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ࡱ;   !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry  !"#$%&'()*+,-./012457  FMicrosoft Word-Dokument MSWordDocWord.Document.89q [\\Default1$*$3B*OJQJCJmH sH KHPJnH^JaJ_HtHBA@BAbsatz-Standardschriftart44 WW8Num7z0B*phOJQJ66 WW8Num16z0B*phOJQJ66 WW8Num25z0B*phOJQJF2FHeading x$OJQJCJPJ^JaJ.B2. Text body x /1B List^J@R@Caption xx $CJ6^JaJ]&b&Index $^JH> B.`JKLMN> @ Z z!"6+|,R25<7<:<?GBQ.UYn[<]^_`ddeXgnqNruwx{|T}fXOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|H OJQJB*phOJQJB*phOJQJB*phP@@0```00WW8Num7WW8Num16WW8Num25HHPGTimes New Roman5Symbol3&ArialIArial Unicode MS5Tahoma;MS Mincho5TahomaBh׆ F F'0Oh+'0|8 @ L X d p0@@@χd@՜.+,D՜.+,\M 0Caolan80 $HJO.lzzz4,tb XxrKT< APPENDIX 2  DETAILED TCO Detailed IT Implementation Life Cycle and Total Cost of Ownership Below is a partial list of implementation tasks, organized by implementation phase, which would be the Ministry of Health s burden to staff and execute if the ministry builds and implements a health information system in-house. The Comments column indicates where the task may be different if a software package is purchased or outsourced. Highlighted in gray are the tasks where if the system were outsourced, the SaaS provider bears full responsibility and cost, and highlighted in yellow are the tasks where there is shared responsibility and cost between the health ministry and the SaaS provider. These tasks are the variables that should be factored into a TCO calculation. This is not an exhaustive list of TCO variables because it cannot represent every possible type of in-house system implementation. Table  SEQ "Table" \*Arabic 1. Detailed Tasks/Costs of the IT Implementation Life Cycle Phase and TasksCommentsInitial ImplementationProject InitiationDefine Strategy and Project Objectives, High Level ScopeEstablish management team, key stakeholders, core working groups, steering committees, project governance structure, roles and responsibilities, communication strategyAllocate preliminary budgetMay need to include salary adjustments, salaries for new positions, incentives, bonuses, or rewards for achievements during the implementationRequirements Specification and Needs AssessmentRequirements Definition and PrioritizationSection IV part C provides a detailed listing of the types of requirements that should be analyzed.Business Process AnalysisThis would be a high level analysis, with a more detailed analysis during the design phase.Server Room and Site AssessmentEvaluate whether existing hardware and network infrastructure can support the new system; whether physical space and security measures are sufficient; whether the cost of downtime and recovery warrants installing not just the typical redundancy in servers but also redundant network connections and power supplies; cost of floor space; estimate power consumption cost.Signoff on Requirements Specification, Final Budget Create Scope of Work (SOW) or Request for Proposal (RfP) or Quote (RfQ)The SOW would be incorporated into the RfP or RfQ and the organization would publicly announce this tender offer.Evaluate Procurement and Implementation Options and Select the OptionIssue RfPReview submissionsSelect short listDetailed business and technical reviews of solutions from the short-listed vendorsInclude demos from the vendorsReference checks and on-site visits (optional) with final candidateNegotiate priceSign contractDetailed Design and ArchitectureBusiness Process Mapping and Re-engineeringWith a package or outsourced system, an organization can choose to adapt some of its processes to the way the application functions, rather than create new processes and business rules from scratch.Create a more detailed functional specificationIf the ministry buys a package or uses a SaaS provider, the IT team and users still need some level of training on the software functionality, design, and architecture.Create application design, data model, object model, physical database design, and system and network architecturesIf buying a package, there will be little to no effort expended on most of these tasks except for customizations and for the system and network architectures, assuming the plan is to host in-house. If outsourcing, the only effort required will be for customizations.Software and Hardware ProcurementHardware Selection and Procurement Firewalls, routers, intrusion sensors Load balancers Web servers Application/middleware servers Database servers Document management servers Image servers/file servers IVR hardware Racks, switches, and cabling Includes the time to understand the expected system usage and performance requirements well enough to design the overall system and network architecture, develop the hardware specs, and to get multiple bids and negotiate with vendors. Also, for an in-house system, the ministry will need to procure test servers in addition to the production servers and create a test environment. If building the system from scratch, the ministry must also procure development servers and create a development environment.Hosting Environment UpgradeIf the system will be hosted in-house, the server room may need modifications depending on the number of additional servers. More air conditioning, power, and cabling may need to be installed. Need to have adequate backup power supplies and/or redundant power sources. May need to upgrade security systems such as security cameras, biometrics. Supervise any contractors, construction crews.Software Selection and Procurement  Licenses and maintenance agreements for a complex software stack on the servers: Application license Operating systems Network management software System monitoring and notification tools Backup and recovery software Database engine Application servers Web server Security software and monitoring (virus and intrusion detection) Document management software Software development tools and source code version control system (if building the system from scratch) Bug/defect tracking database User tools such as reporting softwareLicenses need to be purchased for the development, test, and production environments if building a system from scratch and hosting in-house. If buying a package, the development environment probably will not be required or only a smaller version will be needed if the ministry plans to customize the software. If outsourcing, most of these licenses will be unnecessary, again only needed if the ministry s IT staff will be building custom features to integrate with the software.Hardware and Software Installation, Configuration, and Testing: See list under  Hardware Selection and Procurement May include setting up a virtual private network (VPN) or a dedicated leased line, depending on requirementsIncludes integration with the ministry network, other ministry database systems if any, etc. This will be required regardless of whether the system is built from scratch, bought, or outsourced.DevelopmentSoftware Development/CustomizationIncludes the user interface, reports, database. Unit testingDevelopers test their own code before integrating it with the rest of the codeDocumentationShould include documentation of customizations, system and network architecture, database and application architecture, system configurations.Define test planIf outsourcing, the health ministry staff and the SaaS provider must collaborate on this task.Define release management planIf outsourcing, the health ministry staff and the SaaS provider must collaborate on this task.Install a bug/defect tracking systemManage the bug resolution process by tracking bugs, assigning them to staff, prioritizing bugs, and analyzing the volume of new versus resolved bugs.Quality Assurance (QA)Application TestingEncompasses testing the functionality and reports. User Acceptance TestingUsers test the system against a pre-defined set of acceptance criteria. If the system meets the acceptance criteria, the users accept the system and the system can go-live.Regression TestingMust re-test the application after major changes have been made to the system, to ensure the changes have not broken any functionality that was working prior to the change. Integration and Testing with other health information systems the MoH may run or interact with.If any of these are outsourced, could require additional time and costs to coordinate with the vendorEnd-to-end TestingTests the system after it has been fully integrated, to test the system  end-to-end by testing functionality that exercises every major component of the system, including integration with third party or other external systems.Data Conversion and TestingCreate plan, define conversion rules, create conversion scripts. May require multiple iterations to clean all the data before data can be successfully converted to the new system.Performance, Stress, and Load TestingPerformance testing includes testing if the system can handle the required number of users, transactions per second, or volume of data. Stress testing tests the peak levels the system can handle. Load testing tests a constant load on the system to see if the system fails under this load (e.g. memory leaks that lead the system to run out of memory). Security TestingBoth physical and virtual security systems should be tested. Includes testing of internal procedures to ensure that all staff understand and are following the procedures correctlyFailover and Redundancy TestingMost mission-critical systems will have redundant systems; if one server fails, the other will take over the load. This needs to be tested and the associated performance degradation and impact to health operations should be measured and evaluated relative to the public health and reputational risk and formally accepted (signed off) by management Backup and Recovery Plan, Implementation, and TestingIncludes backup and recovery software and devices, contract with a remote tape storage facilityDisaster Recovery Plan and TestingDepends partly on amount of downtime that is acceptable. For large institutions, this can be a complex solution and easily double the cost of an in-house implementation due to the need to create a mirrored system in another data center, preferably located a significant distance away from the primary location. Smaller institutions have less at stake and may determine that some downtime is acceptable and rely on the backup and recovery plan.Training and DocumentationFor all training: If the training is held during work hours, there is an opportunity cost; while a person is at training, they are not performing their regular job duties.User TrainingIncludes the development of a training plan (approach such as  train the trainer and designating certain users to be  super users ), training manuals, a training schedule, repeat or  refresher training, and staff time spent in training versus doing their real job. IT staff trainingManagement trainingTo provide them with an overview of the system benefits, functions, and especially the reports and data available from the system.Help guides, user manuals, operations manualHelp guides and user manuals will be provided by the software vendor or SaaS provider if this is the approach taken. For the build and buy approach, the MoH IT team needs to create its own operations manual which describes its system maintenance procedures, backup and recovery procedures, security procedures, etc. With outsourcing this task is the SaaS provider s responsibility.Go-Live/DeploymentRelease ManagementManage the process of pushing system modifications from the test environment to the production environment. Make an image of the pristine database and code prior to go-liveRun data conversion programsPerform a  smoke test To ensure that the release to production was successful  all files were copied, data was properly updated, configuration is correct, etc. Establish an end-user help deskStaff Costs during the Implementation Software developers Web developers Database developers Report programmers Application architect User interface designers/information architects Quality assurance testers QA manager Release/build engineer Configuration manager System/network administrators System/network architect Telecom/telephony engineer Database administrators (DBA) Database architect Data modeler Security specialists (network and physical) Business analysts Project manager Team manager IT directorWith the  build approach, the ministry will require a full software development team and other staff to manage and execute the various implementation tasks. With  buy , the development team can be greatly scaled back. With outsourcing the SaaS provider would supply most of this staff and the ministry would need a few counterparts. Ongoing Maintenance and SupportCalculate cost for next 3-5 yearsInfrastructure and MaintenanceDBA cost Required if maintaining the system in-house. Suggested cost basis is one-third of a full-time employee.System administrator cost Required if maintaining the system in-house. Suggested cost basis is one-third of a full-time employee.Application license/subscription feeAnnual support/license fees for software and user toolsUser tools include reporting software and software residing on a desktop or laptop PC. Includes software development tools. If outsourcing, then count only the cost for user tools.Annual support/license fees for infrastructure software (server-level software)See server-level software list above. If outsourcing, this cost is included in the SaaS provider s monthly subscription fee.Hardware support/license feesIf outsourcing, this cost is included in the SaaS provider s monthly subscription fee.7x24x365 Application monitoring, administration, optimizationIncludes troubleshooting system performance issues, monitoring all security issues,  ping tests to test that the system is available, etc.Configuration Management, including Upgrades, Updates, Patches, Bug fixesThis can be complicated  a patch for software X might run only on Operating System Y version  abc service pack level  1 but Database Z and web browser A have not been tested with this yet.Facilities costs such as office space, server room or data center space, cooling systems, fire suppressionElectrical power, backup power/fuel, lightingScheduled maintenance (downtime)Some maintenance tasks may require the entire system to be shutdown. The system should be designed such that most maintenance tasks can be done while the system is still online.Hardware upgrades in Year 3, 4 or 5CommunicationsInternet ConnectionIn the SaaS provider model, the only cost a health ministry must bear will be connectivity to the SaaS provider and any additional Internet Service Provider (ISP) and network costs for other office network needs such as email. Internal network traffic will increase with increased usage of the health information system, and more Internet Internet bandwidth may be needed.Voice PRIsSMS Gateway serviceApplication ManagementSoftware customizationsEach customization will go through its own mini-implementation life cycle: requirements, design, develop, test, document, go-live.Integration with other systemsAdditional reportsSome new reports may come from the solution provider.End-user supportManagement reporting, decision support tools, also known as  business intelligence The value from a transaction processing system is fully realized when advanced reporting is available for trend analysis and forecasting which management can use to make strategic decisions. The cost of these tools, the availability of pre-built and pre-tested reports, and consulting services from the vendor may vary for in-house versus outsourced systems.Data ManagementDefine fields, valid values, and valid formats and set up data fieldsDefine and enforce data standardsManage user access levels and permissionsSupport Data import/export needsData cleanupStaffOther dedicated IT staffStaff in addition to the DBA and system administrator will vary, depending on how much customization and integration with other health information system components is needed and the need for reports.Recruitment, retention, management time, staff turnover/productivity lossOngoing end-user and staff training Training on new features in the health information system, new reports, new business processes, new tools, etc. This task/cost may be shared with the SaaS provider in the case of training about a new feature, release, or upgrade of their product. Include effort to create training documentation. Include opportunity cost if training is held during regular work hours.Support from Procurement, Finance, Contracts, Facilities, Administration departmentsOther departments contribute to the health information system in some way, whether it is to process purchase orders and invoices, negotiate contracts, create budgets, etc. There will be less work for these departments with an outsourced system, because many vendor relationships, products, and contracts are replaced by a single relationship and contract with the SaaS provider.Unplanned CostsThe SaaS provider must notify the MoH IT manager in case of an outage or other sudden event. The IT manager will coordinate with the rest of the MoH to mitigate impact and devise workarounds until the system is restored.Unscheduled Maintenance, Outage, Downtime, and Recovery EffortUnscheduled maintenance differs from an Outage in that it is not a sudden system failure that causes the system to shutdown, but an unforeseen maintenance task that must be done, such as applying a fix in response to a new virus that is infecting systems.Response to Security/Data BreachesOverall ManagementCalculate for next 3-5 yearsChange managementNeed to establish a change control process and change control board to manage and prioritize incoming change requests that will come from all parts of the MoH, donors, NGOs, etc.Vendor managementAn IT manager is likely to be the person designated as the main contact person to liaise with the vendor.Define policies and procedures Align the organization and establish organizational structure, roles and responsibilities To manage the ongoing operations effectively and to provide ongoing management oversightOversee ongoing costs and budgetSet strategy and vision for the application of IT in support of MoH strategic initiativesThis is the responsibility of the CIO, VP, and/or IT director.Evaluation of new products, services, and technologies This list will vary in scope and detail depending on the size of the MoH and the complexity of its operations: country population, number of offices and locations (urban, rural or remote), number of staff, geographic distribution of staff and operations, number of transactions per day. 46x z " . 0 \ ^ ` b  > ֹ֜օll=]B*CJmH sH 5PJnH^JaJ_HtH\UB*CJmH sH 5PJnH^JaJ_HtH\0B*CJmH sH 5PJnH^JaJ_HtH\U-B*CJmH sH 5PJnH^JaJ_HtH\8B*CJmH sH fHq PJnH^JaJ_HtH8B*CJmH sH fHq PJnH^JaJ_HtH'B*CJmH sH PJnH^JaJ_HtH*B*CJmH sH 5PJnH^JaJ_HtH> @ h j 24nHF@$$ tvZJ .!z!!!!"H"~"""""& ' *+6+Z+++,>,f,|,,8-.B.'B*CJmH sH PJnH^JaJ_HtH*B*CJmH sH 5PJnH^JaJ_HtH*B*CJmH sH 5PJnH^JaJ_HtHKB..R22<345556d667<7Z8~8<9|9:::;;;<x<<>.>?N@ABA 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