............................ ............................ ............................ ............................. ................. 64 9.1 CONTENT DATA FLOW DIAGRAM ............................ .......................................... ............................ ............................ ............................ ............................. ............................. ...................... ........ 64 9.2 FUNCTIONAL DECOMPOSITION DIAGRAM ............................ .......................................... ............................ ............................ ............................ ............................ ......................... ........... 65
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9.3 EVENT-R ESPONSE ......................................... ............................. ............................ ............................ ............................ ............................ .................... ...... 66 ESPONSE / USE-CASE LIST .......................... 9.4 EVENT DECOMPOSITION DIAGRAM.......................... ........................................ ............................ ............................ ............................ ............................. ............................. ...................... ........ 70 9.5 EXTERNAL EVENT DIAGRAMS .......................... ........................................ ............................ ............................ ............................ ............................. ............................. ............................ ................ 71 9.5.1 GENERATE NEXT WEEKS PATIENT R EPORT .......................................... ............................. ............................ ............................ ........................... ............. 71 EPORT........................... 9.5.2 GENERATE THERAPIST PATIENT R ECORDS ........................................... ............................. ............................ ............................ ........................... ............. 72 ECORDS ............................ 9.5.3 GENERATE COMPLETE CBOC SCHEDULE ........................... ......................................... ............................ ............................. ............................. ............................ ................ 73 9.5.4 PROCESS APPOINTMENT SCHEDULE............................ .......................................... ............................ ............................ ............................ ............................ ......................... ........... 74 9.5.5 AUTOMATICALLY SCHEDULE APPOINTMENT............................ .......................................... ............................ ............................. ............................ ........................ ........... 75 9.5.6 MANUALLY SCHEDULE APPOINTMENT ........................... .......................................... ............................. ............................ ............................ ............................ .................... ...... 76 9.5.7 MANUALLY CHANGE/ADD APPOINTMENT........................... ......................................... ............................ ............................. ............................. ............................ ................ 77 9.5.8 SEND APPOINTMENT R EMINDER .......................................... ............................ ............................ ............................ ............................. ............................. ................ 78 EMINDER ............................ 9.5.9 GENERATE BILLABLE HOURS ........................... .......................................... ............................. ............................ ............................ ............................ ............................ .................... ...... 79 9.5.10 GENERATE MONTHLY BILLABLE HOURS R EPORT ......................................... ............................ ............................. ............................. ................ 80 EPORT ........................... 9.5.11 GENERATE PER PATIENT BILLABLE HOURS R EPORT .......................................... ............................ ............................ ......................... ........... 81 EPORT ............................ 9.5.12 MANUALLY CHANGE BILLABLE HOURS ............................ .......................................... ............................ ............................ ............................ ............................. ................. 82 9.5.13 TRACK BILLING HOURS ........................... ......................................... ............................ ............................. ............................. ............................ ............................ ........................... ............. 83 9.5.14 TRACK /S /STORE SESSION MINUTES .......................... ......................................... ............................. ............................ ............................ ............................ ........................... ............. 84 9.5.15 PROCESS PATIENT R X R ECORDS ........................................... ............................. ............................ ............................ ............................ ........................... ............. 85 ECORDS ............................ 9.5.16 VIEW PATIENT R X R ECORDS ......................................... ............................. ............................ ............................ ............................ ............................ .................... ...... 86 ECORDS .......................... 9.5.17 UPDATE PATIENT R X R ECORDS ......................................... ............................ ............................ ............................ ............................. ............................. ................ 87 ECORDS ........................... 9.5.18 PROCESS PATIENT MEDICAL R ECORDS .......................................... ............................ ............................ ............................ ............................ .................. .... 88 ECORDS............................ 9.5.19 VIEW/UPDATE PATIENT CASE HISTORY NOTES .......................... ......................................... ............................. ............................ ............................ .................... ...... 89 9.5.20 VIEW PATIENT MEDICAL R ECORDS .......................................... ............................ ............................ ............................ ............................. ....................... ........ 90 ECORDS ............................ 9.5.21UPDATE PATIENT MEDICAL R ECORDS .......................................... ............................. ............................ ............................ ............................ .................... ...... 91 ECORDS........................... 9.5.22 COMPILE PATIENT CASE HISTORY ............................ .......................................... ............................ ............................ ............................ ............................ ......................... ........... 92 9.5.23 E NTER N NEW PATIENT........................... ......................................... ............................ ............................ ............................ ............................. ............................. ........................... ................. .... 93 10. PROCESS MODEL ........................... .......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ......................... ........... 94 10.1 DATA FLOW DIAGRAM (DFD)........................... ......................................... ............................ ............................ ............................ ............................. ............................ ........................ ........... 94
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11. SYSTEM ALTERNATIVE ASSESSMENT ........................... ......................................... ............................ ............................ ............................ ............................. ............................. ...................... ........ 95 11.1 SYSTEM ALTERNATIVES .......................... ........................................ ............................ ............................. ............................. ............................ ............................ ............................ .................... ...... 95 11.2 FEASABILITY A NALYSIS .......................... ........................................ ............................ ............................. ............................. ............................ ............................ ............................ .................... ...... 97 11.2.1 OPERATIONAL FEASIBILITY .......................... ........................................ ............................ ............................ ............................ ............................. ............................. ...................... ........ 97 11.2.2 TECHNICAL FEASIBILITY ............................ .......................................... ............................ ............................ ............................ ............................. ............................ ........................ ........... 98 11.2.3 ECONOMIC FEASIBILITY .......................... ........................................ ............................ ............................. ............................. ............................ ............................ ........................... ............. 99 11.2.4 SCHEDULE FEASIBILITY ........................... ......................................... ............................ ............................. ............................. ............................ ............................ ........................... ............. 99 11.3 SYSTEM ALTERNATIVE SELECTION ............................ .......................................... ............................ ............................ ............................ ............................. ............................ ............. 100 11.3.1 CANDIDATE 1 (COST/BENEFIT A NALYSIS)........................... .......................................... ............................. ............................ ............................ ......................... ........... 101 11.3.2 CANDIDATE 2 (COST/BENEFIT A NALYSIS)........................... .......................................... ............................. ............................ ............................ ......................... ........... 102 11.3.3 CANDIDATE 3 (COST/BENEFIT A NALYSIS)........................... .......................................... ............................. ............................ ............................ ......................... ........... 104 12. TECHNICAL R EQUIREMENTS ......................................... ............................. ............................ ............................ ............................ .................. .... 106 EQUIREMENTS AND ASSUMPTIONS.......................... 12.1 GENERAL OVERVIEW........................... ......................................... ............................ ............................ ............................ ............................ ............................ ............................ ....................... ......... 106 12.2 FACILITIES ............................ ........................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ....................... ......... 107 12.2.1EXISTING NETWORK CONFIGURATION ............................ .......................................... ............................ ............................ ............................ ............................ ................ .. 108 12.3 TECHNOLOGY OVERVIEW ........................... ......................................... ............................ ............................ ............................ ............................. ............................. ........................... ............... .. 109 12.4 TECHNICAL COSTS SUMMARY ........................... ......................................... ............................ ............................ ............................ ............................. ............................ ...................... ......... 110 13. A NALISYS OF NEEDS VS.CAPABILITIES .......................................... ............................ ............................. ............................ ............... .. 111 APABILITIES O F CONTRACTORS ............................ 14. PROJECT R ISK ......................................... ............................ ............................. ............................. .................... ...... 112 ISK A NALYSIS AND R ISK ISK MITIGATION P LAN ........................... 14.1 PROJECT R ISK ........................................ ............................ ............................. ............................. ............................ ............................ ............................ .................. .... 112 ISK A NALYSIS .......................... 14.1.1 IMPACT R ISK .......................................... ............................ ............................ ............................ ............................. ............................. ........................... ............... .. 113 ISK TABLE ............................ 14.1.2 R ISK .......................................... ............................ ............................ ............................ ............................. ............................ ...................... ......... 113 ISK A NALYSIS TABLES ............................ 14.2 R ISK ......................................... ............................ ............................. ............................. ............................ ............................ ............................ .................. .... 115 ISK M ITIGATION P LAN ........................... 14.2.1 R ISK .......................................... ............................ ............................ ............................ ............................. ............................. .................... ...... 115 ISK MITIGATION TABLES ............................ 15. PROJECT COSTS, STAFFING, R ESOURCES .......................................... ............................. .................... ...... 117 ESOURCES , DEPENDENCIES AND SCHEDULE........................... 15.1 R ESOURCE ......................................... ............................ ............................. ............................. ............................ ............................ ......................... ........... 117 ESOURCE COSTS BY PHASE ........................... 15.2 R ESOURCE .......................................... ............................ ............................ ............................ ............................ ............................ ............................ ............................ .............. 117 ESOURCE R ATES ATES ............................ 15.3 SCHEDULE ........................... ......................................... ............................ ............................ ............................ ............................. ............................. ............................ ............................ ......................... ........... 118
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15.4 DEPENDENCIES ........................... ......................................... ............................ ............................. ............................. ............................ ............................ ............................ ............................ .................. .... 119 16. I NTEGRATION .......................................... ............................. ............................ ............................ ......................... ........... 120 NTEGRATION OF I NTERNAL & EXTERNAL SYSTEMS ........................... .......................................... ............................ ............................ ................ .. 121 16.1 I NTERNAL AND EXTERNAL SYSTEM I NTEGRATION NTEGRATION DIAGRAM ............................ .......................................... ............................ ............................ ............................ ............................. ............................. ........................... ............... .. 122 16.2 I NTERNAL COMPONENTS ............................ ......................................... ............................ ............................ ............................ ............................. ............................. ........................... ............... .. 122 16.3 EXTERNAL COMPONENTS........................... 17. SYSTEMS ADMINISTRATION , SECURITY, BACKUP AND R ECOVERY .......................................... ............................ ............................ .................. .... 123 ECOVERY............................ ......................................... ............................ ............................ ............................ ............................. ............................. ........................... ............. 123 17.1 SYSTEM ADMINISTRATION ........................... .......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ................ .. 123 17.1.1 TRAINING........................... ........................................ ............................ ............................. ............................. ............................ ............................ ............................ .................. .... 124 17.1.2 DOCUMENTATION .......................... ......................................... ............................ ............................ ............................ ............................ ............................ ............................ ............................ .............. 124 17.1.3 TECHNICAL ........................... ........................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ....................... ......... 125 17.2 SECURITY ............................ ......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................ ................ .. 125 17.2.1 GENERAL .......................... ........................................ ............................ ............................ ............................ ............................ ............................ ............................ ..................... ....... 125 17.2.2 CLIENT ACCESS .......................... ........................................ ............................ ............................ ............................ ............................. ............................. ........................... ............. 126 17.2.3 EMPLOYEES ACCESS .......................... ......................................... ............................ ............................ ............................ ............................. ............................ ............. 126 17.3 ADMINISTRATION HIERARCHY ........................... .......................................... ............................. ............................ ............................ ............................ ......................... ........... 126 17.3.1 SYSTEM ADMINISTRATORS ........................... 17.3.2 NETWORK SECURITY ........................... ......................................... ............................ ............................ ............................ ............................. ............................. .................... ...... 127 17.3.2 N .......................................... ............................ ............................. ............................. ............................ ............................ ............................ ......................... ........... 127 17.3.3 BACKUP ............................ ........................................... ............................. ............................ ............................ ............................ .................. .... 128 17.3.3.1 BUSINESS CONTINUITY ............................ 18. SCOPE CHANGE DUCUMENTATION .......................... ........................................ ............................ ............................. ............................. ............................ ............................ ......................... ........... 129 ........................................ ............................ ............................. ............................. ............................ ............................ ......................... ........... 129 18.1 SCOPE CHANGE PROCEDURE .......................... .......................................... ............................. ............................ ............................ ............................ ............................ .................. .... 131 18.2 SCOPE CHANGE R EQUEST EQUEST FORM ........................... 19. R EFERENCES .......................................... ............................. ............................ ............................ ............................ ............................ ............................ ............................. ............................ ............... .. 133 EFERENCES ...........................
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1. Executive Summary
The Veteran’s Health Administration provides physical and mental health services to veterans across the country. With two recent wars the VA has seen a growth growth in the number of patients they are servicing per year. A growing number of these patients are located in rural areas making treatment difficult difficult for both the patient and the VA. To address this issue the VA has deployed community-based outpatient clinics (CBOC) (CBOC) in many of these rural areas. This provides the patients with a more local means of accessing the health services by using the CBOC as satellite offices of the VA. While the CBOCs greatly increase the patient satisfaction, the VA has iden tified a few ar eas eas of inefficiency inefficiency that need to be addressed. The VA’s VA’s primary concern is with how therapy treatments for post-traumatic post-traumatic stress disorder (PTSD) are handled. One of the primary treatments for PTSD is counseling sessions with professional professional therapist on a routine basis. basis. These therapists specialize in this field and are often based in more urban areas making it difficult to fill these positions with local personnel. This in turn creates the situation where the therapists are driving an average of 4 hours h ours per day of session which is leading leadin g to low patient workloads and high transportation costs. Along with this, the VA has also identified a general inefficiency in how data is stored and accessed within within these locations. The current methods include hand written written files mixed with loosely organized digital records, which often creates wasted time and inaccuracies. The VA has contracted 4guys 4gu ys Consulting to design a system that addresses these concerns by producing a more cost effective and efficient solution. Our consulting firm consists consists of 25 highly trained staff members with over 15 years of experience in database design, system s ystem
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design and deployment, system system automation, hardware integration, and network security. 4guys Consulting has designed a pilot system to be b e deployed at a single CBOC for evaluation of effectiveness that will hopefully be deployed for all CBOC locations locations in the following years. years. The pilot system consists of a video conferencing system that will link link the CBOB via secured connection to the nearest VA with with a staffed therapist. Patients will enter a room at the CBOC, login and begin their counseling sessions without the need for the therapist to travel to the CBOC. At the end of the session, session, the patient will automatically be prompted to schedule their next appointment via the automated scheduling feature. This system will work in conjunction with a database system that will allow the therapist to access/update patient records, prescribe and E-sign for medication, link prescribed medication directly to the CBOC pharmacy, allow for managerial reporting, and automate billing information entries such as session length. The VA has set a “not to exceed” limit for this project of $175,000.00. $175,000.00. The project project is set to begin on April 15, 2013 and span span a six-month period. The scope of the project is as follows: In Scope
Audio visual capability for mental providers and veterans. Database for storing veterans’ case history and management reports. Interface with Pharmacists at CBOC for prescriptions Report for possible implementation across other CBOC’s Source code for database and software solutions Testing of system Systems diagrams for business processes Systems diagrams for VA IT specialists Training for end-users
Out of Scope
Integration for existing software for this new system Long term maintenance and support of system Database management and warehousing Upgrading of CBOC computer infrastructure
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By eliminating the need to travel, the new system will increase the therapist capable patient workload by a minimum of 10%. The project will provide a unified system for tracking and updating patient records that meets all HIPPA requirements. It will increase increase the efficiency of the entire CBOC by automating many areas of internal business allowing for a reduction in onsite staff. These decreases in staff, travel time, and increased patient turnover will give a minimum of 5% overall operations savings at each CBOC location. Most importantly, the new system will allow the growing number of patients with PTSD P TSD to receive their needed therapy therap y in a timely manner and reduce their time on site from a 2 hour average to roughly 1 hour and 15 minutes. Patients will no longer longer have to wait for their therapist to make his/her rotation to their location, and will have more control over their session scheduling.
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2. Project Charter
Project Name
Tele-Health Veterans
Project Manager Owner(s)
Mission
Scope
P-0003
Gary Fenton
Project Number Prioritization
Veteran’s Administration
Start Date:
April 15,2013
Scheduled Completion Date:
July 26,2013
Medium
The development of a tele-health tele-health system for a CBOC in the Veterans’ Affairs. The competition of the project will be July 26, 2013 and should cost no more than $175,000.
Deliverables as defined by VA: 1. 2. 3. 4. 5. 6. 7. 8. 9.
Audio visual capability for mental providers and veterans. Database for storing veterans’ case history and management reports. Interface with Pharmacists at CBOC for prescriptions Report for possible implementation across other CBOC’s Source code for database and software solutions Testing of system Systems diagrams for business processes Systems diagrams for VA IT specialists Training for end-users
Items that are NOT to be included in this project: 1. 2. 3. 4.
Integration for existing software for this new system Long term maintenance and support of system Database management and warehousing Upgrading of CBOC computer infrastructure
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2.1 Objectives
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The objective of this project is assist the VA in expanding its health care services to veterans: 1. Increase time available for mental health services by 10% 2. Eliminate therapist traveling to CBOC 3. Increase tracking of psychoanalyst drug prescriptions h ealth 4. Decrease travel time of veterans to receive mental health 5. 5% decrease overall therapy expenses This will be accomplished by creating video conferencing for veterans and mental health care providers. A database to track case history and mediation history for veterans. The budget for this project will be $175,000, $ 175,000, and is set to begin on April 15, 2013 and be completed and operational by July 26, 2013.
2.2 Assumptions
1. CBOC computer network infrastructure infrastructure will be able to to handle the video conferencing workload without slowing down the current network. 2. All veterans receiving services services will be from within within the state the services services are being offered. 3. Database will be stored on VA intranet. 4. Increase patient work work load
2.3 Constraints
Equipment purchase and installation must be conducted no later than three months into the project. The budget will not exceed $175,000. Database and video conferencing data transmissions must be secured.
2.4 Cost/Financial Assumptions
2.5 User Acceptance Criteria/Quality
2.6 Major Risks
The VA sponsor will will be providing all funding for for the project. A 5% cost increase of quoted project cost is to be allotted for any fluctuation in market prices during the course of the project.
User will adhere to all HIPPA compliance codes for digital information storage of case file records. Network must be able to maintain mai ntain a 300 Mbits transfer rate for video and data conferencing.
Major areas of risk network and database security. Unauthorized access to case history information in violation of HIPPA. Current infrastructure unable to handle tele-health solution Physiologist unwilling/uncomfortable using video conferencing for therapy.
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Project Core Team:
Subject Matter Experts (SME) ( Include Include company & channel designations if applicable)
2.7 KEY STAKEHOLDERS Name Gary Fenton Timothy Glennon Matthew Powers Michael White
Project Core Team consists of 4 guys consulting and augmented by VA representatives. All other external experts will be selected as needed.
Type Name Project Manager Approval:
Owner/Sponsor Approval:
APPROVALS Signature
Date
11
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3. Project Value Statement
The Veterans Health Administration’s deployment of community-based community-based outpatient clinics (CBOC) in rural areas is creating situations where the qualified personnel are traveling long distances in order to counsel patients at these sites. sites. This scenario is increasing therapy costs and decreasing the capable workload of the therapists treating patients with post-traumatic stress disorder (PSTD). In order to more more efficiently treat the growing growing number of patients with PSTD, the VA has begun to look into a video conferencing system deployed at the CBOC location to connect the patients with the counselors at a remote location and link this system into a database datab ase that would allow increased functionality and patient turnover at a decreased cost. A recent study published by the Congressional Con gressional Budget Office sampled nearly a half a million veterans over six years to determine the costs of treatment for PTSD and traumatic brain injury (TBI). The study showed that of the sampling sampling 21% of the veterans suffered suffered from PTSD and 5% suffered from TBI. In the first four years of the study $2.2 billion was spent spent on treatment of patients with PSTD and TBI, with $1.1 billion billion dedicated to therapy treatment. On average PTSD patients yearly costs were $8,300 per patient while the average patient was $2,400. (Cushman, 2012) These staggering numbers begin to point to a need to more efficiently efficiently handle therapy to these patients, and present a large window to cut costs by implementation of newer technologies like video conferencing, tele-presence, and a unified patient database to streamline the entire treatment process. In these remote locations, qualified therapists often see travel times of 2 hou rs in both directions which equates to 4 hours hou rs travel time per visit. visit. A therapist’s therapist’s average rate is $120-$170 $120-$170 per session hour depending on the state in which the CBOC resides with average sessions being
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45-60 minutes. This means the travel time alone reduces the potential workload of the therapist by 4 patients at a cost of $480-$680 per day of sessions. The VA also pays the travel expense of the therapist, which include car rentals and fuel. By eliminating these costs and increasing patient load potential, the new system will offer a minimal savings of 5% and increase the patient throughput by a minimum of 10%. 10%. Given the above study’s stated stated $1.1 billion spent on therapy over 4 years and the anticipated 5% overall savings projected, this equates to a savings of $13.75 million per year if the proposed pilot system was fully implemented throu ghout the country. The new system will also increase patient satisfaction satisfaction in a number of ways. ways. The system will allow the patient to schedule appointments while at the CBOC without the need to call in. This also reduces the workload on staff that would normally handle these calls. The prescription features of the system will allow the therapist to prescribe medication during the session and Esign the prescription sending it into the system and making it immediately accessible by the CBOC pharmacy. This will make prescriptions prescriptions available at the end of the session greatly reducing the patients’ time at the location, and increasing the number of patients that can c an be cycled through the system per day by 10%. The VA is also subject to audit which with no electronic files can often be very time consuming as well as lead lead to inaccuracies. The accounting portion of the system system will automate much of the billing data such as length of session session for more reliable time billing. The new system will ensure that all audited files are easily accessible and accurate. The issues related to paper files is leading the push for all physical health records to be digitized digitized by 2013. Though this does not directly affect mental health patients at this time, it is expected to expand to include mental health records in the following years which would put the VA ahead of the curve and prepared for this transition.
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The CBOC locations currently employ an average of 15 people. The new system will not only make the CBOC more capable of handling more patients due to the decreased patient time at location, it will also allow for a reduction of 2 staff members per location. Currently the billing department at each location employs 3 staff members. The new system will automate much of the data collection for the billing process eliminating the need for the third staff member. Since the new system will also allow the patients to handle their own appointment scheduling and prescriptions will now go directly from the therapist to the pharmacy, there will be a decrease in workload on the receptionist thus a reduction of one member will be feasible without affecting the flow of patients.
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4. Project Strategy Statement
Create a tele-health pilot system to be deployed deplo yed at a single CBOC location linking link ing veteran patients at the CBOC CBOC to a therapist at the VA. The system will increase increase patient satisfaction and the CBOC’s efficiency level for PTSD treatment b y allowing therapists to carry 10% larger workloads, decrease patient time on site, reduce overall costs by 5%, increase ease of data management, and create a more efficient data flow within the CBOC. 5. Project Methodology
5.1 Project management Methodology
4guys Consulting has decided to use the Waterfall Model as the methodology for this project. Waterfall is a system development life cycle (SDLC) that uses uses 5 key phases during the project in sequential order. These phases include requirements analysis, design, implementation, testing (validation), integration, and maintenance and can be expanded to include sub-phases if necessary. Waterfall is a methodology that relies heavily on well-defined requirements for system requirements. (Ganeshan, (Ganeshan, 2011) This methodology also works best when the team has much experience with similar projects, thus giving them a firm grasp on possible risk areas and which requirements may need to be changed or modified prior to moving into the design phase. This matches up to the current current project for several reasons. First 4guys Consulting has developed multiple tele-health solutions for customers over the last 5 years and has th e experience to identify problem areas early on in the requirement analysis analysis phase. Along with this, the VA has performed a full analysis of their business problem prior to to contracting 4guys Consulting and has established a firm set of requirements for the new system. Waterfall is also well suited for for less complex projects that operate under relatively relatively short timeframes. timeframes. These factors inherently leave
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little room for requirement changes to develop, which often plagues projects that extend out ou t to a year or longer thus necessitating necessitating a more flexible methodology. The proposed system is a relatively simple system due to the fact that it is a pilot system and will not be fully integrated into the existing software and is scheduled to be b e completed in six months. One methodology that was considered by b y 4guys Consulting was the SCRUM methodology. SCRUM allows for the project to be broken down into into subsections that address key requirements of the project which are built b uilt by multiple teams working simultaneously while being over watched by a single project leader referred to as the SCRUM master. Each subsection of the project would be completed by the team before that team moves to another subsection. This method allows for small portions of the the project to go online even before the the project is complete allowing the stakeholders to begin seeing benefits prior to completion of the entire system. SCRUM is most often often used on large projects with with loosely developed requirements because of its flexibility. SCRUM also requires a large number of resources due to the fact that the project is broken down to multiple multiple teams. (Uhlig, 2012) Though the current project could easily be broken down into these requirement categories, its relative simplicity does not necessitate this method. Also the VA would not see a substantial benefit to deploying partial segments of the overall system. system. The primary concern when discussing this methodology amongst the 4guys Consulting team was the concern of mitigating over complication of the subsystems. With SCRUM it is more likely that that the subsystems would grow in complexity in order to give them a higher deployment value while the rest of the system s ystem was being developed. This would lead to added expenses and prolong the project schedule.
MIS 600 Capstone
5.2 Work Breakdown Structure (WBS)
Hardware and Software Implementation Project (VA System) 1.1 Scope 1.1.1 Determine project scope 1.1.2 Secure project sponsorship 1.1.3 Define resources 1.1.4 Secure core resources 1.1.5 Scope complete 1.2 Analysis/Hardware and Software Requirements 1.2.1 Conduct needs analysis 1.2.2 Draft preliminary software specifications 1.2.3 Draft preliminary hardware specifications 1.2.4 Develop preliminary budget 1.2.5 Review software specifications/budget with team 1.2.6 Review hardware specifications/budget with team 1.2.7 Incorporate feedback on software and hardware specifications s pecifications 1.2.8 Develop delivery timeline 1.2.9 Obtain approvals to proceed (concept, timeline, budget) 1.2.10 Test existing network capacity to establish baseline 1.2.11 Secure required resources 1.2.12 Analysis complete 1.3 Design 1.3.1 Review preliminary software specifications 1.3.2 Review preliminary hardware specifications 1.3.3 Develop functional specifications 1.3.4 Review functional specifications 1.3.5 Incorporate feedback into functional specifications 1.3.6 Obtain approval to proceed 1.3.7 Develop software system 1.3.8 Develop database 1.3.9 Design complete 1.4 Implementation 1.4.1 Project kick off meeting 1.4.2 Identify possible locations 1.4.3 Assign development staff 1.4.4 Procure hardware and software 1.4.5 Implement system 1.4.6 Implementation complete 1.5 Testing 1.5.1 Testing 1.5.1.1 Develop unit test plans using product specifications 1.5.1.2 Develop network integration test plans using product specifications 1.5.2 Unit Testing
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1.5.2.1 Review coding 1.5.2.2 Test component modules to product specifications 1.5.2.3 Identify anomalies to product specifications 1.5.2.4 Modify coding 1.5.2.5 Re-test coding 1.5.2.6 Unit testing complete 1.5.3 Network 1.5.3 Network Integration Testing 1.5.3.1 Test module integration 1.5.3.2 Compare network usage to baseline 1.5.3.3 Identify anomalies to specifications 1.5.3.4 Address network anomalies 1.5.3.5 Network 1.5.3.5 Network integration testing complete 1.6 Training 1.6.1 Develop training specifications for end users 1.6.2 Develop training specifications for helpdesk support staff 1.6.3 Identify training delivery methodology (computer based training, classroom, etc.) 1.6.4 Develop training materials 1.6.5 Finalize training materials 1.6.6 Develop training delivery mechanism 1.6.7 Training materials complete 1.7 Maintenance 1.7.1 Create software maintenance team 1.7.2 Create hardware maintenance team 1.7.3 Update user manuals 1.7.4 Update help documentation 1.7.5 Continuous feedback from users for improvement 1.8 Pilot 1.8.1 Finalize location 1.8.2 Develop software delivery mechanism 1.8.3 Install/deploy hardware and software 1.8.4 Obtain user feedback 1.8.5 Evaluate testing information 1.8.6 Pilot complete 1.9 Post Implementation Review 1.9.1 Document lessons learned 1.9.2 Distribute to team members 1.9.3 Post implementation review complete 1.9.4 Hardware and software development template complete
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6. Business Requirements and Rules
6.1 Table 1 – Actor Glossary Term
Synonym
Description
Veteran
War Veteran, Service Member
A person who has served or is serving in the armed forces and eligible to receive VA benefits.
Therapist
Psychologist, Social Worker
A Veteran’s Administration licensed mental health provider who performs mental health services for veterans.
Management
Supervisor, Clinical Supervision, Administrative Officer
Oversees therapists and gives consulting and advice for harder mental health cases. Monitors budgets, workloads, and manpower requirements to operate the CBOC.
Pharmacist
Pharmacologist
A person who is licensed and educated in the therapeutic use, toxicology, composition, and administration of drugs.
Audit Services
Internal Audit Agency in the VA who performs annual inspection and services to address congressional investigations.
Billing Services
VA’s financial accountant and budget managers who track billing for insurance and federal reporting requirements.
Time
An actor responsible for triggering temporal events
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6.2 Context Diagram
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6.2 Use Case Glossary Use-Case Name
Use-Case Description
Participating Actors and Roles
Automatically/Ma nually Schedule Appointment
This use-case describes the process of a veteran or management scheduling an appointment
Veteran (External)
Email Appointment Time
This use-case describes the system’s ability to send an email confirmation of appointment.
Veteran (External) Video Conferencing
Access Video Conference
This use-case describes the processing using the video conferencing services for sessions. This use-case describes the process of the system to tack billing hours. This use-case describes how the system will send the appropriate information to audit services upon request. This use case describes the ability of the therapist to enter case history of a veteran into the system. This use-case describes the process of viewing prescriptions and reporting history of prescriptions. This use-case describes the report generation of monthly billable hours reports for upper management. This use-case describes a therapist case load of client on a weekly basis.
Veteran (External)
This describes the process of generating case histories of tougher cases for therapist and supervisor to review for learning and training purposes.
Therapist (Internal)
Billing Hours
Audit Reports
Enter Case History
Pharmacy Drug History
View Monthly billable hours
Following week patient report
Create Case History Reviews
Therapist
(Internal)
w Therapist (Internal) Billing Services (Internal)
w Audit Systems (Internal)
Therapist
Therapist (Internal) Pharmacist (Internal)
Veteran (External)
Management (Internal)
Therapist (Internal) Management (Internal)
Management (Internal)
MIS 600 Capstone
Enter New Patient
Change Scheduling and Billing hours Case History workload reports.
This describes the process of management entering a new client into the system. This describes the process of management to change scheduling and billing. This describes the process of generating case history workload report for the month.
Management (Internal)
Management (Internal)
Management (Internal)
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March 29, 2013
Veterans Use Case Diagrams
Tele-Health System
Schedule System Accounting Email Appointment Time
Schedule Appointment Time Billing Services
Time Billing Hours Automatically schedule appointment
Manually schedule appointment
Audit Reports Audit Systems
Veteran
View Monthly Billable Hours
Video Conferencing
Access Video Conference
Medical Record Following week patinet report Pharmacist
Enter Case History
Pharmacy Pysotropic Drug History
Case History Workload Report
Therapist
Create Case History Reviews
Managment
Manually change Biilling Hours
Enter New patient
Page 1
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6.5 Use Case Narrative Author: Matthew Powers Use-Case Name Use-Case ID Priority Source
Date: 3/24/2013 Version: 1 Create Case History Reviews HJ-01 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Therapist, Manager
Precondition Trigger Typical Course of Events
Use-Case Type Business Requirements:
This describes the process of generating case histories of tougher cases for therapist and supervisor to review for learning and training purposes. User must be logged in into the system This use case is initiated when a user enters system s ystem and presses “Case History review” from main menu. Actor Action
System Response
Step 1: User selects the appropriate client’s names from selection menu
Step 2: System searches for case history notes upon selected client/clients and returns case history notes in dated order from Step 3: User selects whether to newest to oldest. Bottom of screen print case history or create a pdf is display “print” or “create pdf” file. Step 4: System prompts user to search for other clients or exit Alternate Courses:
Alt-Step 4a: If the user input “search” clients the program will return to Step 1.
Alt-Step 4b: If the user selects “exit” then the system will return to main menu.
MIS 600 Capstone
Conclusion:
The use case concludes when the user has viewed or printed case history.
Post-Condition:
The system will return to main menu.
Business Rules
Case History can be viewed by internal user.
Implementation Constraints and Specifications
View Case History reports can only be viewed by therapist and management.
Assumptions
N/A
Open Issues
N/A
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Author: Matthew Powers Use-Case Name Use-Case ID Priority Source
Date: 3/24/2013 Version: 1 Change Billing Hours HJ-02 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Management
Precondition Trigger Typical Course of Events
26
Use-Case Type Business Requirements:
This describes the process of management to change chan ge billing. User must be logged in into the system This use case is initiated when a user selects the option o ption to change billing hours. Actor Action Step 1: User selects the option to change billing hours.
System Response Step 2: System prompts user to specific which week they would like to change billing hours.
Step 3: User inputs which week Step 4: System displays users they would like to change desired week of billing hours and billing hours prompts user to confirm week with “yes” or “no” prompt. Step 5: User selects verification. Step 6: System opens billing hours edit menu and has a save button on the bottom of screen. Step 7: User edits billing hours and clicks save. Step 8. Systems prompts user if they want to save changes. Displays “save” and “cancel”.
Alternate Courses:
Step 9: System returns to main menu. Alt-Step 4a: User selects yes go to step 5.
Alt Step 4b: User selects no the system returns to step 2.
MIS 600 Capstone
Alt-Step 8a: User selects save then system saves edits and returns to main menu.
Alt-Step 8b: Selects “cancel” then system returns to step 6.
Conclusion:
The use case concludes when system stores the changes.
Post-Condition:
The system returns to main menu.
Business Rules
Management is the only one who can view change billing hours.
Implementation Constraints and Specifications
Management is the only who has access to the change billing hours menu.
Assumptions
N/A
Open Issues
N/A
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MIS 600 Capstone
Author: Matthew Powers Use-Case Name Use-Case ID Priority Source
Date: 3/24/2013 Version: 1 Change Scheduling Hours HJ-03 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Management
Precondition Trigger Typical Course of Events
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Use-Case Type Business Requirements:
This describes the process of management to change chan ge scheduling. User must be logged in into the system This use case is initiated when management selects change c hange scheduling from the man menu. Actor Action
System Response
Step 1: User selects the option to change scheduling hours.
Step 2: System prompts user to specific for which week to change scheduling hours.
Step 3: User inputs which week of hours to change.
Step 4: System displays users desired week of scheduling hours and prompts user to confirm week with “yes” or “no” prompt.
Step 5: User selects yes or no.
Step 6: System week of scheduling hours edit menu and has a save button on the bottom of screen.
Step 7: User edits scheduling hours and clicks save.
Alternate Courses:
Step 8. Systems prompts user if they want to save changes. Displays “save” and “cancel”.
Step 9: System returns to main menu. Alt-Step 4a: User selects yes go to step 5.
Alt Step 4b: User selects no the system returns to step 2.
MIS 600 Capstone
Alt-Step 8a: User selects save then system saves edits and returns to main menu.
Alt-Step 8b: Selects “cancel” then system returns to step 6.
Conclusion:
The use case concludes when system the new scheduling hours.
Post-Condition:
The system returns to the main menu.
Business Rules
Management can only see change scheduling hours in main menu.
Implementation Constraints and Specifications
Management is the only user allowed access to change scheduling.
Assumptions
N/A
Open Issues
N/A
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Author: Matthew Powers Use-Case Name Use-Case ID Priority Source
Date: 3/24/2013 Version: 1 View Monthly Billing Hours HJ-04 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Management
Precondition Trigger Typical Course of Events
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Use-Case Type Business Requirements:
This describes the process of management to view monthly billing hours. User must be logged in into the system This use case is initiated when user selects the view monthly billing hours from main menu. Actor Action
System Response
Step 1: User selects the appropriate client’s names from selection menu
Step 2: System searches for case history notes upon selected client/clients and returns case history notes in dated order from Step 3: User selects whether to newest to oldest. Bottom of screen print case history or create a pdf is display “print” or “create pdf” file. Step 4: System prompts user to search for other clients or exist
Alternate Courses:
Alt-Step 4a: If the user input “search” clients the program will return to Step 1.
Alt-Step 4b: If the user selects “exist” then the system will return to main menu.
Conclusion:
The use case concludes when users prints or views the billing hours.
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Post-Condition:
The system returns to main menu.
Business Rules
Only management can view the view billing hours.
Implementation Constraints and Specifications
Only management user will have view billing hours displayed in main menu.
Assumptions
N/A
Open Issues
N/A
MIS 600 Capstone
Author: Matthew Powers Use-Case Name Use-Case ID Priority Source
Date: 3/24/2013 Version: 1 Enter Case History HJ-05 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Therapist
Precondition Trigger Typical Course of Events
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Use-Case Type Business Requirements:
This describes the process of management to change chan ge scheduling. User must be logged in into the system s ystem This use case is initiated when a therapist selects the option to enter case history notes for client. Actor Action Step 1: User selects the option to enter case history notes from main menu. Step 3: User selects new or current client.
System Response Step 2: System prompts user for new or current client. Step 4: System opens a blank data block and block for date and time for client. Menu at bottom of page has a save button.
Step 5: User enters notes into Step 6: System saves data into data block and date and time and database using name, date, and time presses save. as index.
Alternate Courses:
for client’s Alt-Step 4a: User selects new and the system prompts for client’s name. for client’s Alt-Step 4b : User selects current client. System prompts for client’s name.
Conclusion:
The use case concludes when user presses “save” and information is transferred to database.
Post-Condition:
The database is updated and the user is returned to the main menu.
MIS 600 Capstone
Business Rules
Only Therapist can enter the notes.
Implementation Constraints and Specifications
Therapist is the only user to enter case history on the main menu.
Assumptions
N/A
Open Issues
N/A
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Author: Matthew Powers Use-Case Name Use-Case ID Priority Source Primary Business Actor Other Participating Actors Other Interested Stakeholders Description Precondition Trigger Typical Course of Events
Date: 3/24/2013 Version: 1 Enter Pharmacy Drug information HJ-06 High Requirements Analysis
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Use-Case Type Business Requirements:
Therapist Pharmacist
This describes the process of a therapist to enter drug prescriptions. User must be logged in into the system This use case is initiated when therapist selects enter drug prescriptions. Actor Action
System Response
Step 1: User selects enter drug prescriptions.
for client’s Step 2: System prompts for client’s name.
Step 3: User enter client’s name.
Step 4: System accesses database and displays medication history and blank section for new entry of drug. The bottom of screen displays “save”.
Step 5: User enters drug prescription information and presses save.
Step 6: Medications is entered into database and an email notification no tification is sent to pharmacist with updated prescription. Alternate Courses: Conclusion:
The use case concludes when system stores the new medication information in the database and pharmacist is notified of prescription update.
Post-Condition:
The system returns to main menu.
Business Rules
Only Therapist may enter information and Pharmacist may view the information.
Implementation
Therapist is the only with access to enter prescriptions.
MIS 600 Capstone
Constraints and Specifications Assumptions
N/A
Open Issues
N/A
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MIS 600 Capstone
Author: Matthew Powers Use-Case Name Use-Case ID Priority Source Primary Business Actor Other Participating Actors Other Interested Stakeholders Description Precondition Trigger Typical Course of Events
Date: 3/24/2013 Version: 1 Case History Workload Reports HJ-07 High Requirements Analysis
Use-Case Type Business Requirements:
Management
This describes the process of view case history workload. User must be logged in into the system This use case is initiated when a user selects the option o ption to view case history workload. Actor Action Step 1: User selects the case history workload. Step 3: User selects whether to print case history workload or save a pdf file.
Alternate Courses:
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System Response Step 2: System displays manpower hours for weekly and monthly case histories for each therapist. Screen shows “pint” or “save to pdf” Step 4: System exits to main menu upon completing user action.
Alt-Step 4a: User presses print and system sends report to printer.
Alt-Step 4b: User presses save to pdf and system creates pdf report on users’ desktop. Conclusion:
The use case concludes when report is printed or saved as a pdf.
Post-Condition:
The system returns to the main menu.
Business Rules
Only management may access case history workload.
Implementation
Only management has the “case history workload” on main screen.
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Constraints and Specifications Assumptions
N/A
Open Issues
N/A
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Author: Michael White Use-Case Name Use-Case ID Priority Source
Date: 3/23/2013 Version: 1 View weekly billing hours HJ-08 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Management, Billing Services
Precondition
Trigger Typical Course of Events
Alternate Courses:
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Use-Case Type Business Requirements:
Auditing Services
This describes the process of management to view weekly billing hours. 1. User must be logged in into the system 2. User credentials meet security level to view information 3. Weekly hours have finished for week requested This use case is initiated when a user selects the option o ption to view weekly billing hours. Actor Action
System Response
Step 1: User selects the option to view weekly billing hours
Step 2: System opens the screen “Enter week to be viewed (MMDDYYYY)”
Step 3: User enters the week to be viewed in the appropriate format.
Step 4: System returns summation of the requested week’s billable hours. System gives gives the option to print report, return to previous screen, or exit weekly billing hours.
Step 5: User selects exit.
Step 6: System closes weekly billing hours and returns to main options screen
Alt-Step 5a: User selects “previous” system returns to step 2.
Alt-Step 5b : User selects “print” system sends report to local printer and waits on current screen for user to select “previous” or “exit”.
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Conclusion:
The use case concludes when user has viewed or printed all the desired reports and selects exit.
Post-Condition:
System returns to main options screen.
Business Rules
Only management, Billing services, and Audit services can view weekly billing hours
Implementation Constraints and Specifications
GUI to be provided for management and billing services from main options screen.
Assumptions
N/A
Open Issues
N/A
MIS 600 Capstone
Author: Michael White Use-Case Name Use-Case ID Priority Source
Date: 3/23/2013 Version: 1 Enter new patient HJ-09 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Management
Precondition
Trigger Typical Course of Events
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Use-Case Type Business Requirements:
This describes the process of management entering a new n ew client into the system. 1. User must be logged in into the system 2. User credentials meet security level to view information 3. Patient does not exist in system. This use case is initiated when the user selects “Enter new n ew patient” from main option screen. Actor Action Step 1: User selects the option to Enter new patient from main option screen.
System Response Step 2: System opens screen to enter patient’s information: Last Name First Name Address Phone Insurance information With “Verify” and “Exit” options at the bottom of screen.
Step 3: User enters the patient information and clicks Verify.
Step 5: User reviews information and clicks submit.
Alternate Courses:
Step 4: System verifies that the patient is not currently in the system and returns a summation of entered information with “Submit” and “Edit” at bottom of screen. Step 6: System stores the user information and returns “patient added” dialog box before returning to main option screen.
Alt-Step 3a: User selects “Exit” system returns to main option screen.
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Alt-Step 4a: Patient information is already in the system, system returns “Patient already exists” dialog dialog box and exits to main option screen.
Alt-Step 5a: User selects “Edit”, system returns to step 2 with previously entered information still in information information fields to allow editing.
Conclusion:
The use case concludes when user clicks exit or successfully enters a new patient into the system.
Post-Condition:
New user information is stored into the database.
Business Rules
Only management can add a new patient into the system.
Implementation Constraints and Specifications
GUI to be provided for management from main options screen.
Assumptions
N/A
Open Issues
N/A
MIS 600 Capstone
Author: Michael White Use-Case Name Use-Case ID Priority Source
Date: 3/23/2013 Version: 1 Following week patient report HJ-10 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Therapist, Management
Precondition
Trigger Typical Course of Events
Alternate Courses:
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Use-Case Type Business Requirements:
Auditing Services
This use-case describes a therapist case load of client on a weekly basis. 1. User must be logged in into the system 2. User credentials meet security level to view information 3. Weekly scheduling is is complete. This use-case use-case is initiated when the user selects “Following week patient report” from the main option screen. Actor Action
System Response
Step 1: User selects the option to view following week patient report.
Step 2: System returns screen to request therapist ID of the therapist’s schedule the user wishes to view or “Exit”.
Step 3: User enters the therapist’s ID.
Step 4: System validates therapist’s ID and returns the schedule for that therapist. System gives the option to “Print”, “Previous”, “Exit”
Step 5: User views report and clicks exit.
Step 6: System exits to main option screen.
Alt-Step 2a: User selects exit, system exits to main options screen.
Alt-Step 4a: Therapist ID is invalid, system returns “invalid therapist ID” and returns to step 2.
Alt-Step 4b : User selects “Print”, system prints schedule and waits for
MIS 600 Capstone
user to select previous or exit.
Alt-Step 4c: User selects “Previous”, system returns to ste p 2.
Conclusion:
The use case concludes when user has viewed/printed all needed schedules and clicks exit.
Post-Condition:
System returns to main options screen.
Business Rules
Schedule can be viewed by any internal user.
Implementation Constraints and Specifications
GUI to be provided for internal users from main options screen.
Assumptions
N/A
Open Issues
N/A
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Author: Michael White Use-Case Name Use-Case ID Priority Source Primary Business Actor Other Participating Actors Other Interested Stakeholders Description Precondition
Trigger Typical Course of Events
Alternate Courses:
Date: 3/23/2013 Version: 1 Automatically Schedule appointment HJ-11 High Requirements Analysis
44
Use-Case Type Business Requirements:
Veteran Therapist, End of Session
This use-case describes the process of a veteran or management scheduling an appointment 4. User must be logged in into the system 5. User credentials meet security level to view information 6. Veteran and therapist must exist in the system. This use case is initiated automatically when a counseling co unseling session ends. Actor Action
System Response
Step 1: Veteran or therapist ends the counseling session.
Step 2: System prompts veteran to schedule next appointment and provides a list of available dates and times. times. System provides a button to “schedule later”.
Step 3: Veteran selects available time from list and selects schedule.
Step 4: System returns a verification screen with options to verify appointment or edit.
Step 5: User verifies appointment.
Step 6: System updates schedule database, initiates timer for automated reminder system, and closes automated scheduler.
s ystem closes. Alt-Step 3a: Veteran selects option to schedule later, system
to edit, system system returns to step 2. Alt-Step 5a: Veteran selects to
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Conclusion:
The use case concludes when user has scheduled and verified next appointment.
Post-Condition:
System updates schedule database, initiates timer for automated reminder system.
Business Rules
Scheduler must only initiate if veteran remains logged in after session.
Implementation Constraints and Specifications
GUI to be provided to veteran after a session ends. GUI will automatically close after 2 minutes of inactivity to ensure patient does not remain logged in by prematurely leaving leavin g session room.
Assumptions
N/A
Open Issues
N/A
MIS 600 Capstone
Author: Michael White Use-Case Name Use-Case ID Priority Source Primary Business Actor Other Participating Actors Other Interested Stakeholders Description Precondition
Trigger Typical Course of Events
Date: 3/23/2013 Version: 1 Manually Schedule appointment HJ-12 High Requirements Analysis
46
Use-Case Type Business Requirements:
Management Therapist
This use-case describes the process of a management manually m anually scheduling an appointment. 1. User must be logged in into the system 2. User credentials meet security level to view information 3. Veteran and therapist must exist in the system. This use case is initiated when user selects the “manually “manuall y schedule appointment” from main options screen. Actor Action
System Response
Step 1: Management selects the manually schedule appointment option from main screen.
Step 2: System requests the therapist ID. ID. The system system also offers an “Exit” option at the bottom of the screen.
Step 3: Management enters therapist ID.
Step 4: System returns a list of available appointment times for that therapist. therapist. System provides a “Previous” button to allow user to select a different therapist.
Step 5: Management selects a time.
Step 6: System requests the patient ID of the patient that the appointment is for, and provides a “previous” and “OK” button.
Step 7: Management enters patient ID and selects OK.
Step 8: System gives a verification screen with all information to be added to schedule database with the option to “verify” or “edit”.
Step 9: Management selects
Step 10: System returns
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verify.
Alternate Courses:
“Appointment has been scheduled” dialog box, updates schedule database with new information, initiates automated reminder, and exits to main option screen. Alt-Step 3a: Managements selects exit, system exits to main screen.
system returns Alt-Step 4a: Management has entered an invalid ID, system invalid ID dialog box and returns to step 2.
Alt-Step 5a: Management selects previous, system returns to step 2.
Alt-Step 7a: Management selects previous, system returns to step 4.
Alt-Step 8a: Management enters invalid patient ID, system returns invalid ID dialog box and returns to step 6.
Alt-Step 9a: Management selects edit, system returns to step 2. Conclusion:
The use case concludes when management has verified the appointment
Post-Condition:
System updates schedule database, initiates timer for automated reminder system.
Business Rules
Manual scheduler must only be accessible by management. Therapist will be granted partial management access to their schedules only. In this case their therapist ID will be permanent in step 2 preventing them from entering alternative therapists ID.
Implementation Constraints and Specifications
GUI to be provided to management mana gement at main options screen.
Assumptions
N/A
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Open Issues
N/A
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Author: Michael White Use-Case Name Use-Case ID Priority Source Primary Business Actor Other Participating Actors Other Interested Stakeholders Description Precondition
Trigger
Date: 3/23/2013 Version: 1 E-mail Appointment Reminder HJ-13 Low Requirements Analysis
49
Use-Case Type Business Requirements:
Veteran, Time
This use-case use-case describes the system’s ability to send an email confirmation of appointment. 1. User must be logged in into the system 2. User credentials meet security level to view information 3. Weekly hours have finished for week requested This use case is triggered by the system clock 2 days prior to the veteran’s appointment.
Typical Course of Events
Actor Action
System Response
Step 1: System clock reaches 48 hours prior to a scheduled appointment
Step 2: System automatically sends reminder e-mail to patients with a “do not respond” message stating the appointment time, therapist’s name, and patient name.
Alternate Courses:
N/A
Conclusion:
The use case concludes when the system confirms a successful reminder has been sent.
Post-Condition:
N/A
Business Rules
Reminder must contain patient name, therapist name and appointment time only in order to mitigate any information leakage risk. No other patient information should be sent.
Implementation Constraints and Specifications
System clock must me synced to ensure accurate timing of reminder.
MIS 600 Capstone
Assumptions
N/A
Open Issues
N/A
50
MIS 600 Capstone
Author: Michael White Use-Case Name Use-Case ID Priority Source
Date: 3/23/2013 Version: 1 Access Video Conference HJ-14 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Veterans, Therapist
Precondition Trigger Typical Course of Events
Alternate Courses:
51
Use-Case Type Business Requirements:
This use-case describes the processing using the video conferencing services for sessions. 1. Users must be existing therapists and patients. 2. Patient must have a scheduled appointment. This use case is initiated once both the therapist and patient are at their appropriate login screens. Actor Action
System Response
Step 1: Patient uses patient ID and password to log into the system.
Step 2: System gives dialog box “validating patient and appointment”. Once appointment is validated, system sends request for therapist to join. System displays “connecting” screen to patient.
Step 3: Therapist uses therapist ID and password to log into the system.
Step 4: System verifies therapist credentials and connects therapist to the patient.
Alt-Step 2a: Patient enters invalid credentials, system returns “invalid credentials” dialog box and returns to login screen.
Alt-Step 2b : Patient does not have an appointment scheduled, system returns “No appointment scheduled” dialog box.
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52
Alt-Step 4a: Therapist enters invalid credentials, system returns “invalid credentials” dialog box and returns to login lo gin screen. screen.
Conclusion:
The use case concludes when either the therapist or the patient exits the counseling session.
Post-Condition:
System returns to main login screen.
Business Rules
Link between therapist and patient be secured. secured. Sessions begin within within 10 minutes of scheduled appointment.
Implementation Constraints and Specifications
GUI is the default login screen on patient end and cannot change screens unless a successful successful login has been made. GUI is on therapists therapists desktop at VA.
Assumptions
N/A
Open Issues
N/A
MIS 600 Capstone Author: Michael White
Date: 3/23/2013 Version: 1
Use-Case Name Use-Case ID Priority Source
Track billing hours
Use-Case Type Business Requirements:
HJ-15 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Patient Billing services, Auditing services
Precondition
1. Patient is an existing patient 2. Patient has a valid scheduled appointment This use case is initiated when the patient logs into video conferencing system.
Trigger
53
This use-case describes the process of the system to tracking billing hours.
Typical Course of Events
Actor Action
System Response
Step 1: Patient logs into video conferencing system
Step 2: Video system triggers system clock to start tracking the number of minutes for the meeting.
Step 3: Patient exits video conferencing session
Step 4: System stops tracking minutes. System stores total minutes of session into billing database under patient’s billing information. information.
Alternate Courses:
Conclusion:
The use case concludes when patient exits video conference session.
Post-Condition:
System stores the session length in minutes into billing database.
Business Rules
Session lengths are rounded to nearest minute, and visible only to billing services, auditing services, and management.
Implementation Constraints and Specifications
This use-case should be invisible to the user.
Assumptions
N/A
Open Issues
N/A
MIS 600 Capstone
Author: Michael White Use-Case Name Use-Case ID Priority Source
Date: 3/23/2013 Version: 1 Enter new patient HJ-17 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Management
Precondition
Trigger Typical Course of Events
54
Use-Case Type Business Requirements:
This describes the process of management entering a new n ew client into the system. 1. User must be logged in into the system 2. User credentials meet security level to view information 3. Patient does not exist in system. This use case is initiated when the user selects “Enter new n ew patient” from main option screen. Actor Action Step 1: User selects the option to Enter new patient from main option screen.
System Response Step 2: System opens screen to enter patient’s information: Last Name First Name Address Phone Insurance information With “Verify” and “Exit” options at the bottom of screen.
Step 3: User enters the patient information and clicks Verify.
Step 5: User reviews information and clicks submit.
Alternate Courses:
Step 4: System verifies that the patient is not currently in the system and returns a summation of entered information with “Submit” and “Edit” at bottom of screen. Step 6: System stores the user information and returns “patient added” dialog box before returning to main option screen.
Alt-Step 3a: User selects “Exit” system returns to main option screen.
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55
Alt-Step 4a: Patient information is already in the system, system returns “Patient already exists” dialog box and exits to main option screen.
Alt-Step 5a: User selects “Edit”, system returns to step 2 with previously entered information still in information information fields to allow editing.
Conclusion:
The use case concludes when user clicks exit or successfully enters a new patient into the system.
Post-Condition:
New user information is stored into the database.
Business Rules
Only management can add a new patient into the system.
Implementation Constraints and Specifications
GUI to be provided for management from main options screen.
Assumptions
N/A
Open Issues
N/A
MIS 600 Capstone
Author: Michael White Use-Case Name Use-Case ID Priority Source
Date: 3/23/2013 Version: 1 Following week patient report HJ-18 High Requirements Analysis
Primary Business Actor Other Participating Actors Other Interested Stakeholders Description
Therapist, Management
Precondition
Trigger Typical Course of Events
Alternate Courses:
56
Use-Case Type Business Requirements:
Auditing Services
This use-case describes a therapist case load of client on a weekly basis. 1. User must be logged in into the system 2. User credentials meet security level to view information 3. Weekly scheduling is is complete. This use-case use-case is initiated when the user selects “Following week patient report” from the main option screen. Actor Action
System Response
Step 1: User selects the option to view following week patient report.
Step 2: System returns screen to request therapist ID of the therapist’s schedule the user wishes to view or “Exit”.
Step 3: User enters the therapist’s ID.
Step 4: System validates therapist’s ID and returns the schedule for that therapist. System gives the option to “Print”, “Previous”, “Exit”
Step 5: User views report and clicks exit.
Step 6: System exits to main option screen.
Alt-Step 2a: User selects exit, system exits to main options screen.
Alt-Step 4a: Therapist ID is invalid, system returns “invalid therapist ID” and returns to step 2.
Alt-Step 4b : User selects “Print”, system prints schedule and waits for
MIS 600 Capstone
user to select previous or exit.
Alt-Step 4c: User selects “Previous”, system returns to ste p 2.
Conclusion:
The use case concludes when user has viewed/printed all needed schedules and clicks exit.
Post-Condition:
System returns to main options screen.
Business Rules
Schedule can be viewed by any internal user.
Implementation Constraints and Specifications
GUI to be provided for internal users from main options screen.
Assumptions
N/A
Open Issues
N/A
57
MIS 600 Capstone
7. MS Project Plan
Task Name
Hardware and Software Implementation Project (VA System) Scope Determine project scope Secure project sponsorship Define preliminary resources Secure core resources Scope complete
Analysis/Hardware Analysis/Hardware and Software Requirements Conduct needs analysis Draft preliminary software specifications Draft preliminary hardware specifications Develop preliminary budget Review software specifications/budget with team Review hardware specifications/budget with team Incorporate feedback on software and hardware specifications Develop delivery timeline Obtain approvals to proceed (concept, timeline, budget) Secure required resources Analysis complete
Design Review preliminary software specifications Review preliminary hardware specifications Develop functional specifications Review functional specifications Incorporate feedback into functional specifications Obtain approval to proceed Develop software system Develop database Design complete
Implementation Project kick off meeting Identify possible locations Assign development staff Procure hardware and software Implement system Implementation complete
58
MIS 600 Capstone
Testing/Intergration Testing Develop unit test plans using product specifications Develop integration test plans using product specifications
Unit Testing Review coding Test component modules to product specifications Identify anomalies to product specifications Modify coding Re-test coding Unit testing complete
Network Integration Testing Test module integration Compare network usage to baseline Identify anomalies to specifications Address network anomalies Network integration testing complete
Training Develop training specifications for end users Develop training specifications for helpdesk support staff Identify training delivery methodology (computer based training, classroom, etc.) Develop training materials Finalize training materials Develop training delivery mechanism Training materials complete
Maintenance Create software maintenance team Create hardware maintenance team Update user manuals Fresher trainings Update help documentation Continuous feedback from users for improvement
Pilot Finalize location Develop software delivery mechanism Install/deploy hardware and software Obtain user feedback Evaluate testing information Pilot complete
Post Implementation Review
59
MIS 600 Capstone
Document lessons learned Distribute to team members Post implementation review complete Hardware and software development template complete
60
MIS 600 Capstone
8. Data and Entity Models
8.1 Context Data Flow Model
March 30, 2013 Veteran
Context Data Model Schedule Appointments Therapist
Case History
Management
Prescirption History
Billing Reports
Acounting
Pharmacist
Page 1
61
MIS 600 Capstone
8.2 Key-Based Data Model
Key-Based Data Model
March 30, 2013
Schedule Appointments
Veteran PK
P K, K,F K1 K1 PK,F PK,FK2 K2
Client ID ID
Therapist
Cl ie ien t ID ID Empl Employ oyee ee ID
P K, K, FK FK 1 PK,F PK,FK1 K1
C lili en en t ID ID Empl Employ oyee ee ID
Case History PK,F PK,FK1 K1,F ,FK2 K2 PK,FK1
Management PK
Empl Employ oyee ee ID Client ID
E mp mp lo loyee I D
Prescirption History PK,F PK,FK1 K1,F ,FK2 K2 PK,F PK,FK1 K1,F ,FK3 K3
Billing Reports PK,F PK,FK1 K1,F ,FK2 K2
Empl Employ oyee ee ID
Empl Employ oyee ee ID clie client nt ID
Acounting PK
Em pl ploy ee ee ID
Pharmacist PK
Emp lo loy ee ee I D
Page 2
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MIS 600 Capstone
8.3 Fully-Attributed Data Model
March 30, 2013
Fully-Attributed Data Model
Veteran PK
Schedule Appointments
Client ID ID
PK,F PK,FK2 K2 P K, K,F K1 K1
First Name Last Name Branch of Service email address
Therapist
Empl Employ oyee ee ID Cl ie ien t ID ID
P K, K,F K1 K1 PK,F PK,FK1 K1 PK
Date Time Veteran email address
C lilien t ID ID Empl Employ oyee ee ID Therapist ID
First Name Last Name License
Case History PK,F PK,FK1 K1,F ,FK2 K2 PK,FK1 PK,FK1
Management PK
Empl Employ oyee ee ID client Id therapist ID
Em pl ploy ee ee ID
First Name Last Name Notes Date of Appoinment
First Name Last Name Security Id Level
Prescirption History PK,F PK,FK1 K1,F ,FK1 K1 PK,F PK,FK1 K1,F ,FK2 K2
Billing Reports PK,F PK,FK2 K2
Empl Employ oyee ee ID clie client nt Id
Name of Drug Date Issued Refill date Date Filled Quantity of Drug Instructions to Customer
Empl Employ oyee ee ID
weekly billing hours time for individual individual session monthly billing hours client id client billing hours
Acounting PK
E mp mp lo loyee I D
First Name Last Name license number
Pharmacist PK,F PK,FK1 K1 PK,F PK,FK1 K1
clie client nt Id Empl Employ oyee ee ID
First Name Last name License
Page 3
63
MIS 600 Capstone
9. Data Flow Diagrams
9.1 Context Data Flow Diagram
Veteran Tele-Health Context Data Flow Diagram
March 19, 2013
Veteran
Time
Billing Services Automatically Schedule appointment
Send appointment reminder View next week patient report
Therapist
Access Video conference View billing hours
Manually schedule appointment
Veterans Tele-Health System
Manually change schedule/billing hours
Access Video Conference
View/update Case History View/update View/update patient Rx file
View audit report
View next weeks patient report
Audit Services
View Case Work Load
Management
View weekly Billing Hours View Case History View Monthly Billable hours Automatically schedule appointment View patient Rx file End of Counseling Session
Pharmacist
64
MIS 600 Capstone
9.2 Functional Decomposition Diagram
March 30, 2013
Functional Decomposition Diagram
Veterans Tele-Health System
Scheduling Subsystem
Accounting Subsystem
Medical Record Subsystem
Process Appointment Schedules
Track Billable Hours
Process Patient Medical Records
Generate Next Weeks Patient Reports
Generate Billable Hours Report
Process Patient Rx Records
Video Conferencing Subsystem
Access Video Conference Counseling Session
65
MIS 600 Capstone
66
9.3 Event-Response / Use-Case List Actor Pharmacist, Therapist, Management, Veteran
Event (use-case) View Patient Rx Records
Trigger Inquiry of a specified patients current prescription list
Response Generates report showing the patient’s prescriptions from PRESCRIPTION HISTORY database.
Therapist
Update Patient Rx Records
Therapist prescribes medication
System updates patient PRESCRIPTION HISTORY database.
Therapist, Management
View/update Patient Case History Notes
Inquiry to view a specified patient's case history notes(Therapist has the option to update)
Generates report of patient's complete case history from CASE HISTORY database. If update occurs, system updates Notes in CASE HISTORY database.
Management, Therapist
View Patient Medical Records
Inquiry to view patient's complete medical record
Generates report showing complete medical record for specified patient from VETERAN, CASE HISTORY and PRESCRIPTION HISTORY databases.
Management, Therapist
Update Patient Medical Records
Patient medical conditions are evaluated
System updates CASE HISTORY database for specified patient
Management
Compile Patient Case History
Management queries an overview of patient case history
System generates report showing up to 5 years of patient's case history from CASE HISTORY database.
Management
Enter New Patient
New patient acquired
System creates new client ID in VETERAN database and stores the new patient information into the database.
MIS 600 Capstone
67
Therapist
Generate Therapist Patient Schedule for Following Week
Inquiry from therapist for next week’s patient schedule
System retrieves following week schedule from SCHEDULE APPOINTMENT database and returns veteran information and appointment times for appointments that match their Client ID in THERAPIST database.
Management
Generate Complete CBOC Schedule for Following Week
Inquiry for following weeks schedule
Generates report showing all following weeks schedule in SCHEDULE APPOINTMENT database
Veteran
Automatically Schedule Appointment
Closing of video counseling session
Updates SCHEDULE APPOINTMENT database with the information the veteran has selected
Management, Therapist
Manually Schedule Appointment
New appointment needs to be added
Updates SCHEDULE APPOINTMENT database with the information the manager or therapist enters
Management
Manually Change Appointment
When appointment exists but time/date needs to be modified
Queries SCHEDULE APPOINTMENT database to return any scheduled appointments for a specified patient. Updates SCHECULE APPOINTMENT database with new time/date
Billing Services, Management, Auditing Services
Generate Monthly Billable Hours Report
Inquiry to view billable hours
Generates report from BILLING REPORTS database showing total billable hours
MIS 600 Capstone
68
Billing Services, Management, Auditing Services
Generate Per Patient Billable Hours Report
Inquiry for specific patient's billable hours hours
Generates report from BILLING REPORTS database showing billable hours for specified patient
Management
Manually Change Billable Hours
Billable hours in system are not accurate
Updates BILLING REPORTS database with new billable hours info provided by management
Veteran, Time
Send e-mail Reminder of Appointment
System clock reaches 48 hours prior to a scheduled appointment
System sends e-mail reminder to patient who's Client ID matches the scheduled appointment in SCHEDULE APPOINTMENT database
N/A
Track/Store Session Minutes
Veteran and Therapist begin a video counseling session.
System tracks minutes of session until either the therapist or veteran exits the session. Total minutes of session are saved to BILLING REPORTS database
MIS 600 Capstone
9.4 Event Decomposition Diagram
Event Decomposition Diagram
March 30, 2013
Veterans Tele-Health System
Scheduling Subsystem
Generate Next Weeks Patient Reports
Accounting Subsystem
Process Appointment Schedules
Generate Billable Hours Report
Medical Record Subsystem
Track Billable Hours
Process Patient Rx Records
Process Patient Medical Records
Video Conferencing Subsystem
Access Video Conference Counseling Session
Page 2 Track/Store Session Minutes
Generate Monthly Billable Hours Report
Automatically Schedule Appointment
Generate Therapist Patient Schedule for Following Week
Manually Schedule Appointment
Generate Per Patient Billable Hours Report
Manually Change/ Add Appointment
Manually Change Billable Hours
Send Appointment Reminder
Generate Complete CBOC schedule for Following Week
Page 1
69
MIS 600 Capstone
Event Decomposition Diagram
March 30, 2013
Medical Record Subsystem
Process Patient Rx Records
Process Patient Medical Records
View/Update Patient Case History Notes
View Patient Rx Records
View Patient Medical Records
Update Patient Medical Records
Compile Patient Case History
Enter New Patient
Update Patient Rx Records
Page 2
70
MIS 600 Capstone
9.5 External Event Diagrams
9.5.1 Generate Next Week ’ ’ s Patient Reports
External Event Diagram – Generate Next Weeks Patient Reports
April 6, 2013
Case History
Requested Report Report Info
History Info
Therapist
Veteran
Select Request Select Request
Patient Info Generate Next Weeks Patient Reports
Prescription History Info
Management
Requested Report Info Prescription History
71
MIS 600 Capstone
9.5.2 Generate Therapist Patient Schedule
External Ex ternal Even Eventt Diagram – Generate Therapist Patient Schedule
April 6, 2013
Requested Report Info Therapist
Schedule Appointment
Ap poi nt men t In fo
Select Request Generate Therapist Patient Schedule for Following Week Patient Info
Veteran
Therapist Therapist Info
72
MIS 600 Capstone
9.5.3 Generate Complete CBOC Schedule
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Generate Complete CBOC Schedule
Requested Report Info Therapist
Schedule Appointment
App oin tm ent Inf o
Select Request Select Request
Generate Complete CBOC Scheduling Scheduling for the Following Week
Patient Info Veteran
Therapist Info
Management
Requested Report Info Therapist
73
MIS 600 Capstone
9.5.4 Process Appointment Schedule
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Process Appointment Schedule
App oin tm ent co nfi rm ati on Patient
Request Schedule Schedule Appointment
App oin tm ent Inf o
App oin tm ent Inf o
Case History
Input Request Process Appointment Schedule
Patient Info Veteran Therapist Info
Therapist
74
MIS 600 Capstone
9.5.5 Automatically Schedule Appointment
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Automatically Schedule Appointment
Request Schedule
Schedule Appointment
App oint men t In fo
App oin tm ent Inf o Patient
Case History
Input Request Aut omat ic ally Sch edu le App oin tm ent
Patient Info Veteran
Therapist Info Scheduled Appointment
Therapist
75
MIS 600 Capstone
9.5.6 Manually Schedule Appointment
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Manually Schedule Schedule Ap pointment
Request Schedule App oint men t In fo
Schedule Appointment
App oin tm ent Inf o Case History
Patient
Input Request Manually Schedule App oin tm ent Scheduled Appointment
Patient Info Veteran Therapist Info
Therapist Input Request
Therapist Scheduled Appointment
76
MIS 600 Capstone
9.5.7 Manually Change/Add Appointment
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Manually Change/Add Change/Add Appoin tment
Schedule Info App oin tm ent Inf o
App oin tm ent Inf o
Patient
Schedule Appointment
Case History
Input Change/Add Request Manually Change/Add App oin tm ent
Patient Info Veteran Therapist Info
Change/Add Appointment Info
Therapist
Therapist
Change/Add Appointment Info
77
MIS 600 Capstone
9.5.8 Send Appointment Reminder
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Send Appointment Reminder
Schedule Info App oin tm ent Inf o
App oin tm ent Inf o
Patient
App oin tm ent Remi nde r In fo
Send Appointment Reminder
Schedule Appointment
Case History
Patient Info Veteran
Therapist Info
Therapist
78
MIS 600 Capstone
9.5.9 Generate Billable Hours
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Generate Billable Hours
Ac co unt ing
Ac co unt ing I nfo Therapist Input Hours Request
Input Hours Request Info
Generate Billable Hours
Therapist Info Therapist Patient Info Veteran
Select Request
Billing Info Billing Reports
Ac co unt ing
Input Hours Request Info
79
MIS 600 Capstone
9.5.10 Generate Monthly Billable Hours Report
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Generate Monthly Billable Hours Repor Repor t
Ac co unt ing
Ac co unt ing I nfo Therapist Input Hours
Generate Monthly Billable Hours
Patient Info Veteran Therapist Info Therapist
Select Request
Management Info
Billing Request Info
Billing Info
Management
Management
Select Request
Ac co unt ing Billing Request Info
Billing Reports
80
MIS 600 Capstone
9.5.11 Generate Per Patient Billable Hours
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Generate Per Patient Billable Hours
Input Hours Ac co unt ing
Therapist
Ac co unt ing Inf o
Billing Request Info
Generate Per Patient Billable Hours
Patient Info Veteran Therapist Info Therapist
Management
Select Request
Management Info
Management
Billing Request Info
Billing Info Select Request
Ac co unt ing
Billing Request Info
Billing Reports
81
MIS 600 Capstone
9.5.12 Manually Change Billable Hours
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Manually Change Change Billable Hour s
Ac co unt ing
Ac co unt ing Inf o Input Change in Billable Hours Management
Billing Change Info
Manually Change Billable Hours
Patient Info Veteran Therapist Info Therapist
Management Info
Billing Change Info
Management
Billing Reports
82
MIS 600 Capstone
9.5.13 Track Billing Hours
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Track Billable Hours
Select Request Ac co unt ing
Therapist
Ac co unt ing I nfo
Track Billable Request Info
Track Billable Hours
Patient Info Veteran Therapist Info Therapist
Management
Select Request
Management Info
Management
Track Billable Request Info
Tracking Billable Info Select Request
Ac co unt ing
Track Billable Request Info
Billing Reports
83
MIS 600 Capstone
9.5.14 Track/Store Session Minutes
Ma r c h 3 0 , 2 0 1 3
Ext e r n a l Ev e n t Di a g r a m – Track /S /Stor tor e Session Minutes Minutes
This event event is a internal automated p rocess
Patient Info
Veteran
Track/Store Session Minutes Therapist Info
Storing Session Minutes
Therapist
Billing Reports
84
MIS 600 Capstone
9.5.15 Process Patient Rx Records
External Event Diagr Diagr am – Proc ess Patient Patient Rx Recor Recor ds
April 6, 2013
Update Record
Case History
Veteran
Patient Info Select Request
Process Patient Rx Records
Prescription History Info
Therapist
Update Rx Record
Prescription History
Select Request
Select Request Man a g em en t
Ph a r m a c i s t
85
MIS 600 Capstone
9.5.16 View Patient Rx Records
External Event Diagr Diagr am – View Patient Rx Record s
April 6, 2013
Requested Patient Records Veteran
Veteran
Select Request Select Request
Patient Info View Patient Rx Records
Prescription History Info
Therapist
Requested Patient Records Prescription History
Requested Patient Records Select Request
Requested Patient Records Man a g em en t
Select Request Ph a r m a c i s t
86
MIS 600 Capstone
9.5.17 Update Patient Rx Records
Ap r il 6 , 201 3
Exter Ext er na nall Event Eve nt Dia gr am – Update Patient Rx Record s
Input Update
Case History Info Therapist
Prescription History
Case History
Input Request Update Patient Rx Records
Patient Info Veteran
Update Record Therapist Info
Input Request Therapist
Pharmacist Update Record
87
MIS 600 Capstone
9.5.18 Process Patient Medical Records
External Event Diagr Diagr am – Process Patient Medical Medical Re Recor cor ds
April 6, 2013
Case History
Update Records
Veteran
Patient Info Select Request
Process Patient Medical Records
Prescription History Info
Therapist
Update Records
Prescription History
Select Request
Select Request Man a g em en t
Ph a r m a c i s t
88
MIS 600 Capstone
9.5.19 View/Update Patient Case History Notes
External Event Diagram – View/Update Patient Case History Notes
April 6, 2013
Update Notes Update Notes
Therapist
View Updated Notes
Update Notes
View Updated Notes Management
View/Update Patient Case History Notes
History Info
Case History
89
MIS 600 Capstone
9.5.20 View Patient Medical Records
External Event Diagr Diagr am – View Patient Patient Medical Recor ds
April 6, 2013
Veteran
Patient Info Select Request
View Patient Medical Records
Prescription History Info
Therapist
Request Medical Records Prescription History
History Info Select Request
Request Medical Records Management
Case History
90
MIS 600 Capstone
9.5.21 Update Patient Medical Records
External Event Diagr Diagr am – Update Patient Medical Medical Re Recor cor ds
April 13, 2013
Veteran
Patient Info Request to Update
Update Patient Medical Records
Therapist Info
Therapist Therapist
Update Records
Case History
91
MIS 600 Capstone
9.5.22 Compile Patient Case History
April 6, 2013
External Event Diagr Diagr am – Compile Patient Case Histor y
Veteran
Select Request
Management
Requester Report Info
Patient Info Compile Patient Case History
Therapist Info
Therapist
Select Request
History Info Case History
Therapist
Requester Report Info
92
MIS 600 Capstone
9.5.23 Enter New Patient
April 6, 2013
External Event Diagr Diagr am – Enter New Patient
Select Request Management
Select Request
Therapist
Enter New Patient
New Patient Info
Veteran
93
MIS 600 Capstone
95
11. System Alternative Assessment
11.1 System Alternatives Characteristics
Candidate 1
Candidate 2
Candidate 3
Off Shelf Video Conferencing (Citrix)
Developed in-house
Off Shelf Video Conferencing (Citrix)
Database developed in house Portion of System Computerized
Brief description of that portion of the system that would be computerized in this candidate.
Off shelf Database (Access)
100%
100%
100%
Video conferencing
Video conferencing
Video conferencing
DB storage
DB storage
DB storage
Producing Reports
Producing Reports
Producing Reports
Scheduling Appointments
Scheduling Appointments
Scheduling Appointments
Track billable hours Process Patient Records
Track billable hours
Track billable hours Process Patient Records
Process Patient Records Benefits
Brief description of the business benefits that would be realized for this candidate.
Less expensive build costs A better fit for the for the video conferencing organizations needs software system and greater customization More control and customization of database Better control for and reports generated for future software the user. improvements, and a faster response time Faster setup, testing, and for hardware and implementation of video software issues conferencing system. The in-house process Increased security with DB ensures all of the required features Increased security with both video application and DB
Servers and
We will be utilizing the VA
We will be utilizing the
Less expensive all around because less time acquiring, testing, and implementing software and hardware Access is already installed on users computer systems Integration of total system would have less impact and testing of software and hardware on the network for the DB and video conferencing
We will be utilizing the VA
MIS 600 Capstone
96
servers and VoIP PBX hardware that is currently installed
VA servers and VoIP PBX hardware that is currently installed
servers and VoIP PBX hardware that is currently installed
Software Tools Needed
ASP.Net
ASP.NET
Software tools needed to design and build the candidate (e. g., database management system, emulators, operating systems, languages, etc.). Not generally applicable if applications software packages are to be purchased.
C#
C#
Oracle Database
MS Silverlight
Software video conference software is to be purchased and Microsoft Access is already installed
Workstations
A description of the servers and workstations needed to support this candidate.
Application Software
A description of the software to be purchased, built, accessed, or some combination of these techniques. Method of Data Processing
Generally some combination of: on-line, batch, deferred batch, remote batch, and realtime.
Output Devices and Implications
on client’s computers.
Oracle Database
Citrix video conferencing software is highly stable and secure video conferencing software.
The video conferencing application software and DB will be developed by 4 Guys Consulting
Citrix video conferencing software is highly stable and secure video conferencing software.
Web based Client w/ server model for the video conferencing
Web based Client w/ server model for the video conferencing
Web based Client w/ server model for the video conferencing
Internet capability
Internet capability
Internet capability
Real-time information provided to both Therapist and patients
Real-time information provided to both Therapist and patients
Real-time information provided to both Therapist and patients
Online display of information requires a secured VPN connection
Online display of information requires a secured VPN connection
Online display of information requires a secured VPN connection
Reports are available
Therapist’s, Managers,
for Therapist’s,
Pharmacists, and Accounting department
A description of output devices that would be Reports are available for used, special output Therapist’s, Managers, requirements, (e.g. Pharmacists, and network, preprinted forms, Accounting department etc.), and output considerations (e.g.,
Managers, Pharmacists, and Accounting
Reports are available for
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timing constraints).
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department
Input Devices and Implications
Keyboard
Keyboard
Keyboard
Mouse
Mouse
Mouse
IP camera
IP camera
Scanner
Scanner
Monitor
Monitor
Data that will be stored will be the video conferencing notes, tracking and generating billable hours, medical records and scheduling appointments
Data that will be stored will be the video conferencing notes, tracking and generating billable hours, medical records and scheduling appointments
A description of Input methods to be used, input IP camera devices (e.g., keyboard, Scanner mouse, etc.), special input requirements, (e.g. new or Monitor revised forms from which data would be input), and input considerations (e.g., timing of actual inputs). Storage Devices and Implications
Brief description of what data would be stored, what data would be accessed from existing stores, what storage media would be used, how much storage capacity would be needed, and how data would be organized.
Data that will be stored will be the video conferencing notes, tracking and generating billable hours, medical records and scheduling appointments We will be using the VA Hospitals current storage infrastructure We would organize the data by separating data by functional use (separate top level folders for appointments, billing and medical records). It will make it easier to permit or deny access based on clearly-defined security groups
We will be using the VA Hospitals current storage infrastructure We would organize the data by separating data by functional use (separate top level folders for appointments, billing and medical records). It will make it easier to permit or deny access based on clearlydefined security groups
We will be using the VA Hospitals current storage infrastructure We would organize the data by separating data by functional use (separate top level folders for appointments, billing and medical records). It will make it easier to permit or deny access based on clearly-defined security groups
11.2 Feasibility Analysis Feasibility Criteria
Wt.
Candidate 1
Candidate 2
Candidate 3
11.2.1 Operational Feasibility
30%
The system would provide a solid video conferencing platform and a
Candidate 3 will meet all specifications
The system would provide a solid video conferencing platform
MIS 600 Capstone Functionality. A
description of to what degree the candidate would benefit the organization and how well the system would work.
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customizable DB. The report generation and GUI can be tailored to meet
and a customizable DB. The report generation and GUI can be tailored
the VA’s needs.
to meet the VA’s needs.
There would also be less of a need for contractors to be hired on for long term maintenance of system.
Score: 200
Score: 200 Score: 200
Political . A
description of how well received this solution would be from user management, user, and organization perspective.
11.2.2 Technical Feasibility Technology. An
The VA Hospital may need to hire more IT technicians
Management would approve of the shorter implementation and test phase at lower costs. Users would not see a big difference between any of the solutions. VA IT specialists would like the ability to maintain security over the systems components.
Score: 50
Score: 25
Score: 100
Candidate 1 will have mature and stable video conferencing software with leading industry
Candidate 2 will require 4 Guys Consulting to build the new components to the
Candidate 3 will have a mature and stable video conferencing software package and a stable
Management would approve of the lower costs by using some of the shelf products. Users would not see a big difference between any of the solutions. VA IT specialists may not like a DB built by contractors because of security reasons.
30%
May be difficult to update to newer technology in the future Risk of higher costs Time consuming
MIS 600 Capstone
assessment of the maturity, availability (or ability to acquire), and desirability of the computer technology needed to support this candidate.
security features. The DB will require 4 Guys Consulting to build from the ground up. Candidate 1 will require contract with Citrix for long term maintain and services and a contract with 4 Guys Consulting for maintenance of the DB.
Expertise. An
assessment to the technical expertise needed to develop, operate, and maintain the candidate system.
existing IT infrastructure Candidate 2 will require IT staff with the knowledge to maintain the new portion of the system. Currently, the VA Hospital already has a few technicians that are capable of supporting the new and existing system
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DB platform for the solution. Candidate 3 will require very little expertise after initial setup. Long term maintenance would in form of a contract with Citrix and several people trained in Access DB management at the VA.
Score: 80 Score: 100 11.2.3 Economic Feasibility
Score: 200
30%
$45,000.00
$65,0000.00
$40,000.00
3.4 years
4.81 years
1.6 years
$35,330
($22,075)
$101,372
Score: 190
Score: 125
Score: 300
For the entire concept, build and install is six months.
For the entire concept, build and install is approximately six months
For the entire concept, build and install is six months.
Cost to develop:
Payback period (discounted):
Net present value:
Detailed calculations:
11.2.4 Schedule Feasibility
An assessment of how long the solution will take to
10%
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design and implement.
Ranking:
100 %
Score: 90
Score: 90
Score: 90
630/1000
520/1000
890/1000
11.3 System Alternative Selection
A System Alternative Selection comprises of a comprehensive gathering an d review of information regarding perspective solution for the system. This process breaks down the s ystem into components to measure and analyze for suitability of the client’s needs. Utilizing a weighted measurement system, a score for each solution is calculated. These scores give an overall picture of the best fit solution for the Veteran’s Affairs (VA). Operational feasibility is the ability of the system to meet the need operational needs of the VA. . Technical feasibility refers to the capability capabi lity of current technology and methods of operation. Economic feasibility refers to the costs of developing and implementing the system. Schedule feasibility was conducted to determine the scheduling needs for each solution. Each candidate also has its benefits and drawbacks with meeting the needs to the VA. After considering all the factors, an off the shelf solution for the video conferencing and building an Access database proved to be the best method to meet the needs of the VA. Although the other solutions provided more customization, the technical and economic feasibility of the off the shelf solution solution outperformed the other options. Therefore, purchasing Citrix software to provide the video conferencing and an d 4 Guy’s consulting to build an Access database is the best solution for the VA.
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11.3.1 Candidate 1 Off the Shelf Video Conferencing with DB Developed In-house Cost-Benefit Analysis
Year 0
Year 1
Year 2
Year 3
Year 4
Year 5
Initial Costs
($45,000)
($38,000)
($33,000)
($28,000)
($23,000)
($18,000)
1.000
0.877
0.769
0.675
0.592
0.519
($45,000)
($33,333)
($25,392)
($18,899)
($13,618)
($9,349)
($45,000)
($78,333)
($103,726)
($122,625)
($136,243)
($145,591)
Benefit Revenue
$0
$40,000
$47,000
$55,000
$62,000
$69,000
Discount Rate
1.000
0.877
0.769
0.675
0.592
0.519
$0
$35,088
$36,165
$37,123
$36,709
$35,836
$0
$35,088
$71,253 $71,253
$108,376
$145,085
$180,922
($45,000)
($43,246)
($32,473)
($14,249)
$8,842
$35,330
$14,249
/
$23,091
Payback
3.62
Maintenance
Discount Rate 14.0% Discounted Costs (Present Value) Cumulative Costs (Present Value)
14.0% Discounted Benefits (Present Value) Cumulative Benefits (Present Value)
Cost-Benefit Benefit-Cost
Payback Period
Years
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Return-on-Investment
Net Present Value
=
=
Year 0 1 2 3 4 5 Payback =
$35,330
$180,922
/
$145,591
/
5 Years
+
($145,591)
Payback Analysis Benefit Cost 0 ($45,000) ($45,000) $40,000 ($38,000) $47,000 ($33,000) $55,000 ($28,000) $62,000 ($23,000) $69,000 ($18,000)
3.40
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ROI
4.85%
NPV
$35,330
Net ($45,000) ($43,000) ($29,000) ($2,000) $37,000 $88,000
years
11.3.2 Candidate 2 Video Conferencing and DB Developed In-house Cost-Benefit Analysis
Year 0
Year 1
Year 2
Year 3
Year 4
Year 5
Initial Costs
($65,000)
($50,000)
($43,000)
($36,000)
($34,000)
($32,000)
1.000
0.877
0.769
0.675
0.592
0.519
($65,000)
($43,860) ($43,860)
($33,087)
($24,299)
($20,131)
($16,620)
($65,000)
($108,860 )
($141,947 )
($166,246)
($186,376 )
($202,996 )
Maintenance
Discount Rate 14.0% Discounted Costs (Present Value)
Cumulative Costs (Present Value)
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Benefit Revenue
$0
$40,000
$47,000
$55,000 $55,000
$62,000
$69,000
Discount Rate
1.000
0.877
0.769
0.675
0.592
0.519
$0
$35,088
$36,165
$37,123
$36,709
$35,836
$0
$35,088
$71,253
$108,376
$145,085
$180,922
($65,000)
($73,772)
($70,694)
($57,870)
($41,291)
($22,075)
$57,870
/
$16,578
Payback
6.49
14.0% Discounted Benefits (Present Value) Cumulative Benefits (Present Value)
Cost-Benefit Benefit-Cost
Payback Period
Years
Return-on-Investment
Net Present Value
=
($22,075) ($22,075)
/
$202,996
/
5 Years
=
$180,922
+
($202,996)
Year 0 1 2 3 4 5
Benefit 0 $40,000 $47,000 $55,000 $62,000 $69,000
Cost ($65,000) ($50,000) ($43,000) ($36,000) ($34,000) ($32,000)
Net ($65,000) ($75,000) ($71,000) ($52,000) ($24,000) $13,000
Payback =
4.81
years
ROI
-2.17%
NPV
($22,075)
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11.3.3 Candidate 3 Off the Shelf Video Conferencing with off the shelf DB Cost-Benefit Analysis
Year 0
Year 1
Year 2
Year 3
Year 4
Year 5
Initial Costs
($40,000)
($15,000)
($13,000)
($11,000)
($9,000)
($7,000)
1.000
0.877
0.769
0.675
0.592
0.519
($40,000)
($13,158)
($10,003)
($7,425)
($5,329)
($3,636)
($40,000)
($53,158)
($63,161)
($70,586)
($75,914)
($79,550)
Benefit Revenue
$0
$40,000
$47,000
$55,000
$62,000
$69,000
Discount Rate
1.000
0.877
0.769
0.675
0.592
0.519
$0
$35,088
$36,165
$37,123
$36,709
$35,836
$0
$35,088
$71,253
$108,376
$145,085
$180,922
($40,000)
($18,070)
$8,092
$37,790
$69,171
$101,372
($37,790)
/
$31,380
Payback
1.80
Maintenance
Discount Rate 14.0% Discounted Costs (Present Value) Cumulative Costs (Present Value)
14.0% Discounted Benefits (Present Value) Cumulative Benefits (Present Value)
Cost-Benefit Benefit-Cost
Payback Period
Years
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Return-on-Investment
Net Present Value
=
=
Year 0 1 2 3 4 5 Payback =
$101,372
$180,922
/
$79,550
/
5 Years
+
($79,550)
Payback Analysis Benefit Cost 0 ($40,000) ($40,000) $40,000 ($15,000) $47,000 ($13,000) $55,000 ($11,000) $62,000 ($9,000) $69,000 ($7,000)
1.60
years
Net ($40,000) ($15,000) $19,000 $63,000 $116,000 $178,000
ROI
25.49%
NPV
$101,372
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12. Technical Requirements and Assumptions
12.1 General Overview
4Guys consulting has elected to implement the new n ew tele-health system via an off the shelf selection for both the database system and video conferencing system. Due to the fact that this is a pilot program, the new system will run in parallel p arallel with existing software in use at the CBOC but will not directly interact with existing software. software. The new system will utilize the VA’s existing infrastructure and storage farms to avoid the need for any hosted services services that would decrease the ROI of the project. The VA currently uses a centralized data farm which will allow the VA IT staff to quickly address any needed maintenance of the new system. The selection of the database was largely influenced by the current databases within the VA. VA. By matching software choices with with current systems, the VA IT staff will require very little little training to maintain the new system. Because the project is a pilot that will only be utilized at a single location, impact to existing storage and networks n etworks will see little to no impact from the increased load of the new system. If the system goes live to all CBOC locations the VA will likely see better performance of the database system by decentralizing this portion of the system which would mitigate network delays in storing and retrieving files. By selecting an off the shelf database system s ystem that is currently in use for other areas of the VA and using the current infrastructure, the security measures that a re already in place for existing systems will will encompass the new system. These security measures (as defined by HIPPA) are both timely and costly to implement from from the ground up. The selection of candidate C allows for quick security integration, with the project only n eeding to focus on the video vide o
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conferencing security aspect. Utilization of the current infrastructure also allows the new system to take advantage of the existing backup and disaster recovery plans that are already in place at the VA, which include a complete data farm backup at a secondary location. 12.2 Facilities
The new system will run on a virtual network built on top of the existing architecture that currently connects the CBOC to the the local VA. It will utilize utilize the VoIP PBX that that is already installed at both locations, along with with VPN connections between both locations. These connections use an encrypted tunnel tunn el to transmit between locations to ensure security of data, voice, and video data. The locations do not currently run real time applications between the the two locations; therefore it will be necessary for the VA IT to incorporate QoS packet prioritization for the video conferencing system to avoid any latency that would have a negative effect on the system. The CBOC will require one room to be dedicated to the setup of the video conference system. Access to this room will be secured while sessions are in progress similar similar to an examination room. The room will need to be wired for a Cat5 Cat5 connection to allow the system system to access the CBOC network, and will be equipped with an IP camera, microphone, large screen monitor, scanner and keyboard. At the VA, each therapist will have an upgraded laptop with all the necessary equipment built in. All necessary software software will be installed on these laptops to allow the therapist to to access the database and video sessions from their office. Printing and scanning can be done via the local hardware attached to the VA network. The new system will use a virtual segmentation of the current data farm at the VA location. This segment will be treated as an individual data farm, farm, and will be backed up to the
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off site location in the same manner using the same procedures that the VA currently uses to back up the existing data farm. The existing data farm and back up location, utilize best practice procedures for power management and security. By building a virtual data farm on top of the existing hardware, we will mitigate the expense of developing d eveloping and implementing these procedures. Figure 12.2.1
Existing network with addition of video system
April 6, 2013 VA
CBOC
VPN
VPN Internet
VA edge router
Switch
T3 leased line
Switch
Client Stations
VoiP PBX
VoiP PBX
edge router Off site back up
Therapist Station
Data Farm
Video Conferencing Station
Page 1
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12.3 Technology Overview
The database system that has been selected will use Microsoft Microsoft Access. This selection was made due the fact that the VA currently uses Access which eliminates the purchasing pu rchasing and training costs of this software. software. Since the project is a pilot, the number of records that will be kept from a single CBOC will be relatively small compared compa red to the overall capability of Microsoft Access. The GUIs will be developed on top of Access, which is a practice that is already already in use at the VA and would keep troubleshooting issues to a minimum during maintenance of the new system. This will also streamline streamline any in house changes that the VA may choose to make to the system in the future. future. The database will hold all relevant information from, and to, the new system including the video conferencing notes, tracking and generating billable hours, medical records and scheduling appointments. Security privileges will will be incorporated into the system system via the GUIs and within the architecture of the database itself. The second primary advantage of using Microsoft Access is that the current work stations within the VA and the CBOC already have the software installed. installed. This greatly reduces the implementation time of the project project and reduces project costs. The video conferencing system will utilize Citrix’s GoToMeeting with HDfaces software. This selection removes the expense and training training needed to maintain the video conferencing system from the VA. Citrix is a well-established well-established provider with high high markings in customer service, which gives the VA a dependable d ependable system with little to no upkeep needed. GoToMeeting is widely used software, and is highly customizable. customizable. Citrix developers can easily implement any needed changes chang es to the software to make it fit the VA’s VA’s needs for this system. Utilizing Citrix to make these minor tweaks to the interfaces will greatly reduce the system development time. GoToMeeting offers many tools such as screen sharing that will increase the
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therapist ability to interact with the patient. With the addition of HDfaces, HDfaces, GoToMeeting now incorporates HD video with its already well known conferencing software. software. The software will run over the existing VoIP PBX, and use encrypted VPN tunneling to ensure security of the transmission. Selection of both these off the shelf software solutions gives the VA the advantage of greater control over the new system. Their IT staff will require very little little training in order to maintain or change the new system. system. It also makes the new system highly flexible flexible should any scope changes become evident e vident late in the project, or if it is determined by the VA that the system s ystem needs to be expanded to encompass a larger variety of patient types in the future. 12.4 Technical Costs Summary
Cate gory Operation and Maintenance Expenses Maintenance Discounted
Cos t
Total Costs
$ $
95,000 79,551
$
174,551
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13. Analysis of Needs vs. Capabilities of Contractors
4 Guys consulting has elected to implement the new tele-health system by incorporating an off the shelf option for both the database and video conferencing system. 4 Guys consulting will be the contractor to help facilitate the installation and work with the staff at the VA. In addition, 4 Guys will be collecting the requirements needed and create the user interface (UI). The VA has an on-site IT department that is familiar with the Microsoft Access database. 4 Guys consulting will be utilizing a seven person team to develop and implement both database and video conferencing system. Lastly, 4 Guys Gu ys consulting will be working with six specialists from the VA to ensure the new system will work with the existing VA infrastructure
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14. Project Risk Analysis and Risk Mitigation Plan
14.1 Project Risk Analysis
4guys consulting has identified a number of risks that must be mitigated to ensure a successful project. Each risk has been rated according to to the matrix in figure 14.1.1. The risks are given a probability rating from 1-5 according to the likelihood that the risk will occur and a rating 1-5 according to the potential impact should the risk risk occur. These ratings are then multiplied to give a single single overall ranking of each risk. risk. Risks with higher rankings should be given priority over lower ranked risks if it is not possible to fully mitigate all risks due to expense or resources. Monitoring these risks on a regular basis will help greatly increase likelihood of a successful project. It will be critical that risks be evaluated throughout the project. New risks may be identified at different different stages of the project. Also, risks that have previously been identified may change in probability, and impact, during the course of the project. It is important important to remember that the matrix is not set in stone. It is an evolving plan that must be evaluated before, during, and after the project. Its effectiveness will only be as high as its relative relative relation to current activities, and progress of the project.
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Figure 14.1.1 Impact should risk occur
r u c c o l l i w k s i r y t i l i b a b o r P
1 (Very Low)
2 (Low)
3 (Medium)
4 (High)
5 (Very High)
1 (Very Low)
1
2
3
4
5
2 (Low)
2
4
6
8
10
3 (Medium)
3
6
9
12
15
4 (High)
4
8
12
16
20
5 (Very High)
5
10
15
20
25
Table 14.1.2
Risk Name User Acceptance
Risk Analysis Users (especially the veterans) may have little/no technical experience with video conferencing software. If users find the system to complicated, they are likely to resist the new system. In the the case of the veterans, this could result in insufficient treatment.
Probability
4
Impact
4
Risk Rank
16
MIS 600 Capstone
Network Failure
Hardware Failure
Data Interception
Virus Attacks
Internal User Data Access
Malicious External Attackers
The system will utilize remote access to the database and the therapist. For this reason, the backbone of the system will rely entirely on its ability to connect from the CBOC to the VA. Lose of connectivity between the locations would render the system useless.
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3
5
15
3
4
12
2
5
10
The majority of the new system will be implemented on existing work stations which include multiple laptops, which are used for a variety of other applications. Since the the system system is not on dedicated hardware, virus vulnerability is increased for the system.
3
3
9
Improper delegation of user privileges lead to unauthorized access to private information. This would lead to a violation of HIPPA regulations.
2
4
8
HIPPA imposes very strict guidelines that must be followed to ensure patient information is protected. If the new system introduced a point of attack, the results could be very damaging to the VA’ VA’s reputation as well as lead to major fines.
1
5
5
Key hardware components of the system fail leading to loss of data, loss of conferencing capability, or loss of ability to access data. All data created by the system will be sent from the CBOC to the VA via VPN connections. This leads to the risk that the information may be intercepted via a man in the middle attack.
MIS 600 Capstone
Cost Overrun
Natural Disaster
Schedule Overrun
Costs increase due to changes in scope, vendor pricing, or schedule delays. A small portion of the pilot project will only be located at the CBOC. CBOC. A natural natural disaster disaster at this location would equate to a complete loss of this portion of the system. Project exceeds the VA’ VA’s specified timeline for completion.
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2
2
4
1
4
4
1
4
4
14.2 Risk Mitigation Plan
Figure 14.2.1
Risk Name User Acceptance
Risk Mitigation Plan Training will be provided for all internal users upon completion of the project. External users (veterans) will be provided a brief tutorial tutorial video before their first session session on how to use the video conferencing system. CBOC staff will also provide face to face assistance during first 3 sessions until external users are familiar with the system.
Network Failure
The VA will ensure that all network redundancies are in place to provide a high level of uptime of the internal network. Redundant ISPs will be used to prevent loss of connection between the VA and CBOC.
Hardware Failure
Hardware redundancies and recovery plans will be in place to ensure recovery times are are kept to an acceptable minimum. Data backup will follow the existing backup plan that is currently implemented for all VA mainframes and servers. The VA information security team will ensure all configurations to the VoIP PBX and VPN gateway gatewa y meet the necessary encryption levels to ensure secured transmission transmission over the internet. Maintenance plans will be put into place to ensure all software and firmware are routinely updated.
Data Interception
Virus Attacks
VA information security team will ensure that each work station has dedicated virus protection in place, firewall configurations are adequate, and routine updates are done to all crucial virus software.
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Internal User Data Access
Malicious External Attackers
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Database will utilize user privilege rights, along with user authentication to ensure data can only be accessed by users with the appropriate authorization. VA information security team will work directly with 4guys consulting team while developing the system to ensure the system meets or exceeds all needed levels of security. security. This team is highly highly trained in information security and well versed in all HIPPA regulations.
Cost Overrun
Budgetary meetings will be held weekly to ensure the project is staying within the defined budget. Any deviation from the proposed budget will be addressed immediately to decrease their impact on the project. Currently the proposed budget is well below the funding dedicated to the project as defined in the VA's request for proposal (RFP).
Natural Disaster
A full disaster recovery plan will be implemented before the the finalization of the project. Disaster recovery plan will will address backup hardware for portions of the system that reside exclusively at the CBOC.
Schedule Overrun
Project progress will be addressed at weekly meetings to ensure the project is staying within the defined time frame. Any deviation from the proposed schedule will be addressed immediately to decrease its impact on the overall project schedule.
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15. Project Costs, Staffing, Resources, Dependencies and Schedule
15.1 Resource Costs by Phase
Phas e # 1 2 3 4 5 6 7 8 9
Proje ct Phas e Scope Analysis/Ha rdware an and Software Re Requirements Design Implementation Testing/Intergration Training Mainte nance P ilot P ost Implementation Review Total Resouce Costs
Cos t pe r Phas e $10,382.55 $22,636.83 $12,000.16 $9,254.72 $21,938.37 $17,782.68 $21,670.16 $10,731.36 $18,886.40 $145,283.23
15.2 Resource Rates
Re s ource Name 4 Guys Analyst 5 Guys Analyst 2 4 Guys PM 4 Guys Qality Control 4 Guys Network Specialist 4 Guys Database Programmer 4 Guys Hardware Expert VA IT Specialist VA Manager VA Manager 2 VA Therapist VA Pharmacist VA Accounting
Initials MP MP GF MW TG DD HE VIT VM VM VT VP V AA
Group Consulting Consulting Consulting Consulting Consulting Consulting Consulting VA Hospital VA Hospital VA Hospital VA Hospital VA Hospital VA Hospital
Std. Rate $90.00/hr $90.00/hr $100.00/hr $80.00/hr $80.00/hr $80.00/hr $70.00/hr $85.00/hr $41.35/hr $41.35/hr $43.72/hr $29.81/hr $29.81/hr
Us age 174 hrs 209 hrs 322 hrs 182 hrs 192 hrs 185.6 hrs 150 hrs 128 hrs 290 hrs 27 hrs 90 hrs 24 hrs 48 hrs
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Each of the project phases will be completed as scheduled. Unforeseen factors, however, could create an increase or decrease in the project time.
15.3 Schedule
Tas k Name Scope Analysis/Hardware and Software Requirements Design Implementation Testing/Intergration Training Maintenance P ilot P ost Implementation Review
Duration 5 days 16 days 16 days 27 days 20 days 15 days 16 days 8 days 10 days
Start Mon 4/15/13 Fri 4/19/13 Wed 5/1/13 Mon 5/13/13 Mon 5/13/13 Wed 5/30/13 Tue 6/11/13 Wed 7/3/13 Mon 7/15/13
Finis h Fri 4/19/13 Thu 5/10/13 Wed 5/22/13 Tue 6/18/13 Fri 6/11/13 Fri 6/28/13 Tue 7/2/13 Fri 7/12/13 Fri 7/26/13
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15.4 Dependencies
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16. Integration of Internal & External Systems
Veterans Tele-Health System consists of a video conferencing s ystem that will link the CBOB via secured connection to the nearest VA with a staffed therapist. Patients will enter a room at the CBOC, login and begin beg in their counseling sessions without the need for the therapist to travel to the CBOC. At the end of the session, session, the patient is automatically being prompted to schedule their next appointment via the automated automated scheduling feature. This system will work in conjunction with a database system s ystem that will allow the therapist to access/update patient records, prescribe and E-sign for medication, allow for managerial reporting, and automate billing information entries such as session length.
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16.1 Internal and External System Integration Diagram
Ap r il 1 9, 20 13
Inte In te r na nall an d Ext er na nall Syst em Int I nt eg r at io n Diag Di ag r am
Ac ce ss/U pd ate Patient Records
V e t e r a n s T e l e -H e a t h
Prescribed and Esign for Medication
D a t a b a s e S y s t e m Managerial Reports
Aut oma te B ill ing Information Entries
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16.2 Internal Components
Access/Update patient records – records – The The therapist will maintain the patient’s record by using the Access database interface. Prescribe and E-sign for medication – medication – The The therapist use this system to maintain the medication that is prescribing to the patient. Managerial report – report – This This reporting section will allow the therapist, management and the pharmacist to create report that they will need for the patient for their session. Automate billing information entries – entries – This This will update the patient billing for the length of o f the session, and the billing for the medication to the accounting department. 16.3 External Components
Database Server – The – The database will hold all relevant information from, and an d to, the new system s ystem including the video conferencing notes, tracking and generating billable hours, medical records and scheduling appointments. Integration of internal and external systems will be thoroughly tested and documented; training will be provided to users and technical technic al personnel of both internal and external ex ternal systems to ensure that integration procedures are properly understood and followed.
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17. Systems Administration, Security, Backup, and Recovery
17.1 Systems Administration
In the past several years, the Veterans Administration has seen an increase in its services to assist veterans. To meet this growing demand for services, the organization is exploring leading technology as a means of delivering its services at a cost effective basis. The management team has been leading the way in studying pilot programs, which will open up new avenues of services for veterans through the veterans' ad. The hierarchy of the veteran to ministration organizational management consists of the management supported b y the therapist, pharmacist, and support staff. Upon completion of this pilot project, there will be no organization will change caused by the implementation of the veteran tele-health system.
Manager
Supervisor Therapist
IT Spcialist Supervisor
Therapist
IT Specialist (Data Admin)
Therpist
IT Specialist (SysAdmin)
Pharmicist
17.1.1 Training
Utilizing the veterans’ tele-health tele -health solution, time will need to be allotted have to for training VA employees on the system. There will be b e little training on the hardware installation
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and maintenance for the tele-health solution. Therefore, the majority of the training will be dedicated to training employees on how ho w to use the system. 4 Guys Gu ys consulting will create a training program for the therapists, pharmacists, management, and accounting teams respectively. This training will include hands-on work with the system so that users get a good feel of what the daily operations will be like with minimal interruption of their current workflow. 4 guys consulting also created manuals for using the system and maintenance for the system. These manuals will have specific chapters and sections perspective users of the system. These manuals will be provided at all the trainings for every user to have their own manual for the system. In addition to the manuals and the individual training by 4 guys consulting, a user video training course will be posted on the website interface for veterans understand how to make appointments. Training videos will also be created for users and left on the Veterans Administration network for quick references. 17.1.2 Documentation
With the implementation of the veterans' tele-health system, all records and documentation will be digitized and stored on the VA local area network. With the current federal policies and mandates for all health services to have electronic medical records (EMR), mental health services currently has not been included in these policies; however, in the future mental health records will be mandated to be electronic. The new system will digitize all case histories and medical psychotropic drug prescriptions, which will allow the VA to stay ahead of the upcoming federal mandates. 17.1.3 Technical
The VA has embraced the technological age has been progressively moving towards a
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paperless system. They have highly advanced electronic medical record system and have a nationwide database for all veterans. The VA's technology te chnology infrastructure is robust with Web servers, routers, LANS, and WANs. The bid tele-health system will be an expansion to the technology infrastructure. It will have a minimal impact on the PA's network and will be adding minimal hardware requirements. 17.2 Security 17.2.1 General
Technology and technological advances allow companies and organizations with new opportunities to grow and expand their services. This creates environments where legacy and new technologies exist in the same system. s ystem. Integration of new technology with legacy systems can produce some security problems, which can be exploited. With the federal mandate for electronic medical records, several compani es and organizations are moving to use the Internet connected conn ected with company databases to store and process client's information. For the veterans' administration, it is extremely crucial to protect the clients’ confidentiality in accordance with HIPPA. With the implementation of the veterans' tele-health system, there is integration of new technology with arty existing technologies and; therefore, security risks will arise. The veteran will be a little schedule their appointments through the Internet, which is vulnerable to a cyberc yberattack primarily, man in the middle type of o f attack. The database storing the confidential information of veterans will be stored on the local loca l area network, which has a vulnerability of employees accessing all the client's records. The network has vulnerabilities of securities as well. 17.2.2 Client Access
Veterans accessing the information system will be provided to a login password by the
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Veterans Administration. Upon initial login, veterans will need to change their password. Passwords can be the vulnerable to be cracked. After every 90 days, the password password will need to be changed. The password will be stored in the database, which will be located on the Veterans Administration servers behind firewalls. In addition, the veterans' access to the database will be limited by the systems systems administrators. This will prevent unauthorized access to information if a client’s password is broken. 17.2.3 Employees Access
VA employees have access to the the database and web server information. information. Systems administrators will need to limit the access each employee has to the server and database (i.e. Pharmacist needs to the rights and privileges to the psychotropic medication history but not the case history). Management will need to put into place place an approval process to upgrade and or down grade employee's rights and privileges to the database and server information. The IT department will issue the first password to employees and will create a notification to change password every 90 days. Passwords are vulnerable to being cracked. It is suggested that, at a minimum, passwords be no shorter than eight characters in length len gth with a combination of numbers, symbols, upper and lower case symbols. s ymbols. There shall not be reusing passwords within at least a one-year period. 17.3 Administration Hierarchy 17.3.1 System Administrators
The VA will need to have an at least one IT Specialist (Data Management) GS-221009/11 on staff staff to provide for the management of the database administration. administration. They should have the necessary skills to provide security, data integrity, and backin g up the databases.
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There will also need to be on staff an IT IT Specialist (SysAdmin) GS-2210-09/11. GS-2210-09/11. This position will need to have experience with LAN, WAN, passwords, system permission assignment, intrusion-detection software, backup, recovery, virus scans, and network performance monitoring. 17.3.2 Network Security
The Veterans Tele-health Tele-health system is designed to be placed on the VA’s current networking system while not any additional security beyond the in in place security. As a minimum, the in house security for the network should include a firewall and intrusion-detection system. There should also be a virus protection system in place, which meets federal standards of protection. The Webserver must have a multilayer intrusion protection system and have Secure Socket Layer (SSL) to allow the the veterans to make secure appointments. The Citrix software used for the video conferencing uses a VPN connection, which provides for a secure line of communication for the veteran and therapist. 17.3.3 Backup
Data's availability is a must with the system. system. It would be essential for a therapist to have access to a client’s case history before going into a session. As well, it is critical for the auditing process. There are potential errors like data corruption, natural disasters, and power outages, which can affect the availability of data. The pilot project will have a small enough database footprint that it will easily fold into the VA’s routine backup procedures without needing needi ng to accommodate a large storage space. It could easily reside within 500MB of storage. Expanding Exp anding the project for nationwide coverage would require a new need's assessment and the addition of a more robust backup plan.
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17.3.3.1 Business Continuity
Business Continuity means the ability to keep your operations moving forward without stoppage regardless of an event of circumstances. In the case of the Veteran’s Tele-Health Tele-Health system, there are generally two factors, which could create a work stoppage a connectivity problem with the video conferencing system or a network failure. If there lies a problem such as a natural disaster, which could cause a business stoppage, the VA will implement an emergency emergenc y response plans. This can include therapist’s conducting phone sessions and management teams using previously printed documentation for reports until the systems become operation again.
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18. Scope Change Documentation
Managing the scope of a project is critical to the the success of any project. With a project that has a short time time frame such as this one, it becomes even more important. important. Changes to scope must be properly identified, evaluated and measured to mitigate the overall impact of the project. These changes can be accomplished to ensure the system fits the VA’s needs; however, ho wever, there must be a strict procedure to ensure only critical changes are made. This will save costs and scheduling to overflow due to an abundance of unnecessary changes. It is important to remember that every change, no matter how small, will have an impact on the project. The objective of this section is to determine the process that will be used to make any an y changes to the scope of the project. Having a well-defined procedure in place will help alleviate the impact impact of any changes, as well as, ensures en sures that only critical changes are addressed. 18.1 Scope Change Procedure
All changes to the scope of the project (as defined in the project p roject charter) must follow these steps. 1. Anyone seeking to make changes chan ges to the project must first obtain the Scope Change Request form from from 4guys consulting. Request for this document will notify 4guys consulting of the desire to change the scope so that resources can be set aside to perform an analysis of the request. 2. The top portion of the request form will be filled out and submitted to 4guys consulting. A copy of the request will also be supplied to VA’s CIO. This portion of the form will identify who is making the request to change scope, explain the change, identify primary business drivers for the change, initial assessment assessment of impact, and benefits of the change.
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3. 4guys consulting’s project manager will conduct a comprehensive analysis of the change and record results of the analysis in the second section of the request form. This section will confirm the actual impact, issues that will need to b e addressed in order to get the change, risks analysis of the change, resources required req uired to perform the change, scheduling impact, impact on the overall system, project docu ments that will need to be changed, and cost estimates. 4. This completed form will be will be sent to the VA’s CIO for approval. CIO may require modifications to the request and will communicate these modifications to 4gu ys consulting. If both the CIO and the project manager agree on the change, the document will be signed by both and marked for approval. Otherwise, the document will be marked for rejection. 5. If the change is approved it will be addressed at the next progress meeting, during the meeting the project manager will allocate the necessary nec essary resources and funds to implement the change. If the change has a negative impact on work currently being performed, performed, an emergency meeting will be held in order to address the change and limit the impact of the change. 6. Project manager will make all the necessary changes to the project documentation. 7. All scope change documentation will be attached to the project documentation in a single appendix before the finalization of the project.
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18.2 Scope Change Request Form
Project Scope Change Request Form Section A - Requestor Section
Date Submitted: Submitted by: Department/Contractor: Affected subsystem: Change Description:
Business Drivers:
Estimated Impact:
Change Benefit:
Affected Project Documentation:
Section B - Project Manager's Section
Date Reviewed: Reviewed by: Actual Impact of Change:
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Issues:
Risks:
Resources Required:
Scheduling Impact:
System Impact:
Documentation Impact:
Cost Cost Estim ate
Internal Labor Cost: Contractor Cost: Vendor Cost: Material Cost: Other: Contingency Amount: Total Estimated Cost: Financial Comments: Project Manager's Manager's Signature___ Signature_________________ ___________________________ __________________________ _____________ Date_______________ Date_______________
Recommendation (circle one): Deny
Approve
CIO's Signature______________ Signature_____________________________ ___________________________ ______________Date_____ __Date_______________ __________ __
Recommendation (circle one): Deny
Approve
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19. References
Cushman, J. (2012). New study gives scope and costs of combat-related conditions among veterans. New York Times. Retrieved from http://atwar.blogs.nytimes.com/2012/02/24/new-study-giveshttp://atwar.blogs.nytimes.com/2012/02/24/new-study-givesscope-and-cost-of-combat-related-conditions-among-veterans/ Ganeshan, D. (2011). Waterfall versus agile methods: a pros and cons analysis. The Server Side. Retrieved from http://www.theserverside.com/tip/Waterf http://www.theserverside.com/tip/Waterfall-versus-Agile-methods-A-pros-andall-versus-Agile-methods-A-pros-andcons-analysis Uhlig, D. (2012). Advantages and disadvantages to the SCRUM project management methodology. http://smallbusiness.chron.com/advantages-disadvantages-scrum-projectojectChron. Retrieved from http://smallbusiness.chron.com/advantages-disadvantages-scrum-pr management-methodology-36099.html