system acquisition refers to the process that occurs from the time the decision is made to select a...
TRANSCRIPT
SYSTEM ACQUISITION AND IMPLEMENTATION
System Acquisition
System acquisition refers to the process that occurs from the time the decision is made to select a new system until the time a contract has been negotiated and signed.
System implementation begins once the organization has acquired the system and continues through the early stages following the go-live date
Systems Development Life Cycle
Planning & Analysis
DesignImplementation
Support & Evaluation
Systems Development Life Cycle
Panning & Analysis Examine current systems and problems to identify
opportunities for improvement (independent of technology)
If new IS is needed, what are the information needs of the users and what are the functional requirements?
Design In-house, outside developer? Or purchase from a
vendor or contract with an Application Service Provider (ASP) “the cloud”
All the alternatives are considered, cost-benefit is done and a system is selected
Systems Development Life Cycle
Implementation Workflow and process analyses Installing new system Training, converting data
Support & Evaluation Longest phase in the life cycle
The first two states are referred to as the acquisition process the second two implementation
Prior to System Acquisition
Health care executive team should Engage in strategic information systems
planning Identify goals and strategies and how IT
will be employed to aid the organization in achieving them
Establish IT priorities Gain budgetary approval and
institutional support
System Acquisition
Establish Project Steering Committee Primary function is to plan, organize,
coordinate, and manage all aspects of the acquisition process.
Project manager Is critical Often clinicians with training in informatics
Chief medical informatics officers or nursing informatics officers
Size of the committee
System Acquisition
Define Project Objectives and Scope of Analysis What does the committee expect to achieve? What process will be used to ensure success? How will milestones be acknowledged? How will committee communicate progress? What resources are needed?
Screen the Marketplace and review Vendor Profiles
Determine System Goals The system goals should be aligned with the strategic
goals of the organization and should serve as measures of success throughout the system acquisition process.
System Acquisition
Determine and Prioritize System Requirements Focus groups/interviews/written surveys/product
demonstrations Software Technical infrastructure Training and support
Develop and Distribute RFP or RFI RFP tend to be highly detailed and are costly and
time consuming to develop RFI is considerably shorter Some may send RFI and then RFP to screened
vendors
System Acquisition
Explore Other Acquisition Options Contract with an ASP
On a subscription basis to deliver an application and provide the support. Buy vs. lease
Benefits Requires less IT staff Fewer up-front costs and less capital Rapid deployment
Disadvantages Off the shelf Technical support will not be site specific Data ownership, security and privacy worries
System Acquisition
Explore Other Acquisition Options Contract with a system developer or build in-
house Evaluate Vendor Proposals
Develop evaluation criteria Vendor demonstrations Make Site visits/check references
Conduct Cost-Benefit Analysis Prepare Summary Report and
Recommendations Conduct Contract Negotiations
CH 7: System Implementation and Support
Organize the Implementation Team and Identify a Champion May contain some of the members of the
selection team, but also others System champion is someone who is well
respected in the organization, sees the new system as necessary to the organization and is passionate about implementing it.
EG: Physician (system champion), nurse manager,
lab manager, radiology director, CIO, IT analysis, business manager
Determine Project Scope and Expectations Should be consistent with the system goals
established in the system selection process Establish and Institute a Project Plan
Major tasks and milestones Estimated duration of each task Dependencies among tasks Resources and budget Individuals responsible for completing each task Target dates Measures for evaluating completion and success
Typical Components of an Implementation Plan
Workflow and Process Analysis Analyze current process and procedures Identify opportunities for improvement Identify sources of data Determine location and number of workstations Redesign physical location as needed Involving users at this stage is critical
System installation Determine system configuration Order and install hardware Upgrade or implement IT infrastructure Install software and interfaces Test, rest, and test again
Typical Components of an Implementation Plan
Staff training and procedure manuals How much training? Do different groups have different
training needs? Who should conduct the training? When should the training occur? What intervals of
training are ideal? What training format is best (classroom, one-on-one,
small group, computer-based?) What is the role of the vendor? Who in the organization will manage or oversee the
training? How is it documented? What criteria and methods will be used to monitor
training and ensured that staff are adequately trained? Will staff be tested?
Typical Components of an Implementation Plan (continued) Conversion
Data should be complete, accurate, and current before being converted
Testing Communications
Establish communication mechanisms for identifying and addressing problems and concerns
Communicate regularly with various constituent groups Preparation for Go-Live Date
Select date when patient volume is relatively low Ensure sufficient staff are on hand Set up mechanism for reporting and correcting problems
and issues Review and effect process reengineering
Managing the Organizational Aspects
Create an appropriate environment Expectations are defined, met and managed
CFO – financial return CMO – physician’s time/quality of care Nursing staff – workload, patient satisfaction IT staff – help desk calls
Do not underestimate user resistance One of the biggest managerial challenges
Allocate sufficient resources Provide adequate training
Managing the Organizational Aspects
Manage unintended consequences More work or new work Workflow (workarounds) System demands
Opportunity cost of time Communication Emotions New kinds of errors
Upcoding Juxtaposition errors
Power shifts Dependence on the system (what happens when
the system is down?)
Common Implementation Mistakes
American College of Physicians and AmericanEHR Partners The following are 10 mistakes that physicians commonly
make with EHRs:1. Thinking a site visit to a practice that is using the same EHR
product isn't worth the effort.2. Signing an unvetted contract with a vendor. 3. Neglecting to perform a workflow analysis before implementing
EHRs.4. Undertraining other physicians and staff on EHR use.5. Refusing to purchase a laboratory or device interface.6. Entering too much data into the EHR.7. Doing EHR-related work staffers should be doing.8. Using shortcuts and workarounds while using EHRs.9. Creating "shadow" paper documents and believing they are more
accurate than EHR information.10. Accepting inefficiency as the new status quo.