2 pages on Evaluation Plan and System Development Timeline and Deliverables

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You need to write 2 pages on Evaluation Plan and System Development Timeline and Deliverables. One page each based on the power-points that attached. Here is the professor feedback for both Evaluation Plan and System Development Timeline and Deliverables .

Slide 13 – Evaluation Plan

SCORE: 7 out of 10

There are 4 levels of evaluation as described in lecture 5. Please review lecture 5. Attached

Slide 14 – System Development Timeline and Deliverables

SCORE: 9 out of 10

Make sure to leave development time after testing as well as more implementation time after evaluation

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Coordinating Diabetes Care AUTHORING A FUNCTIONAL REQUIREMENTS ANALYSIS DOCUMENT (FRAD) Chronic Diseases Group HIT Standards and Systems Interoperability March 7, 2017 Health Problem & Need for Information System • • • 29.1 million: People affected by diabetes in the United States2 • $6.5 billion: Estimated diabetes cost in Maryland, which is largely attributed to poorly managed diabetes and associated complications including diabetic kidney disease and diabetes retinopathy, the most common complication 1 • • • 44%: Percentage of all kidney failure cases where the primary cause is diabetes2 o o o o 9.2%: The percentage of adult population (age adjusted) affected by diabetes in Maryland 3 8 counties in MD: Including baltimore city (12.2%) and somerset county (13%) have some of the highest percentages of adult population with diabetes in the country4 33%: Percentage of diabetic population in Maryland not receiving an annual dilated eye exam in 2010 (no recent data available) 3 166.6/100,000: Prevalence of diabetes related end-stage renal disease in Maryland3 Poorly managed diabetes can lead to complications that pose great health and economic burdens on patients. Specifically, diabetic retinopathy (and blindness) and diabetic kidney disease both severely impact patient’s quality of life. Due to their insidious onset (asymptomatic until advanced stage of disease), timely screening/monitoring and early intervention become imperative to control disease progress and improve clinical outcome. Health disparities (especially in Maryland) exist, exposing certain patients to elevated risk. In Maryland, there is currently no statewide population health decision support system to identity those who are at high risk of developing these complications. Overview and Scope of the Information System ❏ We propose a population health decision support system that ● utilizes predictive modeling to identify diabetic patients who are poorly managed and are at high risk for developing diabetic retinopathy and diabetic kidney disease ● coordinates patient care using master patient index which will allow integration of records for each individual incorporating all data from various sources/care providers ● alerts appropriate providers for targeted intervention ● generates report for clinical researchers and policy makers ❏ Target population: patients diagnosed with diabetes currently residing in the state of Maryland ❏ Target information sources: hospital EHRs, ambulatory EHRs, diabetes registries, laboratory, billing, and pharmacy systems Information System Goal • An informatics approach used to collect high quality data on individuals with diabetes validated data from multiple sources reconciled within the repository without creating duplicate records • The system will use the collected data to identify high risk patients within the population who are risk of developing negative outcomes such as retinopathy and kidney damage - as the program matures, we intend to identify additional patients at risk for other negative outcomes such as nerve damage • Targeted individuals will be identified by a population health decision support system, generate alerts and be contacted by healthcare providers in order to intervene and lower the risk of complications - by the end of the first year, we anticipate a significant decrease in the incidence of retinopathy and kidney damage compared to the previous year Business and Technical Actors - Technical - Data repositories (MPI and clinical data repositories) CRISP (HL7 interface engines to connect to CRISP) Various health information systems (hospital EHRs, ambulatory EHRs, diabetes registries, laboratory, pharmacy and billing systems) - Business - Project manager Board of directors Engineers/Software developers Implementation manager Healthcare providers (Case manager, medical director, clinical management team) Policy makers Researchers HIPAA Functions that the System Will Support • Collect clinical data of diabetes patients from multiple healthcare providers with jurisdiction and extracted data streams in need • Transfer data from different sources into structure or semi-structure data and integrate it into a single data repository • Generate alerts or reminders based on designed algorithms and send them to health providers Generate reports on the risk of diabetes complications for system evaluation purpose • Non-Functional Requirements Quality Requirement Constraints Usability: The system should be intuitive enough for new users to catch up within one day of use. Implementation: The deployment duration of the system should be less than one year. Extension should be submitted through formal request with justification. Reliability, dependability, robustness, safety: All critical parts of the system should be connected with a backup generator to ensure constant operation. Performance: The system should be able to access any internal page within one second response time. Supportability, adaptability, maintainability, portability: The system should allow institute expert to modify the decision support rule after obtaining applicable approval. Interface: The system should be able to interface with the current information system of institutes. System security: User authentication to access system information should not go beyond individual legitimate need. Legal: The system should be able to support upgrades to any required data collection process, rules for regulatory review, and new code sets if mandated by government. Use Case Description and Use Case Diagram Collect Data • Extract relevant data from various EHR database Risk Stratification • Analyze patient’s characteristics and categorized it as low risk or high risk to develop diabetes complication Alert • Generate alert for high-risk individuals to their respective health care providers Report • Create report based on risk stratification for policy maker and researcher Workflow and Dataflow Diagram System Architecture Selected Standards Category Selections Data Standards ICD-10-CM for diagnoses, LOINC for lab tests and results, CPT for encounters and procedures, NDC for medications Information Content Standards Consolidated Clinical Document Architecture (C-CDA) encoded in XML Information Exchange Standards HL7, NCPDP SCRIPT Identifiers Standards National Provider Identifier (NPI), Patient identification through statistical probabilistic matching methods, Hospital identifiers, Record identifiers, Test order identifiers Privacy and Security Standards The Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”), The HIPAA Security Rule Functional Standards Procedures, workflows, dataflows, and use cases are described in previous slides Business Standards This system is designed to be heavily automated. Data receipt, rules processing, and alert transmission is all to be done electronically. The process model is described in previous slides. Hardware and Software Requirements Category Requirements Hardware The hardware requirements for this system are driven by expected performance. As throughput increases (i.e. as more provider systems are onboarded), requirements will increase. Architecture The system architecture diagram is included on a previous slide. Processing Power The interface engine must be able to process [the average expected daily record count] in under one hour. The rules engine must be able to process [the average expected daily record count] in under one hour. The data repository must be updated in real time. Memory The interface engine must be able to process batches of 10,000 records. Storage The data repository must be able to concurrently store the system’s entire history of clinical data records, all master patient index records, and all required clinical vocabularies. Storage must be expandable to accommodate growing record counts. Software Software requirements are based on supporting data exchange between systems and securing stored data. Platforms The operating system must support the programs, functions, and technologies listed below. Programs, APIs, Internet Technologies The interface engine must support data transmission with the provider information systems and the data repository. The data repository must support database software (Oracle, SQL Server, etc.), security software, and data transmission with the interface engine and rules engine. The alert system must support data transmission with the provider systems. Evaluation Plan The evaluation plan will follow the following six steps (CDC,1999) : 1. Engage stakeholders - Form an evaluation team - Engage an evaluator - Report status 2. Describe the program [technical level] - Describe the system - Team’s experiences (does system support data entry and report generation?) - Barriers plus external factors affecting the system 3. Focus the design [usability and functional level] - Assess functionality (does system support user workflow/dataflow?), quality, and barriers to users - Priorities: feasibility, utility, usability (is the system user-friendly?), robustness, reliability 4. Establish metrics and gather evidence [knowledge level] - Determine accurate quantitative measures to assess the complexity and robustness of the system - Pilot test 5. Draw conclusions [knowledge level] - Examine results against intended outcomes - Report on validity, reliability, and reproducibility 6. Develop recommendations - Develop recommendations - Explain benefits, costs plus challenges System Development Timeline and Deliverables Deliverables: • A data repository that interfaces with health information systems • A predictive modeling rules engine • An alert and reporting system Timeline: Stagedesign System 1-3System months design System design 1-3System mont development System design Pilot testing 1-3 months Period Months 1-3 Months 4-9 Month 9 Implementation phase 1 Months 10-18 System evaluation Months 13-21 Operation Months 22-24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Functional Standards Anna Orlova, PhD Johns Hopkins Bloomberg School of Public Health Session Outline ► Functional standards ► System development process: how to communicate your needs to developers ► Documenting functional requirements ► Final assignment 2 Functional Standards – Intro The material in this video is subject to the copyright of the owners of the material and is being provided for educational purposes under rules of fair use for registered students in this course only. No additional copies of the copyrighted work may be made or distributed. HIT Standards Categories Standards Categories Examples Data Standards Vocabularies and terminologies Information Content Standards Reference information models (RIMs), templates, datasets Information Exchange Standards Message-based, structured document-based, e-mail-based standards, IT standards Identifiers Standards National Provider Identifier (NPI), record ID, test order ID, Privacy and Security Standards Access control, consent directives, other Functional Standards Procedures, work processes (workflow, dataflow), checklists, use cases Business Standards Guidelines, best practices This classification of health IT standards types has been developed by the Health Information Technology Standards Panel (HITSP, www.hitsp.org) in 2006. 4 Health IT Standards Categories – 2 ► To date, the main focus of the standard development activities has been on:  Data standards (vocabularies and terminologies)  Information content standards (data representation, RIMs)  Message-based, document-based, secure e-mail information exchange standards  IT standards ( programming languages, protocols) 5 National Biosurveillance Use Case ► Charge: Biosurveillance Workflow “Transmit essential data from electronically enabled healthcare to authorized public health agencies in real-time” A total of 40 data elements…. Health Information Technology Standards Panel (HITSP). Biosurveillance Interoperability Specification (IS-02). URL:http://www.hitsp.org/InteroperabilitySet_Details.aspx?MasterIS=true&InteroperabilityId=49&PrefixAlpha=1&APrefix=IS&PrefixNumeric=02 6 National Biosurveillance Use Case – Selected Standards HIT Standards Categories Data Standards Information Content Standards Information Exchange Standards Identifiers Standards Privacy and Security Standards Functional Standards Business Standards TOTAL Selected Standards 28 17 46 11 5 1 1 107 Note: This classification of health IT standards types has been developed by the Health Information Technology Standards Panel (HITSP, www.hitsp.org) in 2006. 7 Communicating your Needs to Developers Functional standard: communicating your needs to developers 8 Client-Vendor Communication Reality http://www.projectcartoon.com/ (CC BY 3.0) 9 Functional Standard – 1 ► Functional standard describes work processes that support data exchange between users (e.g., clinicians and public health practitioners) in a format of functional requirements analysis document (specification) for electronic communication between settings (e.g., clinical and public health settings) 10 Functional Standard – 2 ► Functional standard is a vehicle to assure that the work processes of stakeholders (e.g., clinicians and public health practitioners) related to the electronic data exchange are well understood and agreed upon by stakeholders themselves and then communicated clearly to the developers as functional requirements (functional standard) for the information system 11 Functional Standard ► Functional standard serves as a foundation for the implementation of all other standards ► To date in the United States, there is no consensus on the format, content, and approach for how to specify the functional requirements (functional standards) 12 Specifying functional requirements 13 System Development Process: How to Communicate Your Needs to Developers The material in this video is subject to the copyright of the owners of the material and is being provided for educational purposes under rules of fair use for registered students in this course only. No additional copies of the copyrighted work may be made or distributed. Information System Development Process ► Information system development process is comprised of the following activities:  Requirements elicitation  Design  Development  Pilot testing  Implementation  Evaluation  Deployment Bruegge B. and Dutoit A.H. Object-Oriented Software Engineering. Pearson Prentice Hall. Upper Saddle River, NJ. 3rd Edition. 1-172 3 Requirements Elicitation – 1 ► During requirements elicitation, the client/user and developer define the problem, the goal(s), actors, and functions of the information system ► The client/user selects use case(s); with the help of the developers, they create:  Use case diagrams, workflow, and data flow diagrams  High-level system architecture  Non-functional requirements for the information system  Hardware and software requirements, system evaluation plan  System development timeline and documentation 4 Requirements Elicitation – 2 ► These requirements are documented in a functional requirements analysis document (specification) that serves as a contract between the client and the developer ► The specification is written in a natural language and supports communication between developers and users 5 Requirements Elicitation Includes – 1 ► Specifying goals ► Specifying high-level system architecture ► Specifying actors (business and technical) ► Specifying hardware and software requirements ► Specifying functional and non-functional requirements ► Specifying system evaluation plan ► Specifying use cases ► Specifying project timeline and documentation ► Developing models/diagrams ► Use case, workflow, and dataflow 6 Requirement Analysis Document ► The result of these activities is a description of the system in terms of goals, actors, functions, and use cases in the format of the Requirement Analysis Document (RAD) Bruegge B. and Dutoit A.H. Object-Oriented Software Engineering. Pearson Prentice Hall. Upper Saddle River, NJ. 3rd Edition. 1-172 7 Requirements Elicitation Includes – 1 ► Specifying goals ► Specifying high-level system architecture ► Specifying actors (business and technical) ► Specifying hardware and software requirements ► Specifying functional and non-functional requirements ► Specifying system evaluation plan ► Specifying use cases ► Specifying project timeline and documentation ► Developing models/diagrams ► Use case, workflow, and dataflow 8 Specifying Goals 9 Defining the Goal ► Defining and communicating the purpose of the information system—the problem it will help to address—by end user to developer is the key issue in the development of an information system 10 Purpose? 11 How Do We Define Goals of our Systems? – 1 ► CDC Environmental Public Health Tracking Network’s goal is to build a standards-based, coordinated, and integrated environmental public health tracking (surveillance) network at the state and national level that will allow linkage and reporting of health effects data with human exposure data and environmental hazard data Source: Sandy Thames. (2003). PHIN Conference. Atlanta, GA. 12 How Do We Define Goals of our Systems? – 2 ► CDC Public Health Information Network’s vision is to transform public health by coordinating its functions and organizations with information systems that enable:  Real-time data flow  Computer assisted analysis  Decision support  Professional collaboration  Rapid dissemination of information to public health, clinical care, and the public Source: John Loonsk. (May 13, 2003). PHIN Conference. Atlanta, GA. 13 How Do We Define Goals of our Systems? – 3 ► The vision of National Electronic Data Surveillance System (NEDSS) is to have integrated surveillance systems that can transfer appropriate public health, laboratory, and clinical data efficiently and securely over the Internet Source: http://www.cdc.gov/nedss 14 We Define Goals As: ► To build the system (EPHTN) ► To transform public health by coordinating its functions and organizations with information systems (PHIN) ► To have integrated surveillance systems (NEDSS) 15 So … ► “The goal of the system is to build the system” … ? ► This is the main reason for our systems failures ► The goal of the system cannot be defined as “to build the system”  That is, focus on the process of building, integrating, coordinating, etc. ► The goal of the system must be defined as “what” the system will do when built 16 Example: Immunization Registries – 1 ► Let’s attempt to define the goal of immunization registries based on this description from the CDC Web site: “CDC is continuing the investment to assist states in developing immunization information systems (registries)—confidential, computerized information systems that collect vaccination data within a geographic area. By consolidating vaccination records from multiple health-care providers, generating reminder and recall notifications, and assessing clinic and vaccination coverage, registries serve as key tools to increase and sustain high vaccination coverage. The Healthy People 2010 objective is to increase to 95% the proportion of children aged
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Evaluation Plan
The aim of this evaluation is to understand the ability of the system to provide a broad range of
clinical as well as economic benefits to diabetic patients. Four levels of the system will be
evaluated. They include the technical level which will look at whether the system works to
support data input and generate reports. Level two is the usability of the system which will assess
whether the user like it, its input and output. Level three will be evaluate the functional level, that
is, whether it supports user functions, workflow, and data flow, as well as information requests at
the right time, correct format, and place. Finally, the knowledge level of the system will be
evaluated to determine whether it supports defined goals including the expectations of the user in
solving the problems.
The evaluation plan will follow the following six steps. Step one will be engaging stakeholders
who will involve forming an evaluation team and be convening the data analysts plus the
principal coordinator. Then finding an evaluation expert to address the necessary questions, help
the group with decision-making and perform some evaluations. The group will then plan reports
on the present assessment status during meetings. Next, the program will be described where the
program coordinator will help the evaluator to learn about the system, the team’s experiences
and barriers plus external factors which might affect the program. Each activity will be aligned
with the intended outcome. The third step will be focusing the design. The team will identify
what to evaluate and choose the activities to evaluate. The team will evaluate the functionality

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plus the quality of the ...


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