HOSPITAL MANAGEMENT INFORMATION SYSTEM

SYSTEM ANALYSIS, SYSTEM DESIGN, AND FLOWCHART

By :
Ayunda Zilul Gosanti 101311133040
Didi Intan Pratiwi 101311133107
Nur Azizah Fairuz 101311133136
Nadia Rizqi Aulia 101311133223

DEPARTMENT OF HEALTH POLICY AND ADMINISTRATION

PUBLIC HEALTH UNIVERSITAS AIRLANGGA
 System Analysis, System Planning and Flow Chart

A.1. SYSTEM DEFINITION

System comes from Greek word, “systema”. It means an organized whole. According to the
Webster’s dictionary, a system is defined as “a regularly interacting or interdependent group
of items forming a unified whole.” Also, it is defined as “a set or arrangement of things so
related or connected as to form a unity or organic whole.”

A.2. SYSTEM THINKING

The organization receives inputs, transforms them and exports the outputs to the
environment as shown in the basic input-output model below.

Source: Weihrich, et al (2008)

In their own opinion, the above model requires expansion and development into a model of
process, or operational management that indicates how the various inputs are formed
through the managerial functions of planning, organizing, staffing, leading and controlling.
However, the following sub topics are the basic components of a system, they are:

1. Inputs - The composition of inputs from the external environment may include people,
capital, managerial skills as well as technical knowledge of skills. It also includes the
various claimants – groups of people making demands on the organization; such as
employees, consumers, suppliers, stakeholders, federal, state and local governments.
2. Transformation process – In an organizational system, inputs are transformed in an
effective and efficient manner into outputs. This can be viewed from different
 perspectives. Focus can be on such management functions as finance, production,
personnel and marketing.
3. External variable – As a component of the systems model, the external environment
plays a key role in the transformation of inputs into outputs. While it is true that
organizations have little or no power to change the external environment, they have no
alternative but to respond to it.
4. Outputs – Inputs are secured and utilized by transformation through the managerial
functions – with due consideration for external variables into outputs. Outputs of different
kinds vary with the organization. They usually include many of the following; products,
services, profits, satisfaction and integration of the goals of various claimants to the
organization.
5. Reenergizing the system – It is worthy of note that in the systems model of management
process, some of the outputs become inputs again. Apparently, the satisfaction and new
knowledge or skills of employees become important human inputs. Similarly, profits are
reinvested in cash and capital goods, such as machinery, equipment, buildings and
inventory. Buttressing what Weihrich et al had written, Amobi and Nnabuife (1999),
revealed that the systems theory has been likened by many management experts to the
three – part production process of an organizational activity. They revealed that Katz and
Kahn in their analysis of the basic properties of an organization had also identified the
input – throughout – output process.

There are two types of system thinking:

1. Cybernetics and closed systems thinking

The field of cybernetics exemplifies the modern version of closed systems thinking and it
is attributed to the work of Norbert Wiener. In 1949, Norbert Wiener, a distinguished
mathematician and engineer at MIT (Massachusetts Institute of Technology) discovered
this over lunch with a colleague who was a neurosurgeon. The development of the field
of Cybernetics allowed diverse disciplines to communicate about their problems in the
common language of systems theory. More importantly, it allowed a common set of
principles to be applied to problems of control and regulation. It has been seen that the
principles of system design that allowed ancient mariners to steer ships with “governors”
were the same principles that allowed mechanical engineers to design thermostats for
air-conditioning units, industrial engineers to control product quality, astronomers to
describe the behaviour of planets, and accountants to design budgetary control systems.
These systems can be seen as returning to equilibrium after being disturbed by
regulating themselves through feedback information. The cybernetic closed systems
 model is the intellectual base for traditional cost and quality management approaches.
Another key idea in closed systems is the increase in entropy or the tendency to
maximum disorder. This is because the system is closed to the environment and has no
ability to import energy to counteract the growth in entropy. This view, exemplified by the
second law of thermodynamics, means that closed systems will inevitably tend to
breakdown from an increase in entropy.
2. Biology and open systems thinking
Open systems theory has its foundations in biology, particularly Darwin's work on the
evolution of the species. The popular version of open systems theory is attributed to
Ludwig Von Bertalanffy who used the term ‘general systems theory’ to describe the main
ideas and to distinguish them from closed systems thinking. Bertalannfy maintained that
closed systems thinking was not appropriate to study biological phenomenabecause
biological systems interact with their environment, grow and survive. However, the
environment of living organisms is less forgiving and often the luxury to learn from errors
does not exist.

There are four main differences between closed and open systems theory. Each
difference is discussed below:

1. Relations with the external environment

Open systems theory focuses on the interchange between a system and its environment.
Biological organisms are open systems because they constantly evolve and adapt to the
needs of their environment. Their behaviour is a response to the threats and resources
available in the environment in which they exist.
2. Variables considered
A second area, which differentiates open and closed systems thinking, is the number of
variables included. A closed system has a few variables. An open system typically deals
with a more complex set of interrelationships. Cost and quality, viewed from a closed
systems perspective, are internal variables that need to be managed within the
boundaries of a firm. In an open system, cost and quality are viewed as externally driven
variables that must be managed by understanding the environmental influences on these
variables.
3. Form of regulation or control
Closed systems use error-controlled regulation, this is control after-the-fact. Open
systems use anticipatory control. They are regulated by anticipating errors before they
occur and taking corrective measures before final output. Like a mouse, open systems
anticipate a cat’s next move. Waiting for feedback from errors is usually fatal. This form
 of regulation is called ‘feed forward’ control. If cost is to be managed as an open system,
it should be controlled before a product is produced and not after.
4. Purpose of Regulation
Unlike closed systems, open systems are not interested in returning a system back to
some predetermined stable state. They recognize that the purpose of regulation is to
adjust and move the system on a dynamic path. Open systems seek continuous
improvement and not just stability. They are said to achieve a dynamic equilibrium. Like
living systems, most organizations operate in constant interchange with their
environment. They have many complex interactions and interrelationships within their
boundaries.

A.3. SYSTEMS THEORY AND EFFECTIVENESS

System theorists propose that systems can be categorized in three ways:

1. Conceptual systems (a language)

Organizations use the notion of a system to view their internal and external world and
how the parts relate and interact with each other. By viewing the individuals, groups,
structure, and process of organizations in terms of a system, organizations are able to
identify common and uncommon themes that help explain the behaviour and
effectiveness of people. Identification of themes or patterns is important because it helps
to explain how effective an individual, group or entire organization is, in terms of goals
(Peterson, 1994).
2. Concrete systems (machines)
Systems theory enables us describe an organizations’ internal and external behaviour.
Internally, it can be seen how and why people inside the organizations perform their
individual and group tasks. Externally, an organization’s transactions with other
organizations and institutions can be assessed. All organizations acquire resources from
a larger environment of which they are part of, and in turn, provide the goods and
services demanded by the larger environment.
3. Abstract systems (culture of an organization)
The organization is one element of a number of elements interacting interdependently.
The flow of inputs is the basic starting point in describing the organization. Every
organization is part of an industry (a larger system), a society (a yet larger system), and
increasingly, a global economy (perhaps the largest system of all). Systems theory can
also describe the behaviour of individuals and groups within an organization. An input
(cause) can be processed by an individual mental and psychological process to produce
a particular output (outcome).
A.4. QUALITIES OF AN IDEAL SYSTEM

According to Harry (1990) the following elements are indicators of a quality system:

1. Components: A system consists of more than one part called component elements of a
system. A component refers to anything that is part of a system or sub-system.
2. Connection: These components of a system are connected together.
3. Structure: The concepts of structure and organization become more interesting in large
systems, where more than just one or two possible structures or organizations may be
considered.
4. Interaction: The components affect each other by their presence in or removal from the
system which results from mutual interaction with the systems environment.
5. Process: the changes resulting from these interactions are called processes.
6. Holism and emergent properties: A system is a whole which exhibits properties which
only have meaning in terms of the interactive processes of its components.
7. Identity: The properties of a system that enable it to be identified and separated from
other things which are not part of the system.
8. Environment: There are things which are not part of the system, which significantly affect
it, but which the system can only marginally influence, called the environment of the
system.
9. Conceptualization: a system is a concept whose particular form reflects the aims and
values of the individual or group whose concept it is (Harry, 1990).

B. PLANNING, DESIGN AND IMPLEMENTATION OF INFORMATION SYSTEMS

B.1. Planning for Information System

The complexity of the information resources environment suggests that planning is vital to
success. The plan describes the structure and content of the information system and how it is
to be developed. The organization’s strategic plan should be the basis for the Management
Information System strategic plan. The overall responsibility of IS planning is the responsibility
of Chief Information Officer (CIO).

a. Information System plan requires updation :

1. Changing organizational setup
2. Changes in technology
3. Changing needs of system
 4. Internal events
5. Progress of new systems
6. External events
b. Analysis of Organizational information requirements
Information requirements are required at the organizational level for information system
planning, identifying applications, and planning an information architecture. More
detailed information requirements are required for detailed design of applications.

B.2. Stages / phases of systems information development life cycle

A. Phase 1 : SYSTEMS INVESTIGATION
1. Include preliminary study of proposed solutions to meet a company’s e-business
priorities & opportunities.
2. Investigation stage:
a. determine how to address business opportunities.

b. conducting feasibility study.

c. develop project management plan & obtain management approval.

3. Feasibility Study :
a. Organizational feasibility
Focuses on how well a proposed system supports the e- business priorities of the
organization.
b. Economic feasibility
Focuses on whether expected cost savings, increased revenue, increased profits,
and reductions in required investment, will exceed the costs of developing and
operating a proposed system.
c. Technical feasibility
Focus on the reliabilities/capabilities of the hardware and software to meet the
needs of the proposed system.
d. Operational feasibility
Focus on the willingness and ability of the management, employees, customers,
suppliers, and others to operate, use, and support the proposed system.
e. Schedule feasibility
Focus on the solution be designed & implemented within an acceptable time
period.

B. Phase 2 : SYSTEM ANALYSIS

1. Systems analysis is an in-depth study of end user information needs, which produces
functional requirements that are used as the basis for the design of a new information
system.
2. Types of analysis:
a. Organizational Analysis
Involves evaluating the organizational and environmental systems and
subsystems involved in any situation.
b. Analysis of the Present Systems
Involves analyzing activities, resources (hardware/software/people), and the
products.
c. Functional Requirement Analysis
Determine the information processing capabilities required for each system
activity (input, processing, output, storage, and control) to meet the information
needs.

C. Phase 3 : SYSTEM DESIGN

1. User Interface Design
Focuses on supporting the interactions between end users and their computer-based
applications, e.g : display screens, interactive user/computer dialogues, audio
responses, forms, documents, and reports.
2. Data Design
- Physical View : the design shows how the database is arranged, stored and
accessed on the storage devices of a computer system.
- Logical View : conceptual design within an abstract model. Data elements and
relationship are used in the model.
3. Process Design

D. Phase 4 : SYSTEM IMPLEMENTATION

1. The activity includes:
a. Acquisition of hardware, software and services.
b. Software development or modification.
c. Testing of programs, procedures, and hardware.
d. System documentation.
e. Conversion (parallel, pilot, phased, plunge).
f. End User training.
2. Conversion Methods
 a. Parallel Conversion: Both the old and the new system are operated until the
project development team and end user management agrees to switch
completely over to the new system.
b. Phased Conversion: Only parts of a new application or only a few departments,
branch offices, or plant locations at a time are converted. A phased conversion
allows a gradual implementation process to take place within an organization.
c. Pilot Conversion: Where one department or other work site serves as a test site.
A new system can be tried out at this site until developers feel it can be
implemented throughout the organization.
d. Plunge/Direct Cutover: Use the system immediately and totally abandons the old
system.

E. Phase 5 : SYSTEM MAINTENANCE / EVALUATION

1. System Maintenance
System maintenance is the monitoring, evaluating, and modifying of operational e-
business systems to make desirable or necessary improvements.
2. System Evaluation
Evaluate or judge the performance of a system over a longer time period than that
just after immediate installation.
3. Problem areas contribute to system failure
a. Design
- System fail to capture essentials business requirements.
- Poor format of the system ,e.g: represent wrong piece of data.
- Poor user interface , not user friendly. Hard to use by the user.
b. Cost
 - Cost to implement may be over budget.
- System project may be too costly to complete.
c. Data
- Data inaccurate or inconsistent and not properly organised.
- Information in certain fields may be erroneous or ambiguous.
- Data incomplete, information may be inaccessible.
d. Operation
- System does not run well.
- Information is not available in a timely & efficient manner because computer
breakdown.
- Response time may too long.

B.3. Prototyping

1. Prototyping is the rapid development and testing of working models, or prototypes, of

new applications in an interactive, iterative process involving both information system
specialists and business professionals.
2. Tools for prototyping :
a. Screen generators (screen painters)
b. Graphics
c. Report generators (report writers)
3. Categories of Prototype
a. Non-working prototypes
b. Partially working prototypes.
c. Pilot prototypes
d. Staged prototypes
4. Four Steps in the Prototyping Process
a. Identify the user’s basic requirements : the system designer works with the user
to capture the user’s basic information needs.
b. Develop an initial prototype : the system designer creates a working prototype
quickly, using tools for rapidly generating software.
c. Use the prototype : the user is encouraged, to work with the system to determine
how well the prototype meets the requirement and make suggestions for
improving the prototype.
d. Revise and enhance the prototype : System builder notes all changes the user
requests and refines the prototype accordingly.
5. Advantages of Using Prototyping
 a. Prototyping makes the development process faster and easier for Information
System specialists and business professionals.
b. Prototyping involve end-user development throughout the systems development
life cycle

C. FLOWCHART

Flowchart is a type of diagram workflow or process, showing the steps as boxes of various
kinds, and their order by connecting them with arrows. This diagrammatic representation
illustrates a solution model to a given problem. Flowcharts are used in analyzing, designing,
documenting or managing a process or program in various fields.

Flowchart are used in designing and documenting simple processes or progrmas. Like other
types of diagrams, they help visualize what is going on and thereby help understand a
process, and perhaps also find flaws, bottlenecks, and other less-obvious features within it.
There are many different types of flowchart, and each type has its own repertoire of boxes
and notational convntions. The two most common types of boxes in flowchart are :

1. A processing step
Usually called activity, and denotaed as a rectangular box
2. A decision
Usually denoted as a diamond
Flowchart is described as cross functional when the page is devided into different swimlanes
describing thecontrol of different organizational unit. This technique allows the author to
locate the responsibility for performing an action or making a decision correctly, showing the
responsibility of each organizational unit for different parts of a single process.

Flowchart depict certain aspects of processes and they are usually complemented by other
types of diagram. For instance, Kaoru Ishikawa defined the flowcharts as one of the seven
basic tools of quality control, next to the histogram, Pareto Chart, check sheet, control chart,
cause and effect diagram, and the scatter diagram. Similarly in UML, a standard concept
modelling notation used in software development, the activity diagram, which is a type of
flowchart, is just one many different diagram types.

Sterneckert (2074703) suggested that flowcharts can be modeled from the perspective of
different user groups (such as managers, system analysts and clerks) and that there are four
general types:
 a. Document flowcharts, showing controls over a document-flow through a system
b. Data flowcharts, showing controls over a data-flow in a system
c. System flowcharts, showing controls at a physical or resource level
d. Program flowchart, showing the controls in a program within a system

Notice that every type of flowchart focuses on some kind of control, rather than on the
particular flow itself.

However, there are several of these classifications. For example, Andrew Veronis (1978)
named three basic types of flowcharts: the system flowchart, the general flowchart, and the
detailed flowchart. That same year Marilyn Bohl (1978) stated "in practice, two kinds of
flowcharts are used in solution planning: system flowcharts and program flowcharts..." More
recently Mark A. Fryman (2001) stated that there are more differences: "Decision flowcharts,
logic flowcharts, systems flowcharts, product flowcharts, and process flowcharts are just a
few of the different types of flowcharts that are used in business and government"

Systems flowcharts graphically illustrate the major processes, inputs and outputs of a
system and are primarily used for the physical modelling of the system. The increasing use
of data flow diagrams for logical and physical modelling has led, to a steady decline in the
use of systems flowcharts in recent years, however many systems analysts continue to use
them.

Systems flowcharts have several symbols used to represent different media, such as disks,
tapes, documents, terminal inputs and terminal outputs. Lines with arrowheads indicate the
flow of data.  The flow of data generally goes from top to bottom and left to right and depicts
the sequence of processing steps along these data flow lines. So with flowchart, everything
about input, analizing or documenting database can easily.

The following are examples of some of the symbols used in systems flowcharts:
Symbols

Data Flow symbol

System Flowchart Example

 Reference

Alan B. Sterneckert (2008) Critical Incident Management.p. 126

Andrew Veronis (2011) Microprocessors: Design and Applications. p. 111

Chikere, Cornell C. and JudeNwoka. 2015.The Systems Theory of Management in Modern

Day Organizations - A Study of Aldgate Congress Resort Limited Port Harcourt.
International Journal of Scientific and Research Publications, Volume 5, Issue 9,
September 2015
Department of Civil and Environmental Engineering. 2011 System Definition and Structure.
Maryland: University of Maryland
Marilyn Bohl (2011) A Guide for Programmers. p. 65

http://digitalprinciples.org/wp-content/uploads/2015/05/TS_opt_ict_toolkit.pdf

http://www.slideshare.net/Eacademy4u/planning-design-and-implementation-of-information-
systems

http://www.slideshare.net/engineerrd/information-system-plan