System Analysis for Health Informatics - Analysis Area

Analysis Areas

Introduction

The acquiring of information is one of the principal concerns of the system analyst when starting a new analysis and design activity. The analyst seeks to unearth answers to vital questions that are essential to defining the new system. Functional analysis, process analysis, tasks and activities analysis, and data analysis should be scrutinized closely when performing a system analysis. This process was performed on the electronic medical record project at University of North Carolina (UNC) Health System. UNC developed an integrated Electronic Medical Record UNC health system that the entire organization can access. This paper will discuss the business knowledge relevant to UNC and their paperless electronic medical record project. It will describe the primary elements and approaches of functional analysis, process analysis, activity and task analysis and data analysis. The orientation and flow between each within a functional model will be explained.

Business Knowledge from a Systems View

Business knowledge is defined as a comprehensive understanding of business functions and the specific areas under analysis (Modell, 2003). A requirement of gathering business knowledge is to attain an in depth understanding of the functions of the organization. The analyst needs to know the processes and tasks that are essential to accomplish those functions as well as the association of those functions, processes, and tasks to all of the others throughout the firm. The business knowledge of the analyst starts with identifying each function of the firm and of the user (Modell, 2003).

Within an 8-year span, the University of North Carolina (UNC) Health System developed an integrated Electronic Medical Record consisting of an electronic inpatient progress note and outpatient clinic note documentation system and applied it in the health care clinical setting with plans to eliminate the paper chart within the entire Health System. The overall objective is to develop modules within the clinical information system (CIS) for a myriad of services to include physician electronic order entry, inpatient nursing documentation, health maintenance prompts, clinical image acquisition and a display for radiological and other graphical based documentation (Berger, Brooks, Kichak, & Kammer, 2001).

Functional Analysis-Primary Elements and Purpose

A function is defined as a group of related processes or activities composed of all performed to achieve a predetermined goal (Modell, 2003). UNC organized a board inclusively to manage the budget and CIS development. This committee is inclusive of a Chief Information Officer of the Health System, representation for the Hospital Administrator, and the Medical School clinic. Members of programmers, nursing staff, physicians, medical record administrators all take part in developing electronic applications and improve the existing ones. All of these representatives agree to an electronic medical records system for inpatient and outpatient populations.

Key Processes in Clinical Noting

A key process described in UNC's development of an electronic medical record is clinical noting. Progress notes for inpatients and a clinic note for outpatient documentation were created electronically at the institution. Instead of utilizing the paper billing form as done in many medical practices, the outpatient notes are dictated and coded for electronic billing by the physician. Thus a clinic note is generated before billing rather than afterwards as done in inpatient coding of care. This system of electronic documentation is based on required dictation, transcription, activity list edits, and electronic signature of all outpatient clinical care notes (Berger et al., 2001).

Process Analysis

Modell defines process analysis as a series of tasks or activities that are reliant on each other and distinctly flows from one activity or task to another (Modell, 2003). A problem that many medical centers face today is that physicians are not receiving notification in a judicious manner that there are documents such as discharge summaries, history and physical exams, outpatient clinic notes, and operative notes are ready for signature (Berger et al., 2001). Formerly, physicians had to report to the records department if they had any documents that needed their signatures; this caused a big issue with retrieving the patient's chart due to the increased outpatient visits. To alleviate that problem, the clinical information