Http://dn58412/IS531/IS531_SP15.html Lecture 10 System Implementation and Maintenance (Chapter 10)

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Lecture 10System Implementation and

Maintenance (Chapter 10)

Learning ObjectivesLearning Objectives

1. Cultural change in System Implementation

2. Implementation committee3. Issues in test, training, and

production environments. 4. The “go-live” process5. Implementation pitfalls.6. Maintenance and System Life Cycle

IS 531 : Lecture 10 2

System ImplementationSystem 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


Implementation CommitteeImplementation 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


Implementation CommitteeImplementation 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.


Committee Tasks 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.


Getting to Know the SystemGetting 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


Issues to Revisit 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


Cultural Changes in System Cultural Changes in System ImplementationImplementation


• “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 …)

Base System vs. CustomBase 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.


System FunctionSystem Function

• A task performed manually or automated• Must identify information pertinent to

completion of each function• Examples

– Order entry– Results reporting– Documentation


System OutputSystem Output

• Material generated by the system• Examples

– Requisitions produced in other departments

– Reports– Diagnostic results– Work lists– Charges


Required Output for Required Output for New SystemNew 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.


Test EnvironmentTest 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


Test PlanTest 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


Hardware RequirementsHardware 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


Network InfrastructureNetwork 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


Workstations and Mobile Workstations and Mobile DevicesDevices

• 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.


Procedures and Procedures and DocumentationDocumentation

• 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


System DocumentationSystem 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.


User System TrainingUser 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


Go-Live PlanningGo-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


Implementation PitfallsImplementation 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


MaintenanceMaintenance

• 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


Technical MaintenanceTechnical 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


Return on Investment (ROI)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


The Role of NursingThe Role of Nursing

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

• Nurse informaticists provide “credibility” for information system projects.


Nurse Informaticist Nurse Informaticist ResponsibilitiesResponsibilities

• 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.


Documents

Http://dn58412/IS531/IS531_SP15.html Lecture 10 System Implementation and Maintenance (Chapter 10)