System Implementation and Operation

Which is a correct description of the life cycle of an information system?

1. It refers to the continuous flow from planning and procurement through implementation, operation, and evaluation to the next upgrade
2. Once a system is introduced, it never needs to be upgraded afterward
3. The life cycle is a term that refers only to the useful life of the hardware
4. The results of evaluations made during operation need not be reflected in the plan for the next system

Which is a correct description of an RFP (request for proposal)?

1. A document asking vendors to provide information about their products and technologies
2. A detailed design document that the vendor prepares after the contract is signed
3. A document in which a vendor presents only an estimated price to the healthcare institution
4. A document in which the healthcare institution states its requirements and asks vendors to submit proposals

Which is the correct chronological order of steps for procuring a hospital information system?

1. Issue the RFP → clarify procurement requirements → create vendor evaluation criteria → select the supplier and contract
2. Select the supplier and contract → issue the RFP → clarify procurement requirements → create vendor evaluation criteria
3. Create vendor evaluation criteria → select the supplier and contract → issue the RFP → clarify procurement requirements
4. Clarify procurement requirements → create vendor evaluation criteria → issue the RFP → select the supplier and contract

Which is a correct description of a requirement specification?

1. A document that contains the program source code as-is
2. A document in which the healthcare institution clarifies the requirements it wants realized and conveys them to vendors
3. A document defining procedures for handling failures that occur after the system goes live
4. A completion report that the vendor submits to the healthcare institution when the system is delivered

Which is the most appropriate practice for making vendor selection fair and objective?

1. Create vendor evaluation criteria before issuing the RFP and compare proposals against them
2. Give only a particular vendor requirements more detailed than the RFP and let it propose
3. Do not evaluate at all, and always choose the vendor with the lowest quoted price
4. Wait until all vendors' proposals have arrived, then create evaluation criteria to fit their content

Which is a correct statement about ways of procuring equipment?

1. In a lease, the healthcare institution purchases the equipment directly and books it as its own asset
2. Purchased equipment carries no risk of obsolescence from technological progress
3. A lease assumes long-term use and, as a rule, cannot be cancelled mid-term
4. A rental assumes long-term use and, as a rule, cannot be cancelled mid-term

Which is a correct statement about the difference between outsourcing contracts and temporary staffing?

1. In outsourcing, the ordering healthcare institution directly supervises and directs each of the contractor's workers
2. In outsourcing, the contractor carries out the work under its own direction, while in temporary staffing the client site directs the workers
3. There is no difference in the right of direction between the two; only the name of the contract differs
4. In temporary staffing, the staffing agency supervises and directs the daily work at the client site

Which of the following is the most appropriate subject of a software maintenance contract?

1. Replacing and repairing failed parts in the server itself
2. Laying and wiring cables for the in-house LAN
3. Relocation work when a terminal's installation site changes
4. Fixing defects discovered after the system goes live

Which is the most appropriate description of inter-system connection requirements written in a requirement specification?

1. Connection details can be decided after go-live, so they need not be written in the requirement specification
2. Connection requirements are decided freely by each vendor, and the healthcare institution is not involved
3. Clearly state the systems to be connected, the information to be exchanged, and the connection method, including use of standards
4. If the products are from the same vendor, connection requirements need not be written

Which is the most appropriate statement about the strategy for implementing a hospital information system?

1. The purpose of system implementation is limited to making clerical work more efficient
2. Once the implementation strategy is decided, no subsequent evaluation or review is considered necessary
3. The implementation strategy should be formulated by the IT department alone, without involving management or clinical departments
4. The implementation strategy is formulated based on the hospital's management strategy, with the healthcare CIO playing the central role in promoting the IT strategy

Which is the most appropriate statement about creating master data at implementation?

1. Master data creation can start after the system goes into service
2. Because vendors supply standard masters for drugs, disease names, and so on, the healthcare institution need not be involved at all
3. Masters for drugs, disease names, test items, and so on depend heavily on in-house operations, so the healthcare institution's involvement is essential
4. Once master data has been created, it never needs review or updating

Which is the correct order of work from the implementation phase to the start of service?

1. Master data creation → detailing operations and specifications → acceptance → operational test (rehearsal)
2. Detailing operations and specifications → master data creation → operational test (rehearsal) → acceptance
3. Acceptance → detailing operations and specifications → master data creation → operational test (rehearsal)
4. Operational test (rehearsal) → detailing operations and specifications → acceptance → master data creation

Which is the most appropriate statement about migrating data from the old system to the new system?

1. Decide the scope of data to migrate, and verify after migration that the data was carried over correctly
2. Data migration can be done slowly after the start of service, so no pre-go-live planning is needed
3. No verification of the migrated data is necessary
4. Discard all data from the old system and carry nothing over to the new system

Which is a correct description of acceptance (kenshū)?

1. Analyzing the causes of failures that occurred after go-live
2. The vendor runs unit tests on the programs in-house to confirm quality
3. The healthcare institution confirms that the delivered system works as specified in the requirements and accepts it
4. The healthcare institution runs operation training sessions for its staff

Which is the most appropriate purpose of the operational test (rehearsal)?

1. Estimating the effort and cost the vendor needs for development
2. Measuring the cooling capacity of the air conditioning installed in the server room
3. Using the system end to end along the actual workflow to uncover operational problems before go-live
4. Visually checking the developed program's source code 1 line at a time for errors

Which is the most appropriate purpose of setting up working groups with frontline staff during system implementation?

1. To detail each department's operations and specifications and build consensus within the hospital
2. To make decision-making procedures by management unnecessary
3. To reduce IT department staff and cut costs
4. To keep the contract price with the vendor secret from other staff in the hospital

Which is the most appropriate description of the vendor-side structure in an implementation project?

1. The vendor's staff assignments need not be decided even after the contract is signed
2. No project structure is formed on the vendor side; a single sales representative handles every phase
3. The vendor's structure is internal information and must not be disclosed to the healthcare institution
4. A structure is formed around a project manager, with staff in charge of design, development, and implementation support

Which is the most appropriate description of coordination when multiple vendors are involved in implementing a hospital information system?

1. Establish in advance mechanisms for coordination between organizations within the hospital, between the hospital and vendors, and among the vendors themselves
2. Coordination should as a rule be done orally only, with nothing left in writing
3. Departmental system vendors must not share connection specifications with one another
4. Decide that no vendor will coordinate with the others, and think about a response only after problems arise

Which is the most appropriate response immediately after the start of service?

1. Decide not to respond to contacts from the frontline during the period just after go-live, even if failures occur
2. Temporarily suspend all staff accounts to avoid confusion
3. Erase all data from the old system immediately when the new one goes live
4. Vendor and IT department staff stand by on site and respond immediately to questions and problems

Which is the most appropriate statement about the purposes of implementing a hospital information system?

1. The purpose of system implementation need not be clarified before preparing the requirement specification
2. The sole purpose of system implementation is to enable prompt health insurance claims
3. The purpose of system implementation is to increase the IT department's workload and expand its organization
4. Beyond work efficiency, purposes have diversified to include improving quality and safety of care and regional cooperation

In the 3-layer structure of information system operating rules, which one states the organization's basic policy?

1. Manifesto
2. Policy
3. Procedure
4. Standard

Which of the following is not an appropriate item to include in a hospital information system's operating management regulations?

1. Provision of education and training
2. Safety measures for outsourced work
3. A list of individual patients' diagnoses
4. Users' responsibilities

Which is the most appropriate user management for a hospital information system?

1. Post passwords on the terminals so everyone knows them
2. Suspend retirees' accounts promptly
3. Share 1 ID among everyone in a department
4. Keep retirees' accounts valid forever as a memento

Which is the most appropriate description of the principle of segregation?

1. The idea of separating authority and duties so they are not concentrated in 1 person and mutual checks can work
2. The idea of painting terminals different colors for each clinical department to tell them apart
3. The idea of giving every user identical administrator privileges so anyone can perform the same operations
4. The idea of unifying passwords across all staff and sharing them

Which is the most appropriate handling of the master entry for a drug the hospital has stopped stocking?

1. Do nothing in particular, leaving it selectable in new orders
2. Physically delete the entry from the master
3. Rewrite the entry's name to another drug's name and reuse it
4. Deactivate (suspend) it without deleting, preserving consistency with past data

Which is the most appropriate response when the hospital information system stops during clinical care?

1. Assess the scope of impact, notify the affected departments, and switch to alternative operation such as paper procedures
2. Do not contact the user departments at all until the cause of the failure has been determined
3. Proceed with recovery work without telling anyone in the hospital that a failure has occurred
4. Suspend all care and wait until the system is restored

Which is the most appropriate statement about IT-BCP and disaster recovery?

1. IT-BCP is a plan for continuing critical operations even in a disaster, and disaster recovery refers to restoring the damaged systems
2. Disaster recovery refers to the set of procedures for procuring and replacing a new information system
3. If an IT-BCP has been drawn up, drills for disasters are unnecessary
4. IT-BCP is a plan for advertising and publicity conducted in normal times

Which is a representative system modification that arises regularly during the operation phase of a hospital information system?

1. Handling revisions of parking fees
2. Handling revisions of the medical fee schedule
3. Handling menu changes in the staff cafeteria
4. Handling a change of the hospital's logo

Which is the most appropriate flow of continuous improvement for a hospital information system?

1. Define what to measure, collect and analyze data, compile the information, and connect it to corrective actions
2. Only collect data, without analyzing or using it
3. Proceed by first carrying out corrective actions and then defining what to measure and how
4. Make no improvements, giving top priority to maintaining the status quo

Which of the following is cited as a side effect of implementing hospital information systems and digitalization?

1. Introducing a system always cuts the hospital's electricity use in half
2. Confusion caused by partial loss of communication and changes in workflow
3. The number of handwritten documents used in the hospital increases with digitization
4. The legibility of clinical records declines greatly compared with paper records