In the book, we follow a case study of a fictitious company, EAB Healthcare, Inc., to demonstrate how they began to understand their business systems, how they made changes to those systems to better serve their customers (both internal and external), and how they designed new elements in their database to best serve their purposes.
EAB Healthcare is a fictional provider of physical rehabilitation and nursing care to older adults. While traditional healthcare facilities are suffering financial difficulties and are undergoing industry-wide consolidation, EAB has been tremendously successful. This is primarily due to their innovative rehabilitative therapy programs and their focus on efficient facility operation.
In an effort to remain a leader in their industry through improving their operational excellence, EAB has undertaken a project to computerize the vast volume of paper medical records that all of their nationwide facilities must handle on a daily basis.
The business client's ultimate vision for this project is to have a fully automated, online medical records system that will
Eliminate the need to manually handle the large volume of paper medical records by providing these records in electronic form
Fully integrate their records into a medical records database
Enforce regulatory record-keeping requirements
Eliminate the manual transcription of information between currently paper-based information sets
The desired outcome is improved patient care through better information management and more effective staff operations.
Using the new system, the staff of EAB will typically access the medical records via touch-sensitive information display panels that will be present in each resident's room, in all treatment areas, and in all staff offices. The following de scribes a typical usage scenario.
A nurse enters a resident's room to assess the resident's status. Noticing the resident's trend toward excessive weight loss, the nurse needs to review the patient's dietary orders in the medical records. She goes to the informational display and swipes her personal access card. Once recognized by the system, she enters her personal identification number (PIN). Security verification al lows her to access the system. She enters the resident's name and the system displays the resident's records to her. (Depending on the person's role, the system may grant access as read-only, read/write, read/write/create/destroy, or other appropriate combinations. The system may also make available only certain sections of the medical records, also established by role.) The nurse finds and reviews the information she needs. She then ends her session with the system.
The ultimate business goals for this project are as follows:
To reduce errors and improve the accuracy of the medical records
To improve efficiency by reducing the amount of physical paper the workers handle in daily operations
To streamline the interaction between the EAB facilities and the myriad external regulatory agencies and other private service providers with whom EAB interacts
Due to their commitment to quality and since there is such intense oversight of the healthcare industry by external government agencies, EAB has committed to a thorough analysis and design of this new system. The process will begin with business modeling, then system analysis and design using the UML and object-oriented techniques.
We use this case study throughout the book to illustrate how such a system may be developed using UML-based techniques. However, we focus primarily on the database design aspects of the project, not on the development of the application software. Thus, while many of the designs in this book may address application issues, we ultimately focus on the database design supporting the EAB Healthcare system.