Professional Documents
Culture Documents
By Tara Wyllie
Contabilidad Every project starts with a need. In IT departments, the need for a particular innovation is often
con OpenERP warranted and the project justified, but many innovations fail to materialize because the managers
Gestione sus driving the initiative are unable to link it to the rest of the organization. Aligning any project with
the overall vision and goals of your organization should be considered critical. Without this, the
operaciones
true benefits of the project are unlikely to materialize.
contables
Análisis For Ryan, the planning process started with consultations with the executive on both projects to
financiero en ensure that the initiatives didn’t contradict the overall business plan and strategic vision of Interior
línea Health. Executive sponsorship was critical to these projects — the executive maintained its
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accountability, helped resolve issues, eliminated barriers and supported the project teams.
Once the projects lined up with Interior Health’s directives, the IT department had to ensure both
projects had solid planning and business-case principles backing them up as they moved from
preparation and planning into deployment.
Interior Health’s clinical systems implementation (CSI) followed suit. Norma Malanowich, director
of electronic health records development, championed this project. The need for a single, efficient
solution was extended beyond business systems through to end users and patients. In this case,
the charge was to create a system that would consolidate and standardize the electronic health
record (EHR) of individuals within the health authority and make it accessible from both on-site
and off-site locations. This evolving record of an individual’s health care history information, when
standardized and available to authorized clinicians and physicians within Interior Health, provides
vital and current patient information when and where it’s needed.
The business case here stressed that any proposed system would have to bridge the distance
between multiple facilities and regions within the Interior Health’s vast geographical framework.
The solution eventually chosen would include an investment of $20 million in IT and EHR
initiatives.
With the plan in place and the technology partners on board (Meditech, IBM, EMC, Telus, VODA
and Picis), the next step was to embark on the process of establishing standards and retraining an
entire organization.
Getting managers to commit to a large scale IT initiative and sticking to the plan is half the battle.
The other half is empowering those managers — challenging and stretching them to find ways for
continuous learning through the process, and adapting to roadblocks along the way. To do this,
ensure that there are open channels of communication, hold frequent project reviews, and select
managers that have the foresight to circumvent risks before they happen. All of these are effective
ways of empowering your managers to work with you toward an end goal. Ryan states that “one
of the keys to success in both of the IHA deployments was the strong foundation of teamwork
based on these concepts.”
Project teams were established from the top down, starting with the executive. The project
steering committee for the BSI was made up of project managers from each specialized area
required for the different modules of the business system. The committee met and submitted
reports bi-weekly to the executive sponsor, and submitted quarterly reports to the board.
This type of organizational structure, while typically hierarchical, represents how the pieces of this
project were broken down and responsibility assigned to ensure adequate levels of support and
accountability. It maximized project flow efficiency by focusing on frequent and effective
communication that flowed through all levels of the project teams up to and including executive
sponsorship. This was deliberate and successfully avoided potential roadblocks by keeping all
participants aligned with senior management. Initiative project manager Mal Griffin adds, “Never
underestimate the importance of communication. Communicate often and use many forms.”
The CSI project was more formal, though it still allowed some creativity through workshops for
everyone from project managers through to end-users. The project managers developed project
charters in a facilitated workshop setting, creating a strong commitment to the plan and a sense of
ownership in the process. Formal communication and risk management plans were developed and
tools such as decision and issue documentation were used extensively.
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Cohesive teamwork drove the success of the first two phases of this project. It took 34 project
teams led by 123 individuals planning and executing consecutively to implement the EHR. Despite
the fact that all systems went live simultaneously, there were no major issues or downtime. All
projects were completed and implemented on time and under budget. There were no occurrences
where project scope was decreased. In some instances, however, additional scope was authorized.
For example, a physician payments system was added and completed.
IT initiatives are commonly beset by cost overruns and poor delivery — companies just don’t get
what they’re told they should expect from a system. Demonstrating the ROI on IT projects has
often been considered difficult, but successful project managers now accept that it’s crucial for
getting projects off the ground and for proving the benefits of the system once implemented. The
investment must be justified by demonstrating clear business results — cost savings, time and
efficiency improvements etc.
The integration of disparate business systems for the IHA has shown the anticipated benefits in
both time and cost savings, operational efficiency and consolidated and improved financial
information. These efficiencies extend across the organization, providing improved organizational
effectiveness and customer service to Interior Health’s employees as well.
Interior Health’s CSI project has progressed through a multi-phased, geographically based plan
encompassing numerous facilities and health service areas in both urban and rural settings. With
phases one and two of the plan complete, 70% of the organization’s physicians now use the EHR
from both facilities within the authority and from off-site locations. Sixty-two per cent of all
facilities have now been converted to the system at this point. Phase three went live in March, and
the final and most complex phase due to number of facilities and largest geographical area, is
scheduled for April 2005.
The statistics and progress for the CSI project are impressive, but it’s the high level of user
adoption and acceptance that is the real success story. The health industry is typically considered
slow to adopt new technologies. Staff and physicians accessed the EHR system almost 500,000
times in a three-month period, which shows how the technology has been embraced to enhance
medical decision making.
Back to basics
For Pat Ryan and Interior Health, going back to basics by focusing on the principles of
organizational alignment, business case approaches, teamwork, and proven benefits have been
practical magic for their large-scale IT initiatives over the past two years. The projects have not
only been approved in the midst of a cautious economic atmosphere, but ran smoothly to
completion. Both implementations, when plugged into IHA’s project management method, were
completed on schedule, under budget, with direct and measurable financial and clinical benefits.
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Reflecting on both projects, Pat Ryan boils it down to this — “having great people, applying
practical, common sense approaches and working hard to ensure IT alignment with all levels of
the organization is what it’s all about. What we’re really doing is laying a foundation for business
intelligence to support the organization as a whole.”
The best practices that IHA’s team has sifted out of the volumes of those out there seems to be
working for Interior Health, establishing them as innovators in the Canadian healthcare market.
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