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ICT616 Data Resources Management

MURDOCH UNIVERSITY
ICT616 Data Resources Management
Semester 1, 2021
ASSIGNMENT 1
Case study
Assignment Information
This is an individual assignment for each student.
You should submit your assignment from the ICT616 LMS site using the Assignment course tool.
Late submissions will be penalised at the rate of 10 marks per day late or part thereof.
You must keep a copy of the final version of your assignment as submitted and be prepared to provide it on
request.
The University treats plagiarism, collusion, theft of other students’ work and other forms of dishonesty in
assessment seriously. Any instances of dishonesty in this assessment will be forwarded immediately to the
Faculty Dean. For guidelines on honesty in assessment including avoiding plagiarism, see:
http://our.murdoch.edu.au/Educational-technologies/Academic-integrity/
SUMMARY
ELK County Maine has been awarded a federal grant to build a modest pediatric medical center. The grant
also paid for the medical education of a pediatrician that will practice at the medical center for at least five
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years. The grant included purchasing a medical information system to assist the doctor and the county in
managing the medical center. The county’s Director of Information Systems assigned a business analyst to
explore and report on the hardware and software requirements of the new medical system. After the business
analyst completed her report, she conducted an extensive investigation to see if an off-the-self software
package would meet the functional requirements of the medical center’s stakeholders. It was determined that
no such software package was available. Due to a near term software development backlog in the county’s
Information Systems Department, the county decided to hire a consultant to design and implement the
relational database for the new medical information system.
ORGANIZATIONAL BACKGROUND
Elkhorn is the county seat of Elk County and is located in north central Maine. Elk County is the largest
county in Maine in terms of geographic size but at the same time is the least populated. Elkhorn has a
population of approximately 9,500 and the county’s total population is about 35,000. With the exception of
Elkhorn, the county’s population is highly geographically dispersed. The main industries in Elk County are
lumber, tourism with several well-known year round resort lodges, and paper products. This case is based on
a real pediatric medical practice. However, the geographic location, the names of patients and their parents,
and the general setting have been changed. For the past decade, like many other rural areas in the United
States, Elk County has been experiencing a shortage of medical personnel and facilities. Several years ago the
county received a grant from the Federal Government to fund a new but modest pediatric medical facility and
the medical education of a pediatrician. The County Manager is responsible for the management of the
federal grant. In return for the paid medical education, the pediatrician signed a contract to practice for a
minimum of five years at the new pediatric medical facility, the Pediatric Medical Center (PMC), located in
Elkhorn. The doctor, having just recently completed medical training, arrived in Elkhorn a little over a month
ago and has started to fulfil her contractual obligation.
DETERMINING THE REQUIREMENTS
The initial budget for the medical center included the purchase of a small client/server based medical
information system to assist in patient billing and medical record keeping. After consulting with the county’s
Director of Information Systems, the County Manager decided to wait until the doctor arrived before
purchasing the system. The Director of Information Systems was unsure of the requirements in terms of
hardware and software and wanted the doctor’s input into the decision. He was uncertain about the
physician’s desired location of individual personal computers (PCs) in the new medical center and,
consequently, the quantity of PCs that needed to be purchased. But even more troubling for the manager, was
his strong belief that he was highly unqualified to determine or evaluate the software requirements for a
pediatric medical system.
Shortly after the doctor arrived, the Director of Information Systems assigned one of the county’s assistant
business analysts to determine the software requirements for the new medical information system.
He brought the analyst up to speed on the situation at the Pediatric Medical Center and requested that she find
a suitable -off-the-shelf- software package that will satisfy the processing and reporting requirements of the
doctor, the county, the federal grant, the state’s Medical Assistance (MA) program and the primary local
health maintenance organization (HMO), Healthy in America. Medical Assistance is a statewide program run
by Maine’s Department of Public Welfare for low-income families that cannot afford medical insurance.
Medical Assistance works very much like an insurance company where the doctors that agree to participate in
the program accept the state’s published fee schedule for services provided to Medical Assistance patients.
The business analyst knew the first task was to determine the functional requirements of the new patient
billing and medical records system. This was accomplished by conducting multiple interviews with the
doctor, and personnel from the county, the state’s Medical Assistance Office and Healthy in America. After
the interviews were complete and she felt she understood the requirements of the various parties, the analyst
prepared a functional requirements report. The report was submitted for approval by all the parties she
interviewed. A few minor changes were suggested and incorporated into the report and then a final version of
the PMC Functional Requirements Report was distributed to all concerned parties.
FUNCTIONAL REQUIREMENTS
Below are the specifications contained in the Data and Information Requirements section of the PMC
Functional Requirements Report.
Family Information
The PMC medical system needs to track information on the parents whose children are registered with
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Pediatric Medical Center and eligible to receive health care services. The new application must be able to
determine the financially responsible head of the household’s name, address, telephone number, and the name
of their insurance carrier (if any). The doctor would like to assign each family a unique alphanumeric
identifier so that they may identify a specific family that is registered with the Pediatric Medical Center. The
identifier will consist of the first 4 letters of the family’s last name with a unique two digit number added at
the end. For example, if there were three families registered with the last name Smith, the 3 family numbers
would be SMIT01, SMIT02, and SMIT03.
Patients
The new system must contain static information on all the patients that are registered with the Pediatric
Medical Center. The doctor needs to know the patient’s name (last name may be different from the parent
responsible for the child). Each patient is assigned a unique medical record number (MRN). A simple
algorithm is used to create this number, which consists of three parts; 1) the first three characters of the
patient’s last name, 2) the first character of the patient’s first name, and 3) two digits that are assigned
sequentially so that the first two components when combined with the third insure the MRN is unique. For
example, the boxer George Forman has five children named George. Their MRNs would be assigned as
follows; FORG20, FORG21, FORG22, FORG23, and FORG24. This assumes that MRN FORG19 already
existed in the database. If the parents have any type of medical insurance, including Medical Assistance, then
the parents social security number must be tracked. The insurance companies require that this field be 12
characters long. The first 9 characters are the parent’s specific social security number with no dashes. A
unique 2 digit number is then assigned to each dependent child and appended to the end of the parent’s social
security number, i.e., 999999999-99, to form a unique identifier that can be used by the insurance companies
to identity each child.
Services Performed
The billing application must contain information on all of the medical services available from the Pediatric
Medical Center. This information consists of an industry standard medical services code, a description of the
service performed, the standard fee charged by Pediatric Medical Center for this specific service (this is the
fee charged to parents with no insurance), the fee that will be accepted for this service by Maine’s Medical
Assistance program (MA), and the fee that will be accepted by all of the other insurance carriers.
Diagnosis Codes – DRG Codes.
The new application needs to support the use of industry standard DRG (Diagnostic Related Group) codes.
These are predefined unique codes where each code corresponds to a specific medical diagnosis that a
physician may make. These codes and their corresponding descriptions may be purchased on a CDROM,
where they are stored in tab delimited text file.
Insurance Carriers
The new application requires the capability to track insurance carriers that have contracts with PMC
including Medical Assistance provided by Maine’s Department of Public Welfare. Elk County has contracted
with the state for PMC to accept Medical Assistance patients. Each insurance company has been assigned a
two character insurance code. Parents that do not have medical insurance with a firm that has a contract with
PMC are considered to be self-insured.
Patient History
The new system must retain a complete patient history. This includes services performed and fees charged for
those services. The doctor wants the capability to override the standard fee schedule. Also, some fees are
subject to frequent change, especially those associated with injections and lab work. Consequently, the doctor
needs to know the fee charged at the time the service was provided. In addition to tracking historical services,
the system must maintain a complete history of the diagnoses made by the doctor on each patient visit. If a
doctor sees a patient multiple times in a single day it will be recorded in the system as a single visit. The
pediatrician may perform multiple services and make multiple diagnoses on individual patient in a single day.
Also a doctor may perform a service without making a diagnosis, for example: allergy injections given on a
biweekly basis or a scheduled immunization.
Reporting & Query Requirements
The Pediatric Medical Center’s new medical information system must support the following reporting and
query requirements: 1. What services does the doctor perform? Display the service code and description. Sort
by service code. 2. Same report as above but only for laboratory services. 3. Which PMC patients live in
Elkhorn, Maine? Display the family number, the parent’s last and first names in separate columns, city, state,
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and phone number. 4. Patient List Report. Display the family number, parent’s last and first name separated
by a comma, patient’s first name, and patient’s last name. Sort by family number and patient’s first name. Do
not repeat the family number or the parent’s last and first name. 5. Patient Insurance Report. Display the
insurance carrier, family number, parent’s last and first name separated by a comma, patient’s first and last
name, and insurance assigned social security number. Sort by insurance carrier, family number and social
security number. Do not repeat the insurance company, family number, or the parent’s first and last name. 6.
Daily Non-Insurance Billings Report (parents that are self-insured). Display the date of service (formatted as
mm/dd/yy), family number, parent’s last and first names separated by a comma, the patients first and last
name, insurance carrier, service code, description of service and the service fee. The report is to total the
service fee by family and a grand total is to appear at the end of the report. The service fee is to be formatted
as currency. This report is to contain appropriate descriptive column headings (no abbreviations), Report
Title, and Report Footer. The report is to be sorted by family number. The report is to prompt the user to enter
the date the services were performed. 7. Same report as above but this time for all insurance carriers (parents
that have medical insurance). Do not include Medical Assistance patients. 8. Patient Medical History Report.
Display the date of diagnosis (formatted as Mmmdd, yyyy), family number, parent’s last and first names
separated by a comma, the patients first and last name, DRG code, and diagnosis description. The output is to
be sorted by date. This report is to contain appropriate descriptive column headings (no abbreviations),
Report Title, and Report Footer. The report is to be for a single patient and the user is to be prompted to enter
the patient’s MRN. 9. What patients have had the same services performed on them as another patient?
Display family number, patients first and last names, service code, and service description. This query is to be
completely data driven, which means the only information available to the user running this query is the
comparison patient’s MRN. Include the comparison patient in the output. 10. This report to display the
families that have less patients in their family then the average number of patients per family for the city in
which they reside. Display the family number, parent’s first and last name, the number of patients in the
family, city, and the average number patients per family in a city. Sort the output by city and number of
patients in the family.
CURRENT CHALLENGES FACING THE ORGANIZATION
The business analyst began to match up the functional requirements with the features available in various -off
the- shelf- software packages. But to no avail, no standard software package was able to meet all of the
critical requirements. There were lots of standard packages that handled patient billing and medical histories.
A few of the packages even had very good HMO billing and tracking capabilities. But, the real issue was that
no package could handle the integration of state’s requirements for Medical Assistance billing into a single
comprehensive package. This is a significant issue as the county and state have estimated that approximately
25-30% of the medical center patients will be on Medical Assistance. The business analyst reviewed her
findings with the County Manager and the Director of Information Systems. They understood the situation
and asked the analyst to make a recommendation. She stated that the only real alternative was for the county
to internally develop the software for PMC’s medical information system. The Director of Information
Systems said that his department already had a backlog of work and it would probably take months to get the
software written. Frustrated, the County Manager exclaimed that the Pediatric Medical Center needed the
software yesterday and that the staff was currently doing everything by hand! The business analyst then
stated the project could easily be done utilizing a standard relational data base management system
(RDBMS). The Director of Information Systems agreed. In order to speed up delivery of the system, the
county decided to contract with a consultant to design and implement the database. In addition, the consultant
was to develop the procedures to populate the database, as well as, write many of the required queries. After
the consultant completed the work, the county’s Information Systems group would then use the tools that
came with the RDBMS to construct the user interface, build the input and query forms, and develop reports
based on the consultant’s queries.
QUESTIONS
Q1. (50 marks) The DAMA DMBOK textbook describes the following two core activities as part of the Data
Architecture management exercise: “Understanding enterprise information needs” and “Develop and
Maintain the Enterprise Data Model”.
Explain these activities, citing relevant academic sources where appropriate. Your discussion should not
simply contain general definitions but should consider the context of the organization described in the case
study. For instance, how would each of the components in an Enterprise Data Model apply to the healthcare
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provider described?
Q2. (50 marks) Consider what makes this particular industry unique from others. Data management is
constrained by certain requirements such as (a) government regulations, (b) business concerns and (c)
legitimate needs. These should be mentioned in your discussion.
To address Q2a you must locate legislation or rules specific to Australia that pertain to the collection, storage
or use of medical or healthcare records. These may consist of general privacy legislation as well as specific
acts relating to healthcare.
All sources used should be referenced appropriately using APA or IEEE referencing style (but not both!).
Your whole answer to these questions should be around 1500 words excluding the reference list.
Note: The case study may provide context which will help you to describe the Enterprise Data Model in Q1.
However Q2 is more general in nature and you will find more suitable sources (likely online) for information

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