e-Healthcare in ABC county health department (ABCCHD): trade-offs analysis and evaluation

Abstract

The issue of privacy stirred a tumultuous uproar when the ABC County Health Department (ABCCHD) was planning for an e-Healthcare system that utilized information technology to streamline the administration process of patients. ABCCHD had hired a software vendor, Info-Health, a company that specialized in information system development for the healthcare industry to help in the project. The privacy of patients with Sexually Transmitted Diseases/Human Immunity System was a thorny issue in the implementation of the e-Healthcare system. A trade-off between privacy and cost was discussed and debated. Three alternatives, with varying degrees of privacy and cost, were considered.

Appendix A1. Teaching notes

e-Healthcare in ABCCHD – Trade-offs Analysis and Evaluation

Objectives

This case accentuates the issue of trade-off between privacy and cost. It presents the privacy issue encountered during information system planning and presents three alternatives. Students are encouraged to analyze the issue and to address the problem while keeping in mind the limitations and constraints of ABCCHD, which is a public health department.

After completing an analysis of this case, the students will appreciate:

• i) Privacy issues in information systems.

• ii) Trade-offs decisions that need to be made.

Methodology

The case of ABCCHD, a real-life scenario, exemplifies a privacy issue encountered by a government institution during system planning. This case is developed based on an intern's experience in ABCCHD. The intern had participated in system planning and realized its complexity, especially in the planning of STD/HIV system.

Teaching suggestions

The case is written to foster the understanding of systems analysis and design for senior undergraduate and graduate students. This case allows students to analyze each possible solution by taking several factors into consideration: the issue of privacy, the system's requirements, and the cost.

The ABCCHD case could be covered within the time span of a single 60–90 min session. This case is suitable for students who are taking a System Analysis and Design class, or a module related to Privacy in an Introduction to MIS class. The case could be used in conjunction with topics such as information privacy, information security, project management, alternatives evaluation, and information systems development.

This is an interesting case on system planning, and it covers the analysis and evaluation of each alternative, while simultaneously dealing with the privacy, system efficiency, and cost issues. The case should be distributed at least 1 week prior to class time. The instructor could begin the discussion by having the students describe the ABCCHD as an organization. The discussion should take about 5–10 min and would serve to introduce the ABCCHD. For an actual case discussion, it is useful to begin with the STD/HIV system. The instructor could pose the following questions: ‘What was the STD/HIV system in the case?’ or ‘What were the system requirements for the new STD/HIV system?’ Students would then realize the shortcomings of the existing system and begin thinking about the changes that should be considered to establish a more efficient system.

A follow-up question could be ‘What kind of constraints were ABCCHD facing?’ In this section, the instructor could spend another 15–20 min to discuss the constraints that ABCCHD faced, and then relate the constraints to the planning of STD/HIV system. ABCCHD was a government institution that had a tight budget and limited computer resources.

For the next 20–25 min, the instructor could discuss the trade-off between privacy concerns and system efficiency, as well as privacy concerns and cost. Some system users such as nurses would prefer to incorporate the STD/HIV system into the main system as such system integration facilitated easy retrieval of patients' data. Nevertheless, the epidemiologists believed otherwise. They strongly insisted that the privacy of STD/HIV patients was paramount, and they demanded that the Info-Health should isolate the STD/HIV system from the main system. However, building another similar system was redundant because the STD/HIV system was basically the main system in a smaller scale. Having a separate system adds to the cost of development. These different perspectives should be made known to the students.

The instructor could spend the next 20–25 min discussing the three alternatives available to ABCCHD. In this section, the instructor should ask the students to highlight the advantages and disadvantages of each alternative. After a thorough analysis of these three alternatives, the instructor could then ask the students to recommend the best option. There are no right or wrong answers as the choice of the best alternative would depend on the value and cost associated to privacy. And that is the strength of this case as it allows for arguments and counter-arguments.

If there is time remaining, the instructor could discuss the health information system in general. For example, the instructor could also briefly mention the prospects of the health information system and the adoption of information systems in the healthcare industry in general.