Paul Capello Cerner Health Conference

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 SystemsBayfront Health SystemsOctober 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 Change.

� Project Risk.

� Project Issues.

� Etc…….

Bayfront Project Portfolio Success Metrics.

“You can’t argue with Success”

Bayfront Health Systems founded in 1968, consists Bayfront Health Systems founded in 1968, consists Bayfront Health Systems founded in 1968, consists Bayfront Health Systems founded in 1968, consists

of the facilities listed below:of the facilities listed below:of the facilities listed below:of the facilities listed below:

• Bayfront Medical Center (BMC) St. Petersburg

• Bayfront Medical Plaza St. Petersburg

• Bayfront Convenient Care Clinics –Throughout • 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” A Bayfront Project is a “temporary” A Bayfront Project is a “temporary” A Bayfront Project is a “temporary”

endeavor (consisting of greater than endeavor (consisting of greater than endeavor (consisting of greater than endeavor (consisting of greater than 40 40 40 40

hours of workhours of workhours of workhours of work) undertaken to create a ) undertaken to create a ) undertaken to create a ) undertaken to create a

unique product, service or result, i.e., install unique product, service or result, i.e., install unique product, service or result, i.e., install unique product, service or result, i.e., install unique product, service or result, i.e., install unique product, service or result, i.e., install unique product, service or result, i.e., install unique product, service or result, i.e., install

new technology, upgrade or change existing new technology, upgrade or change existing new technology, upgrade or change existing new technology, upgrade or change existing

technology. technology. technology. technology.

Projects are quantified by more than Projects are quantified by more than Projects are quantified by more than Projects are quantified by more than 15K15K15K15K in in in in

Capital Costs and need approval from the Capital Costs and need approval from the Capital Costs and need approval from the Capital Costs and need approval from the

Bayfront Technology Steering Committee.Bayfront Technology Steering Committee.Bayfront Technology Steering Committee.Bayfront Technology Steering Committee.

BHS Project Process

7

Data from HIMSS AnalyticsTM Database N = 5166 N = 5235

American Recovery and Reinvestment Act of 2009

� HR 1 -- 111th Congress

� $787 Billion

� Highly partisan vote

�

8

� Healthcare gets $147.7 Billion

(HITECH Act)

•$87B for Medicaid

•$25B for support for extending COBRA

•$10B for NIH

•$19B directly for HIT$19B directly for HIT$19B directly for HIT$19B directly for HIT

$19,000 Million

New Project Work Breakdown Structure

� PPPD Approval Process

� Project Kickoff

� Define Software Resources

� Define Hardware Requirements

� Define Network Configuration(If applicable)� 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 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 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 Steering Committee Steering Committee 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.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 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 LeadProject Manager or LeadProject Manager or LeadProject 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.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: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:The key deliverables for the project are as follows:The key deliverables for the project are as follows:The key deliverables for the project are as follows:

Visualize the final product Visualize the final product Visualize the final product 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? 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?

MilestonesMilestonesMilestonesMilestones

*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 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.

MeetingsMeetingsMeetingsMeetings

Project status review meetings serve to convey status, identify issues, and detect scope changes to the overall project. Additionally, these meetings serve as a 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.

MeetingsMeetingsMeetingsMeetings

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� 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

Agenda Item Discussion Action Items Owner Scheduled End

Date

Deactivate "beginning of year" hard code in programs:CUG100EX, CUG110EX, CUG140EX.

Some temporary code exists in these programs that need to be activated for the first run of the year, and

Deactivate "beginning of year" hard code in programs:CUG100EX, CUG110EX, CUG140EX.

Melanie McKee

TBD

MEETING: Bayfront Change Management MeetingDATE/PLACE/TIME: Monday March 22, 2010 Mangrove Conference room 1:00 pmATTENDEES: 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

run of the year, and then deactivated.

Personnel transaction custom programs needed to be modified to submit the self-service file update after the HR file updates so that self-service would pick up the group associated with the new position. Programs to change are:CUGTRTR, CUGTRDM, CUGTRHI, CUGTRPR, CUGTRRH, CUGTRTR

Not a critical item, but one that should be cleaned up...I have noticed several people in the HR group of self service that are not and never have been in HR. Additionally, that HR group has traditionally been limited to a very small group of people. Not sure why it has been expanded to include people from Barely Sick etc.

Personnel transaction custom programs needed to be modified to submit the self-service file update after the HR file updates so that self-service would pick up the group associated with the new position. Programs to change are:CUGTRTR, CUGTRDM, CUGTRHI, CUGTRPR, CUGTRRH, CUGTRTR

Melanie McKee

2/26/2010

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 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 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.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

insure success

Vendor involvement at a level to

insure success

Vendor involvement not at a level to

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 ControlsUser Access ControlsUser Access ControlsUser 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 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 Security will be controlled by menu design as well as security levels Security will be controlled by menu design as well as security levels Security will be controlled by menu design as well as security levels attached to individual items.attached to individual items.attached to individual items.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 ManagementPassword ManagementPassword ManagementPassword Management

Passwords are not displayed when entered.

Employee Awareness ProgramsEmployee Awareness ProgramsEmployee Awareness ProgramsEmployee Awareness Programs

Monitoring/ReportingMonitoring/ReportingMonitoring/ReportingMonitoring/Reporting

Change Management

Change ManagementChange ManagementChange ManagementChange 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. 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: Identify the Change: Identify the Change: Identify the Change: Determine if the change is within or outside the scope of the project.

Record the Request: Record the Request: Record the Request: Record the Request: Complete the Change Request Form and submit to the Project Manager.

Evaluate the Request: Evaluate the Request: Evaluate the Request: Evaluate the Request: The Project Team will review the Evaluate the Request: Evaluate the Request: Evaluate the Request: 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: Implement the Change: Implement the Change: 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, An Issue is anything that arises which, if left unresolved, An Issue is anything that arises which, if left unresolved, An Issue is anything that arises which, if left unresolved, could could could could

delay or have an impact delay or have an impact delay or have an impact delay or have an impact on the success of the project.on the success of the project.on the success of the project.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 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 an issue can be escalated an issue can be escalated an issue can be escalated directly to Level IV based on issue criticality.directly to Level IV based on issue criticality.directly to Level IV based on issue criticality.directly to Level IV based on issue criticality.

BAYFRONT MEDICAL CENTER

2007.19.03 TESTING ISSUES2007.19.03 TESTING ISSUES2007.19.03 TESTING ISSUES2007.19.03 TESTING ISSUES

SR# CWX or

SWX?

DATE APP 2007.19.03 TESTING ISSUES-

MOCK HPUX

Reported

by

Daily Update

CWX UPTIME (package installation) March 22nd to March 26th

STEPS BEFORE GO-LIVE

CWX-

Mo, Tony

Fat clientsUpdate \\nas\p5102 with new code

warehouse.

On your NAS share if you have no

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 P5102. Use that one for Prod Fat

client setup.

CWX- Mo Fat clientsSend new batch file for fat clients

including setup.ini and group files

3-24 Mo copied to RRD02 DBMIG

BMC Fat clientsDavid and Leonard will test upgrading fat

clients before upgrade

Mo and Tony BMCCitrix03- CPDI needs setup?

Desktop PACS Upgrade PACS Viewing Stations for Citrix

version 11.0

Almost done

PROJECT PROFILE DOCUMENT

Name Specialty Position

PART IPART IPART IPART I————PROFILE IDENTIFICATION AND REGISTRATIONPROFILE IDENTIFICATION AND REGISTRATIONPROFILE IDENTIFICATION AND REGISTRATIONPROFILE IDENTIFICATION AND REGISTRATION

1.1.1.1.Profile/Project TitleProfile/Project TitleProfile/Project TitleProfile/Project Title

2.2.2.2.Profile Control NumberProfile Control NumberProfile Control NumberProfile Control Number

The PMO will register the PPP in the project control system.

1.1.1.1.Profile Preparation TeamProfile Preparation TeamProfile Preparation TeamProfile Preparation Team

Name Specialty Position

1.1.1.1.Profile Completion DateProfile Completion DateProfile Completion DateProfile Completion Date

2.2.2.2.Business/Clinical CaseBusiness/Clinical CaseBusiness/Clinical CaseBusiness/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 ScopeProject ScopeProject ScopeProject Scope

Project ObjectivesProject ObjectivesProject ObjectivesProject Objectives

Project Background/LinkageProject Background/LinkageProject Background/LinkageProject Background/Linkage

Project AssumptionsProject AssumptionsProject AssumptionsProject AssumptionsProject AssumptionsProject AssumptionsProject AssumptionsProject Assumptions

Project ClassificationProject ClassificationProject ClassificationProject Classification

Recommended Project Start and Recommended Project Start and Recommended Project Start and Recommended Project Start and

Completion DatesCompletion DatesCompletion DatesCompletion Dates

PART III—PROPOSED PROJECT MANAGEMENT PLAN

Project Manager

Project Management Team

Name Specialty Position

1.1.1.1.Project PhasingProject PhasingProject PhasingProject Phasing

Project PhaseProject PhaseProject PhaseProject Phase----Workload Estimate TableWorkload Estimate TableWorkload Estimate TableWorkload Estimate Table

Phase

Work

Package/Activity

Recommended

Schedule

Recommended

Resource

Estimated

Cost

PART IV—PROJECT EVALUATION AND VALIDATION

4.1 Project Objectives4.1 Project Objectives4.1 Project Objectives4.1 Project Objectives

4.2 Project Risks4.2 Project Risks4.2 Project Risks4.2 Project Risks

4.3 Project Structure4.3 Project Structure4.3 Project Structure4.3 Project Structure

4.4 Hardware Requirements (If applicable)4.4 Hardware Requirements (If applicable)4.4 Hardware Requirements (If applicable)4.4 Hardware Requirements (If applicable)4.4 Hardware Requirements (If applicable)4.4 Hardware Requirements (If applicable)4.4 Hardware Requirements (If applicable)4.4 Hardware Requirements (If applicable)

PROJECT TEAM REVIEW AND APPROVAL FORM

Document/Deliverable:Document/Deliverable:Document/Deliverable:Document/Deliverable: Project WorkbookProject WorkbookProject WorkbookProject Workbook

Date Presented: Date Presented: Date Presented: Date Presented:

Paul Capello, PMO Manager Paul Capello, PMO Manager Paul Capello, PMO Manager Paul Capello, PMO Manager Paul Capello, PMO Manager Paul Capello, PMO Manager Paul Capello, PMO Manager Paul Capello, PMO Manager

Date_____________Date_____________Date_____________Date_____________

Jennifer Greenman , Chief Information Officer Jennifer Greenman , Chief Information Officer Jennifer Greenman , Chief Information Officer Jennifer Greenman , Chief Information Officer

Date_____________Date_____________Date_____________Date_____________

Project Success Statistics

The Standish Group surveyed 365

respondents covering 8,380 IT applications

across several industries:

• 16.2%16.2%16.2%16.2% of projects completed on-time

and on-budget. .(Bayfront success rate

is 95%)

•• 52.7%52.7%52.7%52.7% of projects completed over

budget, over time, and with fewer

features than originally specified.

• 31.1%31.1%31.1%31.1% of projects canceled during the

development cycle.

Bayfront Project Portfolio 2009-2010

Pharmacy Clinical Intervention Documentation

Email antispyware / Antispam and Trend Antivirus / Antispyware systemsExplorer 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

Project Name

PACS CubePoint 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 BaseKronos

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 That is a sobering That is a sobering That is a sobering

statisticstatisticstatisticstatistic.

Bayfront’s successful PMO is in its 7th year of existence.

Bayfront Active Projects

1 Cerner Provision Document Imaging(Lab) Active Shari Goodwin

2 CPOE Active Paul Capello

3 SurgiNet Active John Amodeo

4CLINICAL TRANSFORMATION - Rehab Evaluation & Treatment Documentation Active Denise Murphy

5 CLINICAL TRANSFORMATION- Medication Reconciliation Active Lee Ann Sahagun

6 CLINICAL TRANSFORMATION- ED Documentation Active Lee Ann Sahagun

Project

#

Project Name Status Project Mgr

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

44

- The London Times, 1834

Commenting on the

“stethoscope”

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.”

Questions and Answers?Email: [email protected]

Phone: 727-893-6038

Name: Paul Capello

Email: [email protected]

Phone: 727-893-6038