This is a text written by Jon Berg <jon.berg|a|turtlemeat.com> spring 2005 in the Computer Science course Medical Informatics at Tromsø University, Norway.
Current and future possibilities of Medical Informatics
5. Introduction of new medical systems
The purpose of introducing information technology into the health care sector is to increase the possibilities of service and effectiveness. How successful the investment into new technologies is depends on a range of factors like how well the system get implemented according to the requirements, how user friendly it is to use and how well and fast the personnel that is going to be using it accept it.
Role of medical systems
The role computer systems fill in the health care can be categorized as:
In data acquisition the computer helps to collect and process data on a scale that would be impossible for a human to do. Record keeping is the process of registering data, processing it and generation of reports. Communication is distributing data among different systems and integration is formatting the data in a proper way for the systems to use the data. Surveillance is timely reaction to medical data. Information storage and retrieval is the processes to get data stored for example in data bases, and properly indexed to facilitate efficient retrieval with search. Decision support system helps health professionals to make medical decisions. Education systems provide systems for helping health professionals learn and practice new skills.
Investigating the need for new medical systems
Before a purchase of new software that costs a lot of money is done, there needs to be an analysis of need for the new software. The initial motivation for getting new systems is often a desire to improve quality or cost of health care. It may also be motivated by improving deficiencies in old systems such as adding features that where not previously available or improving functionality because of new technology has become available. What also must be considered is that the actual cost of getting a new system also includes the cost of installing the new software and training the personnel to use it. The total cost must be evaluated against the benefits the new system will give. The benefits of a new system may also be difficult to quantify, for example if the system helps to reduce the patient’s mortality.
When the need for a new system has been analyzed and the decision for getting a new system has been made the requirement phase begins. The requirements for the new solution must be put down, and then the search for a solution can begin.
Designing custom solutions
Designing a custom system should only be undertaken if it is not possible to buy an off the shelf software. An institution should also buy a pre-made system if it can find a system that only roughly fit their needs, even if it means that the institution have to change its methods somewhat. It should also be considered to keep the make do with the current system until something possible comes to market that fits the needs. Building an entire system for all the functions in a health institution is never viable. It must also be evaluated if the personnel responsible for the systems in the health care institution have the required competence for running large software projects. The development will likely require additional help for design and implementation from hired contractors or from software development companies.
Using off the shelf software
For most branches in the health care there already exists pre-designed software that can be purchased from a commercial software companies. Most of the time there exist multiple applications from competing vendors that can fill the requirements for the needed software. Applications from competing vendors often have strengths and weaknesses compared to each others. That can be in price and user friendliness. Demonstration of the different software solutions will reveal the differences in functionality.
Differences between a custom designed system and an off the shelf system
The major difference between acquiring pre-made solutions and custom designed solutions is that there will be a longer delay to get the software implemented with a custom designed solution. A custom designed solution will be would possible be the only way to get a system that is compatible with previously custom designed solutions. A off the shelf system is likely to be cheaper to purchase, since it would not require any custom development work.
One problem that will arrive is the interoperability of the new system with the old systems and potential future systems. This will be a problem for both custom designed systems and off the shelf systems. Systems that are developed according to widely recognized standards are likely to be more interoperable with other systems that follow these standards.
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