Post on 21-Dec-2015
transcript
Health Informatics Series: Software Selection1 |
Health Informatics Series
Software Selection
Mark H. Spohr, MD,Health Care Informatics IER/HIS, World Health Organization, 20, Avenue Appia, CH-1211 Geneva 27 SWITZERLAND
Health Informatics Series: Software Selection2 |
Why Health Informatics?
Health Informatics provides information to make decisions
Better information leads to better decisions
Health care, management, planning and policy all need good information
Health Informatics Series: Software Selection3 |
Enterprise Architecture
Health Informatics Series: Software Selection4 |
Software Industry Characteristics
Information Technology is a "Network Industry" with these characteristics:– Complementarities, compatibility and standards – Consumption externalities [network effects] – Switching costs and lock-in – Significant economies of scale in production
Health Informatics Series: Software Selection5 |
Complementarities, compatibility and standards
IT is a System that consists of:– Complementary products (computers, monitors,
keyboards, software, operating systems)– All of these must be compatible to work together– They all must follow standards to work together
Vendors should follow these standards– Often vendors try to limit your options by producing
proprietary computers, software, operating systems, and data formats that do not follow standards and do not work well together.
Health Informatics Series: Software Selection6 |
Network Effects
These are known in economics as "consumption externalities"
One telephone is useless, two are useful, three are a network
The value of the network increases exponentially as more "nodes" are added.
Health Informatics Series: Software Selection7 |
Switching Costs and Lock-in
Users can be prevented from switching by various factors:
– Contracts– Training and learning– Data conversion– Search cost– Loyalty cost
Adherence to standards can help address some of these costs
Health Informatics Series: Software Selection8 |
Economies of Scale
Software is the ultimate product when it comes to economies of scale
– The first copy is very expensive (design, coding, testing)
– All subsequent copies cost nothing to produce– (Implementation, however, does have costs)
Health Informatics Series: Software Selection9 |
Data Economy
Data is expensive to collect
The cost to copy and communicate data is very low
Must have data standards to have meaningful communication
Health Informatics Series: Software Selection10 |
Open Source Economy
Free Open Source Software (FOSS) allows sharing of high development costs
The public sector can benefit greatly by sharing their contribution to software development
Health Informatics Series: Software Selection11 |
Now that you understand the market…
You can use your understanding of these market characteristics to your benefit when selecting software:
– The value of Standards– How to benefit from Network effects– Lock-in (and how to avoid it)– The true cost of software and data
Health Informatics Series: Software Selection12 |
Health Information System Life Cycle Methodology
Health Informatics Series: Software Selection13 |
Overview of Software Selection
Define functional and technical requirements
Research software vendors
Conduct vendor evaluations
Plan for the implementation of the selected software
Health Informatics Series: Software Selection14 |
Preliminary Considerations
Does an information system plan exist?
Is software the answer to this problem?
Does software exist or will the project require custom software or extensive modification of existing software?
Health Informatics Series: Software Selection15 |
Understanding the Project
Does everyone understand the project in terms of cost, timeline, internal resource commitments, impact on the organization and the need to change processes?
Health Informatics Series: Software Selection16 |
Define the Scope
What functions/data are needed?
Is this within the overall information architecture vision?
What is the business case?
What are the process impacts?
Health Informatics Series: Software Selection17 |
Assess and Plan
Review current information systems and processes
Design the "To Be" information systems and processes
Design and document changes (how to get from "As Is" to "To Be")
Health Informatics Series: Software Selection18 |
Mind the Gaps
List and plan to address gaps in:– Computer hardware– Software– Communications– Business processes– Human resources– Data Standards and Interoperability
Health Informatics Series: Software Selection19 |
Evaluate Software
Using the "To Be" system design, create a list of software functional requirements tailored to your specific needs.
– Data elements captured– Data input screens– Data access screens– Workflow capabilities– Interoperability capabilities – functionality– Standards supported
Health Informatics Series: Software Selection20 |
Compare Software
Create an evaluation matrix to compare the various software options against each other.
Health Informatics Series: Software Selection21 |
Make or Buy?
You always have the option of building your own software
This should only be considered when you cannot find adequate software or the software is too expensive or would require extensive modifications
Health Informatics Series: Software Selection22 |
Modify
Consider that open source software will be easier to modify and will give you more control of the product
All software will require some modification. Always look at how easy it is to modify the software and who will do the modifications.
Health Informatics Series: Software Selection23 |
Make vs. Buy… Or Modify
Buy Software– May not be an exact fit to your needs
Build Software– Long expensive process not guaranteed to succeed.
Modify– Start with open source software that you can modify– This may meet only part of your needs but can be
modified to meet your exact requirements– Everyone benefits from your investment in the software
Health Informatics Series: Software Selection24 |
IT Resources
Most organizations will need additional IT people for new IT projects
Consider contracting with an outside specialized IT service for new projects or modifications to existing IT projects
Baseline IT needs can be staffed by in-house personnel
Health Informatics Series: Software Selection25 |
How and Who?
Who should evaluate software?– Persons familiar with the business processes– People who will use the information– Technology people who will implement– Experts in technology
How?– Consider a broad "landscaping" to gather all potential
solutions– First pass to eliminate weak solutions– Second pass to decide on finalists
Health Informatics Series: Software Selection26 |
Software Selection Factors
Software Capabilities
Vendor strength and capabilities– Size of vendor– Length of time in business– Experience with this application– Vendor references
Health Informatics Series: Software Selection27 |
Modification and Support
Alternative support options (open source can provide the option of multiple vendors for support)
Customization and software modification capabilities
Health Informatics Series: Software Selection28 |
Vendor Negotiations
Initial software purchase costs – what is included?
– Definition of "users" (concurrent, named, development, active)
– Number of users or sites
Ongoing support costs– Response time– Maintenance costs– Cap on support costs
Health Informatics Series: Software Selection29 |
Vendor Implementation Assistance
The contract should spell out:– Number of days of configuration assistance– Number of days of user training (when, where, cost)– General technical assistance– Specific technical assistance (hardware selection and
conversion costs)– Training materials and implementation tools– Availability of vendor support hours
Health Informatics Series: Software Selection30 |
Cost
Core charges typically include:– Per system base charge– Charges for additional modules– Per user charges ("seats)
Software, hardware and services
Implementation and training
Cost for Changes
Health Informatics Series: Software Selection31 |
Payment schedule:
– 50% on signing– 20% on installation (after "acceptance")– 30% upon completion and ready for "go-live"
Health Informatics Series: Software Selection32 |
Acceptance Criteria
System performance levels (response time under expected load)
Document custom work that will be done
Functional Specification
"Out clause" for non-performance
Health Informatics Series: Software Selection33 |
Essential Contract Elements
Clear definition of objective criteria to define a successful implementation
Contractual remedies for failure to meet acceptance criteria
Change Management Process defined
Health Informatics Series: Software Selection34 |
Contract Process
Technical people must review and accept contract
Legal Review of Contract
Health Informatics Series: Software Selection35 |
Change Management Process
No specification is ever perfect
All software requires changes
Change management– Clear written description of the change– Cost for the change– Timeline for the change– Approvals by all parties
Health Informatics Series: Software Selection36 |
Health Informatics Series
Mark H. Spohr, MD– email: mhspohr@gmail.com
Lectures in this series:– Introduction to Health Informatics– Enterprise Architecture– Interoperability– National Health Information Systems– Patient Identifiers– Software Selection