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System Design Life Cycle Flashcards

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1
Q

What is the systems development life cycle (SDLC)?

A
  • Standardized approach
  • Process for developing information systems in a:
    • deliberate
    • structured
    • methodical manner
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2
Q

What are the four phases of the SDLC?

A
  1. Planning
  2. Analysis
  3. Design, Develop, Customize
  4. Implementation, Evaluate, Maintain, Support
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3
Q

What is a project life cycle?

A
  1. Initiating
  2. Planning
  3. Execution
  4. Closing
    May be used in conjunction with the SDLC
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4
Q

What is the Planning phase of the SDLC?

A

It is a foundational, fundamental and often longest phase (sets the stage for the project)

  • system requirements
  • feasibility study
  • project charter
  • project plan
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5
Q

In the Planning phase of the SDLC, what are the system request components?

A
  1. Project sponsor
  2. Business need
  3. Business requirements
  4. Business value
  5. Special issues/considerations
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6
Q

In the Planning phase of the SDLC, what are the feasibility analysis types?

A
  1. Technical, “can we build it?”
  2. Economic, “should we build it?”
  3. Operational, “if we build it, will they use it?”
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7
Q

In the Planning phase of the SDLC, what are the elements of the project charter?

A
  1. Project champion
  2. Dates (start, milestones, end)
  3. Problems or opportunity statements (purpose/justification)
  4. Objectives (what we want to achieve)
  5. Key stakeholders
  6. Scope of the project
  7. Target benefit
  8. Budget
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8
Q

In the Planning phase of the SDLC, what is a project charter?

A
  1. Draws from system requests
  2. Created by project sponsor or initiator (often delegated to the project manager or informatics nurse)
  3. Formally authorizes the existence of a project
  4. Authorizes project manager to apply organizational resources
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9
Q

In the Planning phase of the SDLC, what are the goals assessment?

A
  1. Return on investment (ROI)-ratio of expected financial gains divided by the total costs
  2. Cost-benefit analysis (CBA). Attempt to quantify tangible and intangible items
  3. Tangible-improve revenue, decrease staff needed
  4. Intangible-increase in patient satisfaction
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10
Q

In the Planning phase of the SDLC, what are the tools used?

A 
System Selection & Implementation:
     -customer site visit
     -surveys
     -RFI/RFP
     -Gap analysis
System/Product Development
     -Stakeholders analysis
     -Market survey
     -Feasibility analysis
     -Assessment of competitors
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11
Q

In the Planning phase of the SDLC, what is a GAP analysis template?

A

A visual tool that involves a comparison of actual performance & potential or desired performance.

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12
Q

In the Planning phase of the SDLC, what is the informatics roles and skills?

A 
System Selection & Implementation:
     -Project manager
     -SME
     -System analyst
     -Autor of artifacts:
          project charter
          system selection plan
          RFI/RFP
System/Product Development
     -Market/user researcher
     -SME
     -Systems analyst
     -Author of artifacts
          product concepts
          scope document
          feasibility assessments
          other artifacts of planning
     -Respond to RFI/RFP
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13
Q

In the Planning phase of the SDLC, what is an RFI?

A
  • Is it a request for information
  • A document that the organization sends to vendors
  • Indicates interest in gaining knowledge about the vendor’s product
  • Lists (high level) the key features desired for the new system
  • Vendor responds to RFI w/their products ability to meet these high-level requirements
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14
Q

In the Planning phase of the SDLC, what is an RFP?

A
  • Request for proposal
  • Created by the project team
  • Sent to selected vendors requesting greater and more detailed information about the features/functions desired for the new system
  • Response from vendor from an RFP are equally detailed
  • Supports comparison of vendors
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15
Q

In the Planning phase of the SDLC, what are outputs?

A

System Selection & Implementation
-system request
-feasibility assessment
-charter
-team formation
proj governance structure/implement committee
proj team(s) (actually implements the system)
-gap analysis
-timeline
-workplan & resource requirements
Systems/Product Development
-feasibility assessment
-product scope document
what it will and will no contain functionally
-product concept document
summary of customer needs
proposed solution
potential market use
-In product development, the decision to “go” or “no go” is made in the planning phase

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16
Q

In the Planning phase of the SDLC, what are typical teams and committees?

A

Systems Selection & Implementation:
-Executive steering committee
-Data governance committee
-Information technology steering committee
-Physician advisory committee
Systems/Product Development:
-Project core group or build team(s)
-Testing team
-Change management/communication team
-Training team
-Support team

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17
Q

In the Planning phase of the SDLC, what is the purpose of a project charter?

A

To formally authorize a project or a phase and document initial requirements which satisfy the stakeholder’s needs & expectations.

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18
Q

Categories of competencies with nursing informatics include?

A
  1. Basic computer skills
  2. Information management skills
  3. Information literacy skills
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19
Q

The foundation of an organizations’ strategic system planning begins with a review of the?

A

The organization’s business mission

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20
Q

In what phase of the SDLC are feasibility studies performed?

A

Planning phase

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21
Q

The informatics nurse may recommend gap analysis in order to determine the?

A

Resources needed to move from the current state to a proposed state

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22
Q

When looking at potential products and gathering information, one of the first tools is often a:

A

Request for Information (FRI)

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23
Q

What is the 2nd phase in the SDLC?

A

System Analysis

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24
Q

During the Analysis phase of the SDLC, what are the main focus?

A
  • Fact-finding phase
  • In-depth assessment and leads to the definition of the new system’s requirements
  • Understanding the existing situation (the as-is system)
  • Identifying improvements
  • Define requirements for the new system (to-be system)
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25
Q

During the Analysis phase of the SDLC, what are the major activities performed?

A 
1. Answers the question of:
     Who uses the system?
     What the system does
     Where and when the system will be used
2. All deliverables are combined into the System Proposal 
     -Requirements determination
     -Use case analysis
     -Process modeling
     -Data modeling
Primary Deliverable: SYSTEM PROPOSAL
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26
Q

During the Analysis phase of the SDLC, what are the key deliverables?

A
  1. Gap analysis
  2. Technical requirements for hardware, software, ^ networks
  3. Functional design document
  4. System proposal document
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27
Q

During the Analysis phase of the SDLC, what are the goals for a system selection & implementation?

A

-Conduct a detailed assessment of gaps-gap analysis-and user needs (requirements) understanding the “must-have” functionality of the desired system
-Conduct market survey to assess options/compare for selection
-Develop FRI and RFP
-Establish a system selection process including an objective decision-scoring methodology
typically developed from the RFP
scores based on functional requirements
necessary elements scored higher than “nice-to-have”
-Assess readiness for change

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28
Q

During the Analysis phase of the SDLC, what are the goals for a systems/product development?

A

-Fully understand and prioritize gaps and needs in existing systems and products
How will your development address those?
-Understand the diagram-related workflows, data flows, and processes in order to effectively analyze
-Document functional and technical requirements
Functional end-user requirements
Technical: define programmer instructions
-Outline future-state workflows, data flows, & processes
Outline the impact on existing processes

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29
Q

During the Analysis phase of the SDLC, what are the tools used in systems selection & implementation and systems/product development?

A
  • Qualitative analytical methods:
    • Interviews and focus groups with stakeholders
    • Observations, questionnaires
    • Artifact analysis (document examination)
  • Quantitative analytical methods:
    • RFP and RFI scoring tools to quantify the best product to meet the need
    • Context diagrams (high-level data flow diagram/summary of the system)
    • Data flow diagrams (additional detail about each part of the business process)
    • Clinical workflow diagrams
    • Gap analysis
  • Current state assessment to determine “where we are now”
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30
Q

During the Analysis phase of the SDLC, what are the roles and skills of the informatics nurse in the systems selection & implementation?

A

-Project manager
-SME
-Systems analyst
-Author of detailed user requirements
current & future state diagrams
RFI
RFP
other artifacts

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31
Q

During the Analysis phase of the SDLC, what are the roles and skills of the informatics nurse in the systems/product development?

A

-SME
-System analyst
-Author of functional specifications
current and future state diagrams
other artifacts
-Author of the product concept and scope documents, feasibility assessments & other artifacts from planning

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32
Q

During the Analysis phase of the SDLC, what are the system analysis outputs of the systems selection & implementation?

A
  • prioritizing end-user requirements
  • workflows (steps/process)
  • dataflows (information)
  • RFI/RFP
  • product demonstrations
  • reference call and site visits
  • product select scoring process
  • final recommendations
  • readiness assessment
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33
Q

During the Analysis phase of the SDLC, what are the system analysis outputs of the systems/product development?

A
  • report to stakeholders including interview results & end-user requirements
  • regulatory requirements related to the product you are developing
  • product scope documents
  • functional requirements
  • technical requirements (from which the product can be developed) and also for hardware, software, & networks
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34
Q

During the Analysis phase of the SDLC, what are the system analysis outputs?

A
  1. The requirements analysis (or determination) is a major output of this phase
  2. A detailed list of requirements that are supported by the other activities of the analysis phase
  3. The system proposal combines much of the analysis output into a report. Key components of this report can include:
    a. requirements definition: simply lists the functional & non-functional requirements in an outline format
    b. use cases: define what the users or roles will be doing in the solution. Created considering the actor (someone who interacts with the system), the system (system function process) and goals or tasks to be fulfilled.
    c. process models
    d. data models
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35
Q

During the Analysis phase of the SDLC, what are the system analysis Outputs Use Case examples?

A
  1. Information exchange to be solved electronically
    Actors: PCP Ambulatory practice, MD specialty practice
    System: EHR interface
    Goal: To improve care coordination and meet MU2 transition of care
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36
Q

During the Analysis phase of the SDLC, what is a data flow diagram

A

A DFD shows the flow of the data through a system and the work or processing performed on the data as it moves through the system

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37
Q

During the Analysis phase of the SDLC, what is an entity-relationship diagram?

A
  • Shows relationships between entities.
  • Data modeling-data object and relationship between objects
  • graphically illustrates an information system’s entities and the relationship between those entities
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38
Q

In what stage of the SDLC are requirements lists developed?

A

System Analysis phase

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39
Q

In the SDLC analysis phase, name non-functional requirements

A
  1. maintainability
  2. portability
  3. robustness
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40
Q

The informatician is developing a diagram that shows the sequential steps of a process. What is the best choice for chart diagrams?

A

Flow Chart

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41
Q

A data flow diagram shows graphically what?

A

How data flows into a system and from one process to another

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42
Q

What phase comes after the planning and analysis phases of the SDLC?

A

System design, develop, customize

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43
Q

In the SDLC design phase, what is determined?

A
  1. architecture and operation of the system with regard to processes, hardware, software, networking, data retrieval, archiving, and use, user interface, and so on.
  2. development user requirements are translated into new software solutions
  3. Implementation-vendor tools are customized to meet user needs.
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44
Q

In the SDLC System Design phase, what is the primary deliverable?

A
  1. System specification document (architecture document, technical system blueprint)
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45
Q

In the SDLC System Design phase, what are the key deliverables?

A
  1. Functional specifications
  2. Technical specifications
  3. Implementation Workplan regarding interfaces, testing, training, cut over and go-live.
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46
Q

In the SDLC System Design phase, what are the major activities in system design?

A
  1. Transform business requirements identified during previous phases into detailed specifications covering all aspects of the system
  2. All deliverables from the Design phase are combined into the System Specification document
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47
Q

In the SDLC System Design phase, Design versus Build?

A

In this phase, all the information form planning and analysis are used to create a document for the design.

Design does not mean build-build is done in the implementation phase.

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48
Q

In the SDLC System Design phase, what are the goals in System Selection & Implementation?

A
  • Customization of software, including data elements, documentation templates, & screen design
  • With commercial-off-the-shelf (COTS) products, customization/localization is the primary goals
  • End-user input & engagement for customization to meet (clinician) needs-extremely important in the design phase
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49
Q

In the SDLC System Design phase, what are the goals in Systems/Product Development?

A
  • Develop teams to write code that will convert functional and technical specifications into software applications
  • USABILITY testing of prototypes and early product versions lead to system enhancements
  • Stakeholder reviews to ensure that what is built matches the original vision & scope

Usability-easy to use, navigate, better adoption

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50
Q

In the SDLC System Design phase, what are the tools used in the Systems Selection and Implementation?

A
  • Vendor system configuration, including databases, data dictionaries, documentation forms, flowsheets, security profiles, process redesign maps
  • Change management & end-user educational artifacts like stop-start-continue
  • Project management tracking artifacts
  • Clinical & administrative committee review minutes & approval documents
  • Project management overarching during the design phase
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51
Q

In the SDLC System Design phase, what are the tools used in Systems/Product Development?

A
  • Software programming code
  • Product prototypes
  • Software applications
  • Software development progress-tracking artifacts
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52
Q

In the SDLC System Design phase, what are some of the design strategies (methods)?

A

Waterfall
*RAD-Rapid Application Development: Iterative
*RAD-Rapid Application Development: System Prototyping
Agile

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53
Q

In the SDLC System Design phase, what are the steps in the Waterfall development tool?

A 
Planning
     Analysis
          Design
               Implementation
                    System
Each phase has to be completed before moving onto the next phase
54
Q

In the SDLC System Design phase, what are the steps of the Rapid Application Development (RAD) Iterative tool?

A 
Planning
     Analysis
          Design
               Implement
                    System Version I
     Analysis
          Design
               Implement
                    System Version II      and so on
Working system but keeps improving and adding enhancements.
55
Q

In the SDLC System Design phase, what are the steps of the Rapid Application Development (RAD): System Prototyping tool?

A

Planning
Analysis
Design
Implementation System Prototype Implementation
System
All are done at the same time

56
Q

In the SDLC System Design phase, what are the steps of the Agile tool?

A

Planning
Analysis
Design System
Implementation

  • Analysis, design, and implementation are all happening concurrently
  • Short period of time to a functioning product
  • Defined time frames (i.e. 4/5 weeks called sprints/scrum
  • Time boxing-working on chunks of the product
57
Q

In the SDLC System DESIGN phase, what are informatics roles and skills of the system selection and implementation?

A
  1. Participant on system configuration teams; like clinical documentation, CPOE, clinical decision support/CDS, and other
  2. Process redesign analyst
  3. Change manager
  4. The developer of training materials
58
Q

In the SDLC System DESIGN phase, what are informatics roles and skills of the system product development?

A
  1. SME resource for developers
  2. Developer
  3. Usability Tester
  4. Development manager
59
Q

In the SDLC System DESIGN phase, what are informatics roles and skills of other functions and proficiencies in line with clinical informatics contributions?

A
  1. Ensuring systems have an appropriate display of patient-level data for clinical decision making.
  2. Designing reports identifying trends to align with quality measures initiatives.
  3. Translating user requirements into informatics solutions
    a. bridge communication divides between technical
    experts and clinical end-users.
  4. Customizing vendor data elements and forms to meet needs.
  5. Workflow considerations and interfaces with respect to retrofitting legacy systems with newer technology.
60
Q

In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the OUTPUTS of systems selection and implementation?

A
  1. Vendor system configuration documents; like database dictionary, documentation forms, flowsheets, security profiles, process redesign maps, and other artifacts
  2. Change management and end-user artifacts
  3. Clinical committee reviews and approvals
  4. Project management tracking artifacts
61
Q

In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the OUTPUTS of systems/product development?

A
  1. Software/programming code
  2. Product prototypes
  3. Software applications
  4. Software development documentation-including tracking of progress and artifacts
62
Q

In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the aspects of PROJECT MANAGEMENT?

A
  1. Project management is an essential tool of the design phase of the SDLC because it is required to keep implementation and development projects:
    a. on time,
    b. within the scope and
    c. on budget.
  2. PMBOK = Project Management Body of Knowledge
    a. The entire collection of processes, terminologies,
    and guidelines that are accepted as standards
    within the project management industry.
63
Q

In the SDLC System DESIGN phase, what are some project management artifacts?

A
  1. Gantt chart
  2. PERT - Program Evaluation and Review Technique
  3. CDS - Clinical Decision Support
64
Q

In the SDLC System DESIGN phase, what is the Gantt chart in the project management artifacts?

A

At a glance…the Gantt chart lest you see:

  1. What are the various activities
  2. When each activity begins and ends
  3. How long each activity is scheduled to last
  4. Where and by how much activities overlap
  5. Start and end date of the entire project

also considered a bar chart

65
Q

In the SDLC System DESIGN phase, what is PERT chart in the project management artifacts?

A

Program Evaluation and Review Technique

  1. PERT diagrams show precedence, activities that must be completed before the next activities may be started
  2. It illustrates the dependencies and flow of project events and milestones
  3. Once a diagram is drawn, it is possible to identify the CRITICAL PATH, the longest path/duration through the activities
  4. Monitoring critical path will identify shortest time to complete the project.
66
Q

PERT Diagram

A
  1. Circles mark the beginning and ends of tasks to be done in the project (aka NODES)
  2. Arrows are the tasks themsevles. They are identified by letters. The actual names of tasks could be used instead of letters. The lengths of the arrows do not relate to their length in time
  3. Numbers after the task names are the durations of the task. The time interval may be anything from picoseconds to years.

Critical path-longest # of days the shortest amount of time without missing any tasks

67
Q

In the SDLC System DESIGN phase, what is CDS?

A

Clinical Decision Support

  1. CDS tools - like Best Practice Alerts (BPA) provide clinicians, staff, patients, and other individuals with knowledge and person-specific information, intelligently filtered at appropriate times, to enhance health and healthcare.
  2. Variety of decision-making enhancing tools beyond simply alerts:
    a. Computerized alerts/reminders to providers/patient
    b. Focused patient data reports and summaries
    c. Contextually relevant reference information
    d. Clinical guidelines
    e. Condition-specific order sets
    f. Documentation templates
    g. Diagnostic support - like PACS
    h. Reflex orders
68
Q

What are the 5 rights of CDS?

A
  1. The right information
  2. To the right person
  3. In the right intervention format
  4. Through the right channel
  5. At the right time in workflow
69
Q

In the SDLC System DESIGN phase, what are some CDS considerations?

A
  1. CDS can be an extremely effective tool to save time and reduce errors, but alerting algorithms must be carefully designed to avoid unintended consequences -like alert fatigue.
  2. Ultimately, such nuisance alerts interrupt workflow and distract from patient care, leading to the routine override of alerts by users
70
Q

In CDS, what are soft stops and hard stops?

A

Soft stops: moving forward is permitted as long as an active acknowledgment reason is entered

Hard stops: No override accepted. Cannot place an order without first performing the reason for the hard-stop (i.e. have to record allergies before can order medication)

71
Q

What are some considerations for systems design disability accommodations?

A

*Patients who are disabled
*Employees who are disabled
*During the design phase, both developers and implementers are required (by law) to consider ADA requirements
*The regulations define “physical or mental impairment” as any physiological disorder or condition and also cover any mental or psychological disorder
Examples: Deaf/hearing impaired, blindness/low vision, missing limbs, epilepsy, cerebral palsy, schizophrenia, bipolar disorder, PTSD

72
Q

In System Design-What is a database management system (DBMS)?

A

Def: Tool for information storage and retrieval
It is a program or a collection of programs through
which the user interacts with a database

Interact w/a DBMS directly:
User–DBMS–Database
Interact w/program (JAVA, C++) which interacts w/DBMS
User–program–DBMS–Database

IMP: In either case, it is only the DBMS which accesses the database

73
Q

System Design: What are some types of databases?

A
  1. Legacy (older technology)
    A. Hierarchical: “tree” structure (folders on a
    computer). Just as a file on a computer sits in one
    folder, every record in the db has one “parent”
    a. One-to-One and One-to-ManyB. Network: Handles many relationships
    b. One-to-One; One-to-Many; Many-to-ManyC. Relational (popular): collections of tables
    c. each has a primary key (a field whose value is
    diff for every row of the table)
    cc. Tables are r/t ea other by the placement of
    primary from one table into the r/t as a foreign
    key.
74
Q

Systems Design-Relational databases primary vs. foreign key

A
  • Patient ID is the primary key of the patient in the Patient Table
  • *Patient ID is the foreign key of the encounter in the Encounter Table

Database-spreadsheet organized in rows and columns
Designed to add, retrieve, and manipulate data
Use Query or SQL to obtain info form relational db

75
Q

System Design-What is database design and modeling?

A
  • Logical database design-look at the logical relationships among objects.
    a. conceptual, abstract design
    b. involves arranging data into a series of logical relationships called entities and attributes
    c. can be displayed with an ERD (entity relationship diagram) or a logical ERD aka a logical data model
76
Q

System Design-what are key terms in database modeling?

A

Entity: (N) definable, real-world thing or concept w/in a system.

 a. in a relational db, maps to a table (Entity=table)
 b. real life thing, person, name

Attribute: component of an entity and helps define the uniqueness of the entity.
a. in a relational db, maps to a column (property, characteristic (Attribute=column)

Relationship: relationship between 2 entities signifies that the 2 entities are associated w/each other somehow

Unique Identifier: any identifier which is guaranteed to be unique among all identifiers used for those objects.
a. Classic example is SSN

77
Q

System Design-DB design & modeling: What is the physical db design?

A

Physical DB design: convert the data gathered during the logical design phase into a description of the physical db

You translate the expected SCHEMAS (collection of db objects including tables, views, indexes, and synonyms) into actual db structures

Can be displayed with an ERD (entity relationship diagram)…in this case physical ERD - a physical data model

More defined-actual design of db
objects such as tables/columns are created
Blueprint of relational DB

78
Q

System Design-DB design & modeling: Logical vs. physical design

A

Logical Physical
Entity map——— Table
Relationship map——— Foreign Key
Attribute map———-Column
Unique Identifier map———-Primary Key

***db NORMALIZATION is process used to organize a db into tables & columns.

A normalized logical data model can be translated into a physical db that is organized corectly.

79
Q

System Desing-What is Normalization?

A

*db NORMALIZATION is a process used to organize a db into tables & columns.

A normalized logical data model can be translated into a physical db that is organized correctly.

Improves data integrity-organizes data correctly
Decreased redundancy
Establishes relationship between tables

80
Q

System Design-What is discrete data?

A

Discrete data is:

 1. counted
 2. finite numbers-that have integer (whole) values
 3. collected discretely & stored in a db table at the lowest level of granularity
 4. supports subsequent analysis & care improvement efforts
 5. DISCRETE DATA CAN BE QUERIED & COUNTED
81
Q

System Design-what is discrete data graphical representation?

A

Column chart=vertical
Bar chart=horizontal
Pie chart=circle

Note: the length or height of the bar is equal to the qty w/in that category of data

82
Q

System Design-what is continuous data?

A

Continuous data is:

 1. data that is measured (body temp 98.6)
 2. data that is infinitely divisible (Height (180.34cm)
 3. represents measurable quantities but are not restricted to certain specified values (wt in lbs of dog)
 4. only limiting factor is degree of accuracy with which it can be measured (amt of rain, inches, that falls in a randomly selected storm
 5. Measured NOT COUNTED

Note: can take on any number, (ie speed of a car), infinitely divisible

83
Q

System Design-continuous data graphical representation?

A

Histogram: For analysis, continuous data are often converted to a range that acts as a category like 16-24, 25-34, 35-44….called “bins”

Histograms refer to a graphical representation; that displays data by way of bars to show the FREQUENCY of numerical data

84
Q

System Design-why are standard terminologies needed?

A

Standard terminology provides a foundation for interoperability by improving the effectiveness of information exchange aka common language

Data must be collected-discretely and maintained in a standardized format, using uniform definitions
a. in order to link data w/in an EHR system or share health information btwn systems

85
Q

System Design-what are standard terminologies?

A
  1. Interface Terminology: uses common terms that nurses use; thus, supports a user-friendly structured data entry interface (NANDA, NIC, NOC, LOINC, PNDS, CCC, OMAHA, ICNP, SNOMED-CT)
  2. Reference Terminology: acts as a common reference point that can cross-map between interface terminologies. Enable storage, retrieval, and analysis of clinical data (UMLS, ICNP, SNOMED-CT)

Note: ICNP and SNOMED-CT can both interface & reference terminologies

86
Q

System Design-What are the ANA recognized nursing terminologies and data element sets?

A

Nursing Developed Terminologies:

 1. CCC (clinical care classification system)
 2. ICNP (Intl classification for nursing practice)
 3. NANDA (No Am nursing dx assoc)
 4. NANDA  Intl
 5. NOC (nursing outcomes classification)
 6. Omaha system
87
Q

System Design-What are the ANA recognized multidisciplinary terminologies?

A
  1. LOINC (logical observation identifiers, names & codes)
  2. SNOMED-CT (systematic nomenclature of medicine clinical terms)
88
Q

Systems Design-ANA recognized data element sets

A

How do we know what elements to capture?
1. Nursing Minimum Data Set (NMDS): identifies common and core data elements to be collected for all patients receiving nursing care (clinical data elements(

Note: These elements are collected by interface terminologies.

89
Q

System Design-What are vocabulary standards?

A

Def: common clinical vocabulary standards can include:

 1. CPT-(current procedural terminology) formal classification of dx & therapeutic procedures performed by MDs and other HCP (AMA)
 2. HCPCS-(health care procedure code set) collection of standardized codes that represent medical procedures, supplies, products, & services (CMS)
 3. ICD-10 (Intl statistical classification of dx: a dx classification vocabulary standard (WHO)
 4. ISO-639 (Intl organization standardization standard 639). set of standards used to classify languages
90
Q

What is the term used to describe what data is stored in the database and the relationships among the data?

A

Logical

91
Q

The EHR alert for a serious potential error requiring a specific action before proceeding is called a?

A

Hard stop

92
Q

When choosing to display the effects of antibiotic A and antibiotic B on bacterial growth, you might use a?

A

Bar chart

93
Q

ICNP, PNDS, ABC, and NIC are known as?

A

ANA recognized terminologies

94
Q

SDLC-Testing Goals for systems selection & implementation and systems/product development

A

IMP testing is an activity or stage of the Implementation phase

  1. validates that the system works as intended (designed)
  2. ensures elements are ready for end-users in a live environment:
    a. components, features, interfaces, devices, reports, screens, and user interfaces
  3. Answers these questions:
    a. does the system work?
    b. are the interfaces valid?
    c. Is it ready for use?
    d. Is the system easy to navigate?
    e. does it contain the appropriate language or reference tables?
    f. Is it efficient and intuitive to use?
95
Q

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development

A

Develop/build
Test
Train
Production

Box testing types (software testing methods):

 a. Black box testing: testing as a user-internals not known
 b. White box testing: testing as a developer. Internals are fully known. focuses more on program code
96
Q

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-functional testing:

A

Def: functional testing describes what the product does

  1. Unit testing (ie place an order to ensure charge drops)
  2. Acceptance testing (user acceptance)
    a. alpha testing: developers pre-release
    b. beta testing: testing by customers to give
    feedback
  3. System testing (testing complete system& interfaces)
  4. Interface testing (integration testing to expose faults
  5. Regression testing (code/pkg upgrades, makes sure
    works after pkg upgrade loaded
97
Q

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-NON-functional testing:

A

Def: Non-functional testing describes how good the product works

  1. Load testing (performance testing, threshold where you think it will break)
  2. Volume testing (focuses primarily on db, performance testing, throughput time, how many users can access db at same time)
  3. Stress testing (run system above threshold to see what happens-try to make system crash)
  4. Usability testing (heuristics, how easily is the system able to be used, how well the system works)
98
Q

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-Heuristics

A

Def: Heuristics are important concepts associated with usability testing-can serve as a guide

  1. Non-functional testing–usability testing–heuristics
  2. Heuristics are “rules of thumb” to consider when designing usable hc information systems
  3. General principles that seem to describe common properties of usable interfaces
  4. How things are discovered or learned by humans
  5. ex: apple has put a lot of work into usability…if you can operate a cell phone…you can operate an iPad or macbook etc.
99
Q

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-Informatics roles and skills

A
  1. Developing & executing testing plans, including scripts
  2. Validating data integration across disparate systems
  3. Assessing end-user acceptance & system performance (effectiveness)
  4. Identifying & resolving issues with problem-solving & technical skills.
100
Q

SDLC-System Testing tools (part of the implementation phase) systems selection & implementation and systems/product development-Outputs

A
  1. Testing results are the primary outputs
  2. At a minimum, this includes the unit and integration of functional testing & load and volume non-functional testing.

goal of testing is to break the system

101
Q

When interfacing a new cardiac monitoring system with the EHR, the most critical testing is?

A

System integration testing

102
Q

What is the ideal time that user-acceptance testing should be completed?

A

During alpha or beta testing before the release

103
Q

When should we run regression tests?

A

After the software has changed and

When the environment has changed

104
Q

What is the area that addresses how easy something is to use, understand, and recognize?

A

Usability

105
Q

SDLC-What phase does testing occur in?

A

Implementation phase

106
Q

SDLC-What is the focus of the Implement, Evaluate, Maintain, and Support phase?

A

Implementation is the final stage when the system is brought into live use.

System is customized, tested, installed, evaluate outcomes, key performance indicators

Focus: System is built
Focus: System is put into operation
Focus: System is maintained and supported

By this phase there is vestment: money, time, resources

107
Q

SDLC-What are the major activities of the system implementation?

A

*Deploying the new system in its target environment and turning the system over to maintenance and support

Primary Deliverable: Fully installed system in production

Key deliverables:

 1. User documentation (communication & training plans)
 2. Operational documentation (data conversion plan, cutover plan, downtime plan, support plans)

To make transition as painless as possible-training

108
Q

SDLC-What are the goals of system implementation?

A
  1. Bring the system into everyday use by the clinicians
  2. Focus on and evaluate end-user experience
  3. Focus on and evaluate system performance
109
Q

SDLC-What are the goals of system maintenance and support?

A
  1. Apply patches and upgrades provided by vendor
  2. Monitor and address privacy and security in compliance with HIPAA
  3. Support end-users as they encounter needs and problems with the system
110
Q

SDLC-What are common conversion strategies for system implementation?

A
  • A conversion strategy can be developed by combining any of these strategies:
    1. Style
      a. Direct
      b. Parallel
    2. Locations
      a. Pilot
      b. Phased
      c. Simultaneous (all locations at the same time)
    3. Modules
      a. Whole system
      b. Module by module
111
Q

SDLC-In the system implementation phase, what is parallel style?

A

The old system runs in parallel with the new system

 EXISTING SYSTEM
                     ------------------------------
                          NEW SYSTEM
112
Q

SDLC-In the system implementation phase, what is the Direct/Big Bang strategy?

A

EXISTING SYSTEM | NEW SYSTEM

113
Q

SDLC-In the system implementation phase, what is the Phased strategy?

A

Phase 1 Phase 2 Phase 3
go-live go-live go-live
EXISTING SYSTEM NEW SYSTEM

114
Q

SDLC-In the system implementation, what is the Pilot strategy?

A

go-live |
EXISTING SYSTEM NEW SYSTEM
| go-live

115
Q

SDLC-In system implementation, evaluate, maintain, and support, what is data conversion and migration?

A
  1. Migrating the data from the legacy (old) system so that it is visible from within the new system (new system)
  2. Data conversion is often the most technically complicated step in the migration plan
  3. Files and databases in the new system probably do not exactly match the files and database in the old system, formatting of data may not match.
116
Q

SDLC-What is the informatics role and skills during system implementation?

A
  1. knowledge and skills in planning, leading, directing teams
  2. Logging and maintaining documentation of system issues and issue resolution
  3. Skills in creating and delivering education and training
  4. Supporting superusers in their roles on the units
  5. Assessing and evaluating if the system is meeting the needs of the users
  6. Contingency planning for scheduled and unscheduled downtimes
  7. Maybe the implementation manager-requires strong leadership, motivation, and communication skills
117
Q

SDLC-In system implementation, evaluate, maintain, and support phases, what are the outputs?

A
  1. Communication plan
  2. Training and documentation plan
  3. Command center plan
  4. Downtime and recovery procedure plan
  5. Policy and procedure revisions to cover the new workflows
  6. Data conversion plan
  7. Confirmation-post go-live (or updating) of the future-state workflows
118
Q

SDLC-In system implementation, evaluate, maintain and support what is change management?

A

Def: helping people to adjust, adapt, and adopt the new system.

Four basic steps:

 1. Revising management policies
 2. Assessing the cost and benefit models of potential adopters
 3. Motivating adoption
 4. Enable adoption through training
119
Q

SDLC-In system implementation, evaluate, maintain and support what is Education and Training?

A
  1. Training should focus on helping users accomplish their jobs and understand how the computer fits into the bigger picture of their jobs.
  2. Training should focus on what the user needs to do and NOT on what the system can do
120
Q

SDLC-In system implementation, evaluate, maintain and support what is training delivery?

A
  1. Classroom training:
    a. train many users at one time, creates a shared experience
  2. One-on-one training (elbow)
    a. trainer works closely with one user at a time
  3. Computer-based training
    a. can include slide decks, audio, video, and animation
121
Q

SDLC-In system implementation, evaluate, maintain and support what is adult learning?

A
  1. A trainer bases education on previous learning-basis for adult learning.
    a. Your learners are adults with previous knowledge and fixed ideas about what works for them
  2. Three main theories:
    a. Andragogy
    b. Experiential learning (hands-on)
    c. Transformational learning (ahh haa moments)
122
Q

SDLC-In system implementation, evaluate, maintain and support what is the role of the implementation manager?

A
  1. Knows and understands the workflows
  2. Develops implementation teams that include clinicians and champions
  3. Has a strong working relationship with the project champion
  4. Strong leader, organizer, communicator, motivator
123
Q

SDLC-In system implementation, evaluate, maintain and support who does the implementation team consist of?

A
  1. Broad interprofessional representation that includes clinical experts
  2. Broad representation of all users that will be using the system
124
Q

SDLC-In system implementation, evaluate, maintain and support give a go-live support example:

A
  1. Command center: onsite 24/7 for X number of days
  2. Core implementation team: onsite first 24 hours than available by phone or pager for 2 weeks after
  3. Superusers: onsite coverage 24/7 on all units
125
Q

SDLC-In system implementation, evaluate, maintain and support what are the roles of the super users?

A
  1. Unit-based RN who is a resource for unit staff
    a. should not be assigned patients
    b. one per unit during go-live
  2. Department RN supervisor
    a. may be involved in teaching classes
    b. part of the support pool
126
Q

SDLC-In system implementation, evaluate, maintain and support what are metrics for system evaluation?

A
  1. metrics can include the stability of the system, measuring against the strategic plan originally formulated, cost avoidance, risk reduction, progress to long-range goals for the system among others
  2. Whatever the metrics, they should align with the organization’s business strategy
  3. ROI is not the only metric or benefit of a healthcare information system
127
Q

SDLC-In system implementation, evaluate, maintain and support what is system maintenance?

A
  1. Changes and upgrades are expected with the rapid evolution of EHRs and MU/PI requirements expanding capability under the HITECH Act
  2. Upgrade activities can include many elements of the entire SDLC
    a. Workflow redesign
    b. Documentation
    c. Training
    d. Testing (especially regression testing)
    e. Implementation
128
Q

SDLC-In system implementation, evaluate, maintain and support what is ongoing system support?

A
  1. On-Demand training: elbow support, CBTs online support
    a. Online support: documentation and help screens built into the system and separate web sites that provide answers to FAQ
  2. Help Desk: user can talk with a person who can answer questions, usually over the phone
  3. User groups: provide input on how they use the system, relay needs, help message to the broader user community, and can help shape future technology strategies
129
Q

If planning to use a Pilot strategy for conversions from paper documentation to an EHR at an acute hospital, the best choice for the pilot program is?

A

A standalone unit with minimal interaction with other units

130
Q

In which phase of the SDLC is the performance of the new system monitored?

A

System implement, evaluate, maintain, and support

131
Q

What is the purpose of the master patient index?

A

Ensure accurate patient identification

132
Q

What are the characteristics of adults learners?

A
  1. Adult learners need to know how the information benefits them
  2. Adult learners want to know how to use the information immediately
  3. Adult learners like to know why they are learning the information.

**adult learners do NOT tend to accept what they are taught

Nursing Informatics (5 decks)

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