Introduction
Aim
This report aims to research, investigate, implement and promote an IT system in a small business center. In this particular report, we will be looking into a medical simulation business center in Chelsea and Westminster NHS Trust located in central London (Chelsea and Westminster NHS Trust 2008, Centre for Clinical Practice) and attempting to implement an improved IT system within this business center. The Simulation center in Chelsea and Westminster NHS Trust trains doctors and nurses in a safe environment through the process of simulation (Chelsea and Westminster NHS Trust 2008, Simulation). The Chief Medical Officer, Sir Liam Donaldson (2009, pp.49 – 55) in his 2009 annual health report stated the importance of establishing more medical simulation centers in the United Kingdom as they provide better and safer training to doctors and nurses of various grades. That report resulted in large funds being released by the London Deanery for the establishment of 13 simulation centers in London. The development of these 13 simulation centers will pose a serious threat to the business profits of the simulation center in Chelsea and Westminster as now the target customers (doctors and nurses) will be divided between more simulation centers.
Such a competitive environment demands change in the IT system to provide better customer service. This report will investigate possible methods to improve the quality of IT systems in the simulation center in Chelsea and Westminster to give it an edge over its competitors.
Objective
Since the target customers are doctors and nurses we must provide a system that enables easy flow of information from the front end (clients) to the back end (servers). Currently, if a client has to register for a simulation course in Chelsea and Westminster he needs to download a PDF format of the registration form and post it to the center. Once the form is received in the center, the clerical officer does the data entry in a local Microsoft Access Database.
The above process of flow of information from the front end to the back end is cumbersome and time-consuming. We shall be researching and implementing a better IT system to enable an easier flow of information between the front and back end users. We also factor in the necessary suppliers, budgeting and promotional strategy for the implemented new IT system.
Research Methodology
We will conduct thorough research on various available options within cost and time constraints for improvement of the IT system for the front end user as well as a back end user. This will be discussed more in detail in Section 2: IT Systems Options and System Design.
Business Scenario
A developed IT system between the client and server will provide a better platform to attract potential customers to the simulation center resulting in improved business. Its also important that the project of IT systems have pre-defined outcomes with quality criteria, circle fenced finance, resources and period for the completion of the project.
IT System Options and System Designs
Research
The research of various options available for improving the IT system can be broadly classified into front-end and back-end applications.
Front end application: The Front end application will be improved in web hosting service enabling an online form through PHP programming. This online form will allow easy access for doctors and nurses to register for a simulation course. While comparing web-hosting services, the following factors were considered such as cost, maintenance, ease of use, disk space, bandwidth, upload and download speed. The selected web hosting company also had to be supported by the programmer dealing with this project. It was observed that common hosting companies are Host Papa, 1&1, UK2.Net, web fusion, UKhostforu, Easy space, Easily.co.uk and One.com (Web Hosting Review 2009, Top 8 Web Hosts). The research showed that ‘Host Papa’ meets our requirements with the necessary endorsements from the technical team.
Back-end application: Here, various databases such as Microsoft Access (Microsoft Office Access 2009, Overview), MySQL (MySQL 2009, Products), and SQL (SQL 2009, Home) were investigated. The research process factored in costs, technical support, size limit and suitability for driving a web-based application. MySQL was preferred because it was cost-efficient and an open-source database application. It also had better reviews for driving web-based applications. Moreover the chosen hosting company ‘Host Papa’ was compatible with the MySQL database providing a strong link between the front-end website and the back-end database.
Architecture
The architecture of the proposed new IT system will comprise of new webpage initiating the online user in this case a prospective customer to register for a course. The information provided by the online user from the front end will be linked to the back end MySQL database through a continuously running PHP Script. It would also be worthwhile to link the data from the online form to an email address for the back-end user. This will serve as a necessary backup in case MySQL runs into technical problems also ensuring that no data is lost during the downtime period of MySQL.
Implementation
Implementation of a new IT system in a large organization like NHS will have to satisfy certain protocols and policies through the IT department. The factors that need to be considered are discussed below.
IT Policies
Since there will be a download stream of information from remote computers into the NHS Trust network it is imperative that before implementation of the IT system there is consent from the Trust IT Department. Even before the implementation of the IT system, there must be meetings held with the IT department and written documentation of approval.
Cost
Before the implementation of IT system, there needs to be an agreement of budgeting for the project between the center manager running the simulation center and the project manager leading the IT development. Besides agreeing on the total expenditure there also needs to be a written document of approval of distributing of funds. The approvals of costing for the IT project should be carried out between the center manager of the simulation center, the project manager of IT systems and finance manager of NHS Trust.
Resources
A realistic approach is important in understanding the financial and manual resources available to complete the IT project. The project would get a boost by getting the necessary support from concerned departments such as the IT department, Finance department and Estates department who will be doing the necessary networking, cost management and cabling respectively. A proper document listing the available internal and external resources is necessary and also their impact on cost implications.
Time
The use of Microsoft Project enables time management through the use of the Gantt Chart. The project needs to be divided into various smaller stages. In this case, stage 1 would comprise of setting up MySQL database for back end, stage 2 would comprise of programming an online form for the front end, stage 3 would be programming a PHP script to link the rows of the online form to the appropriate cell in MySQL database and stage 4 will be to create a back uplink between the online form and the email address of the simulation center. Documentation of the time frame for the development of each stage in the project needs to be approved between the center manager and the IT project manager.
Business Benefits
This section will discuss how the proposed IT system will benefit the business of the medical simulation center of Chelsea and Westminster NHS Trust. Implementation of MySQL database will replace Microsoft Access Database, which will provide better security of confidential and financial information. Unlike Microsoft Access database, MySQL provides a multi-user interface which will result in two or three employees from the back end accessing the database simultaneously resulting in better time management. MySQL also has a large storage capacity making it suitable to drive a web-based application. MySQL database is compatible with MyPHPAdmin, which provides easier access to the database for technical concerns. These factors contribute to better time management for the employees of the simulation center allowing them to promote and market their courses in a better way. The use of online forms in the front end will replace the traditional way of downloading PDF format registration forms enabling easier use to potential customers and encouraging them to pay online replacing the use of cheque or demand draft. This allows a faster, easier and efficient way to enroll in a simulation course in comparison to other centers in London. Such a protocol will attract more clients to the simulation center hence directly impacting the financial outcome. Furthermore the PHP Script linking the data stored in the online form to the back end MySQL table will enable direct entry of data information from the front end to back end. This process saves time effectively to the employees of the simulation center who are currently investing time in data entry of registration forms into Microsoft access database.
Hence it can be observed that implementation of a new IT system will result in better customer service resulting in more clients attending the simulation course and also restricting futile time consumption of the employees of the simulation center allowing more scope and time to market and promote their course.
Management Challenges
This section will consider certain issues such as security, ethics, risk management, quality management and change management during the implementation of the proposed IT system.
Security
Security needs to be enforced on the front end as well as back end especially since data information will be passed through the NHS Trust network. According to NHS Information ‘Code of Practice’ any data stored in paper, computer, CDs, memory stick and across the network will be subjected to the NHS IT policies of security (Department of Health 2007, Information Security Management: NHS Code of Practice). Several security measures can be adopted through web hosting services to block or control spasm information. Some of the procedures are spasm guard and blocking IP addresses. MySQL provides strong security measures in accepting information through networks. Some of its general security measures are based on Access Control Lists
for all connections, queries, and other operations that users can attempt to perform (MySQL 2009, General Security Guidelines). There is also support for SSL-encrypted connections between MySQL clients and servers (MySQL 2009, General Security Guidelines). There shouldn’t be access given to user tables in MySQL to any user accounts except for MySQL root accounts (MySQL 2009, General Security Guidelines). MySQL allows statements like GRANT and REVOKE to control user access to the back end (MySQL 2009, General Security Guidelines)
Ethics
The development of the new IT system requires liaisons between many departments. The departments involved in this project would be the center manager of the simulation center, IT project manager leading the development of the IT system, Estate Department for the cabling, NHS Trust IT department who will see if the proposed IT system falls in line with the NHS Trust IT policies and Finance department who deals with budgeting, invoice and other finance requirements. Since such a process demands negotiable across tables between different departments it is imperative to consider the ‘ethical dilemmas’ between different departments in implementing a new IT system. Every user accessing the MySQL database will have to sign a form agreeing to maintain the confidentiality of the personal data information of clients. Staff needs to be trained to understand the proper use of the MySQL database and ethical issues concerning it. These relate to honor, honesty, bias, adequacy, due care, fairness, social cost and action (Rogerson, 1996).
Risk Management
For an IT project like this involving different departments and considerable costing, it is important to evaluate the risks impacting the project outcome at the very onset. This initiates risk management which is to manage the project’s exposure to risk by taking action to keep that exposure to an acceptable level in a cost-effective way (Risk Management Guide 2009, Management of Risk). Risk analysis involves the identification and evaluation of potential risks to any aspect of the project. Risk evaluation assesses the probability of the risk occurring and the impact on the project should the risk occur. Having identified the risks, possible actions to deal with the risks need to be considered and appropriate actions selected. Some of the actions to deal with possible risks include prevention of risk, reduction of risk, transfer the risk to another stage, accepting the risk as a last stage if the impact on the project is within tolerance limits or contingency plan which is an emergency plan to eliminate the risk.
Quality Management
Before the start of the project, there should be certain quality criteria established by all the concerned departments and stakeholders. These quality criteria will be the ideal quality outcome of the project and that needs to be documented and approved by all concerned parties. These quality criteria will be based on quality standards and responsibilities for ensuring quality is built into the project will be delivered from a variety of sources, including the customer’s quality expectations, requirements of ISO standards, NHS IT quality management and existing quality management systems. Planning for quality will involve agreement on how each stage will be tested against its approved, documented and pre-defined quality criteria. Also, at what point of the project will such a comparison of quality testing be made and which department. The quality of the project is attained by a combination of actions. Firstly, defining quality criteria for each stage of the project in measurable terms, developing stages according to defined quality standards and checking for quality in all delivered stages. Quality management can be monitored by configuration management and change control.
Change Management
With a new IT system in place, there is bound to be lesser work for the employees in the simulation center with regards to data entry. This will involve changes in management and organizational structure. In this particular case, change in management ensures a fixed process and technique to be followed for efficient management of changes to all IT structures which will result in reduction of the impact of any related incidents on the start of service. Such changes will also be made in the documentation for future reference to the staff. Also, it’s important to see if these changes abide by legislation and legal policies related to the NHS Trust. Change in management of organizational structure needs to be done in measurable terms, slowly but effectively. Sudden unexplainable changes in organizational structure will almost always result in opposition and failure of change. Hence, adopting new IT system will result in changes in technical issues as well as managerial issues which need to be handled sensitively and properly.
Conclusion
From the research conducted it can be concluded that the proposed IT system will require involvement of many departments with different policies and regulations to follow. Since the proposed IT system is to be installed in a NHS Trust this will also result in incorporating IT policies adopted by the trust with regards to security issues. However, with the resources and legislations to be followed the proposed IT system will prove to be cost-effective and far more beneficial for the business of the simulation center in Chelsea and Westminster NHS Trust and will provide it an edge over its competitors.
References
- Chelsea and Westminster NHS Trust. 2009. Centre for Clinical Practice. [Internet] London: Chelsea and Westminster NHS Trust.
- Chelsea and Westminster NHS Trust. 2009. Simulation. [Internet] London: Chelsea and Westminster NHS Trust.
- Department of Health, 2007. Information Security Management: NHS Code of Practice. [Online]
- Liam Donaldson, 2009. 150 years of the Annual Report of the Chief Medical Officer: On the state of public health 2008. [Online].
- Microsoft Office Access. 2009. Overview. [Internet] United States of America: Overview.
- MySQL. 2009. Products. [Internet] United States of America: Products. Web.
- MySQL. 2009. General Security Guidelines. [Internet]. United States of America: General Security Guidelines. Web.
- Risk Management Guide. 2009. Management of Risk. [Internet]. United Kingdom: Management of Risk.
- Rogerson, S., 1996. Training for Ethics. IMIS, [Online]. 6(1)
- SQL. 2009. Home. [Internet] United States of America: Home. Web.
- Web Hosting Review. 2009. Top 8 Web Hosts. [Internet] United Kingdom: Web Hosting Review.