Multidimensional project metamodel Construction methodology for a HIS deployment Farid Lahboube1, 3, Ounsa Roudiès1, Nissrine Souissi1, 2 1 Univ
Mohammed V. Ecole Mohammedia d'ingénieurs. Siweb Team Avenue Ibn sina B.P. 765 Agdal Rabat Morocco
[email protected],
[email protected] 2 e-App Center, Ecole Nationale Supérieure des Mines de Rabat, Morocco
[email protected] 3 Hôpital d’Instruction Mohamed V, Rabat Morocco
Abstract. Today, health facilities can be restructured only as part of a triple challenge: meeting the healthcare needs in a given area, meeting the requirements of safety and quality, and adapting to the constraints of scarcity of both human and financial resources. In this context, hospitals have undertaken full or partial reforms, which consist primarily in the introduction of Hospital Information Systems (HIS). However, digitalization projects of these structures encounter a wide range of issues due to the complexity and difficulty of such projects. This paper proposes a response to these difficulties according to a HIS project multidimensional metamodel. This one apprehends the dynamic nature of a HIS implementation considering its interactivity with other factors, phases and iterative nature. Keywords: Hospital Information System, complex system, metamodel, multidimensional, project management.
1. Introduction Hospital environment has utterly changed these recent years inducing high financial pressures and increasing demands from citizens. It seems mandatory then that healthcare institutions have to adapt their strategy, particularly the one related to the computerization. Indeed, the establishment of a Hospital Information System (HIS) [1], [2] is a real opportunity to achieve the performance objectives that must converge towards three main objectives, which are: meeting regional healthcare needs, ensuring the quality of hospital activity and optimizing the economic and organizational efficiency [3]. The hospital henceforth needs to build and sustain a performance management process, at all levels, in order to come up with a whole vision involving all healthcare actors. To achieve this goal, the healthcare processes IT strategy must take into consideration all the actors requirements, in each decision-making level of the hospital structure [4], [5]. The execution of such policy means: • The implementation of a transversal supervision process that goes from requirements elicitation to the deployment of the solution.
•
The adaptation of the supervision process to every level of decision (e.g. Executive Council, pole, service), by bringing together all healthcare skills. However, such culture isn’t embodied in the current HIS ecosystem [6]. Indeed, most public hospitals do not fall back on monitoring methods and tools (business or transversal), except within small project framework [7]. We believe that a malfunction of the supervision process during the deployment phase of a HIS will stray us from initial objectives. The informatization movements results confirm these statements and reveal a real deficiency in this supervision brick [8]. Our approach is to consider the HIS within the complex system paradigm and expand the engineering project concept according to this context. This paper intends to bring a formal solution to the problem of a HIS deployment supervision through a project multidimensional metamodel. The concepts introduced in this metamodel take into account the structural complexity and stakeholders diversity. This work is organized in five sections: after introducing the objective of the current study and its context, the second section addresses the issue of deployment of HIS, according to the complex systems paradigm. The third one describes the methodology used to construct our meta-model project before presenting the proposed Project meta-model in the section four. Conclusions and perspectives are presented at the last section.
2. The complexity of HIS issue As shown in [9] the complex system paradigm is a valuable approach that allows us to apprehend the HIS multidimensional aspect. The complexity of a HIS can be approached from several perspectives. Indeed, a HIS is considered a complex system if it reflects one of the following properties [10]: heterogeneity, processing flow, size, hierarchy and evolution. The HIS is also characterized by structural complexity due to the multiplicity of its processes and the strong correlation that results from their interaction [9]. Due to this complex and unpredictable quality, hospitals and clinics fall into the category of a complex and adaptive system (CAS) [11]. Furthermore, the non-linear interactions among heterogeneous agents, such as individuals, health care organizations, and governmental agencies [12] represent a risk for a HIS deployment. In other words, the complexity of health care processes is induced by an involvement of several professionals, disciplines, and departments. Multiple stakeholders and complex organizational arrangements are increasingly common features of information systems projects [13]. Thus, there is a need to design strategies that can cope with this complexity. Given the fact that the HIS complexity has a considerable impact on the software project management; their implementation must be preceded by an all level evaluation that respects the diversity of points of view.
3. Project Metamodel construction methodology The incorporation of a "Project Management" dimension into our supervision metamodel, aims to support the early stages of setting up a HIS. This Project metamodel will provide the necessary elements to be in line with the best practices in project management. Also, this metamodel will include standardized project management concepts to facilitate communication between the different stakeholders. Our Work is based on standards consistent with the PMI (Project Management Institut) Corpus Guide dedicated to Project Management Body of Knowledge (PMBOK® Guide - 5th edition). 3.1.
Construction methodology
The proposed methodology is to precede the development of our project metamodel by a comparative study of selected models in the literature. The choice is motivated by the relevance of the models and points of view they represent. Indeed, the project metamodels found during our search did not cover all points of view at once; each metamodel being positioned on a particular point of view. Following this comparative analysis, we identified the concepts closely related to the process of a project. In order to complete this analysis, we compared all these concepts to those recommended by our reference model PMBOK 5.Ed [14]. Figure 1 summarizes the methodology adopted to design our metamodel. The Methodology followed is to go through the literature concerning the project management MMs and undertake a comparative analysis of the different used concepts. The ones chosen are compared, afterwards, to those recommended by the last version of the referential PMBOK based on semantics and terminological correspondence. The retained terms are completed with other concepts related to the HIS particularities.
Fig 1: HIS Project Metamodel creation methodology
3.2.
Comparative analysis of project metamodels
To conduct our comparative analysis, we chose the most significant metamodels in terms of expressiveness and conceptual coverage. The three metamodels used in this study are presented in chronological order of appearance. Each metamodel represents a point of view offering a schedule for the completion of a project. The first metamodel [15] of this study proposes a methodology for a project management mainly based on deliverables, techniques and tools. In fact this metamodel is a technical approach for the completion of all project tasks. Note that this is a monolithic model that affects only a single and simple system. The second metamodel [16] introduces a dynamic approach of a project characterized by several phases and iterations. It also introduces a categorization of the project into disciplines. This metamodel offers a better multi-user point of view for the establishment of an information system. However, it does not support all project resources apart from personal resources represented here by the metaclass "Person". Also, this metamodel considers only one project and doesn’t allow its decomposition into sub-project / sub-processes. The third and final metamodel [17] offers a wider vision of a project. It is activity oriented and provides a structured decomposition of the "resource" concept. Unlike previous models, this one allows a better structuring of resources and therefore a more rational allocation based on project activities. This model also allows to interface with the Zachman interrogative Framework [18] providing a more coherent construction of the system being modeled. The decomposition into subsystems is supported here but is not significant since it appears as a reusable resource. 3.3.
Discussion of metamodels
Project metamodels presented above are monolithic, that is to say, they can be used without adding extensions or modifications. However, it is more than necessary to have a model that can adapt to the context of organizations and the problems inherent to the IT deployment process [19] (functional area, size of the project, experience of stakeholders ...). In order to build a metamodel able to withstand the constraints related to the complex environment of HIS, we conducted a terminological and semantic correspondence of the three metamodels to concepts based on the PMBOK referential through Table 1. This table shows that the different types of metamodels have common concepts. The gray lines in the table indicate that some concepts are included in different project metamodels. The retained terms after this analysis will be used to design our Project Metamodel presented in the next section. Table 1. Summary table of used concepts in the three metamodels
Concepts used in Metamodels
Metamodels 1
Activity
2 ●
3 ●
Activity Relation Project Agreement Assignment Capability Condition Data Deliverable Deliverable package Discipline Project Guidance Information Iteration Project Location Materiel Organization Performer Person Person Role Project Person Type Phase Project Project Resources Role Project Rule Service Standard System Task Technique Time record Tool Tool Usage Work Product Project
● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●
● ●
● ●
● ●
●
●
● ● ● ● ● ● ● ●
● ● ● ● ● ●
4. Proposed Project metamodel Figure 2 shows the proposed project metamodel which involves several HIS specificities. It’s an innovative model since it proposes a project management that is HIS characteristics centered. Furthermore, by using a complex paradigm system, this MM offers an efficient solution for managing IT projects within complex systems. First, we define a project by an Objective representing and describing the desired result of a system. A Project is based on a computerization Process project. Our metamodel incorporate several dimensions including the one related to the multi points of view (users). The metaclass DisciplineProject reflects the different views of the HIS users. It is associated to the activities accomplished in the same field.
Fig 2: Proposed Project Metamodel
The association of a Role to a ProjectActivity with cardinality 1 underlines the multi points of view dimension. Figure 3 describes this association.
Fig 3: The Multi points of view dimension
The proposed metamodel provides more advanced semantics of a Deliverable. We have proposed a specialization of this Deliverable on Capability, Result and Artifact. Capability designates, as an agile software development, the ability to perform a service. The Result, as referred by PMBOK concept, is any output data resulting of the execution of a process and project management activities. Result includes outcomes (revised processes, restructured organization, tests, etc.) and documents (internal policies, plans, studies, procedures, specifications, reports, etc.). An Artifact is something that is produced or consumed by an activity. It can also be formed by a set of small artifacts. These can be a document, a model, a source code, requirements documents, test plans, test cases, etc. In the context of HIS, regional [20], [21], national [22], [23], or even international dimension [24] requires taking space into consideration. Also, given the evolution of new technologies and groupware, the virtual dimension is henceforth to be observed.
Thus we propose the metaclass Location to designate the geographical or virtual whereabouts of the resources. In order to underline the dynamic aspect of a project, we will use the metaclass IterationProject to define a fraction of relatively short and clearly defined time (start date and end date) during which a flow of activities must be achieved. Project resources are represented by the metaclass Resource. It includes both hardware (Material) and human (Stakeholder) resources. Complex projects such as deploying a HIS require the establishment of methodological rules and guides. We suggest the metaclass GroundRule with a specialization on standard and agreement. The latter means any official document including the premises and objectives of the project. The technical aspect of a project is represented by the metaclasses ProjectTechnique and ProjectTools. The first refers to formalized techniques to be used by a role to execute a ProjectActivity. While the second means the computer tools used to facilitate communication and sharing repositories between the project stakeholders.
5. Conclusion and perspectives The establishment of an IT system in a hospital environment is often slow and problematic. This is primarily due to complex interactions between the healthcare processes and the hospital financial and organizational environment and disciplinary diversity of the actors. Several recent studies have suggested addressing the implementation process of a new HIS as well as the costs and benefits of its implementation. Others propose a set of best practices that can make up for the shortcomings while implementing HIS projects. This paper proposes a formal solution to complete the deployment process through a multidimensional project metamodel. The used concepts take into account the hospital environment specificities including those related to multidisciplinary actors. Our metamodel is being experimented underway in a Moroccan hospital structure. Also, it will serve as a corner stone to construct a multi-aspects supervision metamodel. However, it doesn’t take into consideration all the organizational levels of HIS such as regional and national levels. Future researches should suggest more extended approaches to this metamodel in order to incorporate the HIS multi-level aspect and thus meet the users requirements in an overall perspective.
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