Part B - Information Systems and Information Technology Solutions

B.4.10. Maintenance of Information Systems

After the systems implementation phase, the maintenance phase takes over. Systems maintenance
is the on-going maintenance of a system after it has been placed into operation.
When developing information strategy plans, organizations cannot afford to neglect the fact that
systems maintenance is the longest and costliest phase of the systems life cycle. The implications of
the maintenance workload upon the information strategy plans for an organization is a subject that
deserves special attention. The organization structure needs flexibility to support the maintenance of
existing systems concurrently with the implementation of new technologies.
It is important to consider the evaluation and monitoring of a system for needed maintenance and
consequently, to lower or contain maintenance costs. Systems maintenance can be categorized into
four groups. Each of these four categories can affect an organization's information strategy plan in
different ways:

Corrective Maintenance. Regardless of how well designed, developed, and tested a system
or application may be, errors will inevitably occur. This type of maintenance deals with fixing
or correcting problems with the system. This usually refers to problems that were not
identified during the implementation phase. An example of remedial maintenance is the lack
of a user-required feature or the improper functionality of it.

Customized Maintenance. This type of maintenance refers to the creation of new features or
adapting existing ones as required by changes in the organization or by the users, e.g.,
changes on the organization's tax code or internal regulations.

Enhancement Maintenance. It deals with enhancing or improving the performance of the

system either by adding new features or by changing existing ones. An example of this type
of maintenance is the conversion of text-based systems to GUI (Graphical User Interface).

Preventive Maintenance. This type of maintenance may be one of the most cost effective,
since if performed timely and properly, it can avoid major problems with the system. An
example of this maintenance is the correction for the year 2000.

Part B - Information Systems and Information Technology Solutions

SETTING UP HEALTHCARE SERVICES INFORMATION SYSTEMS

A DON'T LIST
1.

Don't depend too much on one pioneering innovator, and do not leave any such
innovator in charge they will become too rigid and narrow-minded in their views,
and stifle change and development.

2.

Don't spend a large amount of time creating a detailed, rigid specification it will be
out of date before being designed, built, and implemented; rather, specify core
principles and functionality together with a design-and-build or prototyping
methodology.

3.

Don't leave performance criteria, both in terms of functions provided and maximum
percentage downtime to chance, but include them in the procurement contract.

4.

Don't forget error correction and maintenance write minimum standards into
supply contracts, and ensure that there are sanctions, e.g., part of procurement
payment held back until satisfactory functioning over a specified period; maintenance
payments paid partly at the end of each period with reductions for loss of service.

5.

Don't let the supplier determine needs or performance; instead, ensure that the
customer remains in control.

6.

Don't exploit your supplier whilst the customer should lead, an aggrieved supplier
provides a poor service and a bankrupted supplier disappears and leaves the
customer stranded.

7.

Don't impose "solutions" on end users and data suppliers; rather, ensure that they
feel they are valued and want the system.

8.

Don't automate today's paper processes look at what new functions and methods
automated Information Systems can undertake.

9.

Don't specify too futuristically there is a limit to how much people or an

organization can change in one move; instead allow an evolutionary path.

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Part B - Information Systems and Information Technology Solutions

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10. Don't treat the organization or the specification as rigid structure, but instead allow for
organizational and end-user learning, as well as technological and environmental
change.
11. Don't stop evaluation at the point of installation testing there will be ongoing
organizational and personal behavioral change that must be identified and appropriate
adjustments made.
12. Don't stop investing in a "successful" system it will soon become out-of-date, and
disillusionment will set in thus, to the dismay of users and paying parties, the "success"
will soon evaporate.
13. Don't be complacent with a "successful" system the very word of its success will
increase usage, overload access, and degrade performance this applies to all
elements, including data networks and communications.
14. Don't confuse Education (concerned with changing professional practice and
performance) with Training (about how to operate a system).
15. Don't change practice and switch on a system in one activity, but also don't
computerize old practice separate the two change processes, even though this will
mean a short period of dysfunctional working, so as to ensure that the different
changes are fully understood, and any problems can be traced to the correct source to
facilitate rapid adjustment.
16. Don't rely on memory or suppliers persons can forget, become ill, or leave;
suppliers can go out of business or be taken over. Ensure that everything is properly
documented, including performance agreements, and all systems specifications,
functionalities, applications, and operational routines the constant test must be
"Could a new person take over that task tomorrow?".
17. Don't overlook the need for convincing answers on confidentiality it will be a prime
question from all health professionals before they use a system.
18. Don't think that removing names from records creates confidentiality other factual
combinations in records can effectively identify indirectly by implication or
circumstance.
19. Don't assume that any types of data item are of low confidentiality for some
individuals any specific item may be very confidential because of personal
circumstances, e.g., address or blood group.
20. Don't touch anything which does not run on open standards, is of a closed proprietary
nature, or cannot accommodate modern recognized data and other standards any
short-term gain will be minimal compared with the cost of the dead end up which you
are committing your organization.
21. Don't think that any Information System project is ever finished if it successful,
people will want more of it; if it unsuccessful, adjustments are clearly needed; and in
any eventuality circumstances will change.