Final Project
Table of Contents
Preliminary Investigation………………………… 3-5
WBS……………………………5-6
Gantt/Pert Charts……………………6-7
Patient Questionnaire………………………7-9
DFD Diagram………………………10
Use Case Diagram……………………11
FDD Diagram……………………12
System Requirements……………………12-13
Electronic Patient Scheduling Software……………………13-14
Sample Input/Output Prototypes……………………14-17
Application Development Plan, System Changeover Plan, User Training Plan & Maintenance/Support Plan………………………18-20
References………………………21
PRELIMINARY INVESTIGATION
1. Understand the problem or opportunity: Heartfelt, a large clinic, would like to implement a new, electronic patient appointment scheduling system to replace the current paper …show more content…
scheduling system. The current system is inefficient, causing long patient waiting times and doctors having to work late because appointments are scheduled too close together.
2. Define the project scope and constraints: The electronic patient appointment scheduling system will be implemented through a software program of the clinics choice. All potential stakeholders and/or users will give input regarding which software they feel will best suit the clinic’s needs.
Constraints: The scheduling system must update on all department computers after any new entry has been made.
The system must be operational by December 20th, 2013.
The system must know average appointment times for all types of visits to avoid over booking patients.
The system must alert users of cancellations or changes so patients on a waiting list can be scheduled in if possible.
3. Perform fact-finding: Analyze the organizational chart of the clinic to determine stakeholders and/or users. Interview receptionists, nurses, doctors and assistants. Review the current paper patient appointment scheduling method. Observe the clinics operations for a day. Survey receptionists, doctors, nurses and assistants on what expectations they may have for an electronic patient appointment scheduling system. Identify the costs of the new electronic system.
4. Study usability, cost, benefit and schedule data: Analyze the interview information. Analyze the user surveys. Analyze observation notes to highlight key facts. Compare cost data.
5. Evaluate feasibility
Operational Feasibility: Will the clinic users be able to effectively use the new system? Will extra training be needed for computer and software use? The IT department will work with all users through hands on training to make sure that everyone understands the new system.
Technical Feasibility: Does the clinic have the necessary software, hardware, equipment and networking resources available for the new system? Does the current system need to be upgraded to handle the change effectively? Heartfelt will upgrade their current computers. Networking resources are currently in place and new software will be purchased.
Economic Feasibility: Can the clinic afford the new patient appointment scheduling software? Can the clinic afford training for the users? Can the clinic afford new equipment if needed? The clinic has been diligent in staying within the allotted budget. Training and software will be purchased once all measures have been set in place.
Schedule Feasibility: Can the clinic stakeholders’ timeline of December 20th, 2013 be met?
6. Present recommendations to management: I will prepare a written preliminary investigation report and present all of my findings to the clinic stakeholders. Some items to be included: Introduction-overview of the report; Systems Request Summary-basis of the systems request; Findings-results of preliminary investigation and Time and Cost Estimates-cost of acquiring and installing the new system and total cost of ownership during the life of the system.
Systems Review: The current patient appointment scheduling system at Heartfelt Clinic is paper based. The clinic started out as a small clinic, but it is centrally located and has since grown tremendously. The paper based scheduling system worked for the clinic in the past, but now with a higher patient volume, increased staff and reimbursement requirements, the clinic is looking for an efficient, user friendly, electronic form of scheduling. Strong points to utilizing a paper based scheduling system: low cost; no software, hardware, equipment or training to worry about; user friendly; always available-no computer crashing or malfunctions. Weak points: takes up desk space; patients appointments can overlap because schedulers aren’t sure of the amount of time each visit calls for; not secure; mistakes can be made and/or missed; not everyone is able to see the schedule book.
With an electronic patient scheduling system, information would be safe and secure, all users would have access, information would be updated instantly, mistakes would be detected and corrected, appointments would be scheduled according to time allotment and it frees up desk space. The new system would cost extra money in equipment, software and training. The extra cost would, in time, pay for itself. Solving the scheduling problem would give the clinic more time to focus on acquiring new patients, keeping up to date with billing and coding and keeping the stakeholders satisfied.
Task #
Description
Duration (Days)
Predecessor Tasks
1 Systems Planning Phase
Systems Request
3
-
Systems Review
5
WBS
1
GANTT/PERT
1
2 Systems Analysis Phase
Questionnaire/Interview Questions
1
1
Context DFD
1
Use Case Diagram
1
System Requirements
1
Commercial Software Package Research
1
3 Systems Design Phase
Input Prototype
2
2
Output Prototype
2
4 Systems Implementation Phase
Application Development Plan
4
3
System Changeover Plan
2
User Training Plan
1
5 Systems Support & Security Phase
Maintenance & Support Plan
1
4
Patient Scheduling Questionnaire
Lucy Smith, executive director, has asked me to investigate Heartfelt’s current paper based patient scheduling system.
Your input concerning the current system will be very valuable in making future decisions affecting the implementation of a new scheduling system. Please return the questionnaire by December 14th to the HR department.
A. YOUR OBSERVATIONS
1. Is the current paper based scheduling system efficient? Why or why not.
2. Is the current system user friendly? Why or why not.
3. Do you see a high amount of errors occurring within this system?
4. Are patients satisfied with this type of scheduling system?
5. Does the current system meet all privacy requirements?
6. What types of errors are most commonly made within this system?
7. Do you feel comfortable using the current system?
8. Would you be interested in trying a new, electronic patient scheduling system?
B. YOUR SUGGESTIONS
Please be specific, and give examples if possible.
1. What changes to the current paper based system, if any, would you
recommend?
2. Please include any other comments here.
If you are interested in having Lucy contact you to discuss your ideas further, please leave your information below. Thank you for taking the time to help us out!
Name: Department: E-Mail:
System Requirements:
The system must update automatically on all computers throughout the department after any information is entered or changed.
The system must know average appointment times and generate a user error message if an appointment is placed incorrectly.
The system must maintain separate levels of security for the users and the system administrator.
The system must be operational 7 days a week, 24 hours a day in case of emergencies.
The system must calculate the average hours worked per week for each practitioner, making sure that schedules are balanced evenly.
1. MediTouch by HealthFusion is the first software package that I researched on the Internet. This software can be used independently or in conjunction with the MediTouch EHR. This system is entirely web based and hosted so the clinic would not need to install or maintain any type of software on site. MediTouch automates billing, registration and scheduling for small and large clinics. MediTouch is a great fit for providers who want to take advantage of federal and state incentive programs. For example, the system supports e-prescribing, which enables physicians to earn an additional 2% on Medicare reimbursements. Also, the system supports PQRI reporting, which can also qualify providers for an additional 2% in Medicare reimbursements. I read most of the reviews for this software and they were all in favor for MediTouch. The Better Business Bureau has given MediTouch an A+ rating. Must sign up for price information.
2. Kareo is the second software that I researched on the Internet. Kareo is one of the most popular web-based medical billing and practice management solutions on the market. This system is used quite a bit for small practices and billing companies. Clinics can easily schedule patients, confirm insurance, manage past due accounts, store patient documents, develop customized reports, etc. Kareo is a web-based solution so the clinic can focus on the patients instead of maintaining and updating software. On average, the reviews were positive with a few that weren’t thrilled with the software. Must sign up for price information.
3. The third software that I looked into was WRSHealth. This software had 5 stars, the other two having 4.5 stars. WRS Health was one of the early leaders in the market for web-based electronic health records (EHRs). While there were a number of web-based practice management systems early on, Waiting Room Solutions was one of the first to deliver a true EHR on a web-based architecture. 2013 WRS Health is a powerful system for EHR, medical billing, patient scheduling, order management, e-prescribing, image management, secure faxing, and disease management. The product has already achieved 2011-2012 ONC-ATCB Certification and CCHIT 2011 Certification. Providers using this system will be eligible for meaningful use incentives. One unique aspect of the company is that the CEO, Dr. Larry Gordon, is a practicing physician. Because WRS has been designed by a practicing physician, it has led to the development of the system 's very intuitive, logical workflow. WRS Health is priced based on the number of providers in the organization and consists of a low monthly subscription fee. Prices include support and upgrades. However, buyers will want to request a detailed price quote as there are discounts available for multi-provider organizations and bundled services.
In my opinion, WRSHealth would be the best option for Heartfelt Clinic. The reviews were great, it’s an industry leader and it’s been around for a long time. I also like the fact that WRSHealth was designed by a practicing physician. Meaningful use is a big deal for clinics and with this software, the clinic will be eligible. Economically, services can be bundled and there are discounts available. Operationally, this will benefit the company. WRSHealth already has a few certifications. Technically, the price of the software includes IT support and all upgrades.
Heartfelt Clinic: Weekly patient scheduling appointment system. This system is electronic. The patient scheduling section consists of basic data entry. If the user needs patient specific information, double clicking the patient’s name will display demographic, reason for visit, insurance and any other pertinent information.
Week of
Monday
Tuesday
Name
Doctor
Name doctor 8:oo
Patient Name
Practitioner Name
8:oo
9:00
9:00
10:00
10:00
11:00
11:00
12:00
12:00
1:00
1:00
2:00
2:00
3:00
3:00
4:00
4:00
5:00
5:00
Wednesday
Thursday
Name doctor Name doctor 8:oo
8:oo
9:00
9:00
10:00
10:00
11:00
11:00
12:00
12:00
1:00
1:00
2:00
2:00
3:00
3:00
4:00
4:00
5:00
5:00
Friday
Saturday/Sunday
Name doctor Name doctor 8:oo
8:oo
9:00
9:00
10:00
10:00
11:00
11:00
12:00
12:00
1:00
1:00
2:00
2:00
3:00
3:00
4:00
4:00
5:00
5:00
Heartfelt Clinic 67584 E. Broadway St. Duluth, MN 76590
STATEMENT
sTATEMENT #
Date:
BILL To
Patient Name
[Street Address]
[City, ST ZIP Code]
[phone]
Medical ID
COMMENTS
dATE
DESCRIPTION of service
BALANCE
AMOUNT
CURRENT
1-30 DAYS
PAST DUE
31-60 DAYS
PAST DUE
61-90 DAYS
PAST dUE
OVER 90 DAYS
PAST dUE
AMOUNT DUE
Remittance
Statement #
Date
Amount Due
Amount Enclosed
Make all checks payable to
Thank you for your business!
Application Development Plan
The best approach for Heartfelt Clinic’s application development plan would be the agile method. The agile methods share some similarities with the traditional methods, but the main focus of the agile method is intense collaboration and communication between the IT team and the users. The development team will be in constant communication with the users. In this case the users would include: schedulers, nurses, doctors, patients, etc. The main goal of Heartfelt’s development team is to match the user’s specifications. Specifically, the Extreme Programming model will be utilized in order to define Heartfelt’s system requirements. Programmers will review user stories to determine the project’s requirements, scope and priorities. Prototypes will be developed and tested and modified as needed. The success of this approach is based on the users approval. The programming team will meet with the users who will test the new prototypes. Once everything has been accepted, obsolete code is removed and the remaining code is restructured to keep the system up to date.
System Changeover Plan
The phased operation changeover method would work best for Heartfelt Clinic. This method allows the clinic to implement the new system in stages. Risks and costs are cut by combining the direct cutover and parallel operation methods. This will benefit the clinic due to its medium size and tight budget. Another advantage of the phased approach is that the risk of errors or failures is limited to the implemented module only. The phased operation changeover method will be very successful due to the fact that the new implementation can be easily separated into logical modules.
User Training Plan
With the implementation of Heartfelt Clinic’s new electronic patient scheduling program, all users will need to be trained in newly added areas. The IT team will work closely with the department managers to make revisions to the original user guide. The new guide will include step-by-step instructions on how to access and utilize the new system. There will be a frequently asked questions section where users can turn if they run into problems. 24/7 online support will be available as well. This is to ensure that any and all questions users may have get answered promptly. Department managers will schedule several training sessions prior to the launch of the new system. The IT department will lead these sessions and all users will be required to attend in order to get signed into the system.
Maintenance & Support Plan In order for Heartfelt Clinic’s new patient scheduling system to be effective, the IT team will work in collaboration with department managers to implement an efficient maintenance and support plan. Maintenance activities include: changing programs, procedures or documentation to ensure correct system performance; adapting the system to changing requirements and making the new system is operating at its highest potential. There are four different types of maintenance: corrective, adaptive, perfective and preventive. All four will be included to ensure optimal performance.
Corrective: During this phase, analysis, design and testing will be performed on the new system before any implementation. Users will be able to submit system requests and if approved, the maintenance team will design, test, document and implement a solution. All requests are added to the maintenance log. The IT team will design the permanent solution and prepare full documentation.
Adaptive: The maintenance/IT team will ensure that the new system is easy to use. Enhancements for Heartfelt Clinic will include: new computers and new software. The support team will work diligently to have the new enhancements working with the constraints of the clinic’s existing system.
Perfective: This maintenance will be performed during the middle of Heartfelt’s operational life. This is the point when it is most effective. User errors will be looked at and the IT team will work with them to modify the data entry process. Analysts will use a technique called software reengineering. This technique will allow the team to identify quality and improvement solutions in the new system. Reengineering will simplify operations, reduce costs and improve the overall quality of the system.
Preventive: The IT team heads preventive maintenance. Preventive maintenance requires analysis of areas where trouble is likely to occur in order to avoid problems. This maintenance will result in increased user satisfaction, decreased downtime and reduced total cost of ownership.
References
Systems analysis and design. Boston: London: Cengage Learning. Shelly, G.B. & Rosenblatt, H.J. 2009
www.healthfusion.com
www.softwareadvice.com
www.waitingroomsolutions.com