TURNITIN RESULT: 9%
Analysing the CSFs for SISP from
HIS Project Implementation Perspective
Noorafini Abdul Wahab & Ariza
Nordin (Dr.)
Faculty of Computer and
Mathematical Science,
UiTM Shah Alam,Malaysia
nurhaqqq@yahoo.com
ariza@tmsk.uitm.edu.my
Abstract— This paper is generally to identify and analyse the critical
success factors for SISP from HIS project implementation perspective in
Malaysia. It will be based on the projects
conducted by MOH which had been carried out in Malaysia since year 2002.
Keywords— SISP, BHIS, IHIS, THIS, CSF
I.
Introduction
Strategic
Information Systems Planning (SISP) had been introduced in 1980s. It is used to
assist the organisation in finding the right information system implementation
for their business. It is proven to be an effective and profitable way for an
organisation to spend in their IT investment.
This
paper will generally discuss the critical success factors (CSFs) in the
Strategic Information Systems Planning (SISP) for Malaysia's public health care
sector perspective. It is based on the previous studies conducted for Basic
Hospital Information System (BHIS), Intermediate Hospital Information System
(IHIS) and Total Hospital Information System (THIS) projects by Ministry of
Health (MOH), Malaysia.
II.
Strategic Information Systems
Planning (SISP)
Strategic
Information Systems Planning or SISP is a combination of three keywords;
Strategic, Information Systems, and Planning. Strategic means planned or
tactical. Information systems is a system which comprising connected computers,
database, policies, procedures and people working on it. It requires software
and hardware to support its system operation and people to operate the system.
Information systems is also known as computerised systems. Planning means to
prepare and get ready all required information, process, procedures and methods
for setting up a plan.
SISP
is a process to produce a planning for information systems development in an
organisation. It involves the use of Information Technology and this is a
continuous process which to be reviewed every 3 to 5 years depending on the
organisation. In order to produce it, the organisation must identify the core
business operations. This is to ensure the information system strategies are aligned
with the business needs in the organisation.
A. Advantages of SISP
The
advantages of developing the SISP in an organisation are:
·
identifying the right information systems
for the organisation
·
aligning the business strategy with the
information systems strategy
·
using the information systems to deliver
the organisation's business strategy
·
producing the right procedures and
policies with the new information systems architecture
These advantages are anticipated to become long term
benefits to the organisation. However, they must be reviewed and be on par with
the current business strategies as well as the current technology used in the
organisation.
B.
The Stakeholders in SISP
There
is a range of important stakeholders from different levels of the organisation
involved in SISP. This group of people will contribute tremendously in terms of
information, services, rules, funding, and knowledge sharing.
The
common stakeholders are:
- top
management directors
- managers
- senior
officers
- IT
managers
- IT
personnel
- users
C.
Information System (IS)
Organisations
are willing to invest in information system development as it can bring big
impact to the business. It improves both internal and external communication in
the business, make business more effective and create more business opportunities.
As a result, the organisation able to achieve its competitive edge and make the
business's standard rise.
There
are a few components in information system. All the components are interrelated
in information system processes:
·
People
·
Process
·
Hardware
·
Software
·
Data
Information
system is designed to solve business problems via computerised processes and
operations. There are many types of information system available.
Information
system can be divided into several categories:
·
Decision support system
·
Executive information system
·
Expert system
·
Management information system
·
Office information system
·
Transaction processing system
The
organisation must know how to select the most appropriate information system
for their business. Each information system is different on their processes,
scope, system requirements, data operations and data requirements, Hence, the
most important criteria is the business requirements in that particular
organisation. Each organisation has their own business needs and differ in each
process.
III.
Health
Care In Malaysia
There
are two (2) main sectors for health care in Malaysia; public and private. Both
are under the Ministry of Health (MOH) rules and regulations. The public sector
is fully controlled by Malaysia's government. Meanwhile there are extensive
numbers of private hospitals and private clinics governed by private
organisations throughout Malaysia.
This
paper will focus primarily on public sector only.
A. Public Health Care Sector
According
to Malaysia Statistics Department website, the Malaysia's population is 30,350,674
citizens as to date. It means the Ministry of Health (MOH), Malaysia is serving
roughly around 10 to 30 million citizens in the public health care services as
not everyone afford to pay private health care services. Ministry of Health
(MOH), Malaysia is the main provider for public health care services in West
Malaysia and East Malaysia; Sabah and Sarawak.
In
Malaysia, there are two major categories of areas in every state; urban and
rural areas. MOH is providing public health care services to both.
The
following list is based on the MOH official portal:
TABLE I : TYPES OF CLINIC AND HOSPITAL (MINISTRY OF
HEALTH MALAYSIA)
NO.
|
TYPE
|
TOTAL
|
1
|
Government
hospital
|
49
|
2
|
Government
health clinic
|
2836
|
3
|
1Malaysia
clinic
|
185
|
4
|
Government
dental clinic
|
667
|
All the above-mentioned are health care service
providers under MOH administration in West Malaysia and East Malaysia; Sabah
and Sarawak. They provide basic health care, secondary level and tertiary or
third level health care services. [8]
B. Hospital Information System (HIS) in Malaysia
Hospital
Information System (HIS) was introduced by Ministry of Health, Malaysia (MOH)
and implemented in three (3) tertiary or third level hospitals; Selayang
hospital, Serdang hospital, and University Kebangsaan Malaysia Medical Centre.
HIS
is integrating the administrative, clinical and financial systems in Malaysia's
perspective. It is considered as a comprehensive information system for
hospital management.
Since
year 2002, MOH had successfully implemented several Hospital Information System
(HIS) projects which are divided into a few categories:
TABLE II : HOSPITAL INFORMATION SYSTEM (HIS)
CATEGORIES
NO.
|
CATEGORIES
|
1
|
Basic
Hospital Information System
(BHIS)
|
2
|
Intermediate
Hospital Information System (IHIS)
|
3
|
Total
Hospital Information System
(THIS)
|
BHIS,
IHIS and THIS are implemented by MOH which are differentiated in terms of the
system's complexity and comprehensiveness.
Basic
Hospital Information System (BHIS) is a combination of Patient Management
System and Clinical Information System. It had been implemented in the
following hospitals; Kuala Batas hospital, Kuala Penyu hospital, Kunak
hospital, Pekan hospital, Pitas hospital, and Setiu hospital. [6]
Intermediate
Hospital Information System (IHIS) is a combination of BHIS integration, Pharmacy
Information System and Laboratory. It had been implemented in the following
hospitals; Keningau hospital and Lahad Datu hospital. [6]
Total
Hospital Information System (THIS) is a combination of IHIS integration,
Administration, Personnel Information System, Financial, Inventory, and Picture
Archiving Communication System (PACS). It had been implemented in the following
hospitals; Alor Setar hospital, Ampang hospital, Pandan hospital, Putrajaya
hospital, Selayang hospital, Serdang hospital, Sungai Buloh hospital and Sungai Petani hospital. [6]
IV.
Control
Success Factors (CSF)
Identifying
the list of Control Success Factors (CSFs) and predicting the outcome in future
is a very good method in producing a strategic planning. It requires deep
analysis and deep thinking involving every levels in the organisation.
The
CSFs discovery can be done by doing review and analysis for the following:
·
management's goal and objectives
·
business document
·
selected individuals' challenges
·
organisation's barriers
Based
on the previous discussion in HIS projects studies, there are several CSFs for
SISP pertaining Malaysia scenario and also clinic or hospital background. These
CSFs are identified from the challenges in BHIS, IHIS and THIS projects
implementation in Malaysia.
TABLE III : LIST OF CSF
NO.
|
CONTROL
SUCCESS FACTOR (CSF)
|
1
|
Vision and
planning
|
2
|
Support
from top management
|
3
|
Financial
investment and support
|
4
|
Appropriate
IT infrastructure
|
5
|
Good
facilities
|
6
|
Proper
skill and knowledge
|
7
|
Cooperation
from other section
|
8
|
IT organisational
structure
|
A. Vision and planning
The
vision must be established by the top management in the SISP. It must be centralised and applicable to
every departments and sectors in that particular clinic or hospital.
A
vision can empower the whole SISP. It is a guideline to be followed by the
organisation in to produce an effective information system planning. Having a
vision in SISP is to ensure the planning will not be deviated from the initial
objectives.
For
example, each clinic or hospital has different needs in terms of the IT
infrastructure to suit their current business requirements. A small clinic
shall need less hardware compared to a big hospital which means the IT
infrastructure for this clinic is simpler and the total cost will be smaller. This
will keep both planning and costing budget are on track while the ongoing
project implementation. It is also another way for the top management to
control their budget.
A
good planning will cover the whole aspects of IT in the organisation. Examples
are business process identification, IT infrastructure planning, staff training
planning, human resource planning, and financial planning.
B.
Support from top management
Top
management's role is very crucial. They must be involved in all the SISP
processes and facilitating the SISP until its completion. In this case, it
involves the top management level of MOH, government hospitals and government
clinics. These top management people will lead and supervise the SISP. They
will provide appropriate resources and leadership to the lower level.
By
having their commitment, it is easier to manage the lower level staff. They are
responsible to demonstrate the organisational strategy, show full commitment,
develop restrictions, and establish the main objectives in implementing SISP.
Top
management will also provide the following information for SISP:
·
National
Health Informatics Standards
·
National
Policy and Governance
·
National
Legislation and Regulations [1]
These
national policy, standards and regulations are crucial for SISP in each clinic
and hospital. It is very important to include and develop the SISP based on
these as Malaysia has its own rules and regulations pertaining IT development.
C.
Financial investment and support
According
to MOH, the overall cost to implement Hospital Information System (HIS) is
ranged from 800 to 100 million per hospital. It involves the cost of
machineries, equipment, hardware, software, network and people.
In
this case, MOH needs to review the overall cost per project in order to
implement HIS throughout Malaysia. Further study on HIS need to be conducted in
order to convince Malaysian government on HIS effectiveness for health care
services in Malaysia.
Malaysia government had practiced
allocating certain budgets for each area including health care. If positive
feedbacks are provided by HIS projects, more financial support can be given to
every clinic and hospital for their SISP.
D.
Appropriate IT infrastructure
In
order to implement the information system, it is very important to have all the
required modern IT infrastructure. This involves the preparation of appropriate
hardware, software and network to support the HIS.
MOH
need to be precaution that there are several hospitals located in rural areas
of West Malaysia, Sabah and Sarawak. Those hospitals might not be able to have
proper online connection due to geographical area barriers. This can become a
challenge to MOH in HIS project implementation. However, proposal can be made
to Malaysia government in order to provide better IT infrastructure in these
rural areas.
Apart
from that, it might be a challenge for MOH to send IT equipments to selected
hospitals in HIS project. Basically, this will affect those in rural areas. It
is because of the great distance between urban and rural. For example, rural
areas in Sarawak.
E.
Good facilities
Facilities
referring to the location, building, room, furniture and security to support
the information system implementation.
Most
of the government clinics and hospitals are using old buildings. Malaysia
government had taken several initiatives by investing new buildings construction
and old building's renovations to improve the public health care services.
This
will include the implementation of having new information system that requires
new location in the hospital area which will need a large spot. It can be a new
building, new rooms and new furniture for the IT infrastructure including the information
system.
Security
scope is more on the IT infrastructure and information system security. It must
be secured as it can drive theft in terms of physical and data theft. IT
hardware and software are very expensive and it might draw interest in people
to steal them.
F.
Proper skill and knowledge
Hospital
or clinic staff including the doctors, nurses, lab officers, imaging officers,
pharmacists and accountants are potential users of HIS. They are required to
have proper skill and knowledge in handling the information system. This
requires a good planning in terms of providing proper training for the staff.
Training can be done while they are using the information system on daily
basis. It is a good practice for them to make mistake and learn from their
mistake. The IT technical and support team will assist them at this point.
The
other issue might be the time frame needed to ensure adequate training provided
to all users. The users involvement in project implementation is very crucial.
They are the ones who are going to use the information system on their daily
basis job process.
For
instance, it might be a bit difficult for elder nurses to operate the
information system. Therefore, they need confidence and longer time to adapt
themselves to the information system. Other examples are new patient
registration and taking images for dental x-rays at laboratory. It requires
time and skill to operate the new information system.
Continuous
training is also important to ensure the information system is not
underutilization in order to make it cost effective to health care providers.
It is also useful to reduce errors or failures by users.
G.
Cooperation from other department
Every
section must know and understand their roles and other section's roles. In
order to ensure the information system beneficial to everyone, full cooperation
is needed from all sections. Each section must understand the correct process
and know how the data linkage between them.
Each
user might experience failure or error in handling their daily basis job
process. Having cooperation from others
are very useful in making the process succeed. The other department can support
the users in telling them the right process and the right data to work with.
H.
IT organisational structure
Having
an information system required several IT teams such as IT planning team, IT management
team, and IT technical and support team. MOH needs to invest in human resources
as there are more than 3000 hospitals and clinics in both West Malaysia and
East Malaysia; Sabah and Sarawak.
The
IT planning team will produce the strategic information system planning (SISP)
which to be reviewed from time to time. The IT management team will manage the
IT infrastructure and information system, produce policies and procedures, and
provide adequate training to the staff. The IT technical and support team will provide
their services in terms of technical support to the information system for the
hospital or clinic. All these teams are very important as they are needed
before, after and within the current implementation of the information system.
The
team selection must be carried by the human resource in the public clinic of
hospital management before starting the SISP. It is better to have the IT
management team to lead the project and produce the right SISP for the public
clinic or hospital.
V. Conclusions
One
of the Malaysia's Vision 2020 component is to achieve a nation of healthy
communities. Various approaches need to be done to achieve this in Malaysia
despite budget constraint, time factor and geographical locations.
The
most important approach is to convert manual health care system in Malaysia to
online health care system services. Or they called it as paperless system. This
to make the health care system services more effective and rapid to the
patients. As mentioned earlier, there are roughly around 20 to 30 million
citizens to be served. Nevertheless, having an online health care system will
upgrade the current level of MOH in both urban and rural areas in Malaysia.
MOH
has taken a step forward by implementing HIS projects in selected hospitals
throughout Malaysia as part of their pilot projects. Huge investments had been
made by the Malaysia government to achieve this and a few studies were
conducted to review HIS implementation. Feedbacks from the users were very
important for MOH to proceed with their future projects. Therefore, more
studies and reviews are required to support MOH.
There
are a few future prospective for HIS implementation in Malaysia such as exploring
the role of patient to become the system user and converting the patient
diagnostic data into clinical research. [5] However, huge investment and long
term projects are required to achieve this in Malaysia. The public clinic and
hospital in Malaysia need longer time to adjust themselves into the usage of
HIS in their daily job process and operations. Therefore, it is better to
implement HIS in all public clinic and hospital and ensure the performance
stability before proceeding to the next step.
References
[1]
S. Selvaraju, "Health Information Management :
Malaysian Experience", Health Informatics Center, Ministry of Health,
Malaysia, 1998.
[2]
B. Killingsworth
& E. Seeman, "An Integrative Health Information Systems Approach For
Facilitating Strategic Planning In Hospitals", Proceedings of the 2005
Southern Association of Information Systems Conference, 2005
[3]
Fahad N. Al-Aboud, "Strategic Information
Systems Planning : A Brief Review", IJCSNS International Journal of
Computer Science and Network Security, VOL.11 No.5, May 2011
[4]
Aniza Ismail et
al., "The Implementation Of Hospital Information System (HIS) In Tertiary
Hospitals In Malaysia: A Qualitative Study", Malaysian Journal of Public
Health Medicine 2010, Vol. 10(2):16-24, 2010
[5]
Roshidi Hassan & Megat Zuhairy Megat Tajuddin,
"Implementation of Total Hospital Information System (THIS) In Malaysian
Public Hospitals: Challenges and Future Prospects", International Journal
of Business and Social Research (IJBSR), Volume -2, No.-2, 2012
[6]
Nurul Izzatty Ismail & Nor Hazana Abdullah, "An
Overview Of Hospital Information System (HIS) Implementation In Malaysia",
3rd International Conference On Business And Economic Research (3rd ICBER 2012)
Proceeding, 2012
[7]
Indah Mohd. Amin et al., "Assessing User
Satisfaction of using Hospital Information System (HIS) in Malaysia", 2011
International Conference on Social Science and Humanity IPEDR vol.5 (2011) ©
(2011) IACSIT Press, Singapore
[8]
http://www.moh.gov.my/index.php/database_stores/store_view/3
[9]
http://www.pivotal.com.my/v1/group/infotech/downloads/myhis_pamplet.pdf
[10] http://www.statistics.gov.my/portal/populationclockNEW/BI.php
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