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System development life cycle of electronic health records

22/12/2020 Client: saad24vbs Deadline: 14 Days


Attributes


Comments


Draft Value


Preliminary investigation


The preliminary outline of system requirements was fine. Your choice of the four phase SDLC is also fine, but you should explain why it's the most appropriate for this application.


3.75 out of 3.75 pts


Requirements identification and analysis


Indicating the need for HIPAA compliance is good.


Specify an ISP, and describe electronic and physical facility protection.


3.75 out of 3.75 pts


System design


Choosing CureMD as your EMR software was fine. Be sure to clearly state how its requirements as used to drive your hardware choices.


The outline was OK but your final design must include specific SW/HW recommendations (make and model) for all computing, server, network, power (UPS protection), anti-virus, office productivity SW, and peripheral components, as you did in the Product Survey. Include a network diagram with the final design.


3.0 out of 3.75 pts


System implementation


The outline was good. Ensure that customer interaction is included as the system is configured.


3.75 out of 3.75 pts


System test plan


The outline was good. Be sure that your testing includes both functional for the facility, i.e., the use of test cases, and security verification. It's important to allow for users to be involved in testing and to account for iterations as bugs are discovered and corrected. Don't forget a training plan for existing and new personnel after the system is implemented, e.g., a training manual.


2.4 out of 2.5 pts


Assignment Management


For the final, include an executive summary.


1.25 out of 1.25 pts


Organization and Structure


Organizing your paper using the phases of the SDLC is best.


3.75 out of 3.75 pts


Readability, Style, Mechanics


See additional comments below


1.5 out of 2.5 pts


Total:


23.15 out of 25 pts


Contribution to final grade:


4.63 out of 5 pts


System Development Life Cycle for Electronic Medical Record Systems Small System Design DRAFT Kristina Englebert 4/15/2015


Table of Contents Requirement Analysis/ Study Phase 2 Design 2 Hardware Requirements 3 Software requirements 3 Implementation 4 Testing Phase 5 Unit Functional 5 System Testing 5 Integration Testing 5 Performance Testing 6 Reference 7


System Systems Development Life Cycle for Electronic Medical Record Systems

There are primarily four phases in the SDLC of EMR System. It starts with the requirement analysis or study phase, followed by the design phase, implementation phase and Testing phase.


Requirement Analysis/ Study Phase


Our Town Urgent care facility is a small care facility that has ten beds and five member primary physician groups. The hospital system has currently been using paper charting systems so this will be considered a complete turnaround. It is required to implement and an Electronic Medical Record System to effectively manage the patients patients' data and personal records for the hospital. Hence, the company has to setup a new IT Infrastructure in order to support the EMR. It includes buying a new software license, setting up new computers, internet connection, LAN setup, Printerprinter, Small small scale servers and other supporting devices.


Requirements include a better customer record management system, and report generation system. Electronic medical records will help the patients understand and be able to gain access to their health care records quickly. The electronic medical records will also help the health care professionals keep the health care records safe and it will help them to access them quicker too.


System should also be able to do both billing and clinical functions on a single platform. It will save time to enter the same data for generating two different reports. System should be capable of keeping a track of schedules, provide reminders for the appointments, Easy easy to use Dashboarddashboard, Template Library to choose customized report options, Patient Portal and Education and Clinical Decisions support.


Design

In this phase we deal with the layout of the systems that will be interconnected for use of the physicians and doctors (redundant) working in Our Town Urgent Care Facility. There are two options to implement the EMR system. Either, Our Town selects a cloud based option or a local server option. As the given company is small, it is better to opt for the cloud based solution because it is cost effective solution. In addition, cloud based system is much more secure. It also provides easy access to the associated users.


After careful examination of the requirements for the small company we decided to go for the system that can meet the criteria outlines in the requirement phase. The company has to choose among, eClinicalWorks, Allscripts, Epic Systems, NextGen Healthcare or CureMD system. On the basis of the features and cost, CureMD is the most plausible option as clinic gets it a better price and all functionalities that are required by a small company.


Soon after selecting the desired EMR, next thing is to select the hardware and software that can run the Electronic Medical Record software without any interruption.


Hardware Requirements

· Five Computers computers with windows Windows 8 platform as most of the users are comfortable with windowsWindows.


· Intel Processor i7 for faster processing of information with an approximate speed of 2.5 GHz


· As most of the data will be stored on the cloud, hence 320 GB hard disk is sufficient to serve the purpose.


· There is an option to choose hardwired desktop computers or mobile notebook or tablet devices at the workstations. We chose hardwired desktop computers to avoid the problems associated with notebooks – increased cost, more difficulty repairing or swapping components, limited battery life, potential for damage due to dropping or fluid spills and the additional layer of technology needed for wireless connections.


· A LAN layout to connect all the computers together.


· Peripheral devices include printers, scanners, Fax fax machines and Card card Reader reader that can read the embedded information in health insurance cards, etc.


· As everything is on the cloud, there is no need of contingency server. It will also save the cost.


· Cloud is a secured medium and everything is secured. With the help of cloud based data system we can provide user specific access. It will limit the role of different users and won’t compromise the security of the system. For example, if someone is entitled to generate patient report, then that same person won’t be able to see the billing information of the patient.


Software requirements

· Only windows Windows 8 License


· Microsoft products will be required


· EHM record system from CureMD so that in case there is no LAN connection data can be entered offline to push it on the cloud. Comment by Barry S. Shender, PhD: define


Implementation

With the hardware selections made, the setting up a small, off-site test installation of the server, workstation, printer and scanner is done. Once the software is installed, a large amount of testing and configuration on the test system is done before moving it to the practice site. Office staff with less computer experience was were given more time to become more familiar with the operating system and the e-mail and word-processing programs.


Software configuration


Good EMR software can be adapted to your practice environment without expensive custom programming. CureMD has its own configuration requirements that need to be taken care of by the team itself. Below are few aspects that are taken care of while implementing the set up.


· Security: EMR software should have the ability to limit access to various portions of the record to particular users. Our goal was to restrict access to all but a few high-level users for functions that posed obvious risks for intentional or accidental compromise of the integrity of the chart, such as the ability to delete progress notes.


· Templates: A template is a set of structured text elements that prompt the user to add pieces of data to document the medical encounter. CureMD is more flexible, allowing data entry by template and direct entry (typing). Developing templates (and even modifying existing templates) requires considerable time and effort (Richard Dell, Charles Rhoades, & Mevis, 2011).


· Backup system Development: CureMD, EMR provider created a good database and application backup system in place. In case of disaster or system shut down, all the data on the cloud can be replicated to another backup database designed by CureMD.


· Entering old data: The amount of old data to load into the EMR before going live depends on available time and money, and the needs and desires of the clinicians. Options range from no preloaded data to extensive abstraction and data entry. We purchased an interface that loaded all of the demographic data from our billing system to our EMR and updates any changes every five minutes. We loaded the last three months’ worth of progress notes shortly before going live. Rest of the data was entered manually in parallel to ensure the timely completion of this process (Smith, 2003).


Testing Phase

Unit Functional

· Each major function performs as specified in user manual.


· Design changes/customizations are present & and work as requested. Document all changes for reference.


· Screens appear as expected (content and placement of fields, codes, drop down menus, and messages).


· No spelling errors or color changes. Readable icons.


· Appropriate representation of content can be printed if necessary for legal purposes.


· Entries that have been corrected and their corrections are both displayed accurately.


· Fields edits (e.g., valid values, options, defaults) function as expected.


· Alerts and clinical decision support provides appropriate reminders and prompts. Use scripts to test various scenarios.


System Testing

· Workflows send and/or receive data properly between systems (e.g., between EHR and pharmacy or billing, PMS messages and EHR). Use scripts to test various scenarios.


· Interfaces between applications move data correctly and completely. Test both sending and receiving when interfaces are bi-directional


· Connectivity with external organizations is accurate and complete as authorized (e.g., portal access to/from hospital/clinic, continuity of care record to referrals, personal health records for patients, disease management to/from health plan).


· System access is appropriate per assigned privileges. Test attempts to gain access when not authorized.


· Data are processed accurately, in graphs, tables, claims, client summaries, reports, etc.


· Data correctly populate registries, reporting warehouses, etc.


Integration Testing

· Ensure all system components that share data or depend on other components work together properly.


· Ensure that workflows reflect actual new processes and workflows.


· Ensure that usage is defined in and follows policies and procedures. Reinforce training as applicable.


· Ensure that help desk, support personnel, and other aids function properly.


Performance Testing

· Measure response times for key transactions or interactions with the system, and assure they are within acceptable limits, which may be defined in the contract.


· Simulate an extremely high volume of activity on the system such as would exceed anticipated peak loads of system usage.


· Measure the time it takes to generate reports and data dumps, and the impact on system performance (National Learning Consortium, 2012).


References National Learning Consortium. (2012, 04 12). Electronic Health Record (EHR) System Testing Plan. Retrieved 04 15, 2015, from www.healthit.gov: www.healthit.gov/sites/default/files/ehr-system-test-plan.docx Richard Dell, M., Charles Rhoades, M., & Mevis, a. H. (2011, 11). 10 tips to implementing an EMR system. Retrieved 04 16, 2015, from http://www.aaos.org/: http://www.aaos.org/news/aaosnow/nov11/managing2.asp Smith, P. D. (2003). Implementing an EMR System: One Clinic’s Experience. Retrieved 04 14, 2015, from http://www.aafp.org/: http://www.aafp.org/fpm/2003/0500/p37.html


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