CSE1IS: Information Systems - Mercy Hospital Pharmacy - Case Study Assessment Answer

Solution Code : 1ACDI

Question: Information System Case Study

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Information Systems Case Study Assignment

Case Study Assignment Task

Problem Description

The pharmacy at Mercy Hospital fills medical prescriptions for all hospital patients and distributes these medications to the nurse stations responsible for the patient’s care. Prescriptions are written by doctors, filed in the patient’s file, and then sent to the pharmacy. A pharmacy technical reviews each prescription and sends it to the appropriate pharmacy station. Prescriptions for drugs that must be formulated (made on-site) are sent to the lab station and prescriptions for off-the-shelf drugs are sent to the shelving station. At each lab or shelving station, a pharmacist reviews the order, checks the patient’s file to determine the appropriateness of the prescription, and fills the order if the dosage is at a safe level and it will not negatively interact with other medications or allergies indicated in the patient’s file. If the pharmacist does not fill the order, the prescribing doctor is contacted to discuss the situation. In this case, the order may ultimately be filled, or the doctor may write another prescription depending on the outcome of the discussion.

Once filled, a prescription label is generated listing the patient’s name, the drug type and dosage, and expiration date, and any special instructions. The label is placed on the drug container, and the order is sent to the appropriate nurse station. Finally, a patient medication report including the patient’s admission number, the drug name and the number of refills, plus the cost of the prescription is then sent to the billing department. An example of such a report is shown on the next page.

Mercy Hospital

Data Flow Diagrams and Data Dictionary

Based on the case study described, you are required to complete the following tasks.

  1. Prepare a context diagram for the Mercy Hospital Pharmacy System (MHPS) with the following external entities: (i) Doctor, (ii) Technician, (iii) Lab station, (iv) Shelving Station, (v) Nurse Station, (vi) Billing Department. 
  2.  Draw a level 0 DFD diagram for MHPS. The level 0 DFD must include at least 6 sub-processes.
  3.   Decompose the Patient Medication Report to its data elements.
  4.  Provide a System Dictionary entry (see the blank table below) for the Drug Price and Patient Admission Number data elements. 

Mercy Hospital

Process Description

Patient safety is the first priority at Mercy Hospital. The pharmacists at Mercy Hospital follow a standard procedure when evaluating the appropriateness of prescriptions. When a pharmacist initially reviews a prescription, he/she first checks if the dosage is set at a safe level. If the dosage is not set to a safe level, the doctor who prescribed the medication is immediately contacted. Furthermore, the pharmacist proceeds to evaluate the patients’ medical history. If the patient is currently taking any medication that may cause an adverse reaction with the prescription, the doctor is also contacted to discuss alternatives. In addition, Mercy Hospital maintains a list which defines “potentially dangerous” drugs in order to satisfy legal requirements. Any drug on this list may cause clinically significant adverse reactions under certain conditions. Due to these regulations, the pharmacist must attach a boxed warning to the order if the prescription contains one of the drugs on this list. Meanwhile if the age of the patient is 65 or above, a boxed warning must be attached to the order regardless of what drugs the prescription contains.

If all the checks have been completed and the pharmacist does not find any reason to contact the doctor or to attach a boxed warning, the pharmacist declares that the order is a “normal prescription” and no further action has to be taken.

Before you implement this process, you want to represent it using process description tools. Your task is:

5. Create a decision table and its associated decision tree that describes how the pharmacists at Mercy Hospital evaluate the appropriateness of medical prescriptions for patients. Make sure you use the simplest form of the table and tree 

Development Strategies – Cost and Benefits Analysis

At the end of the system analysis phase, you are required to prepare a system requirements document and to present it to the board of directors in the Hospital. You must examine tangible costs and benefits to determine the economic feasibility of several alternatives. The finance committee will need to examine the costs and benefits to determine if the development should proceed. If the decision is to proceed with the development, the system can either be developed in-house or a vertical software package can be purchased and configured to meet the needs of the hospital.

Currently, patients’ medical records are manually updated by its staff. Based on previous work logs, the time spent to maintain the manual system is averagely 30 hours of overtime per month. Each is compensated for overtime at the rate of $30 per hour. Based on the current projection, the overtime will need to be expanded to 35 hours per month in order to manage the increased workload associated with residential expansions in the area. The overtime requirement would be eliminated entirely if Mercy Hospital implements the new system. In addition, the current system is accountable for around $1,000 worth of errors per month. The new system should eliminate these errors.

It is estimated that an in-house development project can be completed in 4 weeks. This estimation is based on 40 hours work per week for both you and another software engineer from the IT department. The IT department uses a chargeback rate of $45 per hour for the work. Your consulting rate, which Mercy Hospital agreed to, is $45 per hour.

As an alternative to the in-house development, a vertical software package is available for about $15,000, including an on-site one day training and technical support for the first year. If the hospital buys the package, it would take you about three weeks (40 hours per week) to install, configure, and test it.

The vendor provides unlimited technical support during the first year of operation on the condition that the hospital signs a technical support agreement at an annual cost of $1000.

Training and support for an in-house system would require 25 hours from a training specialist in the IT department (at the rate of $35 per hour) to develop training materials and provide training. Training and technical support for the first year for the vertical software package is included in the initial price.

For either the in-house development or the vertical software package, the necessary hardware will cost $3,000. Network upgrades, necessary for either option, has been estimated at $5,000 by the network operations group. On either option, 3 hours maintenance work per week is necessary to backup databases and to update the system). The rate for maintenance work is $30 per hour.

For either option, it takes six months for the system to be fully in operation in the hospital. The life span of the system is five years starting from its fully operation.

Your tasks:

6. Identify the value of costs and benefits for both options. Note: the first entry is filled in for you as an example

Cost and Benefits Analysis

7. Compare the two options using (i) payback analysis and (ii) ROI analysis. From these costs-benefits analysis, which options do you recommend for Mercy Hospital to take? Justify your

recommendation.

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Solution:

Data Flow Diagrams and Data Dictionary:1.  Context Level Diagram for the Mercy Hospital Pharmacy System (MHPS):

Mercy Hospital Pharmacy System

2. 0-Level DFD for the Mercy Hospital Pharmacy System (MHPS):

0-level DFD with 6 sub-processes

3. Data Elements:

The data elements of patient medication report are as follows,-

 Data Elements:

Data Elements:

 

4. The System Dictionary entry for the elements Drug Price and Patient Admission Number are as follows,-

Drug Price and Patient Admission

Drug Price and Patient Admission

5. The Decision Table for the Problem is as follows,-

Conditions:

Decision Table

Actions:

Mercy Hospital

Mercy Hospital

From the above decision table the following Decision Tree is constructed-

Decision Tree

Decision Tree Decision Tree

Development Strategies – Cost and Benefits Analysis:

6. Identify the value of costs and benefits for both options. Note: the first entry is filled in for you as an example

Cost or Benefit

7. Compare the two options using (i) payback analysis and (ii) ROI analysis. From these costs-benefits analysis, which options do you recommend for Mercy Hospital to take.

By using the above data the cost-benefit Analysis for the option 1 (In-house) is as follows-

payback analysis

The cost-benefit Analysis for the option 2 (Package option) is as follows-

Cost-benefit Analysis

From the above two options it is found that

The overall ROI for option in-house is (-0.01) and package option is (-0.12). As well as from Payback Analysis it is concluded that the Hospital should choose the In-house development option. Because, it is more profitable.

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