hello there

1. Development of a new Hospital system
Name
Institution

2. 1. Introduction
Like many other health information systems, the hospital facility will need a new
system that will enhance the quality of care in the hospital under this study. The hospital has
an aim to approach it through patient-centered care, and the current systems have not met the
required expectations. The paper, therefore, discusses the various ways in which the hospital
could implement the system from a project management perspective. After extensive research
in the health facility, it was agreed that a mare implementation of an information system
would not lead to the organization's efficiency. Still, there are many other considerations such
as involving the leadership and management, the establishment of compatibility between
hardware and software, integration of workflow while focusing on user involvement. The last
aspects include system acceptability and the need for training.
2. Problem Statement
The facility has maintained Electronic Health System, but most of the systems are
currently outdated and lack imaging functionality. The goal of the current project is to
implement a customized system that would ensure that the charts and many other
functionalities are lacking in the facility. The initiative has been driven by the government
regulations that apply in Denmark, the USA, and the U.K. The new custom development has
been driven by the need to make data available for patients and improve efficiency ad patient
outcomes (Schoen, Osborn, Squires Doty, Rasmussen, Pierson, 2012). The new system will
also improve doctor-patient relationships in an era where patient care is shared by a team of
professionals while dealing with the rapidly changing work environment. At the same time,
they need to access their medical information in real-time. The main objectives of the new
system are increasing patient outcomes and making the hospital facility be focused on a
patient-centered approach. The hospital has a varied workforce that includes medical

3. professionals who possess good expertise, power, and autonomy. They may need the system
for various work-related duties such as diagnosing a patient while at home; there will be a
need for prompt access to data in such a case.
3. Background
The change in a healthcare facility is moving at a fast rate to comply with the
regulatory policy requirements such as those by ICD 10 (Alain, 2018). The system needs to
meet the emergence of new models of care such as Patient-Centered home care. The new
practices will be adopted when the new system is implemented (Jeffrey & Hoffer, 2014).
During the stressful times, the providers and their staff have adapted to changes, and the
change has become a new way of life. Fortunately, change management is a well-developed
field, having significant evidence that leads to practices on the way forward towards the
navigation of the change management process. Kotter () believes that the change process in a
company has to be both emotional and situational components, and he proposed a multistep
change model to be used in change management.
It is the work of the healthcare manager to manage an extremely challenging position
and maintain a competitive edge in the healthcare market. Therefore, rapid change is
occurring in many healthcare organizations as they strive to adopt new technologies such as
the implementation of a custom-made chart generation system. Automation has developed
and has become an integral part of the current system as it helps in capturing the information
about patients and allows the sharing of that data. The records to be shared are to be released
to the enterprise-wide system in a summary form (Sattarova and Kim 2017). The data that will
be shared include the immunization data, radiology images, and patient demographics. Other
personal information such as age, weight, and lab tests may give vital signs and billing
information added to the charts.

4. The medical sector is a critical area and has always been growing as there is a
population increase; this is true especially when people need to have access to medical
services. As a result, there are challenges in handling the patient data and using the data for
the purpose of budgeting; since the facilities do not grow in any area of coverage, the data
grow by volume of the patients. Hence there is a great need for handling the data in a
particular manner (Fraser, Biodich, Moodley, Choi, Mamlin & Szolovits, 2015). There is a
need for growth of consistency of the data used in decision making by the health officers and
the government. For this to be successful, The Health records system needs to be automated
and operate in a single facility, manage data, and provide access to the data whenever
necessary (Centers for Medicare & Medicaid Services, 2008, March 27). The system will
also be necessary for reducing the time taken to retrieve charts and images from the current
information system. Also, the time is taken to compile data for various reports and reduce
patient data loss. Therefore, the system's main aim is to have the patients at its core (Simborg,
Detmer, Berner, 2013). When using the system, patients are able to store their information.
They have clear access to their data shared by the practitioners, and the patient information
technology is also useful in preventing the disease prevalence and each patient (McDonald,
2019).
4. Significance of the Problem
The problem of imaging has been in the hospital for a long time, and it is important
for the facility to increase the efficiency of the hospital. The goal of the health facility is to
improve patient and nurse outcomes. The health facility also needs to adhere to the CDC's
requirements for the digital divide and allow accessibility of patient records (Jeffrey, 2014).
The new system will help resolve these problems and help the facility navigate the
interdependency, and improve patient care. The hospital also needs to access complete

5. clinical information that is usually unavailable at the point of care. Currently, no system
addresses the above needs. There is also a lack of innovations currently in the hospital to
improve the system, thus making a new system more urgent (Fraser, Biodich, Moodley, Choi,
Mamlin & Szolovits, 2015).
5. Consequences of the Problem
The facility will need to use the system in accessing up-to-date information from the
database, the new user interface to facilitate the use of graphics. At the same time, the
continued use of the current technology by the nurses and doctors may lead to a negative
attitude towards the use of the new system, hence slow down the hospital operations
(Sattarova and Kim,2017). Since the hospital staff will have access to multiple data, their
enhanced access may lead to patient data disclosure, which is a risk that must be mitigated or
controlled. This is because the nurses may disclose patient-specific data to unauthorized
users. This may negatively affect work-flows and patient-provider interactions, and
information overload from the computer-generated data (Simborg, Detmer, Berner 2013).
The other consequence of the system slow adoption of future technologies by the hospital.
6. Practice Knowledge Gap
Health Information system has improved the coordination of care delivered to the
high-need patients, and productive the health system, the HIT tools available have hindered
the development of new systems, the research team interviewed experts and many hospital
organizations to define the obstacles and determine the path towards improving the healthcare
delivery. The research gap found that there are four barriers to the creation of the complex
coordination of healthcare. Number one, most healthcare information system designers are
handicapped when trying to come up with ways to address the complexity of the healthcare

6. system. Secondly, experts also remain divided on the activities and the providers that should
be factored into the coordination and other initiative activities. The third fact is that there is a
need for diversified practice patterns, job definitions, and workflows; this shows an enormous
variation from one practice to the next while defining the roles and responsibilities among the
various experts.
7. Literature review
The expenditure by the hospital in software has risen, with the spending reaching
more than 67% of I.T. budget allocation on I.T. operations in 2018 alone, and the numbers
are expected to rise. The rise in costs includes procurement, development of new software,
and investment in the modifications and upgrades. Implementation of software change is not
an easy task, as it involves investment and unique staffing needs, which is why it is critical to
get it right the first time. Well-implemented change management is a key component of every
software change. The process will give the decision-makers a complete and accurate
understanding of the impact of the software changes and identify the potential disruptions to
functions, operations, and departments affected by the change. There are many ways to
approach change management, and the best approach is to ensure a glitch-free approach to
the change rollout.
One of the disadvantages of the modern workplace is the emergence of data
warehouses. The warehouses can hamper efficiency and growth and cause other problems
that include redundancy in effort and decreased collaboration. There is a need for efficient
application, discovery, and dependency mapping to break these problems as a crucial step in
the management of the change project. According to the findings of the Forester Survey, 56%
of the I.T. managers have no complete view of their dependences, especially between the
application and the infrastructure. Another survey revealed that 30% of the Information

7. Technology managers think of having all the inventory for hardware and software in-house is
critical for I.T. efficiency. Despite this, 42% still do not collect their data, while another 39%
maintain their inventory manually.
One major disadvantage of inefficient dependency mapping includes low
productivity, increased overheads, and poor team. The critical step in solving the issues is
ensuring that the right technology for dependency mapping is used. It can support a solid
foundation for a software change for any information technology project. When a reliable and
agile software solution is adopted, it means that it will provide micro and macro views of the
changes to be made on the software; additionally, the I.T. decision-makers can have a
consolidated view of their application stack across the multiple message queues, databases,
and unifying languages and codes.
The process of change management has traditionally been related to software
maintenance; the process of controlling changes has been defined as part of configuration
management. The literature review considers two common viewpoints of software change
management. The first viewpoint is examining the process for managing changes in the
existing software configurations and items in any software development life cycle phase.
There has discussion on the relationship between software configuration management and
change management. The software configuration management examines software from
version control, release-oriented, and change-oriented SCM.
The approach gives a 12-level improvement framework for the configuration and
change management where the first level of the configuration includes version control
activities. At this level, change management is limited to the storage and creation of the
change documents. The other levels include the change-oriented level, which supports
software evolution and maintenance; the last six levels also include product management and

8. efficiency highlight use of the reusable components of the advanced assembly systems
(Tomasi, Facchini & Maia, 2014). The difference between system evolution and software
maintenance is that software maintenance deals with fine-grained changes while system
evolution deals with structural changes. The system evolution changes the system's structure;
it is not a short-term activity and has produced few economic benefits. It, on the other hand,
system evolution increases the economic and strategic values of the software.
8. Project Overview
a) Scope of Project
The project includes the preparation of software that implements imaging in a health
facility. The system is to be developed to ensure the various security measures that do not
violate HIPAA requirements. The software will be developed using an agile development
environment that also demands the presence of agile teams.
b) Deliverables
Goals and Objectives
The goal of the system is to improve patient care and nursing outcomes. The project's
main feature will include adding a charting functionality to the system; apart from this, there
are other structural information such as increasing coordination between departments, cash
points and laboratory, and other clinical departments. The medical service billing and
laboratory test functionalities are also included in the project. The system will also add
patient profiles such as medication history and generating reports.

9. In Scope of the project
 Software development
 Transfer of data, change management, and also workflow creation
 Training of the users on the new system
Out of Scope
 System maintenance and update monitoring are out of the scope of the current
system.
c) Goals of the system
Specific:
 The new technology will ensure an easier store of electronic data, and the clinicians
will also have access to the providers and other integrated needs.
 It will also allow easy communications around the facility and
Measurable
 The accuracy of data access will increase by 30%.
 The efficiency of communication will increase by 30%
 The clinical outcome and customer satisfaction will increase by 20%.
Attainable
 There is goodwill from the board on the new system; therefore, the senior board is not
an obstacle to developing the new system.

10.  Nurses and doctor preparedness have been going on for some time, and they are
anticipating the new system.
 Doctors also have a strong belief that the new technology will improve their
outcomes.
Relatedto the Goal
The main goal of the hospital is to improve efficiency and patient outcome. The
information system being developed will assist towards this by:
 Improving communication among the clinicians, nurses, and doctors
 Increase the response time to patient queries in time by doctors.
 Improve the time it takes to assess medical conditions through improved imaging and
charts.
 Collaborate with insurance brokers in sharing patient data to facilitate treatment
settlements.
Timely
 The implementation of the information system will be done in less than one year.
d) Project Players
The key stakeholders for the project include the project manager, team members, and
also resource managers. The team will do the project's actual implementation, while the
health facility owners will be interested in how effective and the project's outcome. The
project manager will ensure that the team delivers what they need, and the resource manager
will contact the suppliers and ensure that the project has enough teams to work on the project.

11. Key Change Agent
Project Manager
Key Stakeholders
Project Sponsor
Community Partner
Project Team
Institutional Leadership
The leadership of the project has been linked to several functions, and it is a
requirement of the hospital care; these include system performance and achievement of
healthcare reforms, the requirement of timely system delivery, and ensuring that the system
developed helps in ensuring the integrity of the system and efficiency during the development
Role or Name Department
Facility Board of governors I.T.
Information Technology Team I.T.
Role or Name Department Est. Hours Rate Total
Vendor selection team member I.T. 40 220 $8,800
Testing team I.T. 20 35 $7,000
Implementation team I.T. 30 25 $7,500
Training team I.T. 23 20 $8,000
Client Tracking system I.T. 12 201 $2,400
Completion and launching team I.T. and health 3 1201 $3,600
Total $37,300

12. process. Since the facility, like the other hospitals, is diverse in services being offered,
institutional leadership has to ensure that the system developed adheres to a number of
mechanisms, including the government policy and balancing the power of service providers.
Therefore, the leadership ensures that there is high-quality healthcare that is both safe
and consistent with the hospital goals. Clinical leadership engagement is, therefore, an
important element in the success of the system. Leadership is crucial in the administration
and management of tasks, and it has also been identified to be crucial in improving an
organization's efficiency and performance.
e) Level of Communication
All forms of communication are through the project managers, and there will be many
types of communication, such as through team applications. A communication plan is
important for the hospital to ensure a smooth transfer of data. The most common
communication levels include emotional, auditory, physical, and verbal communications.
When used in combination with such techniques as matching and mirroring individual
posture and gesture, the receptivity of the message will increase. To have effective
communication at the physical level, there is a need to connect with them in form and
movement and hand and gestures.
At the emotional level, few people appreciate how emotions play down and are
integrated by the recipients. In rhetoric, Aristotle’s pathos refers to appealing to different
human emotions. This form of communication is important to an individual receptive to
another who has a negative life approach or a critical individual (Goedert, 2014). Therefore,
for an individual to communicate effectively at this state, there is a need to be aware of their
mental state and release negative emotions to connect with others. There are other levels,
such as the energetic level, where individuals communicate effectively when they hold their

13. highest intention for other people's wellbeing. All levels are interdependent and affect each
other. From the communication matrix, the levels are as shown in Table 6.
The following table shows various levels of communication
Topic Audience Frequency/Date Owner
Kick-off meeting Project team,
health team
Daily ICT manager
Project Team meetings Weekly ICT manager
Meeting with the vendors. All HIS vendors Monthly ICT manager
Meeting with the health experts. Health department Weekly ICT manager
Training wellness clients Wellness clients Daily Project manager
Milestone review All stakeholders Weekly Project Team
Status reports I.T. Department Monthly ICT manager
Lessons learned Team leader Weekly ICT manager

14. Hardware Resources and Cost
NO ITEM DETAILS QNT UNIT COST SHOP
Desktops
The
Computing
Solutions
Ltd.
3.0 GHZ Speed 13
1 Computers 4.0 GB DDR 2 40,000.00 80,000.00
500 GB HDD
Server 1 50,000.00 50,000.00
2 LTS PowerBack 4 4,500.00 18,000.00
D-Link Router 1 15,000.00 15,000.00
3 LAN
Infrastructure
CAT 6 Cables 50 m 80 4,000.00
Conduits, Clips 20 100 2,000.00
4 Operating
Systems
Windows 10 Pro 1 27,000.00 27,000.00
5 Office
Application
Microsoft Office 2016
Enterprise Edition
1 19,305.00 19,305.00
4GL Object
Oriented
Java SE 8.0 1 FREE FREE
6 Development
Java F.X. Scene Builder 1 9,000.00 9,000.00
Software
7 Local
Database
MySQL 1 32,000.00 32,000.00
8 Antivirus McAfee Antivirus 2016 4 2,800.00 11,200.00
Standards and Guidelines
for Electronic Medical Record
9 Relevant
Publication
1 1,500.00 1,500.00
Systems in Kenya — MOH

15. Running Head: WEAKNESS VS THREATS 15
In addition to the hardware and software costs, there will be costs associated with
development teams. The above costs show how the costs will be distributed in the system.
Outcome Objectives
Data governance: The result of data governance is to avail the integrity, usability, and
integrity of data across the enterprise systems (France, 2011). Effective data governance means that
data is consistent and trustworthy and does not get misused as well. As the organization will
continue facing the new data privacy regulations, they would rely on data analytics to optimize the
data operations.
Data standardization: When the company uses the latest technology, it will allow data
conversion to the standard formats to process and analyze the data. The new technology will use
cloud storage, databases, and various data sources to not make it problematic for various uses to
access.
Risk management
Most software projects are risky and face many problems that might arise during the
development cycle. The experience from the previous projects means that the new project team
must learn from these mistakes and continually develop software. The following list of software
risks is eminent in software (Protti, 2010).
New and Unproven software: The majority of the software projects use new technologies,
tools and techniques, and other development standards. Any of the risks can arise, and even
improper use of the new technologies often leads to project failure.
User and Functional Requirements: Fictional requirements continually evolve with
respect to the failures and functions related to the quality of service. The process requirements are

16. Weakness vs threats 16
sometimes lengthy and tedious, and complex, which means that software engineers need to look at
the discovery and the integration activities., there are also modifications to the user requirements
that may not translate to the functional requirements (Sheikh et al., 2011). The disruptions may lead
to the critical failure of the system.
Performance: The various considerations must be given to the risk management officer;
performance must be tested throughout the project and to ensure that the products are moving in the
right course.
Risk management Plan
The risk management plan includes two options for risk management; risk monitoring ad
mitigation. Risk monitoring includes publishing the project status regularly, reporting the risk
issues, regularly revising the risk plan for any change made to the software, reviewing, and finally
reprioritizing and eliminating the lowest priority risks.
Mitigation activities include
Acceptance: This acknowledges that the risk impacts the project, and there is a need to
accept the risk.
Avoid: This is the scope adjustment to avoid the software risk.
Control risk: this involves taking actions to minimize the impacts of the risk.
Transfer: This is the implementation of the organizational risks to give the risk to another
company.
Continued monitoring of risks: for low impact risks, it is important to continue monitoring
of risks.

17. Weakness vs threats 17
 Implementation methods
 The method for implementing the software will be agile methodology. The requirements
will have iterated over and again till the required requirements are met.
9. Evaluation Plan
The work of the evaluation plan is to set the proposed details about the evaluation and to set
out what will be evaluated during the process (Safi, Thiessen & Schmailzl, 2018). The major
components of the evaluation plan are setting out what is to be evaluated and how the evaluation is
to be carried out. The evaluation plan for the change will have the following elements;
f) Measures
Since the methodology uses agile development methods, the evaluation metrics will include
the lead time, cycle time, and team velocity (Chen, Li, Liang & Tsai, 2018). Other metrics include
production that measures the attempts to find out how much work is done and also determines the
efficiency of the development teams.
g) Data sources
Surveys and Questionnaire: the survey's open-ended information and close-ended
information from patients, clients, and other providers.
Focus groups and interviews: The focus groups use interviews for specific themes;
the focus group for the evaluation will come from patients and doctors.
Evaluation data sources
Statistical models such as T-tests will be applied in the evaluation of data sources.
h) Methods of data collection

18. Weakness vs threats 18
The data collection will be done through interviews and questionnaires on the
physicians.

19. Weakness vs threats 19
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