Description of the Problem

The problem is the inefficiency, complex, and time consuming nature of paper medical records that are used to document patient information. The Patient Admission Department obtains personal information from patients, which is documented before they are allowed to see the physician. Currently, the hospital manages documentation of patient information using paper-based medical records, which are complex and time consuming.

Business Activities and Processes Affected by the Problem

Documentation of patient data; billing; physician-patient relationship.

Actual Performance (e.g., current baseline)

At present, patient documentation process involves recording patient data, peer communication, patient care and other activities. This process requires an average of 30 minutes to complete. Therefore, the process reduces the dedicated time spent on patient consultation and care by nearly 10%.

Target Performance

An achievable target is for patient documentation process to require an average of 10 minutes per patient. There will be an improvement in physician-patient relationship, from a 75% patient satisfaction rating to a targeted rating of 90%. This will help improve the quality of care and billing processes.

Performance Gap

Since the hospital averages 20 patient visits each day, the performance gaps total approximately 10 labor hours per month. This results in an overall 25% decline in productivity.

Organizational KPIs Affected

Return on investments; physician-patient relationship; patient satisfaction ratings.

Principal Stakeholders

Chief Executive Officer; Patient Admission Department; Physicians

Tentative Solution Strategy

Investigate the viability of establishing an easy-to-use, efficient, and commercially-available electronic health record (EHR) that will automate the process documentation of patient information. The system should improve billing processes, patient care delivery processes, management of patient data, and peer communication (exchange of patient data among physicians for better decision-making).

Acquisition Need Confirmation

We/I confirm that this issue can be addressed through the acquisition of IT services (and IT products as needed) from a contractor selected in open competition.

Activity 2 Requirements Development

OBJECTIVE OF THE REQUIREMENTS

Reduce the amount of time required to document patient data and to improve the management of patient information, as stated in the Performance Gap document.

REQUIREMENTS CATEGORY

REQUIREMENTS DEFINITION

1. Stakeholder Considerations that Need to be Reflected in the Solution

Chief Executive Officer seeks increased return on investments and an increase in overall productivity. The Patient Admission Department seeks improvements in the management of patient information. Physicians seek for improved patient care and satisfaction.

2. Factors to Take Into Account Related to the Business Environment (including legal factors, regulations, competition, and business cycles)

Competitors have the capabilities described here since they currently use electronic health records for documentation of patient data.

3. New Capabilities and/or Functionality Required by a Solution (including requirements for ease of use, quality, interoperability, and data sharing)

An electronic health record is required to lessen the time taken by the Patient Admission Department in recording or managing patient information. As a software solution, EHR will help enhance billing and physician-patient relationship.

Must be able to store and support speedy retrieval of patient data, improve peer communication, and enhance billing processes. Must enhance data sharing among clinicians at the facility. The solution must be easy to use, scalable, fast and reliable, and function across platforms. Must operate with existing technology systems.

4. Existing Business Process Shortfalls (why current business process and/or systems cannot meet the needs or be changed to meet the needs)

Current paper-based medical records are cumbersome and time-consuming to prepare. In addition, it takes time to retrieve and share patient data among clinicians. It is error prone, lacks backups, and is likely to create an adverse medical event.

5. Cost Limitations (may be stated in terms of preferred cost range; may specify a maximum cost; cost figures need to include associated overhead costs; may be specified as an annual limit or life cycle limit or both)

The average cost of implementing an electronic health record is $162,000 with additional maintenance of nearly $85,000 in the first year (Quinn, 2016). As a result the total cost of implementation, training, and overhead is expected to range between $170,000 - $240,000.

6. Other Limitations or Constraints (e.g. availability of key personnel, such as subject matter experts, training methods, and time available for training; limitations related to maintenance or to external support)

Since the targeted individuals are hospital personnel, they are readily available for training to use the system. On-the-job training will be used to promote seamless switch from current paper-based records to EHR. The cost of maintenance would be nearly $85,000 in the first year.

7. Safety & Privacy Requirements (any requirements beyond those currently being used by the organization for non-critical and non-sensitive applications)

Since the implementation of EHR will involve switching from the paper-based medical records, the hospital will need to set-up an IT infrastructure to support the new system. A computerized system comprising computers with a processor of at least 2.5GHz, 2GB of RAM, and an internet speed of at least 3 Mb/s is required. The system should support Chrome, Safari, or Microsoft Edge browsers. A comprehensive network security system is also required to safeguard the EHR.

8. Number to be Implemented (e.g. specify the number of places the solution will need to be implemented and whether they are at different geographical locations)

The solution must be provided for the Patient Admission Department, hospital wards/units, and at CEOs office within the facility.

9. Schedule (explain any schedule constraint, whether for financial or non-financial reasons e.g. if the solution be in place as of a certain date, specify the date and why)

Acquire and implement the solution within the next six months February 8, 2022 August 8, 2022.

10. Other Requirements Not Specified Above (e.g. any related to vendors, consultants, partnerships with other entities, unique user interface requirements, documentation needs, special certification requirements)

Requires external/vendor support, especially within the first year of implementation. The implementation process would involve unit and functional...…monitor backup procedures; create redundancy and resiliency protocol for the system.

Risk Category

Probability

Impact if Occurs

Mitigation Strategy

Approximate Risk Exposure

Risk Priority

Organizational Risk

a. Potential user resistance

b. Probable increase in functionality requirements

a. 20%

b. 15%

a. $20,000 - $50,000

b. $30,000 - $50,000

a. Frequent updates to users; involvement of users in all stages

b. Comprehensive review of requirements; pilot testing; provide training

a. $10,000 - $20,000

b. $20,000 $30,000

M2

Information Security and Privacy Risk

Potential data storage problems

20%

$15,000 - $50,000

Strict internal security policies; training users on security risks and measures

$10,000 - $20,000

M2

Complexity Risk

Potential design challenges

10%

$3,000 $5,500

Thorough review of vendor solutions before adoption; ongoing collaboration with the vendor

$1,500 - $2,000

L

Infrastructure Risk

Probable interoperability issues

15%

$2,000 - $5,000

Provide extensive user training

$1,500 - $3,000

L

External Risk

Cybersecurity threats

5%

$5,000 $10,000

Implement strict cyber security policies and procedures

$1,000 - $1,500

L

Average Probability

14.17%

Total Approximate Risk Exposure

$44,000 - $76,500

Alternative Solution #3 (Tentative Solution Rank Order #2):

Identify a third-party EHR system; establish partnerships with the third-party for use its servers to store patient data.

Risk Category

Probability

Impact if Occurs

Mitigation Strategy

Approximate Risk Exposure

Risk Priority

Organizational Risk

Potential collaboration challenges with the third-party

15%

$5,000 - $10,000

Comprehensive review of third-party history and capabilities during the identification phase; establish proper partnership policies or procedures

$2,000 - $5,000

M

Information Security and Privacy Risk

Potential loss of control of data storage procedures

30%

$15,000 - $50,000

Establish proper collaboration procedures with the third-party; on-going partnership

$5,000 - $10,000

M2

Complexity Risk

Incompatibility issues

25%

$3,000 $5,000

Thorough review of third-party solutions before adoption; ongoing collaboration with the third-party

$1,500 - $2,500

M

Infrastructure Risk

Limited capabilities offered by the third-party

15%

$2,000 - $5,000

Comprehensive review of available solutions and their capabilities

$1,500 - $3,000

L

External Risk

Cybersecurity threats

5%

$5,000 $10,000

Provider comprehensive user training

$1,000 - $3,000

L

Average Probability

18%

Total Approximate Risk Exposure

$11,000 - $23,500

Alternative Solution #4 (Tentative Solution Rank Order #3):

Leverage the capabilities of another facility and establish partnerships for subsidized use of electronic health record.

Risk Category

Probability

Impact if Occurs

Mitigation Strategy

Approximate Risk Exposure

Risk Priority

Organizational Risk

Potential collaboration challenges with the host facility

25%

$5,000 - $7,500

Comprehensive review of third-party history and capabilities during the identification phase; establish proper measures for collaboration

$1,800 - $3,200

M2

Information Security and Privacy Risk

Potential loss of control of data storage procedures

30%

$15,000 - $40,000

Establish proper collaboration procedures with the host facility; on-going partnership

$4,000 - $6,500

M2

Complexity Risk

Incompatibility issues

25%

$3,000 $5,000

Ongoing collaboration with the third-party

$2,000 - $2,500

M

Infrastructure Risk

Limited capabilities offered by the host facility

20%

$2,000 - $5,000

Comprehensive review of host facilitys capabilities

$1,500 - $3,000

L

External Risk

Cybersecurity threats

10%

$5,000 $10,000

Provider comprehensive user training

$3,000 - $5,000

L

Average Probability

22%

Total Approximate Risk Exposure

$12,300 - $20,200

Recommendation: Eliminate Alternatives #2 and #4 and Retain Alternatives #1 and #3

Based on this risk analysis and in consideration of the probable benefits and the Template 4 ratings, Alternative #2 (client-server electronic health record) and #4 (subsidized EHR system) are eliminated from further consideration. Alternative #2 is eliminated principally because of its high costs of implementation and the risk of probable interoperability issues and potential data storage problems. Alternative #4 is eliminated due to the risk of potential loss of data storage processes, incompatibility issues, and potential challenges in collaboration. Alternative #1 and…