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In our organization, we are trying to use an application called “Pathogen Asset Control System (PACS)”. This application is for management and control of every action performed with the biological agents such as to receive, transfer, movement, and destruction of agents. Each item in the repository is labeled with a unique barcode label which helps us to work faster, more convenient and secure. The million data will be stored in a separated confidential database of each department. Also, we can customize the program’s configuration as needed. However, we still found a limitation of this program. That it will be more useful if we can search the data in the database for more than 4000 data at one time.
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In my opinion, the successful of PACS system is about its design. It has customizable tool that we can customize configurations as we need. Also, it only needs simple process of data entering or the data can be imported by using the excel file. Staffs can work from each other’s computer at the same time. All of the above reason, a user-friendly program like this makes people would like to use this program to manage their data.
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MY organization, we tried to develop programs aids surveillance systems. Aids surveillance programs is the programs to collect the data of HIV patient in the northern of Thailand to integrate data for planing, follow situation and policy making but the program is failed because of
Data = we used patient data from some organization and not process to exchange data that we lack of standard data to plan develop and manage that are effect to structure of data change and finally the data not shared to use.
Cost = not problems and support from organization.
Operation = Technical support work hard for Solve problems.
= communication failed between organization.
Design = data security is the effect that HIV patient is the secret data that are not systems to protect data.
= Complicated to use program.
People = Poor and failed communication of organization to shared the patient data. -
In our organization, using OpenMRS, an individual patient record system used for HIV program. OpenMRS is implementing national-wide. OpenMRS for HIV program becoming successful. It took more than four year trying to customize, validate the data, train the end users and advocate them the benefit of OpenMRS. But there still problem in technical solution and IT problem like data standards and interoperability. OpenMRS was just developed by foreign developers and there was a communication gaps between programs and IT team. After that MOH plan to recruit local developers for cost saving and affective communication. But the problem is no local developers know much about program logics. There is no data standard and strong eHealth policy.
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X-ray PACS system, despite far from perfect, can be considered a relative success, as
– We can access X-ray films from anywhere in the hospital.
– We can import X-ray from most hospitals into the system.
– Better than traditional film in that we can zoom in and control contrast.Still, despite meeting the criteria for success (significantly better than traditional means), it is far from good enough.
– From some hospitals, we cannot import.
– Communication between doctors/nurses and X-ray personnel worsened, and relying on IT, become much less complete.In this case, it should be more useful to precisely define ‘success’… (as OKR or KPI).
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In my organzation i develope web application MIS for NTIP (National Tuberculosis Information Program) , an application to report register TB patient in ChiangRai , summary of group , age , gender ect. limitation of this program it must update data form NTIP every weeks and it have workload to manage data to update and software to develope web application is Trial program not License program.
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I want to share an example of a failed system (according to me) but still is operating. It’s a system called “X”; the system connects to other systems that overlapped each other. It’s like EMR, collected data and transactions are recorded. The “X” is to record all “ongoing” activities taken throughout the insurance claim cycle, which involved by two departments, the claim and the medical. When a claim is finalized, all data and transactions must be transferred to the “Z” system, which has other back-office departments involved. The transfer is a 95% manual with duplicated data entering, and unformatted datasets. Often, stakeholders end up with using a spreadsheet with another data entering manually out of the “X” and the “Z” instead of extracting out of it. The system is well-designed with advanced data options, but the problem is that the data is not interoperable among systems and does not meet the workflow’s needs in operational and decision-making requirements. The multiple data entry on systems leads to workload and non-valued add steps. The failure, for me, is mainly because of data quality and design if data exchange.
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Please give an example of a system in your organization (either successful or fail). What are main factors that make the system successful or failure (Data, Cost, Operation, Design, and People)?
I would like to use the electronic medical record system in my hospital as an example. My hospital board have purchased EMR from the biggest vendor in Thailand. Despite this EMR have been developed for the third version, hospital staff could not utilize it efficiently. Previously, staff in my hospital had used the electronic medical record merely for patient registration, drug prescribing, and financial record. Registration staff need to find out paper-based health records, nurses and physicians also note down in the paper, doctors prescribe drug both in the paper and in the EMR. On the other hand, other hospitals could implement this EMR from the same vendor in the out-patient department but not the in-patient department. It is showed that even though EMR could be implemented in the other hospitals, my hospital and some other hospitals could not utilize it successfully. The reasons are staff had not been trained enough before implemented the system and there is no follow up on users’ ability. Some function in this software is not user-friendly, however, the software itself was designed well enough to utilize throughout the hospital information system, and the price was reasonable. -
An ilab system is a sample registration for laboratory analysis. At first time, this system is designed for adopting in a regional Medical sciences centre and it is very successful. We can use it for sample registration, tracking, reporting and client contacting. Once we try to apply it in department of medical sciences (DMSc) which has more type of laboratory, and data variety. It seems to be fail because now we can use only sample registration part for creating patient lab code.
The main factors for this situation is design. Because of the different in infrastructure between regional Medical sciences centre and DMSC (centre) even they have same purposes, ilab is not work for DMSc. As a consequence of this, users do not desire to use it or use it in some parts.
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In my organization, as I mentioned before, the eHIS system is failing to success. Significant contributions are from the design and cost.
This system sounds good at the beginning. We can use it to decrease workload for laboratory order and decrease the prescription error. However, after the system launch, we, an end-user, found the difficulty in searching for the lab items, medication name, and also the way to order dosage for each medication. Finally, to confirm the order, we have to do things repeatedly many times. Few week after the soft launch, the developer withdraws the first version of this program. I think the critical factor for designation failure compose of 1. user-unfriendly appearance and 2. the real user involvement since the beginning of the process is a failure, there might involve clinician into the developmental process of this program, but they can not represent all wishes of end-user.
Our organization paid a lot for these systems, and we have high expectation on this. After the first launch, the system can not makes user appreciation. So that why these projects start to fail rapidly -
As my experience in SAP project implementation, there are several causes that impact to project fail or successful, for example, cost, people, project scope, timeline, team ability, technology, knowledge, project management etc.
I do agree with as Aj.Saranath taught about “Good – Cheap – Fast” When a project manager get a requirement from the user, a project team is settled later. From my experience, main factors that impact to the system failure or success is depend on project scope. For high complexity project, it need senior team member, hi-performance project manager and vendor. If team can not get requirement and confirm effectively, it will effect to the other processes in project life cycle, for example, design snd test phase. In my opinion, an effective project management is the best factor.
For K’Penpicha’s point, I agree too. I found that some of successful project in one company. When it is rolled out to the other company, it can not match with 100% requirement. It have to enhance or customize to support later.
In system development life cycle, from gathering requirement phase, design, build , test , deploy, deliver to after go-live support phase. There are a lot of chagnes, for example, user change requirement, design change, technology change or team member change. These effect to project status. If project manager has a good skill in project management, it’s possible that the project will be successful more failure.
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My hospital board have used both EMR and paper-based record from the vendor in Thailand. We did not develop ourselves. Despite this EMR have been developed, the hospital staff could not utilize it efficiently. Previously, staff in my hospital had used the electronic medical record merely for OPD patient for each visit registration, drug prescribing, and financial record but not IPD. When the patient comes to follow-up, the doctor needs to find out paper-based IPD records, nurses and physicians’ former and home-medicine prescription. It showed that even though EMR could be implemented in the other hospitals, my hospital and some other hospitals could not utilize it successfully. The reasons of system failure are staff had not been well trained enough before implemented the system and there is no re-evaluation on users’ ability. The system does not fully achieve the objectives of the users, however, the price was reasonable. The system may need to be upgraded and the technical support team may need to be educated and rebuild the system again as AGILE model.
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Health information system in my organization seems to be not successful. The factors that make the system not successful are
– People: the leader has no clear policy to improve HIS, inadequate communication, not enough training for old and new users, IT needs to work for the whole faculty, not only the hospital
– Cost: limited budget to use the full option
– Data: unavailability, and untimeliness, many data cannot be accessed via HIS
– System: is partially linked between each department
– Design: is not easy to use
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