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INTRODUCTION..

Ms. Aimi is an information system consultant appointed by Klinik Pakar Perubatan Mahang (KPPM) to enhance the development and sustainability of the KPPM information system project. The project aims to enhance several information systems under several units in KPPM. Before joining KPPM, Ms Aimi has vast experience as a Project Manager in Multi-National Company (MNC) such as Shell and Maybank. Thus, the Director of KPPM, Dr Kamil, has requested Ms Aimi to perform an in-depth study to identify the problems related to Mahang Specialist Clinic System (MSCS) and come up with an appropriate rectification solution because MSCS has received many complaints regarding its reliability and accuracy of the information generated.

MSCS helps the clinic manage their patient registration, diagnose the patient, provide prescription and payment.MSCS use a smart card that contains a chip to manage all the patient information, such as their biodata, health, medication and payment. The registered patient who returns for the service will need to provide their smart card for identification.Mr Fahim is an IT staff at KPPM who is responsible for the development and maintenance of MSCS.

MSCS consists of 4 main modules to support the overall patient registration operations in KPPM. The modules include patient registration, diagnosis results, supply medication and payment. Brief descriptions of each module are presented in Table 1.

Table 1:MSCS module descriptions

No	Module	Description
1.	Register Patient	All new patients need to fill in a biodata form prepared by the clinic staff. Then the clinic staff will key in all the information in MSCS. The information is name, identification card number, contact address, telephone number and other related data. The clinic staff keeps all the information in the system. Then, the system generates the identification number for the patient and keeps it on the smart card. The patient keeps this smart card for future reference. Upon returning, the registered patient needs to bring their smart card and give it to the clinic staff. Then, the clinic staff key in the identification number to register the patient. Then the system generates a set of numbers for every patient based on first come, first serve basis to wait for the consultation session.
2.	Diagnose patient	When a patient sees the doctor, the doctor will scan the patient's smart card, and the system displays the patient's record. After diagnosis, the doctor will update the diagnose information, medications, dietary, and other related information. Then, the system store the information. Only doctors have access to the information, except for the medication details that the pharmacist can access.
3.	Supply medication	After consultation, the patient waits for their turn for the medication. The pharmacist will check the medication prescribed by the doctor in the system. The system also displays a list of medicines and the bill. Then the pharmacist hand over the medicine to the patient, and the system will update the stock based on the quantity and prescription.
4.	Payment	Based on the price displayed by the system, the patient needs to make the payment via credit card or cash. Then, the clinic staff will update the payment information for that patient. Finally, the system will reset the number for that patient to zero.

THE HICCUPS OF MSCS 01121702272

GATHERING PROBLEM AND ISSUES

After a meeting, the Dr Kamil and Ms Aimi, started to plan for the in-depth study. Ms Aimi decided to use the focus group approach instead of interviews to ensure that all the MSCS users are included. A series of focus groups were then conducted with the MSCS users in October 2020. Ms Aimi believed that the focus group approach could contribute to rich and in-depth data on the issues. The approach aims at a collective purpose and usually conducted in a small group comprising 4 participants with a moderator. Table 2 shows the list of focus groups conducted in 4 units that represented the users of all the MSCS 4 modules.

Table 2: List of Focus Groups

No.	Department	Date of discussion
1.	Register Patient	10/10/2020
2.	Diagnose Patient	15/10/2020
3.	Supply Medication	20/10/2020
4.	Payment	25/10/2020

All the conducted focus groups were fruitful as Ms Aimi managed to identify in details the issues of MSCS. The identified issues were classified based on the four modules as depicted in Table 3.

Table 3: Issues

No	Module	Issue
1	Register Patient	The information recorded is not tally with the generated reports.
2.	Diagnose Patient	Dashboard function is required. For monitoring, a report on the patient's medical record is required.
3.	Supply Medication	The system needs to be integrated with the medical vendor system. The system failed to detect details on lump-sum payment made by KPPM
4	Payment	The process of payment is slow and unstable.

Based on the problems identified above, Ms Aimi realized that MSCS has many problems, more than she had anticipated. Almost all the modules in MSCS have issues that need to be tackled. Nevertheless, Ms Aimi prepared a full report on all the gathered issues to present to Dr Kamil.

IDENTIFYING POSSIBLE SOLUTION

Based on the discussion between the Director and Ms Aimi, the KPPM board had agreed to allocate RM40,000.00 for MSCS. She was given 4 months to complete the system enhancement, starting from 1 November 2020 until 30 April 2021. In addition, Ms Aimi was also required to allocate the resources on this project properly. There were two possible solutions towards the enhancement: rebuilding or upgrading the system. According to Ms Aimi, rebuilding means that the entire system has to be rebuilt from scratch using a new design and technology, whilst upgrading implies additional features using the same tools, with a new partial design.

In order to decide whether to rebuild or upgrade the system, Ms Aimi had to investigate whether the project is feasible to be developed by the KPPM IT staffs or to outsource. Outsourcing is an action of hiring different company or individual to perform tasks related to the project. It is a way to increase the efficiency and the speed of completing the project. However, one factor that will affect the efficiency and speed of the project is the level of expertise of the outsource company compare to KPPM IT staffs. The underlying principle is that the outsourcing company able to focus on that particular task. Hence, it can do it better, faster and cheaper than the hiring company could. Through outsourcing, the selected company shall accumulate the system requirement and design. Then, to ensure that the system runs as expected, the company performs system development and test it. Moreover, if KPPM IT staffs do not have the expertise of system development, it is impossible that the system can be rebuilt or upgraded using in-house practice. There is a potential delay as KPPM IT staffs need to perform multi-task. So they are unable to focus on only one project.

Her first strategy was to identify and select the potential project team members among the KPPM IT staffs. This was done by collecting related information of 4 staffs representing system analysts and programmers as she was looking for team members with programming, database, and system design skills. The assessment was made based on technical skills, work experience, and personality. She found out that these staffs are not capable of developing an in-house system.

In addition, she also had to identify and evaluate the KPPM infrastructure before deciding whether to upgrade or rebuild the system. The evaluation indicated a slow processing problem, which led to a system halt and eventually led to missing data. Thus, she realized that the system architecture needs to be enhanced (i.e. additional servers, etc.).

CASE PRESENTATION: REBUILD OR UPGRADE?

Based on the given issues and solutions, the management has to decide to rebuild or upgrade the MSCS. In order to rebuild or upgrade, Ms Aimi proposed several options to implement as follows:

1. Insourcing - MSCS will be fully developed in-house by KPPM IT staff.
2. Outsourcing - a party outside KPPM will fully develop MSCS without involving any KPPM IT staff.
3. Mixed insourcing and outsourcing - MSCS will be developed by KPPM IT staff, and some parts of MSCS will be outsourced to external companies.

Ms. Aimi has to make the important decision of whether to rebuild or upgrade.

1. What are the problems faced by the current Mahang Specialist Clinic System (MSCS)?

1. Will you rebuild or upgrade the system? Why?

1. Based on your answer in Question 2,
   1. define and explain what are the resources that will be needed to perform the work?

1. Develop the Activity Analysis (Activity, Description, Estimated Durations (monthly), Predecessor) table for
   1. SIX (6) possible activities
   2. draw the Activity on the Node (AON) Network Diagram (maximum 2 paths), and
   3. identify the critical path