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IT Project Management @ GW: Analysis of DOD’s Electronic Health Record Initiatives


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This is the slide deck for the analysis paper I did on the DOD's several attempts at a unified EHR system for its many stakeholders. There is a 20 page research paper that goes along with this presentation if you are interested.

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IT Project Management @ GW: Analysis of DOD’s Electronic Health Record Initiatives

  2. 2. Project OverviewHISTORY COMPONENTS 1988 - DOD begins to acquire an EHR client-server architecture (“Composite Health Care System”) client-side apps 1993 - deployed but lacked many server software/hardware features like integration b/w systems clinical data repository and did not use data standards “perpetuated the reliance on paper- DELIVERY based record” Like CHCS I, development and implementation contracted out 1997 - new project (CHCS II) with 26 competitive RFPs which nearly identical scope as 1988 but w/ resulted in contracts for T&M & FFP emphasis on worldwide, 24/7 access, 11 non-competitive contracts common data standards later found to be unnecessary by FAR guidelinesKEY INPUTS 2009 - deployment with overwhelming requirements were first of many negative feedback problems; delayed multiple times “Intolerable” - congress hearing => delay in creating WBS “slow, difficult to use, unreliable” “EHR Way Ahead” = CHCS III
  3. 3. ChallengesPOOR PROJECT PLANNING “comprehensive project management plan was not established” - GAO “poor planning and execution and a failure to appreciate the ‘significant complexity’ of the program” - health industry analystREQUIREMENTS GATHERING Essential to establishing and controlling scope End users of the system were only engaged at the beginning and end of the project lifecycle so when they did provide feedback at the end, it was too late to inform developmentLACK OF BUY-IN AND NO FEEDBACK LOOP WITH USERS Army’s Surgeon General “faced a near mutiny of our healthcare providers, our doctors, our nurse practitioners, physician assistants” USAF Deputy Surgeon General: “low productivity and provider morale [from] working around the system trying to find new solutions” GAO: “[DOD] stopped measuring user satisfaction levels in July 2007 after overall user satisfaction had declined to its lowest point in more than 2 years.”
  4. 4. What Project Management?Costs were neither minimized nor benefits maximized (or in many cases realized) $2 BILLION OVER 13 YEARS