System Life Cycle: Needs Assessment / Reading and Sharing Nursing Informatics

The term of system life cycle describes the ongoing process of developing and maintaining an information system.

• Needs assessment
• System selection
• Implementation
• Maintenance

Needs Assessment

• The purpose of the needs assessment is to determine the gap between an organization’s current state and the overall needs of the organization with consideration to the strategic plan.
• evaluation of the strengths and weaknesses of the organization related to efficiency, quality, and financial strengths should be considered
• understanding an organization’s current state workflow process as well as long-term goals related to efficiency, quality, and financial out-comes by creating a gap analysis can assist the decision-making group

The Steering Committee: an essential component of the assessment and selection processes. Its membership should include board members to ensure that information technology is aligned with the organization’s overall strategy.

• Steering committee leadership may affect the success or failure of the project. The committee chairperson may be a manager, director of information services, or an informaticist, or have an administrative position elsewhere in the hospital.
• The steering members much be multidisciplinary, including representation from all departments affected by the new system and incorporating the clinical, administrative, and information system divisions.
  • this strategy is essential for identification of all pertinent issues and reduces the possibility of overlooking potential problems.
  • representation of the voice of the patient should be considered during the evaluation and /or decision-making process.
• It is important to consider the appropriate size of the group, in which should be large enough to make a good decision but small enough to be effective and efficient.
• It is necessary to define who has the authority to make the final decisions.

Consultants: may be hired for assistance in any phase of the selection process, including recommendations for the composition of the steering and selection committee, assessing the current information system, system planning, testing, security, policy and procedure development, and implementation.

• The consultant’s role is to analyze the information and make recommendations for actions.

Developing a common vision: 

• The needs assessment committee should start the process by examining the vision and mission statements of the organization as well as the strategic plan.
• Goals must reflect the organization’s purpose, scope of services, and customers

Understanding the current system: 

• a thorough understanding of how information is currently collected and processed is the starting point in performing a needs assessment. >> also known as assessing the internal environment.
• methods: questionnaires and observation of day-to-day activities
• to determine: what information is used, who uses it, and how it is used; PLUS, what information should be kept, what information is redundant, and what information is unnecessary.

Determining system requirements: understand the organization’s requirements for operation. “musts” vs. “wants”

• Technical criteria: include those hardware and software components necessary for the desired level of system performance
  • type of architecture
    • architecture refers to the structure of the central processing unit and its interrelated elements
  • amount of downtime
    • downtime refers to the period of time when an information system is not operational or available for use.
  • connectivity standards:
    • provides for HL7-compliant interfaces
    • includes the ability to interface from and to client care instruments such as monitors
    • many systems can also interface to pumps and handheld bar coding devices
    • if ancillary systems and specialty areas have different vendor systems, interface of discrete data is preferred
    • provides the ability for transmission of data for key regulatory reporting as in immunization registries
    • ability to hold bidirectional interface to outside medical labs to order and receive results
  • test environment separate from live environment
  • response time: the amount of time between a user action and the response from the information system.
  • support of electronic technologies
• Administrative/ General criteria
  • security levels to comply with regulatory and legal requirements
  • data standards and data exchange
    • HL7-clinical messaging
    • ICD-9 and CPT (coding), DICOM (imaging), and X12N (insurance claims)
    • migration of ICD-9 to ICD-10 should be explored
  • data storage options
  • report capabilities
  • ability to integrate with health information exchanges (HIEs)
• Registration criteria: to ensure client is properly identified for all aspects of information management.
• Order entry/ CPOE /results reporting criteria
• Documentation/billing criteria
• Scheduling criteria
• Special criteria
• Medical records criteria
• Accounting criteria