This document discusses how project management practices from PMBOK and IT service management practices from ITIL can be integrated to help healthcare organizations achieve meaningful use objectives under the HITECH Act. It recommends blending PMBOK project tasks and ITIL service management activities into the project lifecycle. This will help produce solutions that are easier to support and sustain beyond project closure. Integrating the two frameworks provides benefits like increased ability to service EHRs long-term and prepares organizations for future initiatives. The document provides examples of how specific ITIL activities map to PMBOK tasks and urges establishing collaboration between project and service teams.

1. HITECH-Meaningful Use and
The Benefits of the
PMI and ITIL Relationship
May 20, 2011
William ‘Buddy’ Gillespie, ITILv3 Certified
Vice President & Chief Technology Officer
WellSpan Health

2. The Journey
Meaningful Use

3. Introduction
• Since the HITECH Act was passed in February,
2009, healthcare executives have felt the
pressure to implement the electronic health
record and achieve Meaningful Use status
resulting in the flow of incentive dollars over the
next five years.
• In the rush to purchase and implement EHR
solutions, healthcare executives are finding that
Project Management Standards (PMBOK) and
best practices for IT Service Management (ITIL)
need to blend together in order to establish a
reliable roadmap to achieve and sustain the
objectives of HITECH.

4. Objectives
• Introduce the requirements of the HITECH-MU
objectives;
• Identify the challenges facing healthcare
executives relative to the achievement of
Meaningful Use;
• Share the commonalities between PMBOK and
ITIL;
• What approach should be taken to blend the two
practices into a seamless process & avoid gaps;
• What are the expected benefits;
• Share lessons learned and recommendations for
success

5. Agenda
• HITECH & Meaningful Use
• Challenges
• PMBOK & ITIL
• Project Process vs. Operational Process
• Approach & Implementation
• Benefits
• Lessons Learned
• Recommendations

6. Myths
• Service Management plays no part in the
project planning process
• The only touch point between project
management and service management is
at the go-live hand-off to production
• The ITIL Release Management best
practice is the only guidance that ITIL
provides the project

7. HITECH-MU Objectives
• Adoption of certified EHRs
• Meaningful use of EHRs
• Incentive payments to eligible
professionals and hospitals
• Investment in nationwide HIT
infrastructure
• Grant money for demonstration
projects

8. HITECH-MU Outcomes
• High quality, safe, effective, and equitable
care for all
• Seamless patient-centric care
• Realigned incentives and measures that
foster prevention, intervention,
coordination, effectiveness
• Regional clinical information
interoperability on a national backbone

9. Meaningful Use is a Journey
3-Stages over 5-Years

10. Challenges
• Only 20% of Physician Practices have an
EHR
• Competing projects on the horizon
– MU
– ICD-10
– HIPAA 5010
• Cost of IT Infrastructure
• Lack of Best Practices Use for PM & ITSM
• Current focus on implementing vs.
sustaining technology

11. The Big Picture
• Many IT organizations around the
world are turning to PMBOK® best
practices to help them achieve
improved capabilities in meeting the
needs of their business.
• Another best practice frameworks
that is sweeping the globe is ITIL® –
Information Technology
Infrastructure Library™.

12. PMI-PMBOK
• PMBOK
– “Project Management Body of Knowledge”
– Universal Standard for PM in US and the
Globe
– Foundation for PMP Certification
– PMBOK® Guide1 4th Edition

13. ITIL V3
• ITIL
– “IT Infrastructure Library”
– UK Office of Government Commerce
– Growing Popularity for ITSM
– ITIL®2 v3 as framework

14. Definitions
• Project:
– PMBOK: “A project is a temporary
endeavor undertaken to produce a unique
product, service or result”
• Services:
– ITIL: “Services are a means of delivering
value to customers by facilitating outcomes
customers want to achieve without taking
on the ownership of specific costs and
risks.”

15. ITIL Best Practice
• What is ITIL?
–The Information Technology
Infrastructure Library-V3.0
–Provides a systematic-best
practice approach to the delivery
of cost effective and quality IT
services

16. Alerts, Exceptions & Changes
-Inquiries
-Communication
-Reports and updates
-Availability plan
-Targets / thresholds
-Reports
-AMDB
System Management Tools
IT Infrastructure
-Capacity plan
-Targets / thresholds
-Reports
-CDB
-Financial plan
-Types & models
-Costs & charges
-Budget & forecasts
-IT continuity plan
-BIA & risk analysis
-Define requirements
-Disaster recovery contracts
-Security plans
-Intrusion prevention
-Security event logging
-SLAs, OLAs, SLRs, UCs
-Service catalog
-Requirements, targets, achievements
Source: W. Cook
Used with permission.
Service Level
Management
Availability
Management
Capacity
Management
IT Financial
Management
IT Service
Continuity
Management
Information
Security
Management
Customers & Users
ITIL Service Level Management

17. Service Desk
(Function)
Service Design & Support: The Operational Processes
Configuration
Management CMDB
-CI records & relationships
-Entire IT infrastructure
-CMDB reports & statistics
-Audit reports
-Incidents -Problems
-Known Errors -Changes -Releases
-Difficulties
-Questions
-Requests
-Workarounds
-Incident status and updates
-User communications
Incidents
-Service reports
-Incident statistics
-Audit reports
-Trend analysis
-Diagnostic aids
-Problem reports
-Problem statistics
-Problem reviews
-Audit reports
-Process Request for
Changes (RFCs)
-Forward schedule
of changes (FSC)
-CAB minutes
-Change statistics
-Change reviews
-Audit reports
-Release schedule
-DSL & DHS
-Test standards
-Release statistics
-Release reviews
-Audit reports
Customers & Users
Incidents
-RFCs from IT staff,
users, customers
New releases
RFC
RFC
Automated
Tools
Source: W. Cook
Used with Permission
Incident
Management
Problem
Management
Change
Management
Release
Management

18. Service Delivery
• Four Main Components
–Service Catalog (Transition
Catalog during project cycle )
–Operational Level Agreements
(OLAs)
–Underpinning Contracts
–Service Level Agreements (SLAs)
–CI(s) & CMDB(s)

19. Service Catalog
• Listing of services provided to
customer
• Can include varying degrees of
service (e.g. gold, platinum, bronze,
etc.)
• Many application catalog entries
encompass entire application
“platforms.”

20. Operational Level Agreements (OLAs)
• Agreements between
respective areas of the I.S.
department with each other
• Must be able to commit to
each other before committing
to customer.
• Needed to be able to build
SLAs with Customer

21. Approach
• Inclusion of ITIL Service
Management Activities in the Project
Life Cycle Tasks
• Identify stakeholders across the
continuum
• Establish OLAs between PMO and
Service Design & Support team

22. Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Service Portfolio
– Financial Mgt
– Demand Mgt
• Project Plan Tasks
– Service Definition
– Budget
– Business Case

23. Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Service Catalog Mgt
– Service Level Mgt
– Supplier Mgt
• Project Plan Tasks
– Service Definition
– Service Level Rqmts
– RFP & Select

24. Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Availability Mgt
– Capacity Mgt
– Continuity Mgt
– Security Mgt
• Project Plan Tasks
– Impact, Risk & Plan
– Plan & Measure
– RPO & Plan
– Design & Validate

25. Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Change Mgt
– Asset & Config Mgt
– Release Mgt
– Knowledge Mgt
• Project Plan Tasks
– CAB & RFC
– CI(s) to CMDB
– Version Control
– Documentation

26. Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Event Mgt
– Incident Mgt
– Request
– Problem Mgt
– Access Mgt
• Project Plan Tasks
– Monitoring
– Categories/Escalation
– SR Forms/Procedure
– Work Around(s)
– Approval/Procedure

27. Impact of No Collaboration
• A project deliverable which is difficult
to support and sustain
• A solution which is a vertical
deliverable and difficult to “fit” into the
Service Catalog
• Lack of consensus of all stakeholders

28. Lessons Learned
• ITIL is a journey not a sprint
• Credibility is achieved in increments
not a big-bang
• The move from a project focus to a
holistic view of project plus service
management is not an over night
change

29. Benefits
• Increased opportunity to service and
sustain the EHR and MU deliverables
• Position organization to expand
foundational systems for the next big
wave of change: ACO, Medical Home, etc.
• Achieve consistent quality of project
deliverables beyond the project closure

30. Recommendations
• PMO updates Project Work plan to include
ITIL Activities
• ITSM Core Team to engage with PMO
• Request PMs to become ITIL V3
Foundations Certified and engage with
ITSM Leadership
• Establish Collaborative View of Project
Success between PMBOK and ITIL
• Establish Milestone check-points to
monitor PMBOK and ITIL Integration

31. Thank You