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IS531_Lecture-10.ppt

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Lecture 10

System Implementation and Maintenance

(Chapter 10)

Learning Objectives

Cultural change in System Implementation

Implementation committee

Issues in test, training, and production environments.

The “go-live” process

Implementation pitfalls.

Maintenance and System Life Cycle

IS 531 : Lecture 10

System Implementation

Third phase of the life cycle

Begins with purchase of the system

Planning before purchase

Selection of the implementation committee to oversee the process

IS 531 : Lecture 10

Implementation Committee

Project leader—needs to be involved in the entire process

Technical staff

Informatics representatives

Clinical representatives

Managers who understand day-to-day operations and how those processes might be improved

IS 531 : Lecture 10

Implementation Committee

Steering Committee membership and organizational issues are as important as the technology when implementing a new system.

The project leader must have strong leadership and communication skills.

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Committee Tasks

Develop plan /work breakdown structure (who is responsible of what, timeframe).

Schedule tasks for implementation.

Define the scope of each task.

Identify timelines and “go-live” date.

Identify resources and constraints.

Get to know the system.

Research what data is needed and how it is used.

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Getting to Know the System

“Base” system—supplied by vendor without any changes

Training for committee

On-site training by the vendor
Vendor training at corporate headquarters
Consultants may provide training

Should revisit issues examined during selection

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Issues to Revisit

Is technology current? Upgradable?

Financial stability of vendor

Vendor compliance with regulations

Integration with other systems

Support different types of patient accounts

Clinical support (client care)

EMR support

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Cultural Changes in System Implementation

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“If change does not produce a notable resistance, then the change is probably not big [significant] enough”

New IT always change life (at home/at work)

People should embrace (buy-in) the reason for change

Any change should make people feel differently (more important/valuable/ effective/efficient …)

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Base System vs. Custom

System as-is vs. customized

Workflow Optimization: Gap Analysis to identify required changes in workflows and prototype

Customization requires time and resources.

Customization may have ripple effects on other systems and interoperability.

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System Function

A task performed manually or automated

Must identify information pertinent to completion of each function

Examples

Order entry
Results reporting
Documentation

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System Output

Material generated by the system

Examples

Requisitions produced in other departments
Reports
Diagnostic results
Work lists
Charges

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Required Output for
New System

Analyses of the current and desired workflows provide this information.

Specifications must be agreed to, or “signed off” by, managers in the areas that will be impacted.

Constant changes to specifications delay the project and increase costs.

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Test Environment

System testing vs. integrated testing

Use a copy of the information system software to make changes from the off-the-shelf version

Programmed changes are tested to ensure that they work as designed

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Test Plan

Long-range goals (what for) and test items (what)

Test Script provides a series of transactions from beginning to end for all associated functions

Requires input and participation from users from all areas of the facility

Evaluate actual vs. desired output

IS 531 : Lecture 10

Hardware Requirements

Analysis of needs must be done early in the implementation phase

Considerations

Network infrastructure
Types of workstations and mobile devices
Workstation locations
Hardware locations
Printer needs

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Network Infrastructure

Should be determined early—later changes will increase costs

Network configuration requirements
Server specifications—memory, processing power, consider future needs
Technical standards
Cabling and power
Wireless access

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Workstations and Mobile Devices

Advantages and disadvantages of each type of device.

The number of devices needed.

Technology and support for access by PDAs and handheld devices.

Where devices will be located.

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Procedures and Documentation

Determine how the system will be used before end user training starts.

Evaluate/revise policies and procedures for system use and include in training.

Develop user guides.

What to do in the case of planned and unplanned system downtime

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System Documentation

Develop a “dictionary of terms” and map terms from one system to another.

Mapping terms across systems help to ensure high-quality data.

Finalize pathways and screens before the test plan is written and training starts.

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User System Training

Do not start until changes are complete

Training environment—separate copy of the information system software that works the same way as the actual system and is populated by fictitious clients

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Go-Live Planning

Go-live—system running and used to collect and process actual client data

Implementation strategies / rollout —staggered/modular/all at once

Conversion—bring in old data (backloaded)

Develop the support schedule

Develop evaluation procedures

Develop a procedure to request post go-live changes

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Implementation Pitfalls

Underestimation of time and resources needed

Ongoing addition of changes and more features (“scope creep” and “feature creep”)

Failure to consider costs for annual maintenance and other expenses

Problems with testing or training

Lack of system “ownership” by users

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Maintenance

User support—resource staff available during go-live on units and via help desk at all times

User feedback / requests for changes analyzed and appropriate changes made to identify problems

Must apply updates to all three environments—testing, training, and production/live

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Technical Maintenance

Problem solving and debugging

Backup supply of hardware

File backup procedures

Storage space

Interfaces with other current/new systems

System upgrade

Disaster recovery plan

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Return on Investment (ROI)

A system having poor performance, dated, outgrown should be replaced

Financial justification for changes

Decrease in costs/expenses
Increase in profits/benefits (tangible vs. intangibles)

Payback /break-even

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The Role of Nursing

All users should have input into the systems that they use.

Nurse informaticists provide “credibility” for information system projects.

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Nurse Informaticist Responsibilities

The Chief Nursing Officer (CNO) must work with key figures to develop strategies to transform care, prioritize system design to maximize the value and benefits of a clinical information system, and reallocate time saved in documentation and other efficiencies to improve client care services.

IS 531 : Lecture 10