New century health clinic

Background

Five years ago, cardiologists Timothy Jones and Dolores Garcia decided to combine their individual practices in Fullerton, California, to form the New Century Health Clinic. They wanted to concentrate on preventive medicine by helping patients maintain health and fitness and by providing traditional medical care.

Dr. Jones recently asked you to work with him as an IT consultant. He wants you to help New Century develop an information system that will support the clinic's operations and future growth. During an initial meeting, he provided you with some background information and asked for your suggestions about how to get started.

At your desk, you begin to review New Century's situation. The clinic is located near a new shopping mall in a busy section of the city. New Century's staff includes four doctors, three registered nurses, four physical therapists, and six office staff workers.

The clinic currently has a patient base of 3,500 patients from 275 different employers, many of which provide insurance coverage for employee wellness and health maintenance. Currently, New Century accepts 34 different insurance policies.

Anita Davenport, who has been with New Century since its inception, is the office manager. She supervises the staff, including Fred Brown, Susan Gifford, Tom Capaletti, Lisa Sung, and Carla Herrera.

Fred Brown handles office payroll, tax reporting, and profit distribution among the associates. Susan Gifford is responsible for the maintenance of patient records. Tom Capaletti handles most of the paperwork concerning insurance reporting and accounting. Lisa Sung has the primary responsibility for the appointment book, and her duties include making reminder calls to patients and preparing daily appointment lists. Carla Herrera primarily is concerned with ordering and organizing office and clinic supplies.

Each of the six office staff people has one or more primary responsibilities; however, all members of the staff help out whenever necessary with patient records, insurance processing, and appointment processing. In addition to their regular responsibilities, all six office workers are involved in the preparation of patient statements at the end of each month.

New Century Health Clinic's office manager, Anita Davenport, recently asked permission to hire an additional office clerk because she feels the current staff can no longer handle the growing workload. The associates discussed Anita's request during a recent meeting. They were not surprised that the office staff was feeling overwhelmed by the constantly growing workload.

Because the clinic was busier and more profitable than ever, they all agreed that New Century could afford to hire another office worker. Dr. Jones then came up with another idea. He suggested that they investigate the possibility of computerizing New Century's office systems. Dr. Jones said that a computerized system could keep track of patients, appointments, charges, and insurance claim processing and reduce paperwork. All the associates were enthusiastic about the possibilities and voted to follow up on the suggestion. Dr. Jones agreed to direct the project.

Because no member of the staff had computer experience, Dr. Jones decided to hire a consultant to study the current office systems and recommend a course of action. Several friends recommended you as a person who has considerable experience with computerized business

1. Based on the given scenario above, what kinds of questions would you ask to assess the initial feasibility of this project information, does the project seem feasible? [25 marks]
2. Describe what will be the plan of action if New Century Health Clinic management decided to contract your services to perform a preliminary investigation? [25 marks]
3. What types of information is needed when you begin the preliminary investigation? From whom will you obtain it? What techniques will you use in your fact-finding?

INTRODUCTION

The New century health clinic is a fitness and health centre which is well-known and recognized in Fullerton, Carlifornia. The major priority of the listed clinic earlier on, is to concentrate on preventive medicine by giving helping hands to patients in maintaining and monitoring their health, keeping their fitness level and medical status balanced.

But it has now become a necessity and a "must look into" situation concerning the work load and over stressful working conditions which the staffs have to face because, they can't run from their responsibilities. In such circumstances like this, the clinic needs to change its total official system of operation from manual administration /managerial form to computerized management form that will enhance the efficiency and services of the clinic and also save work time.

In the mentioned scenario above , an IT consultant is been required to develop the new computerized information system.Whereby the given system will be easier to manipulate and also user friendly in supporting the clinic's entire management scheme and functions including the future growth of the clinic. First of all in order to develop the clinic's new system, the IT consultant should be able to analyse the issue or problem been faced before taking essential steps in producing a final system that meets the requirements of all end-users.

Based on the given scenario above, what kinds of questions would you ask to assess the initial feasibility of this project information, does the project seem feasible?

RESPONSE

Feasibility study, as we all know, is simply referred to as series of test been performed to the system request/ requirements to check and determine whether it is suitable and convenient to carry on or proceed further on with the development of the given system.

Therefore, to carry on with such initial feasible study, the system analyst (SA) or IT consultant needs to interview the end-user by asking important and relevant questions which will make a great impact or effect on the operational, technical and economic feasibilities to be known by urging the IT consultant to take decisions which the system project will follow the next steps to develop or improve successfully. Else, the total work will be ended.

Cases like this been faced by New century clinic, this are valuable questions to be asked in order to evaluate the initial feasibility of the proposed new systems development:

1. What are the problems being faced using the current manual system?
2. How does the clinic manage all official works using the manual system?
3. How will the clinic manage all official works if the new system is not implemented?
4. Are the staffs/ end-users of new computerized system in your clinic computer literates?
5. Dose the new computerized system contribute to all depts. And objectives of the clinic?
6. How would the new computerized system enhance or solve problems occurring with the manual system?
7. Does the new system have direct contribution to the clinic's business objectives?

By asking questions like this, the necessity of implementing or developing new system can be evaluated or measured. However, to be more broad and fluent in the total feasibility of the proposed project, more questions need to be asked concerning the operational, technical and economical feasibility.

This simply means that the system will be used efficiently after the development and implementation as the user demands because if the system develops defects or become ineffective the end-users face difficulties to work with the system, that means the expected benefit will be tarnished and the new system becomes unproductive. To make sure none of such incidents occur, these are questions that need to be asked concerning its operational feasibility:

1. Do the whole management and users of the new system support the project?
2. Do the users notice the need for change of current manual system?
3. Will the new system reduce workforce?
4. Is the manual system interactive and also being practised effectively by the users?
5. What will be the next step for affected employees if workforce reduction occurs?

This simply means that the given organisation for which the system will be developed, has enough resources of hardware and software technology to develop, install and operate the new system. In order to operate such new systems adequately, the appropriate technology should be put in effect; even if it requires additional up-to-date and advanced technology. Therefore to evaluate the technical feasibility for New Century Health Clinic, these are relevant questions needed to be asked:

1. Can the clinic manage the needed hardware, software, and network resources to implement the computerized system?
2. Does the clinic have the necessary technical knowledge?
3. How can the clinic acquire the technical knowledge if they do not have?

This refers to the total benefit of the new system being outweighed than the total estimated cost for implementing the system. Whereby the estimated cost can either be increased or decreased any time while doing the project development and implementation. While doing all this there is something the organisation need to bear in mind; Total Cost of Ownership (TCO) including its continuous support and maintenance Costs with acquisition costs. To verify such Economical feasibility of the clinic, these are relevant questions needed to be asked:

1. Is the benefit of the new system outweighing the estimated costs?
2. What are the probable savings and costs for acquiring, installing and finally operating the new system?
3. Does the current problem have any significance?
4. Are there any intangible factors like patient satisfaction, clinic image etc.?
5. Will the system requirements outcome be a sound business investment?

From the question being asked above, due to relevant aspects, the initial feasibility of the project been detailed can be assessed easily and effectively. It is expected that the above questions regarding the feasibilities are well-answered that enhance to develop the new computerized system for the clinic. Therefore, from the answers to the already asked questions as well as the given information in the scenario, it is understood that the project of new system development for the New Century Health Clinic is quite feasible.

Describe what will be the plan of action if New Century health Clinic management decided to contract your services to perform a preliminary investigation?

The system requirements from the New Century Health Clinic is totally feasible. In order to continue the project some investigations have to be carried out for studying the system request and for suggesting the specific action. This is called preliminary investigation. To execute the preliminary investigation, the steps given below will be followed: but, before starting the investigation, interaction with Managers and users are prompted: in this particular phase, it needs to meet with the clinic doctors, Managers, Staffs and users to describe the detailed responsibilities, answer questions and request comments of the project.

The project will bring a significant change in the clinic after development. The users, staffs and doctors might be curious, concerning the changes or they might even resist it.

The primary interaction will be of a good help because the opinion, thoughts and reaction of every member/staff of the clinic is very important to know more about constraints and difficulties in the clinic. These are the main six steps to carry out during such investigation:

• UNDERSTANDING THE PROBLEM OR OPPORTUNITY:

In the first approach, the business profile and business model will be developed where the business process and functions will be described. That is where the main problem or operations of the clinic may be understood. In the process carrying out this approach the new system request may not reveal the basic problems of the clinic or may be, the proposed system can affect the total clinic's operation and system. To eliminate these problems, it must need to understand the systems request and its opportunity of the project at hand.

• Define the project scope and constraints:

This is actually the defining of boundaries or extent of the project where the irrelevant expenses of time and money are been avoided and only the main problem is focused. Constraints are the conditions or requirements that the system must meet and the end results of that constrains and it must be a recorded success. Also, project scopes are described in system constrains. There are characteristics needed to be identified in the proposed system while checking for constrains such as:

• Internal vs. external constrains
• Present vs. Future Constrains
• Mandatory vs. Desirable Constrains etc.

in order to avoid misunderstanding and future problems I would lay down a piece of advice insisting that the project scope and constrains are been identified earlier.

• Performing fact-finding:

This is a technique used to find out necessary information from companies and organisations which comprises of various approaches and steps to carry out. We are going to implement these approaches in the clinic's doctors, staffs and users for investigating the system request. In this case, the following fact-finding techniques can be used:

• Interviews
• Questionnaires and surveys
• Review current documentation
• Analyse organization chart
• Observe operation
• Estimate time and cost to continue development:

The detailed time and cost estimation for the further development phase and the overall project will be developed with some important issues, so that the clinic's doctor and manager can understand the total cost and time which will be effective for economic feasibility.

Determine Feasibility:

Following the previous four step of preliminary investigation, the total feasibility of the project been carried out will be determined in this particular stage.

Present results and recommendations to management:

in the final stage, a preliminary investigation report will be prepared to management which includes the assessment of the system requirements, the estimation of the total cost and benefits including the recommendation of processing to next phase named system analysis.

What types of information is needed when you begin the preliminary investigation? From whom will you obtain it? What techniques will you use in your fact-finding? [20 marks]

Before starting the preliminary investigations, there are some essential Information to be known about the clinic, it's current and proposed system, etc. It can be clearly acquired from the feasibility study consisting of the three main users approaches stated as follows:

• Operational Feasibility
• Technical Feasibility
• Economical Feasibility

Some more information like-

• Clinic's background and overview
• Information about the Doctors, nurses, manager and staffs
• The project's priority
• Benefits of the new computerized system
• Effect of the new system in the clinic etc.

Form the chart, it can be measured that the total manpower of the clinic is 17. They are:

• 4 doctors (with 2 founders)
• 3 nurses
• 4 physical Therapists
• 1 office manager
• 5 office staff

To gain the required information for beginning the preliminary investigations, it required that you meet with these 17 manpower i.e. the clinic's doctors, nurses, physical therapists, manager, and staffs of the clinic. In the meeting, by asking questions and collecting some documents, related to the required information or further investigation (if need arises), whereby the essential or wanted information can be gathered.

In the preliminary investigation stage, fact-finding is a very important step. From the various fact-finding techniques, any one or more techniques can be used for fact-finding. With appropriate and suitable technique, the needed information for system request investigation can be gathered. In the case of New Century Health Clinic, I would rather say 'Interview' is the best fact-finding technique.

An Interview is a planned meeting with any person during which the required information can be obtained in-depth from that person. This is the primary method of acquiring information during preliminary investigation stage where the purpose of interview is to uncover facts of the proposed project.

These are the reasons for choosing interview as a fact-finding technique for the clinic:

• The number of manpower of the clinic is very small (17 people only). That is why, it will not be time consuming and cost effective.
• It will be possible here to ask necessary and effective questions to person by person as well as listen carefully the answers.
• It can also be possible to achieve every person's own opinion about the current and new system proposed.
• It has chance to do open-ended questions as well as a set of questionnaires on a same topic to the every person, so that personal opinion(s) on the same topic also with their own idea can be verified.
• The reliability of the systems request can be measured appropriately from the interviewing of the people personally.

It would be the most effective technique for acquiring all the required information from the personnel of the clinic. However, in this preliminary stage, to save time and cost, it should take interview of the two founder doctors, the managers and the five staffs first. Most importantly, interviews can be carried out on the remaining personnel if need arises.

Conclusions:

The New Century Health Clinic is suffering from problems to use the manual system for their office works. As an efficient and user-friendly replacement, the clinic management likes to use computerized system. As an IT consultant, a new computerized system for this clinic will be developed in this project by performing all the primary steps like evaluation and understanding the project, feasibility study, preliminary investigation, fact-finding etc. It is expected that the proposed new computerized system project, finally, will perform adequately and successfully for the New Century Health Clinic that will help the clinic's management system to do their regular work properly with more efficiency

References:

1. [WIK08] Wikipedia (2008), Feasibility study - Wikipedia, the free encyclopedia, http://en.wikipedia.org/wiki/Feasibility_study
2. [BLU07] Blurtit (2007), What are the basic questions for feasibility study?- The key questions for feasibility study? http://www.blurtit.com/q393090.html
3. [McG97] Mcgraw-Hill (1997), Avison, D.E. and Shah, H.U., The Information Systems Development Life Cycle: A First Course in Information Systems, McGraw-Hill International Editions, 1997, Pages 72 and 92-99.

Appendix:

As the fact finding techniques for the New Century Health Clinic project, another two approaches can be used with the interviewing. These two techniques are Current documentation Review and Observe Current Operations.

It is a process where the current system documentation of the organization is reviewed to understand how the current system is working. For the clinic's documentation, it can be out of date. So, at the documentation receiving time, it should check with the clinic's persons that it is accurate and complete of information.

In this process, the typical working procedure of the worker can be viewed. The staffs of the clinic is currently doing the all the official work manually. In this case, their working procedure, input and output of the work, working time and effort etc should observe.

These two techniques are not time consuming and cost effective. Nevertheless, by performing these two, the fact-finding stage will be more resourceful as well as it will be helpful to understand the system request's reliability.