Concordia University
Contents
1. Who Feels the need of a system which helps them in talk ing good care patients by providing expert information along with warning and alerts based on the patient and tasks The Clinical Decision Sup port System Is a software product that integrates the expert knowl edge of supervisors and doctors experiences in an acces sible and systematic approach That Can maintain patients record find browse expert in formation about wound and recommended on course of treatment alerts and warnings about the patients aller gies Unlike Current system where the records are maintained man ually and if a nurse has a trouble she has to ask the supervisor nurse or a doctor every time Our product Makes the process easier by providing easy to use in terface for entering patients wound records providing expert information about wounds and generating alerts and warnings based on the patients information through the use of artificial intelligence 1 3 Stakeholder description 1 3 1 Stakeholder Summary Name Description Responsibilities Nurse The primary end user of the system e Nurses need an application where they can add delete modify and save pa tients information quickly e Nurses need an application where they can quickly add or modify wound record manually or automatically by reading data from other medical de vices e Furthermore they need a system which can be a reminder fo2. 6 12 Licensing Requirements Only ABC Hospital employees with hospital permission are allowed to use the software Any employees of the development company such as developers 62 testers and project manager must sign the Agreement with the hospital before working on the project 6 13 Legal Copyright and Other Notices The system is an asset of ABC Hospital and shall be not installed copied distributed or modified without the Hospital permission The source code and other resources such as graphic items data testing fixtures also belong to the hospital only They wont be used in any purpose without the Hospital permission 6 14 Applicable Standards The system must be cleared approved by FDA and it must follow the EHR standard Furthermore any transmitting data between any devices must be encrypted by AES Advanced Encryption Standard 63 Chapter 7 Interviews 7 1 Interview with Registered Nurse 7 1 1 User Profile Name Catherine Monda Company ABC Hospital Industry Health Care Job title Register Nurse Level One year of Experience Q What are your key responsibilities Key responsibility is to take care of the patients with different type of wounds such as pressure ulcers and Surgical Wounds at different stages Q What outputs do you produce using the system Make patients wound in good progress and be cured Make patient feel happy and satisfied with hospital service Q For whom is the system e
3. Main Success Scenarios 1 Nurse indicates the system that s he is going to enter the wound record 2 Nurse selects the existing patient 3 Nurse selects the wound type 4 Nurse enters all the required fields such as size color or depth of the wound 5 Nurse tells the system to save the record 6 After the record is saved the system should indi cate operation status and redirect to the previous screen 25 Extensions la Nurse is not logged in 1 System redirect to login screen 2 After logging in successfully the system should redirect to storing wound record screen 2a Patient is not existed 1 System redirect to create new patient screen 2 After creating in successfully the system should redirect to storing wound record screen 4a Nurse can enter data by synchronizing with medical devices instead of using keyboard or touchscreen 5a If the entered values are incorrect the system can alert so that he she can modify the information Special Requirements Should be able to edit the information as per the changes in future Technology and data varia tions list The platform used for this system is Windows OS iOS and database software Frequency of occurrence Once day for each patient Some kind of wound requires logging record twice a day Miscellaneous The system should be able to fill out some default values Table 3 1 UC_Store_Wound_Record 26 3
4. Wee Concordia University Engineering and Computer Science CONCORDIA UNIVERSITY ENGINEERING AND COMPUTER SCIENCE SOEN 6481 WINTER 2014 Systems Requirements Specification Project by WE5 Authors Lincoln Taniguchi 4801601 Avi Modi 7006683 Superior Nhat Nguyen 6633617 Dr Sutharsan Sivagnanam Rachit Naidu 7014856 Rashi Kapoor 6926533 April 18 2014 Contents 1 Vision Document 1 TA Introduccion ea o o 1 LAA Purposes setas escala da a a lS a oH 1 T27 COPE iia ei aa Poste gs Sl ce nite o 1 127 POSITIONNE saar A i a YEG te i A PAE E 2 1 2 1 Problem Statement 2 5 hd Ds ow ee es 2 1 2 2 Product Position Statement 3 1 3 Stakeholder destripar Modo ty Gai Gs Wa Baik 4 1 3 1 Stakeholder Summary des ay ooh eas oS 4 1 3 2 Stakeholder environment 4 5 1 4 Product Overview et Senet ive snc a ee Sk Se he et eS 5 1 4 1 Product Perspective lt 2 ali BSG Yes 5 1 4 2 Product Position Statement o oo aa aa 6 1 4 3 Summary of Capabilities y riales do e 6 1 4 4 Assumptions and Dependencies 6 1 4 5 Cost and Pricing 0232 64 2464 a eG BR Os 6 1 5 Feature Attributes ale dk Scare Da Ss Se 6 IG Needs itise Br e e a AS 7 LP Product Features cola a A a ere Boe B ps ds a 7 1 8 Documentation Requirements 9 1 8 1 Applicable Standards a a 9 1 8 2 System Requirements 9 1 8 3 Performance Requirement 10 1 9 U
5. 46 Steps 1 Changes the clock of the system to due time of event or wait until the due time passed 2 Wait until receiving the push notification on the mobile device 3 Updates on the due schedule event such as mark it completed within the allowed interval default is 5 minutes Expected Results e User should receive the push notification on her his mobile device with correct content imme diately when the schedule is due e User should NOT receive either text message or notified email e The correct content of notification should contain task description location and due state Table 3 11 TC_Notify_Due_Scheduled_Events_2 Extension 4c Testcase Test Case ID TC_Notify_Due_Scheduled_Events_3 Title Testcase for Notify_Due_Events Extension 4c Requirement System can not notify user on overdue important event then notify her his supervisor Type Acceptance Test 47 Preconditions User did NOT register either email account phone number or mobile device The supervisor of the schedule s owner registered email account phone number and mobile device User setup added and important schedule into the system Steps Changes the clock of the system to due time of event or wait until the over due time of event passed User take no actions on the scheduled event until it s over due The supervisor of the owner takes no action while receivin
6. Access Expert 5 3 1 3 1 3 1 5 1 Information Access Historical 3 1 1 3 1 1 3 1 1 7 1 3 Records Notify Due Events 5 3 1 3 1 3 1 5 3 Request Advisor s 3 1 1 3 1 1 3 1 1 9 1 3 Support Notify Advice 9 7 5 7 5 9 1 5 Conflicts Generate Patient s 5 3 1 3 1 3 3 1 5 1 Brochure Table 2 1 AHP Comparison matrix with relative values of requirement 19 Brochure SPI SWRI AEI AHRI NDE RAS NAC GPB Rel Enter Patient 0 07 0 06 0 10 0 11 0 02 0 16 0 17 0 13 0 10 Information Store wound 0 37 0 32 0 30 0 33 0 33 0 22 0 21 0 31 0 30 Information Access Expert 0 22 0 32 0 30 0 33 0 33 0 22 0 17 0 22 0 26 Information Access Historical 0 07 0 11 0 10 0 11 0 20 0 16 0 12 0 13 0 12 Records Notify Due Events 0 22 0 06 0 06 0 04 0 07 0 10 0 12 0 13 0 10 Request Advisor s 0 01 0 05 0 04 0 02 0 02 0 03 0 07 0 01 0 03 Support Notify Advice 0 01 0 04 0 04 0 02 0 01 0 01 0 02 0 01 0 02 Conflicts Generate Patient s 0 02 0 05 0 06 0 04 0 02 0 10 0 12 0 04 0 06 Table 2 2 Normalized matrix and relative contributions of requirement to the project s overall value 20 EPI SWR AEI AHR NDE RAS NAC GPB Enter Patient 1 1 3 1 5 1 3 1 5 1 3 1 9 1 5 Information Store wo
7. Low y Y AHR f Priority 3 10 OEP 4 NDE 5 4 GPB P RAS NAC 0 0 5 10 15 20 25 30 35 40 45 50 COST PERCENTAGE Figure 2 8 Value Cost Requirement prioritization obtained by AHP EPI Enter Patient Information SWR Store wound Record AEI Access Expert Information AHR Access Historical Records ASE Alarm Scheduled Events RAS Request Advisors Support Please note that we picked use cases to make fully dressed not based on the result of AHP but for the sake of diversity of diagram We would like to cover special circumstances of use cases such as extend include and whitebox The actor comes from internal instead of external 23 Chapter 3 Detailed Use Cases This chapter describe the selected usecases in fully detailed which includes fully dressed system sequence diagram activity diagram and testcases 3 1 Store Wound Record 3 1 1 Fully Dressed Usecase 4 Store Wound Record Nurse includes A Validate Values Figure 3 1 Store Wound Record Fully Dressed 24 T Database Use case ID UC_Store_Wound_Record Use case name Store Wound Record Scope System Under Discussion Level User level Stakeholders Primary Actor Nurse Stakeholders And interests Nurse want to enter wound record easily and quickly Preconditions Intranet should be available at all times Post Conditions The saved wound records should be accessible at all times
8. 1 2 System Sequence Diagram Select Woundinfo Tabl gt r I aa SYSTEM A Save Input Values gt Figure 3 2 Store Wound Record System Sequence Diagram 21 DATABASE A I I j I I I I l 3 1 3 Activity Diagram Select Patient p Eine Patient Update Record Create New Record Select Wound Type Enter Required Details Figure 3 3 Store Wound Record Activity Diagram System Save Record 3 1 4 Testcases Main Scenario Test Case Test Case ID TC_Store_Wound_Record_1 Title Manually Entering Valid Wound Information Requirement Testcase for main scenario of Store Wound Record Type Acceptance Test Preconditions e User successfully login to the system as Nurse e Patient information exists in the system Steps 1 Select New Wound Record from main menu 2 Select the patient from the list 3 Select the wound type 4 Enter all required wound information fields with valid values 5 Click on save button Expected Results e The new record should be added to the system with correct values e The new record should be added to the selected patient e The system should log the nurse activity entering new wound record Table 3 2 TC_Store_Wound_Record_1 29 Extension 4a Test Case Test Case ID TC_Store Wound
9. e The system should display the Print Preview which allow user to select Printer and other op tions e The content of article should be printed correctly content color amp formatting Table 3 8 TC_Access Expert Information_4 39 3 3 Notify Due Scheduled Events 3 3 1 Fully Dressed Usecase i Time System Clock Figure 3 7 lt lt include gt gt Notify Due Event lt lt include gt gt lt include gt gt Push Notification T Send Email Notify Due Scheduled Events Fully Dressed Use case ID UC_Notify_Due_Scheduled_Events Use case name Notify Due Scheduled Events Scope System under Discussion WhiteBox Level User Level Primary Actor Machine System Clock Stakeholders And interests e Nurses want to be reminded on due scheduled events and warned if overdue by many ways such as Push Notification Email or Text Message e Supervisor needs to be notified if tasks or events that under her or his supervision overdue 40 Preconditions Tasks such as dressing wound reposition have been scheduled either manually or automatically into system System under Discussion Time to get these tasks done is coming or passed but the system has not received any update on these events Post Conditions Owner of scheduled event should receive reminder if scheduled event is going to start or due or over due without u
10. ee SS 62 6 11 2 Hardware Interfaces 2 000 62 6 11 3 Software Interfaces e A ge he al 62 6 11 4 Communications Interfaces 0 62 6 12 Licensing equipement se sa e oa isa e at ee de 62 6 13 Legal Copyright and Other Notices 63 6 14 Applicable Standards a 2 yg gid A 63 Interviews 64 7 1 Interview with Registered Nurse 64 ele SOTA TOMS e oe cer toe ay Aa Bh a te ng ee oy 64 7 1 2 Assessing the problem 65 7 13 Understanding the user environment 66 7 1 4 Recap tor understanding 2 2 4 44 4 2 2 24 4 4 2 4 67 7 1 5 Assessing the opportunity 68 7 1 6 Assessing the reliability performance and support needs 68 7 1 7 Other requirements oe he ge SAN ae SH ew 68 TiS Wrapup e esla Bree ke ee Se A dd 69 7 1 9 Analyst s summary oS be raro Ta Se ee be Se 69 7 2 Interview with Doctor 2 64 2 aioe o eke Bo a ow ath 70 E E s a ai Lets O Sel eg E he E 70 7 2 2 Assessing the problem 71 7 2 3 Understanding the user environment 71 7 2 4 Recap for understanding 72 7 2 5 Assessing the opportunity 73 7 2 6 7 2 7 7 2 8 7 2 9 8 Glossary References Assessing the reliability performance and support needs 73 Other requirements 73 Wrap Ups de h A E a 73 Analyst s summary 4 64s on a 8 ER Eo Re 73 74 77 List of Figures 2 1 2 2 2 3 2
11. skin that is usually made by a scalpel during surgery A surgical wound can also be the result of a drain placed during surgery 2 Wound catalogue A comprehensive reference of wound types including il lustrations of each wound type Medical Brochures The type of medicines required to cure a particular wound is being printed on the paper by the responsi ble Doctor or wound nurse 75 Treatment Plans Treatment given to a patient solely depends on the progress of the wound being cured Therefore treat ment plans helps doctors to maintain a record about which patient list of medicines and schedule which were effective for treatment EHR Format EHR stands for electronic health record which is a kind of standard that can help medical institutions to main tain uniformity in accessing patient information across several Hospitals Patient Allergies Allergy is a kind of a negative reaction that occurs be cause of unsuitability to a particular medication 76 References 1 http www npuap org resources educational and clinical resources npuap pressure ulcer stagescategories 2 http www healthline com health surgical wound 3 Yun Ke Chang Christopher Khoo and Armineh Nourbakhsh Re quirement Analysis for a Nursing Decision Support System TT
12. 1 8 Wrap up Q Are there any other questions I should be asking you No I dont have Q If I need to ask follow up questions may I give you a call Would you be willing to participate in the requirements review Yes You can send me an email anytime 7 1 9 Analyst s summary 1 The system should be able to assess the wound stage based on patients records and progress 2 The system should be able to raise the conflict decision or advice be tween the supervisor or doctor 3 The system should be able to generate the patients brochure when they are being discharged with their records amp states 4 The system should be able to integrate to Mobile Platform especially iOS 69 7 2 Interview with Doctor 7 2 1 User Profile Name Isabella Peirce Company ABC Industry Healthcare Job title Doctor Specialization All kinds of wound Experience 7 years of experience Q What are your key responsibilities e Does initial assessment and recommends the course of treatment e Monitors progress of patients who are being charged in by me or my team e Supports the nurse if unable to identify the wound e Approves the discharge of a patient e Manages and assigns tasks to my team members Q For whom is the system e Patients with specific conditions e Other healthcare professionals such as nurses e Hospital values e g Reputation Q How is success measured e Safety for both patient and employees especially under m
13. 4 2 5 2 6 2 7 2 8 3 1 3 2 3 3 3 4 3 9 3 6 3 7 3 8 3 9 4 1 Context Diagram Use Gases a See o BS 28 Store Wound Record Use Case 200 Enter Patient Information Brief Use Case Generate Patient Brochure Brief Use Case Requests Advisor s Support Brief Use Case Notify Due Scheduled Events Brief Use Case Access Historical Records Brief Use Case 2 2 Value Cost Requirement prioritization obtained by AHP Store Wound Record Fully Dressed Store Wound Record System Sequence Diagram Store Wound Record Activity Diagram Access Expert Information Fully Dressed 2 Access Expert Information System Sequence Diagram Access Expert Information Activity Diagram Notify Due Scheduled Events Fully Dressed Notify Due Scheduled Events System Sequence Diagram Notify Due Scheduled Events Activity Diagram Conceptual Classes 0 EEE ROA List of Tables 2 1 2 2 2 3 2 4 3 1 3 2 3 3 3 4 3 9 3 6 3 7 3 8 3 9 3 10 3 11 3 12 5 1 5 2 5 3 5 4 AHP Comparison matrix with relative values of requirement Normalized matrix and relative contributions of requirement to the project s overall value o oo aa a ee AHP comparison matrix with relative costs of requirement Normalized matrix and relative contribution of requirement to the projectes overall cost o A ew eS UC St
14. C2 UC3 UC4 UC5 UC6 F1 F2 F3 F4 F5 F6 F7 F8 F9 Table 5 2 Product Features versus Use Cases 54 Use Cases e UC_StoreWoundInfo UC1 Store Wound Info e UC_EnterPatientInfo UC2 Enter Patient Information e UC_PrintPatientBrochure UC3 Print Patient Brochure e UC _RequestSupport UC4 Request Support e UC_RaiseAlarm UC5 Raise Alarm e UC_TracePatientRecord UC6 Trace Patient Record 5 3 Use Cases to Test Cases Use Case ID Scenario Test Case ID UC_StoreWoundInfo 1 TC_StoreWoundRecord_1 UC_StoreWoundInfo 2a TC_StoreWoundRecord_2 UC_AccessExpertInfo 1 TC_AccessExpertInfo_1 UC_AccessExpertInfo 2a TC_AccessExpertInfo_2 UC_AccessExpertInfo Ab TC_AccessExpertInfo 3 UC _AccessExpertInfo Ab TC_AccessExpertInfo_4 UC _NotifyDueScheduledEvents 1 TC_Notify_Due_Scheduled_Events_1 UC _NotifyDueScheduledEvents 2b TC_Notify_Due_Scheduled_Events_2 UC _NotifyDueScheduledEvents Ac TC_Notify_Due_Scheduled_Events_3 Table 5 3 Uses Cases to Test Cases 59 5 4 Product Features versus Supplementary SUP1 SUP2 SUP3 SUP4 SUP5 SUP6 Create Y Y Y Y Expert Informa tion Access Y Y Y Expert Informa tion Enter Y Y Y Wound Informa tion Enter Y Y Patient Informa tion Generate Y Y Patient Brochure Notify Y Y Y Due events Table 5 4 Product Features ve
15. Extension 4b Test Case Test Case ID TC_Access Expert Information_3 Title Search for unavailable Expert Information Entry Requirement Testcase for Extension 4b of Access Expert Information Type Acceptance Test Preconditions e The user should have be logged in to the system as nurse e Keyboard and mouse are working properly and connect to the system e The article which user wants to search is NOT available in the Expert System Steps 1 Select the search information option from the main menu 2 Type the query in the search box 3 Click on the search button Expected Results e The system should display error message indicates that there is no entry that matches query e The system should suggest some relevant keywords based on the query Table 3 7 TC_Access Expert Information_3 38 Extension 2a Test Case TC2 Test Case ID TC Access Expert Information 4 Title Print selected Expert Information Entry Requirement Testcase for Extension 2a of Access Expert Information Type Acceptance Test Preconditions e The user should have be logged in to the system as nurse e Keyboard and mouse are working properly and connect to the system e The article which user wants to print is available in the Expert System Steps 1 Select Browse option 2 Select Browse category 3 Select an article from the available list 4 Select to print the artcile Expected Results
16. How do you solve it now I have been usually following my supervisor although I have trusted more on the doctor because she is in charge of me Q How do you like to solve it If the system can track or record the advice from either the doctor or super visor And it is much better if the system can detect conflict between them then raise the issue to them so I wont have to deal this difficulty Q What else Each time the patient is discharged the nurse must give him a brochure but we must enter a lot of information to create a brochure Actually those information are being stored already in the system Q How do you solve it now We are using different Microsoft Word Templates each for each kind of wound But we still have to enter repeated Q How do you like to solve it If there is a software that can access patient records then generate the user brochure automatically without entering data 7 1 3 Understanding the user environment Q Who are using the current CDSS In the hospital all the nurses doctor and supervisor are using the system Q What is your healthcare background Most of the wound care knowledge is obtained from the schools training and hospitals orientation sessions Q What is the computer background of all the nurses in the hos 66 pital For young nurses like me We are quite familiar with computer but using computer or software is quite difficult for the older nurses Q Are users experienced wi
17. Nurse Doctor and Supervisor Stakeholders And interests Browse and query the expert information about the wound Preconditions are working properly e The user should have a valid access to the system e All the hardware e g printer keyboard mouse 31 Post Conditions The user should be able to get the desired infor mation from the system The user should be able to the search the informa tion through the search box The system should provide accurate results Main Success Scenarios User indicates the system that s he want to access to the Expert Information User enter keyword to search for specific entries System processes the request by querying entries from database System displays the queried result User selects specific entry to display bookmark or print Extensions 2a User wants to browse category of expert information 1 2 System fetches category from database System displays appropriate category based on user selection Once user goes to entry level s he can select entry to display bookmark or print 4b No entry found for the keyword 1 System displays error message 2 System suggests a close keyword that may have entries 32 Special Requirements Should show suggestion when user is typing keyword to search Technology and data varia Every time when user wants to retrieve any expert in tions list form
18. Patients who are have been treated or being treated at the hospital e My supervisor Ms Ann e Hospital itself e g Reputation 64 Q How is success measured according to you The success is measured by e Patients wounds progress e Patients satisfaction e And hospital reputation Q What are the problems that interfere with your success Three main problems that prevent me with success e Sometimes it is difficult to determine the stage of the wound e Deal with difference of advises between the supervisor and the doctor e Some redundant work such as entering repeated data Q What trends make your job easier or difficult The complaining of the patients makes the job more difficult 7 1 2 Assessing the problem Q Why is assessing the stage of wound too hard Assessing the wound stage is very difficult because it needs a lot of experi ence Moreover no mistake should be happened during this action Q How do you solve it now Firstly consulting a guide book from the hospital And if it doesnt help then I go to get advice from the senior nurses or doctor Q How do you like to solve this problem It would be much better if I enter the length width or color of the wound the Wound Catalogue provides the stage of the wound automatically Q What else 65 Some patients that need special or extra treatments but the doctors and my supervisor sometime give different advices Then I have to deal these differences Q
19. Record_2 Title Reading data from medical devices Requirement Testcase for Extension 2a of Store Wound Record Type Acceptance Test Preconditions e Medical Device is allowed to connect update the system e Patient information exists in the system Steps 1 Select New Wound Record from main menu 2 Select the patient from the list 3 Select to synchronize with medical devices 4 Wait until the synchronization gets done Expected Results e The new record should be added to the system with the values from medical device e The new record should be marked as Automati cally e The new record should be added to the selected patient e The system should log the nurse activity Table 3 3 TC_Store Wound Record_2 30 3 2 Access Expert Information 3 2 1 Fully Dressed Usecase Browse Category of Entries lt lt include gt gt lt lt include gt gt lt lt include gt gt lt lt include gt gt lt lt include gt gt Supervisor Access Expert Info y lt lt include gt gt y i Search for Entries lt lt include gt gt Bookmark Entry Display Entry A Print Entry Figure 3 4 Access Expert Information Fully Dressed J Expert System Repository Database Use case ID UC_Access_Expert_Information Use case name Access Expert Information Scope System under Discussion Level User Level Primary Actor
20. advices etc Patient s record All the details of a patient including all patient infor mation wound details wound recovery progress report reason for hospitalization possible allergies preferences etc 74 Pressure Ulcer A Pressure ulcer is damage that occurs on the skin and underlying tissue Registered Nurse The minimum of experience They usually have less than five years of experience Works under supervision of Wound Nurse And if any difficult situation is not handled by herself she can get advice from her supervi sor Wound Nurse The most experienced nurse with more than ten years of experience Besides taking care the most difficult stage of wound they mentor some registered nurses Stage I pressure ulcer Non blanchable erythema Intact skin with non blanch able redness of a localized area usually over a bony prominence 1 Stage II pressure ulcer Par tial thickness Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed without slough 1 Stage III pressure ulcer Full thickness skin loss Full thickness tissue loss Subcutaneous fat may be vis ible but bone tendon or muscle are not exposed 1 Stage IV pressure ulcer Full thickness tissue loss Full thickness tissue loss with exposed bone tendon or muscle Slough or eschar may be present 1 Surgical wound A surgical wound is a cut or an incision in the
21. ailable pub licly for using Nurse or doctors or supervisors should be able to retrieve the historical patient s records Doctors or supervisors should be able to generate and print patients reports 16 17 18 19 20 21 22 23 24 25 26 Zi 28 Nurses should be able to add remove edit the schedule tasks The system should raise alert if there is any overlapped schedules The system should notify nurses on the due time of events The system should be able to recommend appropriate treatment and medicine for specific patient Nurses should be able to verify whether patient can use specific drug Users can enter or access information only under their privileges Users can login logout by their username and password Depend on user role different user will have different permission to access specific data The system should be able to export data in EHR format that can be transferred and be understood by other organizations The administrator should be able to create delete modify user ac counts and their roles The administrator should be able to backup restore data for the system If patient is allergic to certain medicine or ointment the system should warn the nurse about it If there is overdue about dressing or reposition of patients the system should raise alarm to the nurse who is in charge or her supervisors and doctors 1 8 Documentation Requirements 1 8 1 Applicable Standards The nursing de
22. ation such wound category Frequency of occurrence Every time when user wants to retrieve any expert in formation such wound category Miscellaneous Automatic spelling feature to correct common typo mis takes when the user e g nurse entries a query Table 3 4 UC_Access_Expert_Information 33 3 2 2 System Sequence Diagram wre SYSTEM DATABASE NURSE _SYSTEM DATABASE l l l l l l l l l l Query l l l l l l l l r Select one Result from the list gt l i l lt Display options view print bookmark 5 i l l l l l select vieiw gt i 1 Query gt 40 7 Display the View of the selected result 5 Select done l l l i l l Ss Display Main Menu 4 Figure 3 5 Access Expert Information System Sequence Diagram 34 3 2 3 Activity Diagram User System heck re Not ed Available Keyword Display List Suggestion Select Item Select S estion gt a View Print bookmark mismatch Figure 3 6 Access Expert Information Activity Diagram 35 3 2 4 Testcases Main Scenario Test Case Test Case ID TC_Access_Expert_Information_1 Title Searching the Expert Information Requirement Testcase for main scenario of Access Expert Information Type Acceptance Test Preconditions e The user should
23. ble store biographic information of patients such as allergies pregnant status health status The nurse doctor or supervisor should be able to retrieve the patient s wound stage according to the patient s current information The system should be able to learn or upgrade its expert knowledge automatically or manually Nurses should be able to print or generate discharged brochure quickly without entering so much data The nurse should be able to submit request advice or special treatment for specific patient to either doctor or her supervisor This request should be recorded and forwarded to appropriate people The doctor or supervisor should be notified when nurses have submitted requests to them They should be able to respond their advices via the system These advices should be tracked and forwarded to appropriate nurse The system should be able to raise alert if there is any conflict on advices to all related people Doctor or supervisor should be able to assess the patient progress easily though chart that reflects the progress of patient wound Nurses Doctors or Supervisors should be able to access the expert information such as wound category prescription Nurses Doctors or Supervisors should be able to search the expert information by keyword or its content The administrator should be able to enter or update the expert infor mation New expert information should be approved before being av
24. cation as well as the patients history 1 4 1 Product Perspective The system would need Windows Server to run server component and database system and Windows or Mobile Platform to run client component 1 4 2 Product Position Statement For The doctors nurses and supervisors Who Would access the System The System to gather information on patients wound history and allergies That Would save time Unlike Other time consuming procedures Our Product Will be efficient and would help in the early recovery of the patients 1 4 3 Summary of Capabilities Stakeholders Benefits Supporting Benefits The system would be user friendly User Guides and Tutorials are available The learning curve is minimal User Interface is user friendly System is responsive and accurate Fast retrieval of required results It is usable by all stakeholders with any background Required training to use the system is very little 1 4 4 Assumptions and Dependencies System would require an operating system preferably Windows OS 1 4 5 Cost and Pricing This project is not aimed to be deployed to any markets therefore no study on costs or prices is referred to it 1 5 Feature Attributes 1 The system provides an easy access to expert information 2 Patients historical medicine records 3 Warning on due assigned tasks or patient treatment 1 6 Needs 1 10 11 N
25. cision support system should follow the quality standards International Standard organization ISO9000 to ensure the accuracy of the results as outcomes of the system 1 8 2 System Requirements The system would require huge amount of memory spaces in terabytes to store the patient records and the treatment plans 9 1 8 3 Performance Requirement The system should perform such that it handles real time situations and could be used when ever needed by the stakeholders In other words it should work nonstop without any fatigue 1 9 User Documentation 1 9 1 User Manual e The user manual should describe the basic functioning of the system e It should also describe how to access the database for medical records e It should also describe the process of authentication needed to get the access e It shall list and describe system features 1 9 2 Installation Guide Configuration and Read me Files e Installation guide shall show how to install the system with pictures step by step e Read me file shall list new features It also shall list common trou bleshooting and workaround 10 11 Chapter 2 Use Cases amp Requirement Priority 2 1 Context Diagram Use Case la T Access Historical Record _ Doctor A e A AS 4 A j Enter Patient Information AS J L ae p Supervisor E e Database Generate Patient Brochure Nurse E a Figure 2 1 Context Diagram Use Case 12 2 2 Brief Us
26. e Cases 2 2 1 Store Wound Record I Store Wound Record Figure 2 2 Store Wound Record Use Case Nurse should be able to store wound record into the system The record involves the size color and depth of the wound blood status Before records are saved in the database the record values should be validated to make sure its values are in correct format and valid range The input can be retrieved from other medicine devices that are being used for patient 13 2 2 2 Enter Patient Information Nurse i at Enter Patient Information MT Receptionist Figure 2 3 Enter Patient Information Brief Use Case The users i e Nurses Receptionist enter the patient information regarding his her personal information such as name address and contact details and medical biography such as the allergies either manually or automatically from data that received other hospitals The system is able to detect if the patient is already existed in the system 14 2 2 3 Generate Patient Brochure Figure 2 4 Generate Patient Brochure Brief Use Case Users especially Nurses can generate patients brochure without entering too much information The users are also able to print and export the generated brochure to standard image format 15 2 2 4 Requests Advisor s Support Figure 2 5 Requests Advisor s Support Brief Use Case The nurse can make a request support to his her supervisor or docto
27. ever it would be more useful for nurses as they have to determine the wounds stage and need assistance while treatment Q How do you value a successful solution 1 2ex I should be able to fetch the progress chart of the patients accurately and it should not take that much time its taking right now 7 2 6 Assessing the reliability performance and sup port needs Not Applicable 7 2 7 Other requirements Not Applicable 7 2 8 Wrap up Not Applicable 7 2 9 Analyst s summary e The system should support the knowledge base or be able to synthesize the patient records in order to provide the view of patients progress e The system should support the nurse in determining the wound stage and assistance for treatment 73 Chapter 8 Glossary Term Definition Assistant Nurse The intermediate experienced nurse with from five to ten years of experience Main responsibility is to taking care of Pressure Ulcer at different levels Bed ridden Confined to bed due to illness Braden scale A tool is for Predicting Pressure Sore Risk It consists of six categories sensory perception CDSS Clinical Decision Support Systems Patient s brochure A comprehensive guide describing the patient s wound its characteristics how it is supposed to be taken care of what kind of symptoms need to be disclosed with a spe cialist in case they re observed e g redness swelling infection etc dietary
28. g the push notification text message or email 48 Expected Results The supervisor should receive the push notifica tion on her his mobile device with correct content immediately when the schedule is overdue The supervisor should receive a text message on her his phone with correct content The supervisor should receive an email on her his email account with correct content The notification order should be push notifica tion then text message and email There are an interval between receiving these no tification the default value is 5 minutes The correct content of notification should contain task owner task description location and overdue state Table 3 12 TC_Notify_Due_Scheduled_Events_3 49 Chapter 4 Domain Modelling The figure is on the next page 50 Expert Info Article Treatment Medicine Prescription Wound Catalogue Wound Type Stage Access Advice Content Datetime Supervisor Nurse PatientReport Request Nurse Wound Ranges WoundRecord Task Dessription DueDate Location Related Patient Patient Room Number Bed Number Wound Type Generates Push Notification Brochure Title Content EventState Guideline Contact me Personallnfo Biographic Email Notification SMS Notification Recipient lag Figure 4 1 Concep
29. have be logged in to the system as nurse e Keyboard and mouse are working properly and connect to the system e The article which user wants to search is available in the system Steps 1 Select the search information option from the main menu 2 Type the query in the search box 3 Click on the search button Expected Results e Each article of the returned list must contain the keyword that user has queried Correctness e The number of articles of the returned list must be complete No article is missing Completeness Table 3 5 TC_Access Expert Information 1 36 Extension 2a Test Case Test Case ID TC_Access Expert Information_2 Title Browsing the Expert Information Entry Requirement Testcase for Extension 2a of Access Expert Information Type Acceptance Test Preconditions e The user should have be logged in to the system as nurse e Keyboard and mouse are working properly and connect to the system e The article which user wants to access is already available in the Expert System Steps N E ew Select Browse option Select Browse category Select the article from the available list Expected Results The number of categories must be displayed in Al phabet order and complete The entry must be displayed under the correct cat egory The entry must be disaplyed in Alphabet in each category Table 3 6 TC_Access Expert Information_2 37
30. hould be able to enter specific information of patients such as allergies pregnant status health status F3 The nurse doctor or supervisor should be able to retrieve the patient s wound stage according to the patient s current information F4 Nurses should be able to print or generate discharged brochure quickly without entering so much data F5 The system should be able to raise alert if there is conflict to all related people F6 Doctor or supervisor should be able to see the patient progress eas ily Once clicked on Progress Chart button the system will display a chart that reflects the progress of patient wound item F7 Nurses Doctors or Supervisors should be able to access the expert information such as wound category prescription 53 F8 Nurse or doctors or supervisors should be able to retrieve the historical patient s records F9 Doctors or supervisors should be able to print patients reports F10 The system should raise alert if there is any overlapped schedules F11 The system should notifies nurses at the right time of events F12 Nurses should be able to verify whether patient can use specific drug by entering it and got the result F13 Nurses should be able to add remove edit the schedule F14 If there is overdue about dressing or reposition of patients the system should raise alarm to the nurse who is in charge or her super visors and doctors 5 2 Product Features versus Use Cases UC1 U
31. ion support system to interface with existing systems used by the hospital The CDSS provides access to patients history recording patients information Wound Catalogue Warning and Alarms features to notify nurses for their duties graph about patients recovery The system supports access to the system through local computers and smart phones or mobile devices e g smartphone tablet 1 2 Positioning 1 2 1 Problem Statement The problem of e Lack of an expert knowledge system which nurses get required information of a wound and recom mended course of treatment e Inaccurate and inefficient in maintaining patients record e Lack of warning on patients allergies or on due assigned tasks or conflict between advices e Time consuming to generate patient brochure Affects Patients doctors nurses and the hospitals reputation The impact of which is Uncertainty and cost inefficient in course of treatment as well as patient dissatisfaction can damage relation between hospitals staffs and even on worse cases they can destroy hospital reputation A successful solution would Clinical support System be e Nurse can refer expert information easily and quickly e Accurate and efficient in storing and accessing pa tient records e Staffs will be reminded on overdue assigned tasks or patients allergies e Can generate patient brochure quickly 1 2 2 Product Position Statement For Hospital nurses
32. n functional requirements of the system that addresses Performance Quality Assurance 58 Reliability Usability as well as Supportability Then the document will address design constraints on the system being built The Online User Doc umentation and Help System Requirements will be discussed followed by a list of the interfaces that must be supported by the application Finally we will address applicable standards applied on the system and the glossary 6 4 Functionality Refer to the vision document 6 5 Usability The users of the system are hospital staff and the administrators who main tain the system The hospital staffs are assumed to have basic knowledge of the computers The administrators of the system to have more knowledge of the internals of the system and is able to rectify the small problems that may arise due to disk crashes power failures and other catastrophes to maintain the system The proper user interface users manual online help and the guide to use and maintain the system must be sufficient to educate the users on how to use the system without any problems 6 6 Reliability The system is safety critical If it moves out of normal operation mode the requirement to drop to the next lower level and open it is given the priority This emergency behavior shall not Software Requirement Specification occur without reason The system has to be reliable due to the importance of data and the damages incorrect or incom
33. nd some basic computer soft wares Q Are you experienced with this type of application Yes We use different systems which support various functions like entering the data and preparing the brochure Q What are your plans for future problems I need a single and well integrated system which provides all the functional ities that are currently provided by different systems Q Are additional applications in use those are relevant to this ap plication If so lets talk about them a bit No Q What are your expectations for the usability of the product 1 2ex It should be easy to understand and use should provide a wound catalogue for the nurses Q Do you require training to work on this software 1 2ex Yes I need the basic training to get familiar with this system Q What are your expectations for training time 1 2ex I dont re quire much training on this software but some documentation would be a good help 7 2 4 Recap for understanding You told me e The current system is not well integrated e There is no knowledge base that assists you to monitor the patients progress Q Does this adequately represent the problems you are having with your existing solutions Yes But I would also like to have a system which should warn or prompt the nurse for any recommendation or warning during patients treatment T2 7 2 5 Assessing the opportunity Q Who in your organization needs this application We all will use it How
34. ng Due Overdue and its location Frequency of occurrence The frequency of occurrence should be configured by User By default it should occurred for each incoming due and overdue event Miscellaneous If the system is to notify two events at the same time in small interval of time it should merge two notifications and notify once instead of twice Table 3 9 UC_Notify_Due_Scheduled_Events 42 3 3 2 System Sequence Diagram 1 AA SYSTEM NURSE MOBILE E A 1 ClockTrigger Event i i m i Detect Due Schedules tasks pa i i i Notifies Push Notification Email Message gt i I i i i i Interact Task Notification i i I gt 3323 Update Event Event 7 5 Stop Notifying Figure 3 8 Notify Due Scheduled Events System Sequence Diagram 43 3 3 3 Activity Diagram User System Has due events Check Registered Mobile Device ww I Registered Y Push Notifications Not Registered Wait for Interaction Y Figure 3 9 Notify Due Scheduled Events Activity Diagram 44 3 3 4 Testcases Main Scenario Test Case Test Case ID TC_Notify_Due_Scheduled_Events_1 Title Testcase for main scenario of Notify_Due_Events Requirement System notifies user on due schedule event and user takes no action while receiving these notifications Type Acceptance Test P
35. ore Wound Record dad a fois de eds he TC Store Wound Record abs 2 pr e ad EC Store Wound Record2 e dale da ads UC_Access_Expert_Information TC_Access_Expert_Informationl TC_Access Expert Information2 TC_Access Expert Information 3 TC_Access Expert Information4 UC_Notify_Due_Scheduled_Events 0 TC_Notify_Due_Scheduled_Events 1 TC_Notify_Due_Scheduled_Events2 TC_Notify_Due_Scheduled_Events3 0 User Needs vs Product Features Product Features versus Use Cases 040 Uses Cases to Test Cases 2 2 Product Features versus Supplementary Chapter 1 Vision Document 1 1 Introduction 1 1 1 Purpose The purpose of this Vision document is to gather analyze and define high level requirements needs and features of the Clinical Decision Support Sys tem CDSS Its primary focus is to provide the capabilities needed by the Hospital staff Doctors and why these needs exist The details of how the CDSS fulfils these needs are explained with the help of different UML use case domain model system state diagram etc diagrams and supplementary document 1 1 2 Scope This Vision Document applies to the Clinical Decision Support System CDSS which will be developed by the WE5 Development team The WE5 team will develop this decis
36. pdate The supervisor of events owner should receive re minder if the events are overdue without update Main Success Scenarios Machine Clock triggers the system to detect due scheduled events The system pushes Notification to owner mobile devices The system sends Notified Text Message to owner number The system sends Notified Email to owner email account Owner should be notified through Push Notifica tion on Mobile Devices Owner should receive the Notified Text Message Owner should receive the Notified Email Message Al Extensions 2a Owner did not register any Mobile Device 1 Go to next step 2b System received update on notifying event 1 Stop the notifying procedure 3a Owner did not register any phone number 1 Go to next step 3b System received update on notifying event 1 Stop the notifying procedure 4a Owner did not register any email account 1 Go to next step 4b System received update on notifying event 1 Stop the notifying procedure 4c The schedule event is overdue 1 Repeat this procedure but the target is his her supervisor Special Requirements There should be an interval between notification actions to give users chance to interact with the reminder in or der to reduce user annoyance because of multiple noti fications Technology and data varia tions list The notification message should contains event name status such as Incomi
37. plete data can do 6 6 1 Availability 6 6 2 Mean Time Between Failures MTBF The system will be developed in such a way that it may fail once in a year 6 6 3 Mean Time To Repair MTTR Even if the system fails the system will be recovered from back up within an hour or less 99 6 6 4 Accuracy The accuracy of the system is limited by the accuracy of the speed at which the employees and users use the system 6 6 5 Maximum bugs or defects rate The maximum defect rate that the application could support is 3 6 6 6 Bugs or defects rate A minor defect shall deviate the behavior of the system from what is expected while a critical defect shall cause the inability to use all the features of the system or leads to a system crash 6 7 Performance The section outlines the performance characteristics of the Software system 6 7 1 Response Time for a Operation The system would be responsive enough It should not take more than 30 seconds to search and display expert information And should not take more than 5 seconds to store a patient information or a wound record 6 7 2 Throughput The system should be able to handle 2000 requests at the same time A request can be storing information storing wound information searching expert information or updating expert information 6 7 3 Capacity The system should be able to handle 2000 users simultaneously Each user will able to use multiple devices at the same time Software Req
38. r When the request is committed the system will forward and notify the receiver All participants will be able to follow the progress of the request 16 2 2 5 Notify Due Scheduled Events f 4 Notify Due Event ma Time System Clock Figure 2 6 Notify Due Scheduled Events Brief Use Case The nurses can be doctors or supervisors want to be reminded or warned when their scheduled events or tasks which entered into the system auto matically or manually are going to start or due or overdue 17 2 2 6 Access Historical Records Nurse Supervisor Figure 2 7 Access Historical Records Brief Use Case Nurse supervisor or doctor accesses historical records of patients which either entered by the hospital or received from other hospitals to assess the patients progress They can see historical records in single mode aggregated mode and progress chart with filtering predicate condition Users can export or print the historical records 18 2 3 Cost Value Prioritization for use cases Requirements Prioritization Using Analytic Hierarchy Process AHP Method Relative Values 1 Contributes equally 3 Contributes slightly more 5 Contributes strongly more 7 Contributes very strongly more 9 Contributes extremely more EPI SWR AEI AHR NDE RAS NAC GPB Enter Patient 1 1 3 1 5 1 3 1 5 1 3 1 9 1 5 Information Store wound 3 1 1 3 1 1 3 1 1 7 1 3 Information
39. r a particular ap proach of treatment Supervisor Works with the Nurses during treatment of a patient e They need a sophisticated system to approve all the changes made by nurses e This stakeholder needs an interface to access the patients historical records and assess patients progress Administrator Works with doctors to manage the knowledge base systems e They need a system to update the in formation and ensure the maintainabil ity of the system e Provide access to all stakeholders as per their privileges Doctor Another primary en duser of the system e They need a system to ensure that all the information updated is accurate as per the medical domain e They need to review the changes ap proved by the supervisor e They need a system to check the pa tients history and the treatment given to patients by nurses 1 3 2 Stakeholder environment User can access CDSS via computer smart phones or tablet device like iPad The software can be deployed in any platform To print reports and patients brochure the system on the mobile devices smart phone or table must be connected to Air Printers through Wireless Network 1 4 Product Overview The main objective of this project is to provide a system that can be effi ciently used by the stakeholders Nurses doctors and supervisors to access all the information about the patients wound and side effects related to any medi
40. reconditions e User registered email account phone number and mobile device e User setup added schedule into the system Steps 1 Changes the clock of the system to due time of event or wait until the due time passed 2 Do not interact while receiving push notification text message and email 3 Do not update the due schedule while receiving these notifications 45 Expected Results e User should receive the push notification on her his mobile device with correct content imme diately when the schedule is due e User should receive a text message on her his phone with correct content e User should receive an email on her his email ac count with correct content e The order should be push notification text mes sage and email e There are an interval between receiving these no tification the default value is 5 minutes e The correct content of notification should contain task description location and due state Table 3 10 TC_Notify_Due_Scheduled_Events_1 Extension 2b Test Case Test Case ID TC_Notify_Due_Scheduled_Events_2 Title Testcase for Notify_Due_Events Extension 2b Requirement System pushes notification and user updates on the due schedule event Type Acceptance Test Settings System network is working properly Preconditions e User registered email account phone number and mobile device e User setup added schedule into the system
41. res versus Use Cases 5 3 Use Cases to Test Cases ai oe ko hited dw a ee wa 5 4 Product Features versus Supplementary Supplementary Gel EMPOS elite a dette a Oo hen a GOES She 0 27 OCODE lt 6 edn eh te ied Sy ee te ey ee A A With coe ire sehen eid ih teed Os ak eed Oy at ohh eels hotel ceed GA o A oy arch el de ae hae he oe ets pee eet a pee ee Gor o ce cared sane 5 03 xe INN 6 67 Reliability ato alle aries e Sw ee ai as 661 Availability xa AAA a OE SS 6 6 2 Mean Time Between Failures MTBF 24 24 24 2 28 29 31 31 34 35 36 40 40 43 44 45 50 52 52 54 59 56 6 6 3 Mean Time To Repair MTTR 59 6 6 4 o ot aor he ok Fat aw Sh ahs oe ea be yee ae be 60 6 6 5 Maximum bugs or defects rate 002 60 6 6 6 Bugs or defects Tse bad Wan ae A de es 60 OT Pertotanees e las NENA Aa ae Se 60 6 7 1 Response Time for a Operation 60 A AN AAA oe ers pay weds Ghee 3 60 Giles CApaciiel ww nine he Benet a dE e a e 60 6 a4 SUP PORbaDIMt ye a do bP a oS o fed 61 6 7 5 Auto upgrade to the new version 61 6 8 Design Constraints of eet ree BO ee BS 61 6 8 1 Software Languages 0 61 6 8 2 Platform requirements e yd eb ra la 61 6 9 User Documentation and Help System Requirements 61 6 10 Purchased Components ocio op pale eee whe ee 62 GAL interfaces ds ge Boe Boe Ke eek as 62 6 11 1 User Interfaces a a Ye RE Ee a
42. rsus Supplementary Supplementary List e SUP1 Functionality e SUP2 Usability 56 SUP3 Reliability SUPA4 Performance SUP5 Interface SUP6 Supportability 57 Chapter 6 Supplementary 6 1 Purpose This Document provides the detailed view of the Clinical Decision Support System CDSS which is mostly concerning the developers It discusses var ious non functional requirements of the system to which the developers have to comply The Supplementary Document lists these requirements in an or ganized way to fully define the system TO BE functionalities It takes care of the aspects such as Supportability Quality Assurance Reliability Usability Performance as well as Design Constraints 6 2 Scope This Supplementary Specification applies to the Clinical Decision Support System CDSS developed for the ABC Hospital The System under Discus sions is supervised by Prof Sutharsan Sivagnanam for the System Require ments Specification course The CDS system should address the real world issues such as for nurse helping them with different wound procedures to alerting and reminding details about patients conveniently storing patients record for doctors operations like viewing patient recovering stats guiding nurse when needed To fulfill the above requirement with better security usability and reliability is within the scope of this document 6 3 Overview The following Supplementary Specification will address the no
43. ser Documentation ee are ba a a da a de 10 1 9 1 User Manual iris o a la e de 10 1 9 2 Installation Guide Configuration and Read me Files 10 2 Use Cases amp Requirement Priority 11 2 1 Context Diagram Use Cast o es daa 12 2 2 Brick Use Casino lps e e e a e A amp As Be 13 2 2 1 Store Wound Record wz wie Coys ea ees 13 2 2 2 Enter Patient Information 2 2 3 Generate Patient Brochure 2 2 4 Requests Advisor s Support 2 2 5 Notify Due Scheduled Events 2 2 6 Access Historical Records 2 3 Cost Value Prioritization for use cases 2 ew Detailed Use Cases 3 1 Store Wound Record sis wy eG a a Be 3 1 1 Fully Dressed Usecase as die eed Se Si 3 1 2 System Sequence Diagram 3 1 3 Activity Diagram A A wood wae wh Slay TESSICASES AA ere otk ea ee KB gw HK 3 2 Access Expert Information lay eS eS ee SE 3 2 1 Fully Dressed Usecase 004 3 2 2 System Sequence Diagram 3 2 3 Activity Diagram ec 88 Ts Sens A 324 MESCASOS gt 0 e Genk Behn ge te a ss Get we gs e 3 3 Notify Due Scheduled Events 4 3 3 1 Fully Dressed Usecase 000 3 3 2 System Sequence Diagram 3 3 3 Activity Diagram een es bao ook e e Ae Bagi Testcases le au LENA E O A Domain Modelling Traceability Matrices 5 1 User Needs versus Product Features 5 2 Product Featu
44. tem Re quirements The system provides embedded documentation in the application so that the end users can access this document from Help menu easily and instantly 61 6 10 Purchased Components In order to enhance the performance of accessing and storing huge data of the hospital the SQL Server 12 has been purchased However the license is for only one machine thus the development team should not use this version but the SQL Server Express version It is free from Microsoft 6 11 Interfaces This section defines the interfaces that must be supported by the system 6 11 1 User Interfaces The client application should be responsive and user friendly Actually the user interfaces should follow the user experience of the platform that it is run ning For example the client application on Windows should follow Windows User Experience but the client on iPad should follow iOS User Experience However the features and application flows should be unified between all platforms 6 11 2 Hardware Interfaces The Local Area Network shall be used to communicate between application and the centralized database 6 11 3 Software Interfaces The system shall use the OpenEHR to transfer or receive electronic health records from other hospitals 6 11 4 Communications Interfaces The system shall communicate with some special medical devices through bluetooth connection to retrieve patient body attributes such as heart rate blood pressure
45. th this type of application Yes most of us are but the familiarity depends on the computer background of each user and the length of time of using that application Q Which platforms are in use Mainly on Microsoft Windows 7 Q Are additional applications in use that are relevant to this ap plication If so lets talk about them a bit Right now we are using a Wound Information Collector Application on the iPad for entering patient information but it is not integrated well with the system so we have to re enter these data each day to the main system 7 1 4 Recap for understanding You have told me 1 You experienced difficulty in assessing or determining the wound stage 2 You refer the hospital guidebook to determine wound stage but some time it is insufficient and wish that there is a system can give you advise on that 3 Sometime doctor and supervisor give different advices and you have to deal with it 4 You hope that the system can detect the conflict and raise the issue to them so that you won t be in hard situation 5 You are entering information twice once on the iPad application then re enter on the CDSS 6 You have to enter boilerplate information when generating Patient Brochure 67 7 1 5 Assessing the opportunity Q Who in your organization needs this application All the nurses doctors and supervisors Q How many of these types of users could use the application In my organization three kind of
46. tual Classes 51 Chapter 5 Traceability Matrices 5 1 User Needs versus Product Features F1 F2 F3 F4 F5 F6 F7 F8 F9 FLO F11 F12 F13 F14 N8 Yo Y Y Y Table 5 1 User Needs vs Product Features User Needs e N1 Nurses should be able to enter wound information doctor recom mendation and patients preferences on Mobile Platform and Computer 92 N2 Nurses should be able to determine the wound stage automatically according to the current data N3 Nurses should be able to print or generate the discharged brochure quickly without entering so much data N4 The system should be able to raise conflicts between doctors and supervisors if they have different advices N5 Doctors or supervisor should be able to see the progress charts of patient easily N6 Nurses should be able to access the expert information such as wound category prescription that saved in the system N7 Nurse or Doctors or Supervisors should be able to retrieve the historical patient s records N8 Nurses should be able to set up schedule to check wound or change dressing and be reminded on the right time Features F1 The nurse should be able to enter wound information such as length color depth blood into the system and these information will be stored This action should be done on either Computer or Mobile platform F2 The nurses s
47. uirement Specification When working in normal mode request by a user for a service should be handled immediately Immediate feedback of the systems activities shall be communicated to the user by link page clicked Even at peek time the CDSS system shall not experience any delay in the service response to the commands longer than 5 second The system is available 100 for the 60 user and is used 24 hrs A day and 365 days a year The system shall be operational 24 hours a day and 7 days a week 6 7 4 Supportability This section indicates the set of requirements that will enhance the support ability or maintainability of the system being built 6 7 5 Auto upgrade to the new version When the mandatory upgrade version is available the application should be able to force users to upgrade it from the centralized server 6 8 Design Constraints This section will indicate design constraints on the system being built 6 8 1 Software Languages The Software system shall support multiple French and English In case of global recognition the system shall detect the workstation culture and load the appropriate language resource library to display the corresponding strings to the user 6 8 2 Platform requirements The device deploying the Software system shall have at least 4 GB RAM in order to support the SQL Server and at least 2 hard disks with each disk has at least 160 GB to store and backup data 6 9 User Documentation and Help Sys
48. und 3 1 1 3 1 1 3 1 1 7 1 3 Information Access Expert 5 3 1 3 1 3 1 5 1 Information Access Historical 3 1 1 3 1 1 3 1 1 7 1 3 Records Notify Due Events 5 3 1 3 1 3 1 5 3 Request Advisor s 3 1 1 3 1 1 3 1 1 9 1 3 Support Notify Advice 9 7 5 7 5 9 1 5 Conflicts Generate Patient s 5 3 1 3 1 3 3 1 5 1 Brochure Table 2 3 AHP comparison matrix with relative costs of requirement 21 EPI SWR AEFI AHR ASE RAS NAC GPB REL Enter Patient 0 03 0 02 0 02 0 02 0 02 0 02 0 05 0 02 0 02 Information Store wound 0 09 0 05 0 04 0 05 0 04 0 05 0 07 0 03 0 05 Information Access Expert 0 15 0 16 0 11 0 16 0 12 0 14 0 09 0 09 0 13 Information Access Historical 0 09 0 05 0 04 0 05 0 04 0 05 0 07 0 03 0 05 Records Notify Due 0 15 0 16 0 11 0 16 0 12 0 14 0 09 0 27 0 15 Events Request 0 09 0 05 0 04 0 05 0 04 0 05 0 05 0 03 0 05 Advisor s Support Notify Advice 0 26 0 36 0 54 0 36 0 59 0 42 0 47 0 45 0 43 Conflicts Generate 0 15 0 16 0 11 0 16 0 04 0 14 0 09 0 09 0 12 Patients Brochure Table 2 4 Normalized matrix and relative contribution of requirement to the project s overall cost 22 COST VALUE GRAPH 35 30 O SWR Medium Priority 25 High atl Priority 20 lt H Z 9 15 gt
49. urses should be able to enter patient wound record both Mobile Plat form and Computer Nurses should be able to determine the wound stage automatically according to the current data of patient Nurses should be able to print or generate patients discharged brochure quickly without entering so much data The system should be able to raise conflicts between doctors and su pervisors if they have different advices Doctors or supervisor should be able to see the progress charts of pa tient easily Nurses should be able to access the expert information such as wound category prescription that saved in the system Nurse or Doctors or Supervisors should be able to retrieve the historical patient s records Nurses should be able to set up schedule to check wound or change dressing and be reminded on the right time The system should be able to recommend the appropriate treatment plan or medicine for patients Nurses should be able to verify whether patient can use specific medicine or not based on doctor recommendation and patients preferences al lergy or health status or in pregnant Authentication 1 7 Product Features 1 The nurse should be able to enter wound record such as length color depth blood into the system and these information will be stored This action should be done on either Computer or Mobile platform 10 11 12 13 14 15 The nurses should be a
50. users In fact four kinds because accounts also are using the system Q How do you value a successful solution Successful solution should be able to support us in entering information accessing wound stage pro viding knowledge about different wounds and making decisions easily 7 1 6 Assessing the reliability performance and sup port needs Q What are your expectations for reliability In accessing the wound stage it should provide us with correct and appro priate results As I said before any mistake can harm the patient and slow the progress Q What are your expectations for performance Time factor is very important while accessing the record it should not take too long Furthermore search patient by name or listing patient at specific room should not take too long also Q What are the security requirements My Authentication should be protected Other nurses should not be able to enter my patient information expect my supervisors Furthermore the system should log the author of records 7 1 7 Other requirements Q Are there any legal regulatory or environmental requirements or other standards that must be supported I think the software must be cleared by FDA before using Furthermore because we have to transfer or record from other hospitals the system must fulfil the specification of Electronic Heath Record 68 Q Can you think of any other requirements we should know about No That all I know till now 7
51. y supervision e Patient satisfaction e Hospital culture e Team work efficiency 70 e Cost effective for both hospital and patients Q Which problem interferes with your success e The cooperation between healthcare professional e Inefficiency of the CDSS system Q What if any trends make your job easier or difficult Automation would make my job easier especially in tracking and synthesiz ing the records 7 2 2 Assessing the problem Q What is the major problem you face in the existing system In order to monitor the progress of the patients I have to review many patient records one by one It is time consuming and probability of inaccuracy is higher Q Why does this problem exist 1 2ex The system simply does not support that Q How do you solve it now 1 2ex Writing down all the patient records on the time table and keep checking the progress and variations in the records Q How do you like to solve it 1 2ex I would like to have a system where all the processes e g nurses will enter updated information of the patient in the system in the hospital are well integrated so I can just enter the patients name and I can get all of the patients information immediately so that I can advice the nurses if there is any wrong on time 7 2 3 Understanding the user environment Q Who are the users Doctors nurses and receptionist Q What is your computer background 71 I am familiar with MS office Outlook a
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