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VistA. Needs Assessment. Vendor Selection. Project Impl. ROI. 100. 100. 100. 100. 100. 200. 200. 200. 200. 200. 300. 300. 300. 300. 300. 400. 400. 400. 400. 400. 500. 500. 500. 500. 500. VistA for 100 Points. What do the acronym VistA stand for?.

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  1. VistA Needs Assessment Vendor Selection ProjectImpl. ROI 100 100 100 100 100 200 200 200 200 200 300 300 300 300 300 400 400 400 400 400 500 500 500 500 500

  2. VistA for 100 Points What do the acronym VistA stand for?

  3. Veterans Health Information System and Technology Architecture

  4. VistA for 200 When did work on VistA began?

  5. Work on the laboratory system began in 1968

  6. VistA for 300 What is this about?The DM&S, the forerunner of VHA, created CASS office, which created DHCP on MUMPS. ODM&T dismissed participating employees and forcibly removed computers.

  7. The Department of Medicine and Surgery (DM&S), the forerunner of VHA, supported computerization efforts outside the purview of Office of Data Management and Telecommunications (ODM&T) by creating the DM&S Computer-Assisted System Staff (CASS) Office in 1977. This office pulled efforts across centers and created the DHCP, a set of interactive programs, running on mini-computers, using Massachusetts General Hospital Utility Multi-Programming System (MUMPS), table-driven reusable modules, and decentralized rapid prototype development. ODM&T responded aggressively to the emerging Decentralized Hospital Computer Program (DHCP). ODM&T dictated that development should stop, dismissed participating employees, forcibly removed computers from hospitals, and slashed the DM&S computer-related budget

  8. VistA for 400 Explain this graph

  9. VistA for 500 Patients from the VHA scored ?? percentage points higher for adjusted overall quality than randomly identified patients. In chronic care, VHA patients were ?? percentage points better off than randomly selected patients. In preventive care they were ?? percentage points better off than randomly selected patients.

  10. Patients from the VHA scored significantly higher for adjusted overall quality (67% vs. 51%; difference, 16 percentage points), chronic disease care (72% vs. 59%; difference, 13 percentage points), and preventive care (64% vs. 44%; difference, 20 percentage points), but not for acute care.

  11. Needs Assessment for 100 Which of the following should be followed in assessing information needs for strategic decisions? Focus on future decisions Involve more than the decision maker Check importance of information within specific decisions Numerically rate relative importance of information items

  12. All of these principles should be followed

  13. Needs Assessment for 200 What is the relationship between essential information, rapid data collection and periodic data collection. Describe this relationship in terms of range and average of ratings?

  14. Needs Assessment for 300 In design of an Electronic Health Record what should the needs assessment focus on so that the system achieves its quality objectives?

  15. Changes in business and care processes

  16. Needs Assessment for 400 In designing an EHR, what are the 10 unique needs of a pediatric clinic? How were these needs arrived at?

  17. 1. Growth data. 2. Multiple patient identifier. 3. Special terminology and information4. Age-based normal ranges 5. Time of birth6. Prescribing of medications7. Immunizations8. Alerts for contraindications 9. Parents' special documentation requirements10. ReportingDerived from consensus of Pediatric Association’s Committee

  18. Needs Assessment for 500 Which information is essential and which needs rapid data collection?

  19. Vendor Selection for 100 What was Dr. Cuddeback’s objection to current vendor selection processes?

  20. It is based on linear need assessment and implementation without any feedback and trial and errors

  21. Vendor Selection for 200 In Eden's 2002 survey of practices, what eight attributes were identified as important when selecting a vendor

  22. 1. The software appeared easy to use 2. Software appeared to improve one or more of the business processes3. The software provided the most value for cost4. The software would help long term business strategy5. The vendor was responsive to practice information needs6. There were strong testimonies from prior users7. The software was already in use by other sites affiliated with this practice8. Software was compatible with existing systems in the practice

  23. Vendor Selection for 300 S = ∑ i W i V i (A j)

  24. What is the formula for Multi-Attribute Value model for evaluating Alternatives 1 through J on attributes V 1 through Vn

  25. Vendor Selection for 400 The decision maker believes that impact on business processes is 5 times more important than compatibility with existing systems and compatibility with existing systems is 3 times more important than cost, what are the relative weights of the three attributes for evaluating vendors

  26. Vendor Selection for 500 In the Leap Frog method of evaluating vendors, each vendors EHR is tested on several patient scenarios that are organized to test the ability of the system to reduce medication errors. What are at least 10 categories that these scenarios test for?

  27. Leapfrog Method Tests for: • Therapeutic duplication • Single and cumulative dose limits • Allergies and cross allergies • Contraindicated route of administration • Drug–drug and drug–food interactions • Contraindications/dose limits based on patient diagnosis • Contraindications/dose limits based on patient age or weight • Contraindications/dose limits based laboratory studies • Contraindications/dose limits based radiology studies • Corollary Intervention that requires an associated or secondary order to meet the standard of care • Cost of care • Test duplication • Nuisance Order

  28. Project Implementation for 100 What are the five phases of project management?

  29. Initiate, Plan, Execute, Control and Close

  30. Project Implementation for 200 What are at least 5 project risk factors identified in the study by Gustafson and colleagues?

  31. 1. How strong was the planning mandate from external power brokers when this project began? • 2. How thoroughly did the planners explore the problem? • 3. Were outside experts and literature reviews used in designing the solution to the problems? • 4. To what extent were significantly different alternatives to the recommended action developed? • 5. Are funds available to support implementation of this project? • 6. How complex is the process for implementing this recommended action? • 7. Is staff provided with sufficient background information and training? • 8. How will the change agent obtain feedback from the target group during the implementation? • 9. To what extent do written materials exist to explain the new project and guide implementation? • 10. How strongly were the endorsements of key power brokers? • 11. To what extent will implementation affect those who support or oppose the proposal. • 12. How dissatisfied are those people most directly affected with the current situation? • 13. Were the key groups actively involved in problem exploration and program design? • 14. What are the perception of the parties affected about chance of successful implementation? • 15. To what extent has the target group resisted attempts to implement projects? • 16. How strong were the endorsements of middle level internal managers? • 17. What is the change agent's reputation? • 18. How committed is the change agent to this project? • 19. What power to force implementation does the change agent have? • 20. To what extent do the change agent and target group share similar values? • 21. How radical is the proposed design? • 22. What kind of concrete evidence exists to suggest this proposed design will work? • 23. How do parties involved perceive the advantages of the recommended action? • 24. How hard is it to modify (without changing the critical elements) the proposed design?

  32. Daily Double Project Implementation for 600 Will changing the finish date of a task in the project always change the finish date of a project? Why?

  33. Only if the task is or goes on the critical path. All other tasks have slack time built on them so small changes will not affect project end.

  34. Project Implementation for 400 In Microsoft Project start and end of project tasks, what does it mean if the duration of project is a number followed by a question mark?

  35. The duration of some sub-tasks are not specified. The number reflects the known minimum path

  36. Project Implementation for 500 In the assigned planning project, why were length of projects of some students different from others?

  37. Differences in assumptions about predecessor requirements

  38. ROI for 100 What are typical areas assumed to be affected by EHR (e.g. what was used in Claudine Beron’s analysis of impact of EHR)?

  39. Materials (paper, etc.), Personnel Time, Transcription and Space

  40. ROI for 200 What advantages the proposed method of calculating business value of IT has over the traditional method?

  41. Does not underestimate which business processes might be affected by new IT investments. • Does not overestimate the potential future benefits. • All costs are included. Does not underestimate cost of training and software maintenance.

  42. ROI for 300 What is the most planned impact of EHR? Reduction in paper work or changes in care processes

  43. Reductions in paper and personnel is what is planned for but changes in care processes are unforeseen consequences

  44. ROI for 400 Calculate ROI at interest rate of 10%

  45. ROI for 500 Can we claim that IT investment (cost) has led to increased revenue? Why?

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