HM312

1. © 2017 American Health Information Management Association© 2017 American Health Information Management Association
Health IT and EHRs:
Principles and Practice, Sixth Edition
Chapter 8: Health IT Project
Management: Roles in Design
and Implementation

2. © 2017 American Health Information Management Association
Project Management
• A well-planned and organized effort to
accomplish a specific mission.
• A well-recognized discipline, spanning all
types of projects in all industries.
o Project Management Institute
o Guide to the Project Management Body of Knowledge
(PMBOK)
o Certifications available in project management

3. © 2017 American Health Information Management Association
Project versus Program
• A project can become an ongoing program
• But the “project” should come to conclusion prior to becoming a program
• A project charter aids in establishing project boundaries
Copyright © 2016, MargretA Consulting, LLC. Reprinted with permission

4. © 2017 American Health Information Management Association
Planning versus Managing
• Planning is preparation
• Managing is carrying out the plan
• But project planning must also be managed:
o The key document in successful project management is the
project plan
o Project planning is important, and the plan needs to be kept
up-to-date
o But, the plan needs to be carried out in order for the project to
be completed, and many project managers find that keeping
the plan current can be all-consuming
o It is essential to manage project planning

5. © 2017 American Health Information Management Association
Project Support
• Executive management support must be actively present
o Education aids in gaining leadership support
o Attention to workflow and process improvement helps move the
focus from purely technical
o Creating a realistic business case, with a benefits portfolio that can
be linked to project milestones helps demonstrates success
• Medical staff buy-in, especially for EHR, but also for other forms
of health IT that impact them and their patients, is essential
o Members of the medical staff must be fully engaged
• Project champion(s)
• Chief medical informatics officer
• Medical director of information systems

6. © 2017 American Health Information Management Association
Project Support (continued)
• Involvement of users and other stakeholders
o Serious interest in health IT projects must be cultivated
o Change management (chapter 6) is essential
• Understanding impact
• Communications
• Resource allocation
o Appropriate
• Resource leveling
• Staff, consultants, outsourced workers
o Sustained
• New roles
• New staff
• Product certification
• Hiring and labor matters

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Project Standards of Practice
• Organizations should establish and enforce clear:
o Policies for project management, such as adopting
recognized standards of practice as well as incorporation
of federally approved standards for health IT
o Business rules that support workflow and process
improvement
o Standards of practice
• PMBOK is a standard approved by the American
National Standards Institute (ANSI) (PMI 2013)

8. © 2017 American Health Information Management Association
Project Scope and Characteristics
• Project have a defined beginning and end,
usually follow a SDLC, and have a defined
budget
• Are a line function, though with special staffing
often through volunteerism from many parts of
organization
• Concern something new and therefore involve
uncertainty and change
• Require great attention to detail, while
maintaining the ability to see the big picture

9. © 2017 American Health Information Management Association
Project Organizational Structure:
EHR Example
Project Sponsor
Project Manager CIO
Vendor
Nursing
Medical Staff
Ancillaries
HIM
PFS
Steering
Committee
Documentation
Pharmacy
RCM
Ambulatory
MAR
Orders
DomainTeams
Consultants
Temporary Staff

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EHR Steering Committee
Copyright © 2016, MargretA Consulting, LLC. Reprinted with permission.

11. © 2017 American Health Information Management Association
Role of Project Manager (PM)
• Tasks
o Supports steering committee
o Responsible for overseeing project
completion
• Qualifications
o General contractor
• Good understanding of health IT
• Some healthcare background
• Understand project management tools and techniques
• Strong leadership skills
o IT skills not as important as vision and leadership
o Clinical knowledge can be a plus
Project
Management
Office (PMO)
• Many projects
• Many PMs
• Specialized
software

12. © 2017 American Health Information Management Association
HIM Professional Involvement
Checklist
• Make yourself an expert. Embrace change
• Help others gain expertise; make sure you also
receive credit as an expert
• Take on volunteer assignments; learn to
delegate while maintaining control
o Don’t volunteer beneath your goals. For example,
do not volunteer to take minutes.
• Educate yourself, your staff, physicians,
administration, vendors, patients

13. © 2017 American Health Information Management Association
Project Manager Skills
• Leadership – not necessarily a
formal leader
• Motivation
• Communication
• Influencing, not grabbing power
• Decision making
• Political and cultural awareness
• Trust building
• Negotiation
• Conflict management
• Coaching
Conflict Management
• Avoiding = lose-lose
• Accommodating = lose-win
• Competing = win-lose
• Compromising = bend-bend
• Collaborating = win-win

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Project Communication Skills
• Instruction
• Feedback
• Meeting
management
• Building consensus
• Follow-up
• Data collection
• Reporting

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Health IT Project Teams
• Steering committee
• Vendor selection team
• Negotiation team
• Implementation team(s)
• Domain teams
• Training team or super users
• Ongoing maintenance team and/or clinical
advisory team

16. © 2017 American Health Information Management Association
Team Building
• Selecting the right team members involves
recognizing there is no “I” in team, but there is a
need for balance
• Teams not only need balance,
but team members must be
able to relate to one another
effectively:
o Group norms
o Group dynamics
o Valuing diversity Copyright © 2016, MargretA Consulting, LLC. Reprinted with permission.

17. © 2017 American Health Information Management Association
Stages of Group Development
• Most newly formed teams go through stages
(Tuckman) that should be recognized and
addressed:
o Forming
o Storming
o Norming
o Performing
o Adjourning

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Seven Sins of Deadly Meetings & Their Salvations

19. © 2017 American Health Information Management Association
Project Management Standards
• Integration management
o Planning
o Change control
• Scope management
o Authorization
o Planning
• Time management
o Activity definition
o Sequencing
o Duration
o Schedule development and
control
• Cost management
o Resource planning
o Cost estimating, budgeting,
and control
• Quality management
o Project performance
o Monitoring results
• Human resource management
o Organization
o Staff acquisition
o Team development
• Communications management
o Planning and distribution
channels
o Performance reporting
o Administrative closure
• Risk management
o Manage adverse events that
may stall or derail project
• Procurement management
o Planning solicitations
o Source selection
o Contract management
• Stakeholder management
o Identification
o Engagement
PMI 2013

20. © 2017 American Health Information Management Association
Project Phases and Life Cycle
Source: Project Management Institute (PMI) (2008). Copyright and all rights reserved. Material from this publication
has been reproduced with the permission of PMI.

21. © 2017 American Health Information Management Association
Components of a Project Plan
• Project charter, scope, and deliverables
• Description of project approach
• Work breakdown structure
• Budget management
• Capacity plan
• Start dates
• Major milestones and target dates
• Dependencies
• Risks, constraints, assumptions, and contingencies
• Controls
• Performance measurement baselines
• Supporting detail: CQI tools (balanced scorecard,
key performance indicators, dashboards)

22. © 2017 American Health Information Management Association
Project Management Tools (Gantt Chart)
Task
Start
Task
End
Note
Duration of
Major Task
(Activity)
Milestone
(Task = 0 Days)
Today
Row Numbers
Task Numbers
Builds List of
Resources
Task
Completed
Dependency
Task
Progress
Copyright © 2016, MargretA Consulting, LLC. Reprinted with permission.

23. © 2017 American Health Information Management Association
Change Controls
• Sometimes called “configuration management,”
change control is a formal process of:
– Tracking every request for a change in a system
– Determining its impact on other elements of the
project or system
– Obtaining necessary authorizations for change
– Keeping track of the change for future actions
– Carrying out change with resources

24. © 2017 American Health Information Management Association
Dashboard Example