Studies in E-business, health care, psychology, and sociology
Case
1: E-business Disabled Employees •
Case 2: Health Care and CPOE/CDSS
Other Case Study Examples • Who We Are
E-Business performance and using
disabled employees
Consultation
studies vary widely in subject matter, size and complexity. Good studies
are well-designed to elicit unambiguous answers. Strategic Solutions can
help you with your study, be it business, E-business, health care, psychological,
or sociological in nature. Our first example is an E-Business consultation
that took several months of periodic work.
A medical transcription company had a significant number of disabled employees in its workforce and wanted to know: (a) Do disabled employees perform comparably to non-disabled employees?; (b) Do disabled employees learn as fast as non-disabled employees? (Learning curve ratio parameters); (c) Can disabled employees earn as much money as their non-disabled counterparts?; (d) What other significant factors might play a role? and (e) Would medical transcription be a good model E-business for certain types of disabled workers vis-a-vis others?
The work involved four phases. First, we formulated the case study basis in conjunction with the employer. We wanted to be able to analyze the two populations of workers using financial and productivity data, and determine if biographical or situation-specific factors had any influence. Analysis of the data was performed using a variety of parametric and non-parametric statistics. Productivity and financial data was already available from company records, so we designed two different questionnaires to collect the other data. One questionnaire was a mail-in biographical type; the other contained a mix of closed and cross-referenced, Likert scale questions to be asked by one interviewer of all employees.
The second phase was collection of the data. Specific instructions were given to the interviewer with regard to both questionnaires. This phase took 2-3 months.
The third phase was the analysis. Procedures, such as the Mann-Whitney ranking test were used to compare the medians of each population with regard to the various primary factors (performance, financial productivity, learning curve ratio parameters, etc.). Some of these tests were performed using large matrices in a semi-automated fashion with procedures developed within the MS Excel program. Biographical and questionnaire -specific data was analyzed using one-way ANOVA, Fisher Exact, Kolmogorov-Smirnov, and Chi Square tests to decide if any of these factors could explain observable differences between the two populations regarding the primary variables. For example, did age, gender, presence/absence of other people, or commuting to an office location, have any significant influence.
Lastly, a scientific paper was generated, including sections for experimental methods, data, results and conclusions. The paper was framed so that it could be rewritten and the company could apply for Government Grants.
The results of the case study showed unequivocally that disabled workers not only performed as well as non-disabled workers, but in some areas significantly outperformed the comparison group. The fact that many of the disabled workers' goals were met in the employment situation were determined to be the primary motivating factors.
Computerized Physician Order Entry and Clinical
Data Support Systems
Here is another consultation study with regard to
health care and CPOE/CDSS.
It
has been estimated that in the United States there are some 2.2 million
ADRs among hospitalized patients, causing over 106,000 deaths annually,
and placing it as the number
four leading cause of death (U.S. Food and Drug Administration: Center
for Drug Evaluation and Research--2003). (An ADR is an Adverse Drug Reaction.)
Several systems are being implemented in health care settings to address this problem. The first is CPOE--Computerized Physician Order Entry, which attempts to create a secure, electronic means for physicians to order drug prescriptions for their patients, thereby removing sources of error, such as poor handwriting, use of wrong drugs at the bedside, and alerting physicians to possible adverse drug reactions. It is often used in conjunction with a CDSS--Clinical Decision Support System. The CDSS is an expert system for experts--physicians--to enable them to search an interactive drug database for the latest information, possible adverse interactions, recommended dosages, routes of entry, and so forth.
Today, several software companies offer such systems, more often than not bundled with CPR (Computer Based Patient Records). Although some health care facilities, particularly those using homegrown systems report favorable results, many are finding major problems implementing such systems.
The consultation study we performed was designed to find out the best method of implementation and discover the reasons why so many health care entities were reporting problems with such systems.
By far, the biggest problem we discovered was that standardized, off-the-shelf software didn't work as advertised. The reasons were many:
• The software was inflexible; it could not be customized.
•
Software designers did not consult sufficiently with users to create a system
that was friendly, cost-effective, or
particularly useful.
• Training of health care workers was a major issue (often too little, too late).
•The CPOE/CDSS systems did not integrate well with existing systems.
•The
software was expensive to begin with, and by the time the poor installation
factors were included, the ROI numbers looked
poor.
Many other system factors were discovered. For example:
•
Users often tried to bypass the system(s), either because they thought it
was too time consuming, or because they
weren't consulted, and
often were plain resistant to its introduction.
•The
systems weren't always fully integrated, resulting in "holes" in the supply
chain; for example, proper barcoding of
drugs in various forms.
•For
such systems to work, "buy-in" by the users is a must, especially the physicians.
Ongoing consultation with users in all
phases of design and implementation is critical.
•The
matching of inexpert users to expert systems. This is a problem that has
been described in some depth in other
areas of business by
Simon Head in his book "The New Ruthless Economy" (Oxford University Press).
Although this was a private consultation study, and hence we cannot discuss implementation in detail here, the single finding that most surprised us was that the ROI for custom systems far exceeded that of off-the-shelf systems. We believe that at the outset, cross-functional teams between software engineers and health care users in the design and implementation phases will make all the difference in the world as to whether CPOE/CDSS succeeds, improves the quality of life for patients, and pays for itself within 2-3 years of going online.
Examples
of other case studies we have performed
Examples
of other case studies we have completed:
•
Implementation of CPOE (Computerized Physician Order Entry) and CDSS (Clinical
Data Support System)
in a health care setting
(hospitals, ER rooms, clinics, and HMO type settings.)
• Auditing covered entities--small businesses--with regard to the Security Rule of the HIPAA ACT
• Security and integrity of medical information entered via medical supply Internet web sites
• Challenges in establishing entrepreneurial business charter schools
• Visual acuity of emergency/disaster technical manuals
• Implementing new strategies concerning multiculturalism.
We possess considerable industrial and business expertise to bear on consultation studies, can quickly determine whether we can help you design a study, and furnish you with a cost estimate.
Who we are
We primarily serve small businesses (1-500
employees). We are not allied with any organizations, companies, or individuals,
so we can present you an unbiased study. Before you spend big bucks to buy
a large software system that the vendor says "will fix all your problems
guaranteed," give us a call for a second opinion
