World University of Florida Maternal-Fetal Medicine Telemedicine Pilot Project
Version – 1.0
Last Updated – 9/25/2010
Date
Version
Description
Author
9/24/2010
1.0 Draft
Initial Project Charter
Ashwini Patki
Group 1 Consulting
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World University of Florida Hospital
Project Charter
9/24/10
Table of Contents
Project Identification ................................................................................................................ 3
Project Roles and Responsibilities......................................................................................... 3
Business Need/Opportunity .................................................................................................... 4
Project Objectives .................................................................................................................... 4
Strategy Alignment of project with WUFH ............................................................................. 5
External Stakeholders.............................................................................................................. 5
Preliminary Cost/Benefit Analysis .......................................................................................... 6
Project Dependencies .............................................................................................................. 6
Basic Deliverables to be Produced by the Project ................................................................ 6
Preliminary Project Scope ....................................................................................................... 7
Project Schedule ...................................................................................................................... 7
Project Assumptions ............................................................................................................... 7
Project Constraints (including Executive or Mandated) ....................................................... 8
Project Impacts ........................................................................................................................ 8
Project Communication: .......................................................................................................... 8
Project Risks and Issues ......................................................................................................... 9
Project Charter Approval (from Ideation). .............................................................................. 9
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Project Charter
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Project Identification
Project Name:
Prepared By:
World University of Florida Maternal-Fetal Medicine Telemedicine Pilot
Project
Group 1 Consulting
Date Prepared:
9/24/10
Project Number:
101004
Project Roles and Responsibilities
Role
Name
Executive Sponsor
Dr. Archie Big
Project Sponsor
World University of Florida (WUF),
World University of Florida Hospital
(WUFH) Division of Obstetrics and
Maternal-Fetal Medicine (DOMFM)
(federal funding), and health
departments at Columbia, Dixie,
Gilchrist, Hamilton counties (Florida
State Department funding)
The World University of Florida
Hospital (WUFH) Division of
Obstetrics and Maternal-Fetal
Medicine (DOMFM)
Business Owner
Project Manager
Security Advisor
Chief Information Officer (CIO)
Responsibilities &
Business Function
Advocate project internally and
externally, review business case,
troubleshoot any organizational
(political) issues, evaluate and
approve business case, support
project manager
Locate budgetary resources, assure
project’s alignment with the
organization’s strategic
goals, analyze cost effectiveness of
the project, allot funds as necessary,
check on project manager
Participate in approval of business
case. keep project focused to
achieve desired outcome, assure
that timely project completion, keep
project within budget and time line,
explore tax advantages,
Project oversight to include: plan
development, task assignment, and
status reporting
Assist with any security related
concerns
TBD
Chief Medical Informatics Officer
(CMIO)
Chief Finance Officer (CFO)
TBD
Chief of Fetal and Maternal
Medicine
Rural Outreach Coordinator
TBD
Director of information Technology
TBD
Director of Epidemiology and
Research
Director of Medical Records
TBD
Certified Network Professional
(CNP)/ Technical Advisor
Assist with any technical/network
concerns
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World University of Florida Hospital
TBD
TBD
TBD
Project Charter
9/24/10
Technical Advisor
QA Manager
Assist with any technical/network
concerns
To oversee quality testing
Team Member
Gather requirements for project
Team Member
Gather requirements for project
Team Member
Gather requirements for project
Team Member
TCHS Technical Team Member
Team Member
TCHS Technical Team Member
Business Need/Opportunity
Overall, women in Florida fall short of the Healthy People 2010 National Target of 90% with only 75.9% of women
receiving first trimester prenatal care. Many women still don’t have access to prenatal care due to financial or
geographical factors. Also many women in Florida are uninsured or underinsured before pregnancy. Florida has
7.2 infant deaths (younger than 28 days) per 1,000 (infant mortality rate). The studies show that preterm birth is
the strongest risk factor for infant mortality. If women receive early prenatal care then the chances of preterm
births can be reduced. Hence the World University of Florida Hospital (WUFH) Division of Obstetrics and
Maternal-Fetal Medicine (DOMFM) has partnered with regional health departments to expand access to prenatal
care and improve birth outcomes in underserved counties in Florida. In the 8 target counties, the percentage of
women who do not receive early (1st trimester) prenatal care ranges from a high of 36% to a low of 22%, and the
infant mortality rate ranges from 5.8 to 24.5 per 1000 infants. The purpose of this pilot telemedicine project is to
provide specialized care to four rural counties in Florida in collaboration with rural health departments. Columbia,
Dixie, Gilchrist, Hamilton are four of the eight counties that have been identified as rural with high infant mortality
rates, and a lack of Obstetricians and other specialists to provide prenatal care.
Organizational Need
This is a great opportunity for the World University of Florida Hospital (WUFH) to expand the concept of
telemedicine to all underserved areas. The success of the pilot project will also prompt state officials and private
insurers to offer appropriate reimbursement for telemedicine. The shared resources between WUFH and rural
health departments offer an additional incentive to start the project within next three months. This pilot project is
an ideal candidate for a federal grant in that it addresses clearly identified health care goals currently emphasized
by the federal government. The project also complies with the HIT meaningful use criteria.
Project Goal
The goal of this telemedicine project is to reduce the rate of premature births, improve birth outcomes, improve
access to maternal-fetal specialists for high-risk pregnancies and provide resources to rural obstetricians to
provide state of the art care in conjunction with specialists at World University of Florida Hospital.
Project Objectives
The objectives of this project include:
1. Provide specialized care to pregnant women through telemedicine that helps to improve health care
services in the four medically underserved rural counties in Florida.
2. Prevent premature births via early scanning, diagnosis and treatment.
3. Combine advance technology and specialized care for better health delivery.
4. Enhance the existing outreach programs by the county health departments.
5. Identify high-risk pregnancies early, provide appropriate interventions in the most convenient location and
determine which patients require a higher level of care.
6. Assist in early planning for the most appropriate place for delivery and what services the infant may require
at birth (e.g. level 1 NICU, Pediatric Surgery etc.)
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7. Provide healthcare to uninsured and underinsured rural population.
Project Capabilities
1. Provide real time video and audio consultations from the University clinical office to the remote clinician and
patient.
2. Provide real time image transfer from ultrasound imaging, colposcopy exams and fetal heart tracings.
3. Provide electronic transfer of records between the local clinic and the University EMR.
4. Be in compliance with HIPPA, Medicare/Medicaid and other relevant Telemedicine guidelines and
regulations.
Futuristic Approach
Project future goals and the pilot project should be designed to anticipate future upgrades as funding allows.
1. Allow remote access from laptops/I-pads for emergent consultation outside of business hours.
2. Allow for simultaneous consultations.
3. 24 hour phone consultations
Strategy Alignment of project with WUFH
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Sustain and expand patient clientele within the region
Take benefit of advanced health information technology to improve health care
Provide specialized care to the underserved population
To be able provide affordable healthcare
Internal Stakeholders
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WUF Hospital Board of Directors
WUF College of Medicine
WUFH Department of Obstetrics and Maternal-Fetal Medicine
WUFH Department of Pediatrics
WUFH CIO
WUFH CMIO
WUFH CFO
Chief of Maternal-Fetal Medicine
Director of information Technology
CNP
Rural Outreach Coordinator
Department of Medical Informatics and Biostatistics
Director of Health Information Management
External Stakeholders
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Patients and medical community from rural counties
Florida Department of Health
Medical Directors for Columbia, Dixie, Gilchrist, and Hamilton county health departments
Florida Medicaid
Community representatives
World University of Florida Hospital
Project Charter
9/24/10
Preliminary Cost/Benefit Analysis
Benefits:
 Improved healthcare delivery for women in rural communities of Florida
 Reduce premature births and infant mortality rates
 Increase in number of prenatal telemedicine MFM and MD (non-MFM) consultations
 Increase in number of successful high risk pregnancies
 Increase in number of referrals
 Potential increase in number of patients at
 Medicaid reimbursements
 Increase in revenue
 WUFH recognition and better reputation
Costs:
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Upfront project initiation costs
Purchase of equipment
Maintenance of equipment
IT administration
Technology upgrades
Training of staff
Transportation and installation of equipment and gadgets
Hiring new staff, re-allocation of resources such as staff
Contract with vendor
Project Dependencies
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Availability of telemedicine equipment
Connectivity between sites
Availability of medical software and hardware
Grant funding approval
Timely installation of equipment at WUFH and health department sites
Willingness of patients to be seen by specialists via telemedicine facility
Training and proper understanding of users about telemedicine, usage of technology
Resources at Rural Health departments such as staff, utilities, etc.
Basic Deliverables to be Produced by the Project
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Establish Project Scope
Develop Project Charter
Develop project management plan
Work Breakdown Structure
Schedule management plan
Scope management plan
Cost management plan
Resource plan
Quality management plan
Process improvement plan
Monitor quality of project
Communications management plan
Contract management with Cisco and documentation
Functionality and operation ability of equipment
Risk management plan
Procure management plan
World University of Florida Hospital
Project Charter
9/24/10
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Manage project execution
Monitor and control project schedule, cost and time
Monitor performance of equipment and employees
Preliminary Project Scope
Items In Scope
 The planned telemedicine workflow will allow all health care providers in the region to make a referral to
the program by contacting the University.
 Accepted patients will be scheduled for a preliminary visit to the appropriate health department
 Clinical and demographic information will be collected/ updated and sent electronically to WUFH, where a
patient record will be created in the EMR.
 All medical information of the patient will be integrated in patient’s EMR (including old medical records,
ultrasounds, allergies, laboratory tests etc.)
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The Clinical Coordinator will review the records and set up an appointment with the appropriate
physician.
 Reminder notices will be sent to the patient by the university
 Consultation via two–way video conferencing between the specialist at the university and the patient,
who will be accompanied by the health department physician/midwife and/or the referring private doctor
(if needed to be present).
 A physical exam, ultrasound, fetal tracings and colposcopy exam will be performed by the local provider
as per instructions by specialist
 Real time electronic transfer of images/tracing to the specialist
 Communication by specialist for any additional lab studies.
 Additional lab studies arranged by local clinical coordinator at the conclusion of the visit.
 Comprehensive assessment and treatment plan to be created before patient leaves rural health
department.
 Future appointments arranged as per requirement.
Items Out of Scope
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Some conditions cannot be treated or diagnosed at the rural health department; such cases will be
referred to the specialist at WUFH for further assessment and tests.
Other programs that are not directly related to ob-maternal and fetal medicine
Community education
EMR management
Data repository management
Project Schedule
(To be completed during phase III of project)
Enter the desired project phase start and end dates and any known or projected milestones at the time the project charter is written.
Program/Project Phase
Requirements
Phase Component
Initiate
Business Requirements
Client Requirements
Functional Requirements
Architecture
Documentation
Projected Start Date
Projected End Date
Project Assumptions
List all assumptions for this project idea known at the time the charter is written
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Necessary funds are available to design and implement pilot telemedicine project
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Necessary resources are available to initiate project (e.g. labor, transportation, equipment, etc.)
Specialists at WUFH are willing to participate and cooperate with telemedicine project
Rural women population is willing to receive testing, diagnosis and treatment
Systems are ready for EMR and new technological adoptions.
Project Constraints (including Executive or Mandated)
List significant constraints such as milestone dates, project end dates, resource availability, resource skill availability, and budget for this
project idea known at the time the charter is written
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New costs may occur as project progresses
Equipment and software required for the project may not be available well in advance before the expected
start date of project implementation
Technical difficulties during data transfer
Patient concerns such as data security and privacy
Failure of patients to keep the appointments
Is the Deployment Date (Production Date) immovable due to regulation, legal, or executed contract?
(Yes or No, if Yes - Explain) NO
Project Impacts
Business Unit or Functional Area
1. WUF Department of IT
2. WUFH department of Obstetrics and
Maternal-Fetal medicine
3. County Health Departments
4. WUF College of Medicine
5. WUF Hospital
6. Finance Department at WUFH
7. HR department at WUF
8. Telemedicine clinical and administrative
staff
9. Clinical Staff
How Impacted?
Increase in responsibilities and accountability, additional
employees to be hired and trained, EMR changes,
interoperability of systems, etc.
Potential increase in patients, increase in revenue,
recognition and reputation, more patient flow, changes in
workflow, scheduling, etc.
Change in workflow, change in work hours and pattern,
increase in number of patients, rearranging offices if
needed, furniture and telemedicine set up, etc.
More patient data available for research, research scope
increased
Potential increase in patients, increase in revenue,
recognition and reputation, more patient flow, changes in
workflow, scheduling, accommodating more patients, etc.
Increased work
Scheduling requirements, contracts, hiring, etc.
New hires, training, reallocation of employees, change of
responsibilities, etc.
More patients, change in work flow, change in care
delivery, training, on site rotation of nurses, etc.
Project Communication:
(To be completed during phase III of project)
Consider what groups will need to be communicated during and upon completion of this project both externally and internally.
Group
Leadership
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Medium
Status Report
Purpose/Content
Update IT
Leaders on
progress, risks,
issues
World University of Florida Hospital
Frequency/Timing
Weekly
Project Charter
Group Membership
All Project Members
9/24/10
Leadership
Steering
Meetings
Project
Team
Meeting
Review and
discuss major
project issues,
risks, and
decisions
Daily 15 minute
stand up
meetings during
implementation
Weekly
All Project Members
Daily
All Team Members
Project Risks and Issues
List all the risk factors or Issues that may affect or have affected/impacted the project idea relating to Cost, Time, Scope, Quality, Risk or
Customer Satisfaction. .
Definitions:
Risk: A potential condition or event that could have either a positive or negative effect on a project's objectives if it occurs.
Issue: A risk event that has already happened or is about to occur.
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Risk/Issue Name
Security concerns
Privacy concerns
Legal issues
Liability issues
Reimbursement issues
Workflow concerns
Accommodation of additional equipment and staff
Patient satisfaction
Facility misuse
Interoperability issues
Project Charter Approval (from Ideation).
(To be completed during phase III of project)
This approval authorizes the project to begin the 1.0 Project Initiations.
Completion of the preliminary project charter, and this approval, will enable the project idea to begin execution.
Name:
Title:
Date:
WUFH Executive Leader
Project Sponsor:
Name:
Title:
Date:
Business Owner:
Name:
Title:
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Date:
World University of Florida Hospital
Project Charter
9/24/10