Home Care – System Analysis and Design
This Home care system case study investigates the selection of a software package by a medium-size hospital for use in the Home Health segment of their organization. The hospital (referred as, General Hospital) is located in North Sydney.
Its constituents reside in most Central Business Districts (CBDs) in the state and consist of both rural, suburban, and city residents.
The 149-bed facility is a state-of-the-art institution, as 91% of their 23 quality measures are better than the national average.
Services offered include Emergency Department, Hospice, Intensive Care Unit (ICU), Obstetrics, Open Heart Surgery, and Pediatrics.
Additional components of General Hospital consist of an Imaging Center, a Rehabilitation Hospital, Four Primary Care Clinics, a Health and Fitness Center (one of the largest in the nation with more than 70,000 square feet and 7,000 members), a Wound Healing Center, regional Therapy Centers, and Home Care (the focal point of this study).
There are more than 120 physicians on the active medical staff, over 1,400 employees and in excess of 100 volunteers. In short, it is representative of many similar patient care facilities around the nation and the world.
As such, it provides a rich environment for the investigation of using the SDLC in a 21st century health care institution.
Home Health and Study Overview
Home Health, or Home Care, is the portion of health care that is carried out at the patient’s home or residence. It is a participatory arrangement that eliminates the need for constant trips to the hospital for routine procedures.
For example, patients take their own blood pressure (or heart rate, glucose level, etc.) using a device hooked up near their bed at home. The results are transmitted to the hospital (or in this case, the Home Health facility near General Hospital) electronically and are immediately processed, inspected, and monitored by attending staff.
In addition, there is a Lifeline feature available to elderly or other homebound individuals. The unit includes a button worn on a necklace or bracelet that the patient can push should they need assistance. Periodically, clinicians (e.g., nurses, physical therapists, etc.) will visit the patient in their home to monitor their progress and perform routine inspections and maintenance on the technology.
The author of this case study was approached by his neighbour, a retired accounting faculty member who is a volunteer at General Hospital. He had been asked by hospital administration to investigate the acquisition, and eventual purchase, of software to facilitate and help coordinate the Home Health care portion of their business. After an initial meeting to offer help and familiarize with the task at hand, the author and the volunteer met with staff (i.e., both management and the end-users) at the Home Health facility to begin the research.
The SDLC in action
The author, having taught the SAD course many times, recognized from the outset that this particular project would indeed follow the stages of the traditional SDLC. While he would not be responsible for some of the steps (e.g., testing, and training of staff), he would follow many of the others in a lockstep fashion, thus, the task was an adaptation of the SDLC (i.e., a software acquisition project) as opposed to a software development project involving all the stages. For students, it is important to see that they benefit from understanding that the core ideas of the SDLC can be adapted to fit a “buy” (rather than “make”) situation. Their knowledge of the SDLC can be applied to a non-development context. The systematic approach is adaptable, which makes the knowledge more valuable. Consequently, the author proceeds in this monograph in the same fashion that the project was presented to us: step by step in line with the SDLC.
Analysis – Home Care System
The first step in the Systems Development Life Cycle is the Problem Definition component of the Analysis phase. One would be hard-pressed to offer a solution to a problem that was not fully defined. The Home Health portion of General Hospital had been reorganized as a separate, subsidiary unit located near the main hospital in its own standalone facility. Furthermore, the software they were using was at least seven years old and could simply not keep up with all the changes in billing practices and Medicare requirements and payments. The current system was not scalable to the growing needs and transformation within the environment. Thus, in addition to specific desirable criteria of the chosen software (described in the following section), the explicit purpose in helping General was twofold: 1) to modernize their operations with current technology; and 2) to provide the best patient care available to their clients in the Home Health arena.