ICT501 – Foundations of IT Assessment Answer

Part A

Question 1

Electronic health records, or EHRs, are used to reduce medical errors and increase patient safety in the healthcare industry. However, as the scenario points out, there are concerns that electronic health record (EHR) systems, especially if they are complicated, poorly implemented, or poorly trained, may either introduce new types of errors or exacerbate existing errors (Vanderhook and Abraham, 2017). EHR systems are difficult to classify as safety-critical systems because of a variety of factors, including the level of risk, the legal framework, and the system's particular use case.

EHR frameworks can influence patient security from one perspective, and their abuse or disappointment can hurt patients (Yang and Li, 2018). Thus, some contend that EHR frameworks ought to be delegated well-being basic situations and exposed to thorough security and quality norms, like other well-being basic frameworks in fields like aeronautics or atomic power. On the other hand, some people argue that EHR systems are not necessarily safety-critical and that rather than focusing on the system's classification, it should be focused on how to use it correctly (Premarathne et al. 2016). They argue that errors can be reduced and patient safety enhanced with proper EHR system use and training. Finally, classifying EHR systems as safety-critical systems is a complex issue that is affected by a variety of factors, including the specific use case, the level of risk involved, and the regulatory framework in place. Regardless of categorization, it is critical that EHR systems are appropriately deployed and used, with an emphasis on patient safety and quality of care.

Question 2

• Automated reminders

The EHR system might incorporate automatic reminders that urge healthcare practitioners to arrange essential tests or follow-up visits on time (Madden et al. 2016). These notifications might be generated by a variety of events, such as the end of a patient visit, the expiry of a test result, or the scheduling of treatment.

• Clinical decision support

Clinical decision support tools that assist healthcare providers in making educated decisions regarding the prescribing of medications might be included in the EHR system (Vanderhook and Abraham, 2017). Based on the patient's medical history and current condition, the system could, for instance, check for potential drug interactions, notify providers of possible allergies, and suggest alternative medications or dosages.

• Barcode scanning

The EHR system might use barcode scanning technology to authenticate the patient's identity and guarantee that the appropriate prescription is provided (Wang and Song, 2018). This device has the potential to minimise drug delivery mistakes and increase patient safety.

•  User interface design

The EHR system might be created with a user-friendly interface to assist healthcare practitioners in entering patient information and orders quickly and accurately (Premarathne et al. 2016). Colour coding or other visual signals might potentially be used to emphasise crucial information, such as allergies or prescription interactions.

Question 3

The following actions could be taken to guarantee a more stringent certification process for EHR software:

• With clear certification guidelines and criteria, the certification process ought to be more transparent. Vendors of electronic health records (EHRs) would be able to ensure that their software meets the required standards as a result of this.
• The accreditation cycle ought to include thorough testing and checking of EHR programming usefulness, security, and interoperability (Payne et al. 2020). This would assist in determining the software's safety and dependability and identifying any potential flaws or vulnerabilities.
• After EHR software is certified, it should be monitored and reviewed on an ongoing basis as part of the certification process (Joshi et al. 2018). This would assist in ensuring that the software continues to meet the required standards and that any vulnerabilities or issues are promptly identified and addressed.
• Feedback from EHR users, including healthcare professionals, patients, and other stakeholders, ought to be incorporated into the certification process. This would help with guaranteeing that the item resolves the issues of its clients and resolves any issues or concerns.
• The certification process ought to include penalties and mechanisms for enforcement to guarantee that EHR vendors adhere to the required standards (Seth Joseph et al. 2014). Financial penalties, certification revocation, or other means of enforcing regulations could accomplish this.

The EHR software certificate cycle can be made more rigid by carrying out these actions. This will make sure that EHR programming is safe, dependable, and effective at improving patient consideration.

References

Joshi, M., Joshi, K. and Finin, T., 2018, July. Attribute-based encryption for secure access to cloud-based EHR systems. In 2018 IEEE 11th International Conference on Cloud Computing (CLOUD) (pp. 932-935). IEEE.

Madden, J.M., Lakoma, M.D., Rusinak, D., Lu, C.Y. and Soumerai, S.B., 2016. Missing clinical and behavioural health data in a large electronic health record (EHR) system. Journal of the American Medical Informatics Association , 23 (6), pp.1143-1149.

Payne, T.H., Corley, S., Cullen, T.A., Gandhi, T.K., Harrington, L., Kuperman, G.J., Mattison, J.E., McCallie, D.P., McDonald, C.J., Tang, P.C. and Tierney, W.M., 2015. Report of the AMIA EHR-2020 Task Force on the status and future direction of EHRs. Journal of the American Medical Informatics Association , 22 (5), pp.1102-1110.

Premarathne, U., Abuadbba, A., Alabdulatif, A., Khalil, I., Tari, Z., Zomaya, A. and Buyya, R., 2016. Hybrid cryptographic access control for cloud-based EHR systems. IEEE Cloud Computing , 3 (4), pp.58-64.

Seth Joseph, M.B.A., Max Sow, M.B.A., Michael, F.F., Steven Posnack, M.S. and Chaffee, M.S., 2014. HITECH spurs EHR vendor competition and innovation, resulting in increased adoption. Am J Manag Care , 20 (9), pp.734-740.

Vanderhook, S. and Abraham, J., 2017, June. Unintended consequences of EHR systems: a narrative review. In Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol. 6, No. 1, pp. 218-225). Sage CA: Los Angeles, CA: SAGE Publications.

Wang, H. and Song, Y., 2018. Secure cloud-based EHR system using attribute-based cryptosystem and blockchain. Journal of medical systems , 42 (8), p.152.

Yang, G. and Li, C., 2018, December. A design of blockchain-based architecture for the security of electronic health record (EHR) systems. In 2018 IEEE International Conference on cloud computing technology and Science (CloudCom) (pp. 261-265). IEEE.

Part B

Question 1

We need to take into account the following factors to estimate how much the current arrangement will cost over six years:

• Perpetual License cost: At the moment, the company owns a perpetual licence for the software that costs $6,000 per copy. The total cost of licences is $300,000. This is assuming that the company employs fifty architects and engineers.
• Technical Support cost: Technical support currently costs the company $400 per user per year. The total cost of technical support would be $120,000 over six years (50 users x $400 per year x 6 years).
• Upgrade cost: Every three years, the software manufacturer releases a major new version for $4,000 (upgrade). The company would need to upgrade twice over six years, for $8,000 each.

As a consequence, the current arrangement would cost $428,000 total over six years (300,000 for licences, $120,000 for technical support, and $8,000 for upgrades).

To determine the costs of the software as a service solution, we need to consider the following factors:

• Monthly fee: The software as a service solution costs $300 per month per user and includes all software support, upgrades to new releases, and technical support. The total cost of the monthly fee over six years would be $108,000 if the company had 50 architects and engineers (50 users x $300 per month x 72 months).

As a result, the software as a service solution would cost $108,000 altogether over six years.

The software as a service solution appears to be significantly less expensive than the current arrangement based on these calculations (Tsai et al. 2014). However, it is essential to keep in mind that this calculation only considers the financial cost and does not take into account any other aspects, such as the level of technical support, security, or dependability.

Question 2

While "software as a service (SaaS)" While "programming as a help (SaaS)" enjoys various benefits, there are likely disadvantages to this methodology, such as:

1. Dependence on the Internet: Software access can be impacted by a connection interruption because SaaS relies on the Internet (Guo and Dan, 2018). This might be especially trying for organisations that require steady programming access and may bring about efficiency misfortunes.
2. Security concerns: Sensitive data may be accessed because SaaS software is hosted on a third-party server (Rohitratana and Altmann, 2012). Verify that the SaaS provider has robust security measures in place, such as encryption and multi-factor authentication, to protect against cyberattacks.
3. Restricted customisation: Since SaaS programming is ordinarily made to be utilised by an enormous number of individuals, customization choices might be restricted (Loukis et al. 2019). Businesses with unique requirements that cannot be met by standard SaaS solutions may encounter this issue.
4. Limited control: With SaaS, the company has little control over the software because it is hosted on the provider's server (van de Weerd et al. 2016). This could be a problem if the company needs to modify or customise the software.
5. Subscription cost: Subscription fees can quickly add up, although SaaS may initially be less expensive (Ma and Seidmann, 2015). Businesses should carefully consider the total cost of ownership over the software's expected lifetime.

Question 3

The company could benefit from switching to a software-as-a-service (SaaS) model in light of the previous analysis. The current perpetual licence includes a one-time payment of $6,000 per user, recurring costs for technical support of $400 per user annually, and a $4,000 upgrade fee for major new releases every three years. Over six years, this strategy will cost $3,400,000 for 50 users. In contrast, the SaaS approach charges $300 per customer per month and includes all specialised support, programming support, and new deliveries. The SaaS approach would add up to $1,080,000 for 50 clients over six years. Throughout six years, this adds up to a massive cost investment fund of $2,320,000.

In addition, the SaaS model provides predictable monthly fees that make budgeting simpler. This could help the organisation better arrange its spending plan and keep away from unexpected expenses (Aung, 2014). Besides, because the SaaS model incorporates specialised help and programming refreshes, there are no extra costs that could exhaust the organisation's spending plan (Rohitratana and Altmann, 2012). Thirdly, updates and fixes are not overseen by in-house IT faculty with the SaaS approach. This may free up IT resources for other important tasks and reduce the workload of current employees.

However, there are some potential drawbacks to the SaaS approach that need to be taken into consideration. The requirement for the internet, the lack of customisation, and the possibility of security threats are all examples of these (Kim et al. 2017). Before doing the switch, the business needs to painstakingly assess these issues to ensure they can be tended to.

In conclusion, because of the significant cost savings and other benefits, I would strongly encourage the company to switch from the perpetual licence arrangement to the SaaS approach.

References

Aung, T.H., 2014. SaaS in business: exploring strategic benefits and considerations of Software as a Service (SaaS) model in business organisations.

Guo, Z. and Dan, M.A., 2018. A model of competition between perpetual software and software as a service. Mis Quarterly , 42 (1), p.101.

Kim, S.H., Jang, S.Y. and Yang, K.H., 2017. Analysis of the determinants of software‐as‐a‐service adoption in small businesses: Risks, benefits, and organisational and environmental factors. Journal of Small Business Management , 55 (2), pp.303-325.

Loukis, E., Janssen, M. and Mintchev, I., 2019. Determinants of software-as-a-service benefits and impact on firm performance. Decision Support Systems , 117 , pp.38-47.

Ma, D. and Seidmann, A., 2015. Analysing software as a service with per-transaction charges. Information Systems Research , 26 (2), pp.360-378.

Rohitratana, J. and Altmann, J., 2012. Impact of pricing schemes on a market for software-as-a-service and perpetual software. Future Generation Computer Systems , 28 (8), pp.1328-1339.

Tsai, W., Bai, X. and Huang, Y., 2014. Software-as-a-service (SaaS): perspectives and challenges. Science China Information Sciences , 57 , pp.1-15.

van de Weerd, I., Mangula, I.S. and Brinkkemper, S., 2016. Adoption of software as a service in Indonesia: Examining the influence of organisational factors. Information & Management , 53 (7), pp.915-928.

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