The impact of a large scale electronic health record implementation transforms a health system. It not only temporarily disrupts business as usual, but it creates new norms, processes, standard practices, behaviors and, of course, new challenges. As such, careful project planning is crucial for a successful implementation.
In the planning process, three important areas to consider are:
- Collaboration between stake holders — operations, IT and the vendor
- Creating and following a detailed project plan
- Identifying correct metrics and tracking accordingly
First, ensure that an implementation is not deemed solely an “IT Project”. A successful implementation is a collaboration between clinical, operations, information technology and other major health system stakeholders, including the vendor. It is important to develop a governance structure and support system that provides all vested parties with direction, stability and transparency, especially for the end users who often feel victimized during an implementation. IT departments should at every opportunity engage stakeholders and fully communicate from the planning phases through go-live and beyond.
The hallmark of a successful implementation is thorough planning. There is no room for operating “on the fly” or forgetting to plan for the unexpected. Those practices can lead to major disruption to timeframes, cost overruns and failure.
There are many different philosophies and methodologies available to create a successful living and surviving project plan. You can choose from philosophies like Lean, Six Sigma, Agile, etc. and variety of commercial project tools to manage the project. Project management tools vary from home grown solutions to Microsoft Project and Workfront, to programs like Excel, Word, Quickbase, Smartsheet and SharePoint. The best chance for success is selecting methodologies and tools that best suit your organizational culture. You should:
Above all else, do ensure your project plan and tracking doesn’t become more complicated or more consuming than the project’s actual end goals.
It is critical for a successful implementation to continually collect data on the project, track it and use it to guide the overall project. Four pivotal tracking elements are milestones, an activation scorecard, an executive scorecard (with calendar) and readiness/go-live assessments.
Milestones are a comprehensive list of high-level strategic waypoints throughout the implementation. A common set is as follows:
- Project Definition
- System Build and End-User Adoption
- Testing, Training, and Go-live Planning
- Testing Kickoff
- Go-Live Readiness Assessments (GLRA)
- Cutover Dry Run Rehearsals
- Quality and Reporting
- Technology Timeline (Key Dates)
- Activation Scorecard
Like baseball game’s one page scorecard that succinctly records every event of the game, an activation scorecard can provide a concise, yet full, picture of where you are on a the project. It should flow from the plan and never be altered with new tasks or milestones.
- Executive Scorecard and Calendar
An executive scorecard and calendar is a routine update on midlevel milestones to project stakeholders with special notes on operational impact.
- Readiness and Go-live Assessments
Readiness planning and periodic assessments is invaluable in preparing the organization for go-live. The assessments are conducted at specific points during the implementation.
Like the old healthcare joke, the operation was a success, unfortunately the patient expired; a project manager must plan to be a survivor. All too often project plans die prematurely (pun intended) due to organizational rejection and compatibility. You have the best chance of success if you embrace and employ these best practices – collaborate, plan and track.
Doug Blair, MBA, FACMPE
Senior Consultant for Intellect Resources