Question Details

Refer to the “Reliable Pharmaceutical Service” case for the remaining questions:

7.	Reliable is seeking your advice on which systems development approach to use for the OBIS project. Provide two reasons against using a traditional waterfall approach for this project. Your reasons should be based on characteristics of the OBIS project in particular, not on arguments against the waterfall model in general. (Note: I am not looking for “one right answer” here; I am looking for a well-reasoned persuasive argument that is based on details of the case and knowledge of the strengths and weakness of traditional vs. agile approaches.)

8.	Give two examples of functional requirements and two examples of non-functional requirements for the OBIS system. 

9.	Identify the stakeholders for OBIS, and describe each stakeholder- interest in the project.

10.	Assume you are a consultant who has been hired by Reliable to help with the OBIS project. Briefly explain to Reliable- management team how IT could be used to streamline the business processes described in the 3rd and 4th paragraphs of the case. Then identify two use cases that the new OBIS system would support and write an initial (brief) use case description for each of them.

RELIABLE PHARMACEUTICAL SERVICE CASE.
The Reliable Pharmaceutical Service is a privately held company located in Albuquerque, New Mexico. It provides pharmacy services to health-care delivery organizations that are too small to have their own in-house pharmacy. In the Albuquerque and Santa Fe area, Reliable- clients include two dozen nursing homes, three residential rehabilitation facilities, two small psychiatric hospitals, and four small specialty medical hospitals. A couple of years ago, Reliable expanded operations into two new service areas (Las Cruces and Gallup).

Reliable accepts pharmacy orders for patients in client facilities and delivers the orders in locked cases every 12 hours. In the Albuquerque and Santa Fe service area, Reliable employs 12 delivery personnel, 20 pharmacist assistants (PAs), 6 licensed pharmacists, and 10 office and clerical staff. There are another 10 employees working in Las Cruces and Gallup. The management team includes another 6 people, who are mainly company owners.

Personnel at each health-care facility submit patient prescription orders to Reliable by telephone. Many prescriptions are standing orders, which are filled during every delivery cycle until specifically canceled. Orders are logged into a computer as they are received. At the start of each 12-hour shift, the computer generates case manifests for each floor or wing of each client facility. A case manifest identifies each patient and the drugs he or she has been prescribed, including when and how often the drugs should be administered. The shift supervisor assigns the case manifests to pharmacists, who, in turn, assign tasks to the PAs. Pharmacists supervise and coordinate the PAs’ work.

All drugs for a single patient are collected in one plastic drawer of a locking case. Each case is marked with the facility- name, floor, and wing (if applicable). Each drawer is marked with the patient- name and room number. Dividers are inserted within a drawer to separate multiple prescriptions for the same patient. When all of the individual components of an order have been assembled, a pharmacist makes a final check of the contents, signs each page of the manifest, and places two copies of the manifest in the bottom of the case, one copy in a file cabinet in the assembly area, and the final copy in a mail basket for billing. When all of the cases have been assembled, they are loaded onto a truck and delivered to the health care facilities. 

Order entry, billing, and inventory management procedures are a hodgepodge of manual and computer-assisted methods. Reliable uses a combination of Excel spreadsheets, an Access database, and antiquated custom-developed billing software to enter orders received by telephone and to produce case manifests. The system has become increasingly unwieldy as facility contracts and Medicare and Medicaid reimbursement procedures have become more complex. Some costs are billed to the healthcare facilities, some to insurance companies, some to Medicare and Medicaid, and some directly to patients. The company that developed and maintained the billing software has gone out of business, and the office staff has had to work around software shortcomings and limitations with cumbersome procedures. Inventory management is done manually. 

Over the last four years, Reliable- revenues and profits have declined steadily. One of the primary reasons for the decline is that Reliable- operating procedures are extremely inefficient, and these procedures have not received a comprehensive review or overhaul in over two decades. Reliable- management team recently developed a 5-year strategic plan to help turn things around. The key element of this plan is a major effort to streamline operations to improve service and reduce costs. Management sees this effort as the only hope of the company- long-term survival. Management plans a significant expansion into neighboring states after the system is up and running to recoup its costs and increase economies of scale. 

Management has placed a high priority on developing a web-based application to connect client facilities with Reliable. Before the web component can be implemented, though, Reliable must automate more of the basic information it handles about patients, health-care facilities (clients), and prescriptions. Next, Reliable must develop an initial informational web site, which will ultimately evolve into an extranet through which Reliable will share information and link its processes closely with its clients and suppliers. One significant requirement of the extranet is compliance with the Health Insurance Portability and Accountability Act (HIPAA). HIPAA requires health-care providers and their contractors to protect patient data from unauthorized disclosure. Ensuring compliance with HIPAA will require careful attention to extranet security. 

After basic processes are automated and the extranet web site is in place, the system will enable clients to add patient information and place orders through the web. The system should streamline processes for both Reliable and its clients. It should also provide useful query and patient management capabilities to distinguish Reliable- services from those of its competitors, possibly including drug interaction and overdose warnings, automated validation of prescriptions with insurance reimbursement policies, and drug and patient cost data and summaries. 

The overall systems development project to improve Reliable- operations (as described above) has been nicknamed OBIS (Order processing, Billing, and Inventory management System). The management team, in conjunction with an IT consulting firm, estimates that it will take 2-3 years and over a million dollars to successfully implement all OBIS functionality.