· Executive Summary · Summary of Recommendation With the vision of Panther Memorial Hospital in mind and their patients’ ease of accessibility to their health plans we recommend the development and implementation of a patient portal system constructed through the organization’s internal resources. From our feasibility matrix we found that weighted score of an internally created patient portal is higher than a commercial bought one; 89.25 vs 63.75. Per the finance department, this patient portal system is projected to yield a positive return of $400,000 annually over a 10 year lifespan with a payback of 4 years. There will be considerable savings in administrative costs, office supplies, and employee wages due to less paperwork and less face-to-face interaction at the hospital’s office; savings are projected to be 50%. Not only does Panther Memorial Hospital save in cost of operations but their quality of care is also improved for their patients through faster and more efficient management of care. The most positive outcome of this patient portal is the improvement of care and satisfaction for the patients, increase revenue, and a decrease in administrative cost. · Summary of Problems, Opportunities, and Directives The problems associated with patient to healthcare provider and patient to hospital hinders the fluidity of care for the patient. Paying medical bills through mail slows the collection of service render for the organization and may also cause problems if lost through the mailing process. Getting in touch with your primary care doctor when questions and concerns arise will have to go through a hospital operator lowering quality of care. Scheduling appointment will have to been done through office visits or by phone which problems may arise through miscommunication between patient and loss of written appointment dates. To view the results to tests, examinations, and procedures are limited to request and face-to-face communication with a healthcare provider. Refilling prescriptions is to slow due to the process of going to the hospital and having the provider write out another prescription. Personal insurance updates and adjust are slow and hinder due to the process of changing it at the administrative desk or through the hospital operator. Personal reminder are to slow through mail and phone which could get lost or missed. Registration and patient history are hard to obtain and may cause confusion for the patient of their plan of care. With all of these problems associated with patient to provider and patient to hospital there are opportunities for improvement through the creation of a patient portal system. The patient portal system will be a web-based applications that enables patients to access important information, conduct transactions of payment, and communicate with healthcare providers. · Brief Statement of System Improvement Objectives We established that some of our system objectives would be decreasing the time required f.

1. · Executive Summary
· Summary of Recommendation
With the vision of Panther Memorial Hospital in mind and their
patients’ ease of accessibility to their health plans we
recommend the development and implementation of a patient
portal system constructed through the organization’s internal
resources. From our feasibility matrix we found that weighted
score of an internally created patient portal is higher than a
commercial bought one; 89.25 vs 63.75. Per the finance
department, this patient portal system is projected to yield a
positive return of $400,000 annually over a 10 year lifespan
with a payback of 4 years. There will be considerable savings in
administrative costs, office supplies, and employee wages due
to less paperwork and less face-to-face interaction at the
hospital’s office; savings are projected to be 50%. Not only
does Panther Memorial Hospital save in cost of operations but
their quality of care is also improved for their patients through
faster and more efficient management of care. The most positive
outcome of this patient portal is the improvement of care and
satisfaction for the patients, increase revenue, and a decrease in
administrative cost.
· Summary of Problems, Opportunities, and Directives
The problems associated with patient to healthcare provider and
patient to hospital hinders the fluidity of care for the patient.
Paying medical bills through mail slows the collection of
service render for the organization and may also cause problems
if lost through the mailing process. Getting in touch with your
primary care doctor when questions and concerns arise will
have to go through a hospital operator lowering quality of care.
Scheduling appointment will have to been done through office
visits or by phone which problems may arise through
miscommunication between patient and loss of written

2. appointment dates. To view the results to tests, examinations,
and procedures are limited to request and face-to-face
communication with a healthcare provider. Refilling
prescriptions is to slow due to the process of going to the
hospital and having the provider write out another prescription.
Personal insurance updates and adjust are slow and hinder due
to the process of changing it at the administrative desk or
through the hospital operator. Personal reminder are to slow
through mail and phone which could get lost or missed.
Registration and patient history are hard to obtain and may
cause confusion for the patient of their plan of care. With all of
these problems associated with patient to provider and patient to
hospital there are opportunities for improvement through the
creation of a patient portal system. The patient portal system
will be a web-based applications that enables patients to access
important information, conduct transactions of payment, and
communicate with healthcare providers.
· Brief Statement of System Improvement Objectives
We established that some of our system objectives would be
decreasing the time required for physicians to explain results by
30%, decreasing by 15% the time a patient waits in line for their
prescriptions, and increasing phone/tablet use to access portal
by 35%. The system constraints we would face would be not
accepting cash or checks, there would be a decrease in personal
communication with patients, and no exceptions for our patients
in booking appointments.
· Brief Explanation of Report Contents
· Final Conclusion
After research we find it a must for Panther Memorial to
implement a patient portal system. This system will allow
patients to have an interactive role in their care and partake in
preventative medicine, which will increase overall wellness of
patients and decrease unnecessary costs for all parties involved.
To add to these savings, Panther Memorial will also receive a
12.27% return on investment annually. If Panther Memorial

3. does not implement this service, we are only doing ourselves a
disservice. We hope you take serious consideration to the
benefits this project will have to our organization.
· Patient Portal Project Charter
· Introduction
While Panther Memorial has implemented an electronic medical
record (EMR), our patients have never been provided with a
patient portal. Patient portals are web-based applications that
enable patients to access information, conduct transactions such
as registration and payments, and communicate with their
caregivers. This project will determine the most appropriate
action regarding the implementation of a patient portal at
Panther Memorial Hospital.
· Vision
With the implementation of an EMR, Panther Memorial now has
the capability to provide patients with access to their
information such (i.e. lab results), to reengineer clinical and
business processes under a patient self-service model (i.e.
registration), and provide another avenue for communication
with patients (i.e. secure patient/physician inbox). The vision is
to create a patient portal that will become the cornerstone of
any significant online activity with our patients.
· Objectives
The objectives of the project are:
· Provide major segments of portal functionality such as
accessing personal medical information, collecting payments,
and enabling patient/physician communication.
· Enhance customer service to our patients.
· Deliver relevant personal health information via secure
methods
· Enhance patient or family member’s experience with their
encounter
· Enhance and improve overall patient safety and quality of

4. care.
· Provide information access, transparency, portability
· Enhance the Panther Memorial brand
· Support our image as a leading health care provider
· Provide a consistent “look & feel” with our existing hospital
web site
· Support patient portal access on mobile devices, such as smart
phones and tablets.
· Ensure that the portal supports social media elements such
video, chat, communities, patient groups, etc.
· Ensure that the portal architecture includes the security and
access controls to protect against unauthorized access and
supports HIPAA, PHI, and IT security requirements.
· Scope
The scope of this project includes all online patient activities
and interactions. This project will not examine any needs of the
employee for an employee self-service portal or intranet.
Additionally, the project will not include a redesign of the
hospital’s public website other than modifications needed for
integration with a patient portal solution.
· Constraints
The project is constrained by the following:
· The solution must integrate with our current EMR system.
· The capital budget for this initiative is $2m.
· The proposed solution should support a wide range of web
browsers and mobile devices.
· The proposed solution must fit our overall technical
architecture and infrastructure standards.
· Assumptions
The following assumptions have been made:
· The portal will provide a single vehicle for access various
information and processes within our hospital.
· The portal will have a quality “look and feel” consistent with
other high end internet web sites.
· The portal will provide non-IT staff with self-service
capabilities to manage web pages.

5. · Deliverables
The project team will deliver a system proposal. The system
proposal shall include an executive summary, this charter,
system improvement objectives, business requirements
including 10 use cases (diagram & narrative) and related
activity diagrams, candidate/feasibility system matrix, and final
recommendation.
Each use cases will document the requirements for different
segments of functionality and will not repeat a similar scenario.
For instance if scheduling an appointment is documented, then
cancelling an appointment will not be submitted as another use
case. Instead the project team will choose another major feature
area to document such as viewing lab results. For each of the
10 use cases, an activity diagram will also be constructed and
submitted.
· Reporting & Project Team
A system proposal for a patient portal will be delivered to the
executive sponsor, Dale Steber, via the D2L dropbox. Any
clarification or questions regarding this project will be
submitted to the executive sponsor.
Each of the project teams will consist of 5 members (1 team
will have 6) with one member designated as the project lead.
Project team rosters will be submitted by February 26th.
· Schedule
The results of this analysis and a formal presentation will be
submitted on May 7th. The presentation will be a maximum of
15 minutes long with additional time for questions and answers
immediately following. Peer evaluations are due May 14th.
· Electronic Packaging
Each group will submit to one team member’s dropbox:
· A Word document containing the executive summary, charter,
system improvement objectives, 8 use case narratives,
feasibility matrix, and final recommendation.
· One or more Visio documents containing the use case diagram
and the 8 activity diagrams.
· Print Packaging

6. Each team will provide one print copy of their work at the
beginning of class on the day it is due. Hard copies of any
presentation materials will also be submitted at the formal
presentation.
· Peer Evaluations
Each team member will submit the peer evaluation form found
on D2L. The point of this form is to provide feedback to me
concerning the work of your teammates. Your feedback will be
confidential. Grades will be adjusted accordingly to the
feedback from the evaluation forms. Each student should
submit the peer evaluation to their dropbox in D2L.
· System Improvement Objectives
Use Cases
System Objective
System Constraint
1. Pay medical bills
2. Message doctors
3. Schedule appointment
4. View Results

7. 5. Refill prescriptions
6. Personal Insurance
7. Send Personal Reminder
8. Pre-registration at hospital
1. Quicker Payment, easier access
2. Reaching physician faster, direct contact instead of with
nurse
3. You can see the open slots, don’t have to call or come in
person do make an appointment
4. See your results quicker
5. Automatic refill, quicker than on phone
6. It’s easy for the hospital to access, you can update your
insurance.
7. Reminds you of something you would have forgotten
8. It documents your visits. And patients can view previous
visits
1. Can’t accept cash or checks
2. Not always available, don’t know when they will respond
3. Two people trying to schedule an appointment at the same
time, and no double booking or exceptions like in person

8. interactions
4. No personal communication for negative results
5. Has to be an active medication, if it’s controlled substance
there can be no refill
6. It’s inconvenient to always have to bring your card in person.
Might forget it
7. Might ignore it because you think it’s unimportant
8. Can only be viewed if you go in person and request it
9.
· Use Case Diagram

9. · Narratives and Activity Diagrams
· Pay Medical Bill
· Narrative
Use-Case Name:
Pay Medical Bills
Use-Case Type
Business Requirements: x
Use-Case ID:
PMB-PMH1982
Priority:
High
Source:
Requirement: PMB-A1:20-8957
Primary Business Actor:
Patient
Other Participating Actors:
· Portal Billing System
Other Interested Stakeholders:
· Management Team—Interested in the reduction of revenue
stuck in accounts receivable.
· Finance—Interested in collecting revenue for service render to
patients within a reasonable amount of time.
Description:
This use case describes how the patient’s actions react with the
system to make payments on the patient’s medical bills. The
patient has the option to pay the full medical bill or make

10. partial payments on their account. The system will debit the
patient’s credit card and credit the clinic ending with a payment
confirmation to the patient.
Precondition:
The patient must have an account in the system, logged-in, and
have entered into the Pay Medical Bills screen.
Trigger:
The use case is initiated when the patient clicks on the Pay
Medical Bills button or drop down selection.
Typical Course of Events:
Actor Action:
Step 1: Patient enter view current medical bill.
Step 3: Patient selects payment amount. “Full Amount”
Step 4: Patient enters payment information.
Step 6: Patient confirms the payment amount.
System Response:
Step 2: System display the status of the patient’s account.
Step 5: System verify payment information “Amount Correct”.
Step 7: The system charges payment amount base off payment
information. The system debits the patient and credits the
clinic’s account.
Step 8: System display the patient’s update account balance.
Step 9: System displays conformation information.
Alternate Courses:
Alt-Step 3: Patient wishes to make partial payment. Alt-Step
3.1: Patient will enter desired payment amount.
Alt-Step 5: System verify payment information. If payment
information is not valid it will display error to the patient and
return to step 2.
Conclusion:
This use case concludes when the system displays a payment
confirmation for payment of medical bills.
Postcondition:

11. The patient must verify the payment amount is correct and debit
from right source. The system updates the patient’s medical bill
status and account to reflect the payment made.
Business Rules:
· The patient must provide correct payment information.
· The patient must have sufficient funds from the source for
debit.
· The patient’s medical bills account will only have an
outstanding balance if services was rendered.
Implementation Constraints and Specifications:
· GUI to be provided for the Billing Staff, and web screen to be
provided for the patient.
Assumptions:
The patient has created an account in our patient portal system
and have sufficient funds plus an acceptable source for
procurement of payments.
Open Issues:
1. Need to determine other options of payment that may be
utilized by the patient and system.
· Activity Diagram
· Pay Medical Bill
· Message Doctor
· Narrative
Use-Case Name:
Message Doctor
Use-Case Type

12. Business Requirements: x
Use-Case ID:
IMD-PMH1993
Priority:
High
Source:
Requirement: MD-b1:80-2145
Primary Business Actor:
Patient
Other Participating Actors:
· Portal Message System
· Clinic
Other Interested Stakeholders:
· Physicians - Interested in patient’s questions and concerns and
answering them.
· Nurses- Interested in gathering a full history of questions and
concerns to help to perform better quality of care for the
patient.
Description:
This use case allows patients to instant message or email their
doctor directly for questions and concerns related to their care.
The use case makes communication between patient and
provider easier without having to call or go through operators.
The use case also allows the patient to go back and view pass
messages when needed.
Precondition:
The user needs to be a patient that has an active account in the
system, logged-in, and have already entered the message doctor
page.
Trigger:
This use case is initiated when the patient signs into his or her
account in the system and clicks the message doctor.
Typical Course of Events:
Actor Action:
Step 1: Patient select to message doctor.
Step 3: Patient can enter, read, respond, or exit Instant Message.

13. System Response:
Step 2: System opens Instant Message Screen
Step 4: The system verify the correct doctor to IM.
Clinic:
Step 5: Doctor receives instant message.
Step 6: Doctor reads and responds to patient. Returns to Step 2.
Alternate Courses:
Alt-Step 2: Patient selects to email doctor. Patient enters
message email to doctor and the system verify the correct email
address. Alt-Step 2.1: Verify doctor’s email address. Alt-Step
2.2: Patient imputed correct doctor email address so the system
creates patient’s email sent copy and sends email to doctor. Alt-
Step 2.2a: Incorrect email address so return to
“Alt-Step 2.” Alt-Step 2.3: System also displays email sent. End
use case.
Alt-Step 4: Patient choose to exit Instant Message and is
brought to home screen.
Conclusion:
This use case concludes when the patient ends communication
with doctor and exist message screen. It also can will end if
email confirmation is displayed.
Postcondition:
The provider has answered all the patient’s questions and the
patient is satisfied with the answers. The patient ends message
with the doctor.
Business Rules:
· The patient must message the doctor in regards to his or her
plan of care and not random questions.
· The provider must answer the patient’s questions or concerns
to the best of his or her abilities.
Implementation Constraints and Specifications:
· This feature must be available to members at all times.
· This feature must be able to notify the doctor in a reasonable
amount of time and have a reply back to the patient within a
reasonable time too.

14. Assumptions:
The patient is knowledgeable in internet use and can access his
or her account with ease. The patient questions and concerns are
related to the plan of care that is established by the doctor.
Open Issues:
1. Need to determine a reasonable reply response from doctor to
patient.
· Activity Diagram
Message Doctor
· Schedule Appointment
· Narrative
· Activity Diagram

15. Schedule Appointment
· View Results
· Narrative
Use-Case Name:
View Results
Use-Case Type
Business Requirements:
Use-Case ID:
RVM-LS007.00
Priority:
Medium
Source:
Requirement: RVM-V1.00
Primary Business Actor:
Patient
Other Participating Actors:
Physician (external server)
Health Records Staff (external server)
Laboratory Vendors
Other Interested Stakeholders:
Laboratory Vendors- Interested in saving time and eliminating
wasted products.
Management—Interested in saving cost of staff
Description:
This use case describes the event of a patient viewing their lab
results. The laboratory vendors can send the patients results to
the clinic. There the health records staff can post the results to
the patient’s portal with a link. The patient can view their labs
either with the dates of services or the type of test if they are

16. unfamiliar with the date. They can view any result once posted
at any time. Physicians can also view the patient’s lab results by
searching the patients name and clicking on the type of test or
date of service.
Precondition:
The patient must be a member and logged in.
Trigger:
The use case is initiated once the patient is sent lab results.
Typical Course of Events:
Actor Action
Step 1: The patient selects the view results option on the portal
website
Step 4: The patient selects which results they want to view.
Step 5: The patient will enter a password to results. Results
cannot be opened without reentry of password
Step 7: The patient views different lab results
Step 9: The patient dismisses
System Response
Step 2: The system checks for any new results from the lab
Step 3: The system list previous results while searching
Step 6: The system will display the results the patient selected
Step 8: The system will ask if any other result needs to be
shown
Step 10: If the patient accepts their new results will be shown
Step 11: The system will give the patient an option to now exit
Alternate Courses:
Alt-Step 7: If the patient can exit and return home
Alt-Step 9: The patient can still view more results
Conclusion:
This use case concludes when the patient hits exit to return to
portal
Postcondition:
The results are now saved.
Business Rules:

17. · The patient’s lab results cannot be viewed or shared by any
other portal.
· Results cannot be posted until completely finished
Implementation Constraints and Specifications:
· Patients can’t access their labs until they are posted by staff
Assumptions:
Patients have drawn blood
Open Issues:
None
· Activity Diagram
View Results
· Refill Prescriptions
· Narrative
· Activity Diagram
Refill Prescriptions
· Pre-registration
· Narrative
· Activity Diagram
Pre-registration
· Send Personal Reminders
· Narrative

18. · Activity Diagram
Send Personal Reminders
· Personal Insurance
· Narrative
· Activity Diagram
Personal Insurance
· Feasibility Matrix
Wt.
Candidate 1
Candidate 2
Description
Purchase commercially built patient portal system.
Write a new patient portal application within the organization.
Operational feasibility
15%
Patient portal system is already in us by other organizations and
has performed to their standards. System is not compatible with
EMR system and will need to be reprogrammed to integrate the
two. Also there is concerns about security in the system in

19. regards to HIPAA, PHI, and IT.
Score: 70
Patient portal system was developed by internal employees but
the functionality has not been proven yet. The system is
integrated with the current EMR system. Portal has security and
access control that protects unauthorized access and supports
HIPAA, PHI, and IT security requirements.
Score: 85
Cultural feasibility
15%
The system is a standard design to of “plug and play” which
may not be a perfect fit to the specifics of an organization’s
needs.
Score: 65
The system was designed by internal employees who have
firsthand experience and knows the functionality and
capabilities needed to address the specific needs of the
organization.
Score: 100
Technical feasibility
20%
Customer reviews of this patient portal system is low among
those organizations that have purchased them. Poor customer
service and IT help when trouble arises in the patient portal
system is one common complaint of customers.
Score: 45
With the system being developed internally the development
team will be knowledgeable of how the system runs and ways to
resolve problems when it occur.

20. Score: 90
Economic feasibility
Cost to develop:
Payback (discounted):
Net present value:
30%
Approx. $2,500,000 + 100,000 in annual maintenance and
upgrades
Approx. 5 years
Approx. $300,000
Score: 60
Approx. $1,500,00
Approx. 3 years
Approx. $400,000
Score: 85
Schedule feasibility

21. 10%
6 months
Score: 65
2 month
Score: 80
Legal feasibility
10%
No foreseeable problems.
Score: 100
No foreseeable problems.
Score: 100
Weighted score:
100%
63.75
89.25
· Final Recommendation
After considering the need for patients to handle their
information and the impact on Panther Memorial Hospital. We
recommend the implementation of the patient portal system
through an internal build to achieve the main results; improve
the service quality given, provide a high level of security,
provide a flexible easy portal for the patient to use, reduce non-
value added time, as well enhancing the effectiveness of staff to
perform their job.
Patient population has been growing rapidly and the system has
become a necessity. The portal will enable the organization to
give patient a secure way to receive services that usually would
have to be handled in the office. The system is an integral

22. element in achieving high service delivery to the patients and
boosting performance levels in the hospital.
Since communication is a key to preventative medicine, the
portal is a valuable aspect of Panther Memorial Hospital, as it
helps to educate and satisfy patients, keeping them up to date
with their health progress.
With the vision of Panther Memorial Hospital in mind and their
patients easier accessibility to their health plans we recommend
the development and implementation of a patient portal system
constructed through internal resources. The
7 | Page
Portal System
Patient
Patient Selects Message Doctor or Email Doctor
Enter Message Email to Doctor
Reads and Responds to Patient
Clinic
Instant Message Screen
Enter, Read, Respond, or Exit IM

23. Instant Message Recieved
[Continue]
Send Email to Doctor
Verify Correct Doctor
Patient's Email Sent Copy
[Exit]
Display Email Sent
Verify Doctor's Email Address
[Incorrect]
[Correct]
[Email Doctor]
[Instant Message Doctor]
Creates New Email
PatientPortal Billing System
View Medical Bill
Select Payment Amount
CreditDebit
Enter Payment Information
[Partial Amount]
[Full Amount]
Verify Payment Information
[Amount Incorrect]
[Amount Correct]

24. Display Payment Confirmation
Display Error Wrong Amount
Enter Desired Amount
Display Status of Account
Confirm Payment Amount
Display Update Balance
Portal Billing System
Patient
View Medical Bill
Select Payment Amount
Enter Desired Amount
Credit
Debit
Enter Payment Information
[Partial Amount]
[Full Amount]
Confirm Payment Amount
Verify Payment Information
[Amount Incorrect]
[Amount Correct]
Display Update Balance

25. Display Payment Confirmation
Display Error Wrong Amount
Display Status of Account
ClinicPatientPortal System
Patient Selects Message Doctor or Email Doctor
Enter Message Email to Doctor
Send Email to Doctor
Patient's Email Sent Copy
Verify Doctor's Email Address
[Email Doctor]
[Instant Message Doctor]
Instant Message Screen
Enter, Read, Respond, or Exit IM
Instant Message Recieved
[Continue]
Verify Correct Doctor
Reads and Responds to Patient
[Exit]
Display Email Sent
[Incorrect]
[Correct]
Creates New Email