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Paul Capello Cerner Health Conference

Paul Capello Cerner Health Conference



Managing the Increase in ARRA-Focused Projects: A Real Success Story with the Bayfront PMO Workbook

Managing the Increase in ARRA-Focused Projects: A Real Success Story with the Bayfront PMO Workbook



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    Paul Capello Cerner Health Conference Paul Capello Cerner Health Conference Presentation Transcript

    • Managing the Increase in ARRA-Focused Projects: A Real Success Story with the Bayfront PMO Workbook Paul A. Capello, PMP Project Management Office Manager Bayfront Health Systems October 2010
    • Session Objectives How using a PMO Workbook will make a difference in the ARRA projects focused future. Documentation, Documentation, Documentation! Project Scope. Project Change. Project Risk. Project Issues. Etc……. Bayfront Project Portfolio Success Metrics. “You can’t argue with Success”
    • Bayfront Health Systems founded in 1968, consists of the facilities listed below: • Bayfront Medical Center (BMC) St. Petersburg • Bayfront Medical Plaza St. Petersburg • Bayfront Convenient Care Clinics –Throughout Pinellas County(6 Locations) • Bayfront Family Health Center St. Petersburg • BayFlite- Largest Helicopter Fleet in the Southeast US. • Cerner Client since 2001
    • Cerner Team 2010
    • What is a Project At Bayfront Technology Services? A Bayfront Project is a “temporary” endeavor (consisting of greater than 40 work) hours of work) undertaken to create a unique product, service or result, i.e., install new technology, upgrade or change existing technology. Projects are quantified by more than 15K in Capital Costs and need approval from the Bayfront Technology Steering Committee.
    • BHS Project Process
    • © Data from HIMSS AnalyticsTM Database N = 5166 N = 5235 7
    • American Recovery and Reinvestment Act of 2009 HR 1 -- 111th Congress $787 Billion Highly partisan vote Healthcare gets $147.7 Billion (HITECH Act) •$87B for Medicaid •$25B for support for extending COBRA •$10B for NIH $19,000 Million •$19B directly for HIT 8
    • New Project Work Breakdown Structure PPPD Approval Process Project Kickoff Define Software Resources Define Hardware Requirements Define Network Configuration(If applicable) Review Domain Strategy Update System Documentation Testing, Testing and More Testing On Going Training Production Implementation CLOSE-DOWN PROCESS BEGINS
    • PMO WORKBOOK HISTORY In February 2004, Bayfront went Live with Cerner from 7.8 to 2004.1(Phase 2 – 12 Nets including ProFit!). Subsequently, a formal PMO Methodology was introduced which included the first rendition of the PMO Workbook. Cerner subsequent upgrades include: 2005.02.46 2005.02.54 2007.12 2007.19.03
    • ORGANIZATIONAL COMMITTMENT One of the key foundations of Bayfront’s Methodology was establishing an effective Project Structure. Success requires the Bayfront's Leadership’s commitment to thorough planning and regular review and approval of Projects. An experienced, knowledgeable and committed Project organization must be assembled and certain members designated as leaders.
    • Steering Committee The purpose of the Steering Committee is the following: Provide Executive Direction to the Project Team. Verify Projects are meeting Bayfront's Strategic Business objectives. Resolve Issues that are beyond the authority of the Project Team. Additionally, The Steering Committee will verify the project deliverables meet the business requirements of Bayfront. These meetings are conducted at key project milestone dates with the results communicated to the Project Team.
    • PROJECT ADMINISTRATION Project monitoring and control procedures document the process and mechanisms for tracking the project. Proper monitoring of the project is dependent upon excellent communication throughout the project organization. This communication is the responsibility of the entire team, but The Project Manager or Project Lead is the #1 Go To person on Communication.
    • Project Manager or Lead Both BMC and Vendor project managers will be responsible for the following: Provide full-time project management as detailed in the contract. Monitoring project plans and implementation schedules to ensure upcoming tasks are identified and communicated to team members. Making task assignments and ensure task completion. Identifying and documenting potential problems or issues and ensuring these are communicated to the Project Director and Project Management Team. Reporting progress to the Project Director and other Team Leaders in status report meetings. Maintain the official project documentation.
    • Status Report for Week Status Report Customer: Project: For period: Starting: Ending: Achievements This Period: Planned Next Period: Scope Status: Budget Status: Original budgeted costs: Expected final costs: Schedule Status: Planned completion: Expected completion: Major Issues:
    • PROJECT DELIVERABLES The key deliverables for the project are as follows: Visualize the final product Build a visual of the implemented application by posing the following questions to the team: When the system is in place, what will it look like to you? What does the application have to do to meet your critical business requirements? How will information get into the system? How will that information be updated, used, modified and distributed? What technical capabilities are essential for your environment? Will the system have to interact and/or integrate with other systems? If so, how will that occur? Milestones *Key deliverables
    • PROJECT WORK PLAN The project work plan is used to control the progress of the project on a day-to-day basis. The project work plan contains the detailed activities and tasks required to develop the project deliverables, to monitor progress compared to plan, and to assign tasks to project team members. The overall project work plan is updated weekly based on the accomplishments communicated at the project status review meetings, documented in project status reports, and discussion with project team members.
    • Meetings Project status review meetings serve to convey status, identify issues, and detect scope changes to the overall project. Additionally, these meetings serve as a tool to record and measure team progress and performance and ensure project objectives are being met. These meetings are conducted on a weekly or bi-weekly basis and typically include the Project Team.
    • Meetings The following agenda will be used: Brief summary of project to date Review of open issues Discussion of previous week’s tasks and accomplishments Review status and update project work plan Identify new issues, provide resolutions, or record on the project issue and project log forms and assign as appropriate Assign new tasks and action items for the next week The results of the meeting are summarized, activities recorded and minutes distributed to the Project Management Team. Team Leaders are responsible for communicating the results of these meetings to their sub-teams
    • Bayfront Technology Services Meeting Minutes Example MEETING: Bayfront Change Management Meeting DATE/PLACE/TIME: Monday March 22, 2010 Mangrove Conference room 1:00 pm ATTENDEES: Paul Capello, Jennifer Greenman, Tony Curtis, Herman Gilyard, Denise Murphy, Mike Musallam, Denise Rafferty, Marge Slater, Melanie McKee, Heather Morrison, Jason Barth, Helen Bruns, Dave Leclaire Agenda Item Discussion Action Items Owner Scheduled End Date Deactivate "beginning of year" Some temporary code Deactivate "beginning of year" Melanie TBD hard code in programs: exists in these hard code in programs: McKee CUG100EX, CUG110EX, programs that need to CUG100EX, CUG110EX, CUG140EX. be activated for the first CUG140EX. run of the year, and then deactivated. Personnel transaction custom Not a critical item, but Personnel transaction custom Melanie 2/26/2010 programs needed to be one that should be programs needed to be modified to McKee modified to submit the self- cleaned up... submit the self-service file update service file update after the HR I have noticed several after the HR file updates so that file updates so that self-service people in the HR group self-service would pick up the would pick up the group of self service that are group associated with the new associated with the new not and never have position. Programs to change are: position. Programs to change been in HR. CUGTRTR, CUGTRDM, are: Additionally, that HR CUGTRHI, CUGTRPR, CUGTRTR, CUGTRDM, group has traditionally CUGTRRH, CUGTRTR CUGTRHI, CUGTRPR, been limited to a very CUGTRRH, CUGTRTR small group of people. Not sure why it has been expanded to include people from Barely Sick etc.
    • Project Documentation Project Documentation is any material related to the project that provides an audit of the project. This includes the formal deliverables identified in the Project Work Plan, as well as project status reports, project and steering committee reports, supporting notes and memos, key decisions forms, meeting minutes, and other informal documentation kept by Project Team members to support their work and deliverables.
    • Project Documentation • Project Documentation may be maintained in electronic form in designated project file directories, with those project documents requiring approval printed for distribution and signature. Project Leads will maintain team documentation, such as meeting minutes, in electronic and/or paper form and supply key deliverables to the Project Director when completed.
    • RISK MANAGEMENT Risk Management is the process of identifying areas of risk that could negatively impact the success of the project and proactively managing those areas. Risk is analyzed during the initial stages of the project to lay the foundation for success and on an ongoing basis during the project. Risk assessments are the means used to analyze risk. They highlight common areas of risk with the intent of identifying and controlling the risk. After high-risk areas are identified, risk control processes are selected and implemented. The following risk assessment describes potential high- risk areas of the project and documents the mechanisms established to control these areas.
    • Risk Target Control Procedures Business Vendor involvement not at a level to Vendor involvement at a level to Vendor involvement not at a level to insure success insure success insure success: •Implement regular status reporting •Detailed project management •Try to expand vendor involvement •Develop a very detailed project plan •Include frequent quality reviews Project Environment New system hardware required No new system hardware required New system hardware required: •Gain access to technical specialists •Integrate delivery and installation into project schedule •Purchase proven hardware
    • SECURITY / CONFIDENTIALITY Data in all its forms (electronic, paper, or other), and throughout its life cycle (creation, entry, storage, processing and disposal) will be protected from unauthorized access, modification, destruction and disclosure, whether accidental or intentional, at Bayfront Health System. User Access Controls One of the key ingredients of information protection is user access controls over who can access the information and how they can access it. To ensure appropriate levels of access, security measures will be instituted for this project. Security will be controlled by menu design as well as security levels attached to individual items. A complete analysis of existing application access and security will be done and adjustments made to ensure all existing users have access specific to their job requirements. Password Management Passwords are not displayed when entered. Employee Awareness Programs Monitoring/Reporting
    • Change Management Change Management is the process of managing changes to previously agreed-upon areas of the project. Changes can affect many areas: the project resources, the project deliverables, the cost and time frame in which objectives must be achieved and even the project priority. Change will be viewed positively as long as its purpose is to ensure Bayfront's business needs are met. Change Management documentation preserves the integrity of the project definition document, provides a mechanism for handling change requests, and provides a means for retaining historical change/issue information to enhance future project management efforts.
    • Change Management The following process is followed when a change to the schedule, budget, or scope of the project is required. Identify the Change: Determine if the change is within or outside the scope of the project. Record the Request: Complete the Change Request Form and submit to the Project Manager. Evaluate the Request: The Project Team will review the proposed change and make a decision to approve, disapprove, or alter the change request. The Steering Committee will be contacted if a decision requires approval at a higher level. Implement the Change: If it is determined the change should be incorporated into the project, the Project Work Plan will be updated to reflect the change in tasks, resource requirements, deliverables and/or timeframes.
    • Scope Change Request Form Customer: Project: Requested by: Description of the Change: Justification for the Change: Project Impacts (Project Manager Use Only) Budget and Schedule Impacts:(Project Manager Use Only) New Project Completion Date: Additional Project Costs: Date: Resolution Required by: Signed (Project Manager): Resolution: (Customer Use Only) Approved Rejected Date: Signed: Name and Title:
    • Issue Management An Issue is anything that arises which, if left unresolved, could delay or have an impact on the success of the project. All Issues are documented on the Project Issue Form. Each issue is prioritized, assigned an owner, and documented on the Project Issue Log. Issues the Project Team is unable to resolve are escalated to the Project Team Management for resolution or submission to the Steering Committee for resolution. Outstanding issues are reviewed at the project status review meeting. Any Issues that result in an increase in the project budget, time estimates, or scope must be documented on the Project Issue Form.
    • Issue Escalation Guidelines: Level I - Issues are resolved and documented by the Project Team and/or Work Team. Decision deadline: up to one (1) week. Level II - Issues which cannot be resolved at the Project Team Management level are submitted to the Project Director for review with the Project Team Management. Decision deadline: up to one (1) week. Level III - Issues which cannot be resolved at the Project Team Management level, or which are so sensitive as to require Executive approval, will be submitted to the Steering Committee, for resolution. Decision deadline: up to fourteen (14) days. Level IV - Issues which cannot be resolved at the Steering Committee level are submitted to the Project Sponsor for review with senior management. In addition, an issue can be escalated directly to Level IV based on issue criticality.
    • BAYFRONT MEDICAL CENTER 2007.19.03 TESTING ISSUES SR# CWX or DATE APP 2007.19.03 TESTING ISSUES- Reported Daily Update SWX? MOCK HPUX by CWX UPTIME (package installation) March 22nd to March 26th STEPS BEFORE GO-LIVE CWX- Fat clients Update nasp5102 with new code On your NAS share if you have no Mo, Tony warehouse. Space issues then, rename your current P5102 to P5102_VMS. Re-sync the DBMIG (copy from RRD02 to NAS) once done synching, create a new copy of DBMIG folder and rename it to P5102. Use that one for Prod Fat client setup. CWX- Mo Fat clients Send new batch file for fat clients 3-24 Mo copied to RRD02 DBMIG including setup.ini and group files BMC Fat clients David and Leonard will test upgrading fat clients before upgrade Mo and Tony BMCCitrix03- CPDI needs setup? Desktop PACS Upgrade PACS Viewing Stations for Citrix Almost done version 11.0
    • PROJECT PROFILE DOCUMENT I— PART I—PROFILE IDENTIFICATION AND REGISTRATION 1.Profile/Project 1.Profile/Project Title 2.Profile 2.Profile Control Number The PMO will register the PPP in the project control system. 1.Profile 1.Profile Preparation Team Name Specialty Position 1.Profile 1.Profile Completion Date 2.Business/Clinical 2.Business/Clinical Case •Refer to an early stage SOC •Strategic Direction or Action Steps •Budgeted for Capital Year (Yes or No)
    • PART II—PROPOSED PROJECT DESCRIPTION AND OUTLINE Project Scope Project Objectives Project Background/Linkage Project Assumptions Project Classification Recommended Project Start and Completion Dates
    • PART III—PROPOSED PROJECT MANAGEMENT PLAN Project Manager Project Management Team Name Specialty Position 1.Project 1.Project Phasing Project Phase-Workload Estimate Table Phase- Work Recommended Recommended Estimated Phase Package/Activity Schedule Resource Cost
    • PART IV—PROJECT EVALUATION AND VALIDATION 4.1 Project Objectives 4.2 Project Risks 4.3 Project Structure 4.4 Hardware Requirements (If applicable)
    • PROJECT TEAM REVIEW AND APPROVAL FORM Document/Deliverable: Project Workbook Date Presented: Paul Capello, PMO Manager Date_____________ Jennifer Greenman , Chief Information Officer Date_____________
    • The Standish Group surveyed 365 respondents covering 8,380 IT applications Project Success Statistics across several industries: • 16.2% of projects completed on-time and on-budget. .(Bayfront success rate is 95%) • 52.7% of projects completed over budget, over time, and with fewer features than originally specified. • 31.1% of projects canceled during the development cycle.
    • Bayfront Project Portfolio 2009-2010 Project Name Pharmacy Clinical Intervention Documentation Email antispyware / Antispam and Trend Antivirus / Antispyware systems Explorer Menu Clean Up Philips Xcelera upgrade for Cardiology QoS/Traffic Shaping on Internet RAD PACS and Cerner Labs for Heart Center/EP WISM(Wireless Services Module) Physician Progress Notes Life Net Stemi for ED/Cardiac Clinical Transformation - Post Partum Documentation Clinical Transformation - Documentation( Phase 1 Form Roll Out and Phase 2 Form Design) McKesson Accudose PACS Cube Point of Care(Arterial Blood Gases) CLINICAL TRANSFORMATION - Handoffs & PAL & Hardware Assessment IN BOX ShoreTel Phone and Voicemail Migration Cerner Provision Document Imaging(Patient Access Services) Cerner Provision Document Imaging(Medical Records(HIM) Cerner Provision Document Imaging(Pharmacy Order Management) CBORD Upgrade Optimal Radiology Interface Sentry Data Systems All Children's - OB Project - Baby Place Health Line ECHO ASP for Med Staff Office Nortel Conversion Trauma Base Kronos Cerner 2007.19
    • PMO Value According to Forrester Research®, companies that implemented a successful PMO achieved an 80% ROI, 20% reduction in project time. Companies without a PMO experienced a 74% project failure rate. That is a sobering statistic. statistic Bayfront’s successful PMO is in its 7th year of existence.
    • Bayfront Active Projects Project Project Name Status Project Mgr # 1 Cerner Provision Document Imaging(Lab) Active Shari Goodwin 2 CPOE Active Paul Capello 3 SurgiNet Active John Amodeo CLINICAL TRANSFORMATION - Rehab Evaluation & 4 Treatment Documentation Active Denise Murphy 5 CLINICAL TRANSFORMATION- Medication Reconciliation Active Lee Ann Sahagun 6 CLINICAL TRANSFORMATION- ED Documentation Active Lee Ann Sahagun 7 CLINICAL TRANSFORMATION - Depart Process Active John Amodeo 8 NextGen Ambulatory EHR Active Heather Morrison 9 Care Focus/ Mercury MD Active Heather Morrison 10 INFOR AP and Material Mgt Active Melanie McKee 11 6 South Conversion Active Dale Graf 12 Philips Xcelera and XPER Upgrade Active Jason Barth Active 12 Complete 222 Not Active 59 Total 293
    • A Computer in the Patient Room? “That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations.” - The London Times, 1834 Commenting on the 44 “stethoscope”
    • Questions and Answers? Email: Paul.Capello@bayfront.org Name: Paul Capello Phone: 727-893-6038 Email: Paul.Capello@bayfront.org Phone: 727-893-6038