Section 2.2 Plan
Project Management
This tool lists the general functions a project manager is expected to perform, including project
oversight and documentation.
Time needed: 4 - 6 hours
Suggested other tools: Section 2.1 Communication Plan, Section 2.4 Visioning, Goal Setting, and
Strategic Planning for EHR and HIE
Introduction
For a home health agency implementing an electronic health record (EHR) and/or health information
exchange (HIE), individuals are likely to wear many hats in support of the initiative. Whether a
person is assigned as a full-time project manager, spends part of the time on IT and part on project
management or is a consultant brought on board for the project, the role of the project manager is
essential.
How to Use
1. Agency administrators should review project manager functions and determine who will serve as
the project manager for its EHR, HIE, and other HIT implementations.
2. Agency administrators should review information on establishing project governance, including
establishing decision making structures and a HIT steering committee.
3. Agency project manager should review the tips for managing project documentation, meetings,
agendas, and minutes.
Project Manager Functions
For any HIT (EHR, HIE, or other HIT) project, the project manager should be someone with strong
organizational skills and attention to detail to perform the following functions:
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Ensure readiness for HIT adoption
– Provide for HIT education for the organization
– Assess readiness
– Facilitate identification of goals, critical success factors, assumptions, risks, and
obstacles
Organize the effort
– Facilitate formation of HIT steering committee
– Plan communications
– Document project tasks
Initiate change management
– Oversee workflow and process mapping and redesign
– Identify HIT functional requirements
– Coordinate technical requirements
– Plan chart conversion
Coordinate vendor selection if applicable to your agency
– Support code of conduct
– Aid in surveying the marketplace and narrowing the field of candidates
• Vendors for EHR
Section 2 Plan—Project Management - 1
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• Vendors for HIE
• Vendors for other HIT
– Coordinate RFP issuance, response, and evaluation
– Coordinate due diligence activities
– Assist in identifying financing
Coordinate implementation
– Establish a progress reporting system
– Maintain an issues log/problem-escalation procedure
– Install a change control process
– Harmonize the vendor’s project plan with the organization’s needs
– Develop a rollout strategy
– Monitor task completion
– Support system build
– Oversee training plan
– Oversee testing plan
– Plan and manage go-live
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author.
Although go-live typically signals the end of a project, adopting EHR and HIE will result in an
ongoing program of clinical quality improvement and HIT enhancements. The person designated as
project manager often stays with this new program to: coordinate ongoing maintenance and benefits
realization; monitor and ensure adoption; optimize use of the EHR, HIE, or other HIT; and evaluate
upgrades and opportunities for additional technology.
Project Oversight
Many organizations find themselves in analysis paralysis over HIT decisions—how they should plan
strategically, which vendor to select, when to implement and who should be involved. Frequently,
this is because HIT may still be somewhat unchartered territory and definitely is expensive.
Establishing an HIT governance structure provides authority for decision making at the lowest level
possible for each type of decision to be made.
Adaptability to Various Types of Organizations
Organizations vary in size and governance. But all need to plan for decision making that provides
authority and responsibility and that everyone understands and accepts. This expedites decision
making and eliminates second guessing.
An organization that is part of a larger, multi-site corporate structure may not create its own
governance structure, but should urge the corporation to adopt such a structure if it does not already
exist. The organization also should understand how it fits into the overall structure.
Large independent organizations may already have an HIT steering committee and/or HIT project
manager. If an HIT governance structure describing the organization and its decision-making does
not yet exist, there is no time like the present to create one. If one exists it can be helpful to review
and modify the structure as needed before any major HIT investment is made.
Small independent facilities may not feel an HIT governance structure is needed. However, smaller
organizations sometimes need structure the most, as they are often accustomed to decision-making
by committee or unilaterally by one individual.
Section 2 Plan—Project Management - 2
Following is a list of many of the decision-making tasks an organization may encounter in its HIT
projects. Identify, for your organization, at what level each decision should be made. Add or delete
tasks that don’t apply.
The tasks are listed by the level at which they are usually made (i.e., board and executive
management at the top; individual user at the bottom). In general, if a group of users will be affected
by the decision, the decision should be made by the group as a whole, or representatives of the group
if it is a larger organization.
Decision-Making Task
Release of funds
Contract approval
Contract negotiation
Benefits expectation setting/benefits realization
Project staffing/steering committee formation
Community engagement
(HIE) trading partner communications
Contract management
Communication plan
Vendor selection code of conduct
Goal setting
Strategic planning/migration path
IT acquisition strategy
Acceptance testing
Project management/domain team formation
Project budget
Functional requirements
HIE participation
Chart conversion strategy
Turnover and roll-out strategies
Input devices
Issues management
Super user identification
Clinical documentation standards
Design of screens
Adoption of practice guidelines/care paths
Clinical work flows
Core data sets
Customization of screens and templates
Clinical decision support rules
Customizations of reports
Data dictionary/master files and tables
Data conversion
Contingency planning
Staff development
End user training
Section 2 Plan—Project Management - 3
Organizational Unit to Make Decision
Decision-Making Task
Organizational Unit to Make Decision
Data quality management
Interface testing
System testing
Go-live readiness
Archive requirements
Network bandwidth requirements
Change control
Document management and control
Security controls
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author
HIT Steering Committee
Steering committees serve the following functions:
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Help educate all stakeholder constituencies
Represent all stakeholder interests to ensure equality in decision-making
Provide shared decision-making so that there is buy-in for the project
Serve as a forum to arbitrate disputes or dilemmas among stakeholders
The following is a guide to the types of people who should be on an HIT steering committee,
depending on the size of the organization. For small, independent home health agencies, four to six
people may be on the committee; larger facilities may have as many as eight or 10 members. For
agencies that are part of a corporate structure, an HIT steering committee may not be responsible for
vendor selection or even customization of the system. But the committee should be responsible for
local communications, workflow and process redesign, testing, training, go-live, change
management, user adoption, and optimization.
HIT Steering Committee Members
Purpose
Chair of steering committee
Individual should be able to lead the committee with an unbiased
approach and be able to devote the time to planning and attending
meetings and performing follow-up activities.
At least two nurse representatives and
one physician, including both champions
and resisters; if multiple sites, include at
least one nurse from each site (or region
if many sites)
Nurses (and to a limited extent physicians) will be the primary users
of EHR and HIE. They need to fully understand and be engaged in
the selection (for independent organizations), implementation,
adoption, and optimal use of the EHR and HIE. Including
champions is the natural inclination. Including resisters helps
recognize types of potential resistance and helps craft ways to
overcome such resistance.
Representative(s) from other support
services as applicable
If there are other key departments that will have input into or
retrieve data from EHR or HIE, be sure to include them.
Representatives from other departments may already have some
experience with information systems and can be called upon to
assist new users in their adoption.
Representative(s) from administration,
business office, health information
management, and IT
While EHR and HIE are largely clinical systems, they must support
charge capture, care management, and other operations of the
organization. IT staff should be involved to understand the scope of
technical support required for both implementation and ongoing
maintenance; and health information management (HIM)
professionals should be involved to ensure a legal health record.
Section 2 Plan—Project Management - 4
HIT Steering Committee Members
Purpose
Project manager
As this individual is the central coordinating person, the project
manager should be a full time member of the steering committee
and be given authority to allocate other staffing resources as
required and feasible for the size of the organization.
Other individuals may support the
steering committee at different times.
For example:
 Board liaison
 Chief financial officer
 Procurement specialist
 Legal counsel
 EHR/HIE consultant
 IT consultant
 External contract negotiator
 Trainers
 Human resource specialist
 Grant writer
Depending on the size of the organization, each of these individuals
may play unique roles. If you have a board of directors, a liaison can
represent the interests of the steering committee to the board. The
CFO or the chief accountant can assist in assessing financial
readiness, identify financing sources, compiling the business case
(return on investment), and planning pro forma financial statements
in preparation for seeking a loan or responding to a grant
opportunity. Some organizations may have a procurement specialist
who is accustomed to negotiating major contracts and can provide
assistance in contract negotiation as well as plan the acquisition of
hardware and any required physical plant and/or furnishing
changes. Legal counsel should review the contract from a legal
perspective and be available to provide assistance in interpreting
state statutes relative to electronic information management. An
EHR/HIE and/or IT consultant may help navigate the many vendor
choices and steps in preparedness, selection, and implementation.
Sometimes a consultant is also brought in to negotiate your
contract. If you have training staff, involve them during some of the
phases to assist in training. A human resource specialist can assist
in developing job descriptions for new/changed positions, work with
the organization to manage change for its employees, and assist in
any labor relations issues. If the organization expects to seek grant
funds, a grant writer will need to be included in some of the steering
committee activities.
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author.
Steering committee members:
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Must be given authority commensurate with their responsibilities.
Must be educated about HIT, EHR and HIE, with education a part of the formative stages of
the committee’s work. It is not necessary or even desirable to seek only members who
already have such knowledge.
Are expected to attend every meeting. Delegates are not acceptable.
Must represent their constituents, have the opportunity to educate them, and learn of their
requirements.
Are expected to work as a team with other committee members, demonstrating willingness to
reach consensus.
May need release time to perform duties such as conducting product reviews, reviewing
proposals, etc.
Tips on Project Documentation
A key responsibility of project management is ensuring that projects are completed on time and
within budget. In addition to the functions described above, documentation is a crucial ingredient in
successful project management.
Project documentation:
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Promotes objectivity
Avoids re-work
Section 2 Plan—Project Management - 5
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Helps achieve on-time, on-budget implementation
Is evidence of action
Supports training
Is a reference for future changes
Some forms of project documentation a project manager should be prepared to handle. The
corresponding sections for applicable tools within this toolkit, include:
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Meeting agendas and minutes see below
Communication planning and tracking
Workflow and process redesign
Requirements specification
Selection evaluation
HIE/HIO participation and other agreements
Issues log
Plans and progress
System documentation
Change control
Training logs
Test results
Patient consent forms
Satisfaction surveys
Version control is often a challenge in managing project documentation. Be sure that every document
created for the project reflects:
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Name of the agency
Name of the person who created the document
Name of the person who approved an important document (such as policies, agreements,
contracts, changes to systems)
Date of creation
Subsequent dates of revision
Tips for Managing Meetings
Committee meetings are essential for planning, making decisions about, and optimizing use of HIT,
but they are also notorious for taking up valuable time. Here are some ways to work more effectively
in meetings:
 Hold a meeting to determine what meeting formats are needed to start off on the right track.
Review the following tips and establish ground rules. Think about how to facilitate meetings,
draw people out, communicate effectively, etc. Many organizations have dysfunctional
meetings because they have never taken time to study processes and correct them.
 Meetings should be held to make decisions, take action, or obtain information that cannot be
learned independently. Circulate reports a few days before a meetings and set the
expectation that they will be read by the time of the meeting.
 Assign groups specific tasks and the authority to accomplish those tasks outside of the
steering committee. These groups—the domain teams—may choose to work using a nominal
group process for structured problem solving or informally over lunch. Encourage them not
to hold formal meetings; suggest stand-up meetings or hallway conversations instead.
 Always adopt an agenda and stick to it for all formal meetings. The agenda should be action
oriented with specific, assigned responsibilities for each member. Keep track of all items on
the agenda and ensure each one is covered, even if it is deferred.
Section 2 Plan—Project Management - 6
 Meetings must start on time, even if only one person is present. Except in a true emergency,
arriving late to a meeting shows disrespect for fellow members and upsets everyone’s
schedule. Meetings must also end on time.
 Identify follow-up activities and assign lead individuals and deadlines. The chair of the
meeting and/or project manager should follow up with these individuals immediately to
ensure they understand the task and have the tools to perform it. Follow-up should continue
until immediately prior to the assignment deadline to ensure the task is completed.
 Use a “sergeant-at-arms” if necessary to put distracting conversations into a parking lot and
to halt discussion if someone is being obstructive, unprepared, or off course. Rotate the
sergeant-at-arms for each meeting so no one person is viewed as the “bad cop.”
 Have fun and celebrate accomplishments. HIT is hard work and may be among the most
challenging and largest investments the organization will make—after a new building,
merger, or acquisition. Organizations that recognize the need to “work hard and play hard”
and to negotiate compromises are generally the most balanced, effective, and efficient.
Sample Agenda and Minutes
Agendas and minutes are important elements to ensure that meetings are run smoothly. A sample
agenda using a standard form to capture key elements for creating the minutes, an example of the
resulting minutes, and a blank template follow.
Sample HIT Steering Committee Agenda
Time: 1:00 – 2:30 PM
Date: Oct. 14
Location: Conf Rm B
Invitees: Ms. Adams (leader), Dr. Brown, Ms. Jones, Mr. Madison, Ms. Smith, Mr. Underwood
Time
1:00 PM
Action
Determine if anyone has any questions
or corrections to minutes or progress
report (attached)
Narrow field of vendors from 10
researched by the EHR Domain Team to
5 to send RFP
1:10 PM
Ms. Adams review key differentiating
factors (attached) approved at last
meeting
1:20 PM
Ms. Smith present matrix comparing
vendors on key differentiating factors
(attached)
1:30 PM
Discussion
2:15 PM
Vote
2:20 PM
Assign RFP Domain Team to assist Ms.
Smith in finalizing RFP
Review accomplishments
Identify improvements to meeting process
2:25 PM
Identify topics for next meeting
2:30 PM
Adjourn
Section 2 Plan—Project Management - 7
Outcome
Sample HIT Steering Committee Minutes
Time: 1:00 – 2:30 PM
Date: Oct. 14, 2009
Location: Conf Rm B
Present: Ms. Adams (leader), Dr. Brown, Ms. Jones, Ms. Smith, Mr. Underwood
Absent: Mr. Madison (excused)
Time
1:00 PM
Action
Determine if anyone has any questions or
corrections to minutes or progress report
(attached)
Outcome
None
Narrow field of vendors from 10
researched by the EHR Domain Team to
5 to send RFP
1:10 PM
Ms. Adams review key differentiating
factors (attached) approved at last
meeting
1:20 PM
Ms. Smith present matrix comparing
vendors on key differentiating factors
(attached)
1:30 PM
Discussion
2:15 PM
Vote
Clarification sought and made to key
differentiator on vendor support.
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2:20 PM
Assign RFP Domain Team to assist Ms.
Smith in finalizing RFP
Vendor J met all key differentiating
factors; however, it is being acquired by
Vendor X. This acquisition will be in
Vendor J’s favor.
Vendor H is a local vendor with 5 clients,
but no national presence. Vendor H
meets all key differentiating factors except
for the ability to perform real time alert
messaging. Vendor H rejected.
Vendors B, C, E, F, and I do not meet
several key differentiators and are
rejected.
Only vendors A, D, G, and J meet all key
differentiating factors at this point in the
analysis and will be sent RFP.
Team comprised of Ms. Jones, Ms. Adams,
Mr. Madison
Special thank you to Dr. Brown for polling physician community about their ability to use a
provider portal and Ms. Smith for facilitating the discussion to reach a list of candidate
vendors and to Mr. Underwood for researching vendor J. Members were reminded to
follow the Code of Conduct for Vendor Selection and to direct all vendor contacts to Ms.
Smith.
2:25 PM
The next meeting will be Oct. 21 to
- Approve the RFP
- Develop the RFP response evaluation form
2:30 PM
Adjourn
Agenda/Minutes Template
HIT Steering Committee Agenda/Minutes
Date:
Invitees (list for agenda):
Present (list for minutes):
Section 2 Plan—Project Management - 8
Time:
Location:
Absent (list for minutes):
Time
Action
Outcome
Review accomplishments
Identify improvements to meeting process
Identify topics for next meeting
Adjourn
Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author.
Copyright © 2013
Section 2 Plan—Project Management - 9
Updated 11-20-13