1. Handbook of Informatics for Nurses and Healthcare Professionals Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Chapter 5 Selecting a Healthcare Information System

2. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar The competitive advantages associated with health information systems are 1-contingent upon the technology. 2- the degree to which technology meets the organization’s needs. 3- the strength of the information services staff. 4- the speed and method by which the system is implemented. Some Thoughts

3. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Some Thoughts Some benefits of a new system are immediate but economic benefits may not be evident for years Awareness of the mistakes made by others can be used to guide decisions The staggering costs associated with purchase and implementation make a wise choice critical

4. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar There is no “right” choice but the best place to start when selecting a healthcare information system with the strategic plan because it sets goals and determines technology needs Some Thoughts

5. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Life Cycle The process for the selection and implementation of an information Ongoing process of developing and maintaining an information system 4 main phases that cover the life span of information systems

6. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Life Cycle

7. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Life Cycle Phases 1. Needs assessment 2. System selection 3. Implementation 4. Maintenance

8. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Needs Assessment Initiated by someone with a vision of the future It should analyze the organization needs Looks at segments in the organization Identifies deficits and issues The selection committee uses data to generate a list of possible solutions for discussion of current deficits and needs. The selection committee includes clinical users, information systems specialists, and administration or executive broad representatives.

9. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar The steering committee The steering committee is an essential component of the assessment and selection process. Its membership should include board members to ensure that information technology is aligned with the organization's overall strategy. The committee leadership may affect the success or failure of the project. The committee membership must be multidisciplinary including representation from all departments. The general rule to follow is any department or area must have a voice in the selection process.

10. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Steering Committee Members Key to process Membership –Board members (ensure congruence with organizational strategic plan) –Representatives from all departments impacted (↓possibility of missing potential problems) –Must include end-users –Chair should be a member of administration

11. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Steering Committee Structure Large enough to make a good decision but small enough to be effective and efficient Who will make the final decisions? –Multilevel committee  Upper level makes final decisions  Lower level makes recommendations

12. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Committee Considerations Steering Committee members must receive release time from other responsibilities Want users with functional expertise, good communication, and ideally a computing background May use input from consultants

13. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Consultants May be used for assistance in any phase of the selection or implementation processes including recommendations for the composition of the steering and selection committee, assessing the current information system, system planning, policy and procedures management. Effective use of consultant requires clear definition of the contractual relationship and expected outcomes as well as good communication through the association. the consultant May be used to analyze all available information and make recommendations

14. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Problems arise with the use of consultants Limited experience. Under knowledge of the needs of hardware and soft ware applications Lack of incentive to work. Failure to keep promises made to clients

15. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Qualities of an effective consultant Experienced. Knowledge and understanding of the health care industry. Has consulting skills. Has verbal and written communication skills. Has good project management skills. Has flexibility and availability. Has advice that the result in cost savings. Has credibility.

16. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Developing a common vision Through examining the vision and mission statements of the organization as well as the strategic plan This guide the work of committee and help in determining the organization's information system needs while continuing to support the mission.

17. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Analysis of Current System Thorough understanding is essential Must determine what information is used, who uses it, and how it is used May use questionnaires, observation, and interviews Must weigh strengths and weaknesses

18. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar System Requirements User needs—“Musts” and “Wants” Technical criteria Administrative criteria Registration criteria Medical Records Criteria Order Entry/Results Reporting Accounting Criteria

19. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar “Musts” and “Wants” Determination of system requirements from what end users identify as essential or “nice” to have to do their work Selection committee develops and uses a weighting system to rank criteria identified by workers

20. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Technical Criteria Hardware and software needed for the desired level of system performance Type of architecture (does it work with other systems) Response time Downtime Test and training environments Support for other technology

21. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Administrative Criteria Compliance with regulatory and legal requirements Report capabilities Ease of use Purging and restoring data

22. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar System Selection Second phase of the Life Cycle Phase begins once decision made to purchase a new system Critical to the success of the project Requires the collection of additional information and awareness of funds available for the project

23. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Sources of Information Trade shows and conferences Publications –Professional organizations –Trade journals –User groups Internet and World Wide Web Site visits Request for information/proposal.

24. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Request for Information (RFI) Brief document sent to vendors that states plans to purchase and install a system Asks the vendor for a description of the system, its capabilities, and perhaps: –About the company –Number of installed sites –Technical capabilities –Updates

25. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Request for Proposal (RFP) Formal document sent to vendors that describes system requirements sought Detailed Solicits proposals from vendors that describe their capabilities to meet the “wants” and “needs Responses are used to narrow the choices

26. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Analysis of RFP Responses Receipt of RFP Responses is the beginning of the “Evaluation” phase Consider –Was it submitted by the deadline date? –Is it a professional effort? –Were the vendor representatives responsive? –Does the proposal address the RFP or is it a standard bid?

27. Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition Toni Lee Hebda and Patricia Czar Future Directions The system life cycle is ongoing Each repetition of the system life cycle process increases the body of knowledge that will help organizations with future choices Increased knowledge will also help to shorten the selection process