transitioning a medical organization to electronic record

Transitioning a Medical Transitioning a Medical

Organization to Electronic Organization to Electronic

Record Keeping Record Keeping throughthrough

Open and Honest Stakeholder Open and Honest Stakeholder

CommunicationCommunication

Ben Kahn, MBA, PMPBen Kahn, MBA, PMP

PMI Corvallis BranchPMI Corvallis Branch

September 21, 2012September 21, 2012

Oregon State HospitalOregon State Hospital

�� Built in Built in

1883.1883.

�� Psychiatric Psychiatric

Hospital for Hospital for

Mentally Ill.Mentally Ill.

�� 2,500 2,500

employees.employees.


�� 600 patients600 patients

�� Paper ChartsPaper Charts

�� Difficult Difficult

work work

environmentenvironment


�� 150 acres.150 acres.

�� 60 60

buildingsbuildings

�� Two Two

campuses: campuses:

Salem Salem andand

PortlandPortland


�� No real No real

technology technology

available. available.

�� Started Started

using using PCPC’’ss

in 2005.in 2005.


�� CremainsCremains..

OSH Replacement ProjectOSH Replacement Project

Behavioral Health Integration Behavioral Health Integration

Project (BHIP)Project (BHIP)

Project Assignment (in late 2007)Project Assignment (in late 2007)::

�� Procure, Configure, Train, & Implement an Procure, Configure, Train, & Implement an Electronic Health Record (EHR) system with Electronic Health Record (EHR) system with Lab Management, Pharmacy Management and Lab Management, Pharmacy Management and Client Funds Management components.Client Funds Management components.

�� Budget: $29 million.Budget: $29 million.

�� Implement while construction is occurring.Implement while construction is occurring.

�� Implement with a team of 8 (including myself).Implement with a team of 8 (including myself).

�� Finish before the buildings are done (Mid 2012).Finish before the buildings are done (Mid 2012).

Stakeholder CommunicationStakeholder Communication

�� One thing I learned over and over again is the One thing I learned over and over again is the

importance of Stakeholder communication.importance of Stakeholder communication.

�� There were many challenges on this project. There were many challenges on this project.

�� II’’ll share some with you & ask how you might ll share some with you & ask how you might

solved them.solved them.

�� Then IThen I’’ll share what we did.ll share what we did.

�� Sometimes we got it right, and sometimes we Sometimes we got it right, and sometimes we

didn't.didn't.


�� Many issues on a project center around Many issues on a project center around

communications and communication communications and communication

management.management.

�� LetLet’’s do a quick PMBOK refresher course on s do a quick PMBOK refresher course on

Communications ManagementCommunications Management..

Identifying StakeholdersIdentifying StakeholdersInputsInputs

�� Project CharterProject Charter

�� Procurement DocumentsProcurement Documents

�� Enterprise Environmental FactorsEnterprise Environmental Factors

�� Organizational Process AssetsOrganizational Process Assets

Tools and TechniquesTools and Techniques

�� Stakeholder AnalysisStakeholder Analysis

�� Expert Judgment*Expert Judgment*

OutputsOutputs

�� Stakeholder RegistryStakeholder Registry

�� Stakeholder Management Strategy*Stakeholder Management Strategy*

Plan CommunicationsPlan CommunicationsInputsInputs

�� Stakeholder RegistryStakeholder Registry

�� Stakeholder Management Strategy*Stakeholder Management Strategy*

�� Enterprise Environmental Factors Enterprise Environmental Factors

�� Organizational Process Assets Organizational Process Assets


�� Communication Requirements AnalysisCommunication Requirements Analysis

�� Communication TechnologyCommunication Technology

�� Communication ModelsCommunication Models

�� Communication Methods*Communication Methods*

OutputsOutputs

�� Communication Management PlanCommunication Management Plan

�� Project Documentation updatesProject Documentation updates

Distribute InformationDistribute InformationInputsInputs

�� Project Management PlanProject Management Plan

�� Performance ReportsPerformance Reports




�� Information Distribution ToolsInformation Distribution Tools

OutputsOutputs


Manage Stakeholder ExpectationsManage Stakeholder ExpectationsInputsInputs

�� Stakeholder RegisterStakeholder Register

�� Stakeholder Management Strategy* Stakeholder Management Strategy*

�� Project Management PlanProject Management Plan

�� Issue & Change LogsIssue & Change Logs




�� Interpersonal Skills*Interpersonal Skills*

�� Management SkillsManagement Skills

OutputsOutputs


�� Change RequestsChange Requests

�� Project Management Plan UpdatesProject Management Plan Updates

�� Project Doc UpdatesProject Doc Updates

Stakeholder RegistryStakeholder Registry

Wants to see Wants to see

business business

continuity continuity

planplan

9/5/119/5/11Unintended Unintended

system system

downtimedowntime

8/2/118/2/11Short Short

EE--mail mail

messagemessage

Nurse Nurse

JillJill

Can halt Can halt

project if not project if not

satisfiedsatisfied

10/5/1110/5/11Security Security --

who has who has

access to access to

system?system?

9/4/119/4/11In In

personpersonDr. Dr.

JonesJones

Other NotesOther NotesNext Next

Comm.Comm.Biggest Biggest

ConcernConcernLast Last

Comm.Comm.Pref. Pref.

Comm. Comm.

MethodMethod

StakeStake--

holder holder

NameName

Interpersonal SkillsInterpersonal Skills

Recent LINKEDIN survey, project management Recent LINKEDIN survey, project management

participants were asked to describe a Project participants were asked to describe a Project

Manager in 3 words or less . . .Manager in 3 words or less . . .

Essential Tired Control Freak

Accountable Planner Magician

organizer babysitter flexible

Leader facilitator COMMUNICATOR

Project Issue #1Project Issue #1

�� We sent out an email to 1,500 hospital staff We sent out an email to 1,500 hospital staff letting them know about the efforts underway letting them know about the efforts underway to procure an electronic health record system. to procure an electronic health record system. Of the 1,500 email messages that went out, Of the 1,500 email messages that went out, only 30% were read. only 30% were read.

�� Is this the right Communication Method / Is this the right Communication Method / Distribution Tool to use for sharing information with Distribution Tool to use for sharing information with the hospital staff?the hospital staff?

�� Is there a better way to communicate? Ideas?Is there a better way to communicate? Ideas?

HereHere’’s what we dids what we did�� In person, Ward visits In person, Ward visits –– all units (22), all shifts; all units (22), all shifts;

�� Attended existing Department Meetings;Attended existing Department Meetings;

�� Newsletter (hard copy); Posters; Contests;Newsletter (hard copy); Posters; Contests;

�� And email & Website.And email & Website.

Four GenerationsFour Generations

�� TraditionalistsTraditionalists –– (Born before 1945) (Born before 1945) –– may not may not always read their emailalways read their email

�� Baby BoomersBaby Boomers –– (Born between 1946(Born between 1946––1964) 1964) ––read most of their emailread most of their email

�� Generation Generation XersXers –– (Born between 1965(Born between 1965--1979) 1979) –– in tune with technologyin tune with technology

�� Generation Y or Generation Y or MillennialsMillennials –– (Born after (Born after 1980) 1980) –– ConnectedConnected

�� Communication methods must be adapted to each Communication methods must be adapted to each audience group.audience group.


�� Because we were a project team, coming to Because we were a project team, coming to

help the hospital purchase and implement an help the hospital purchase and implement an

EHR, there were suspicions and uneasiness EHR, there were suspicions and uneasiness

about whether or not we would purchase the about whether or not we would purchase the

rightright system. Staff from the various hospital system. Staff from the various hospital

departments and disciplines wanted to make departments and disciplines wanted to make

sure we chose the best product that would sure we chose the best product that would

meet their needs. meet their needs.

�� How would you make sure that the hospital staff feel How would you make sure that the hospital staff feel

like they got the right system?like they got the right system?

What we didWhat we did

�� Invited 120 hospital staff to participate in the Invited 120 hospital staff to participate in the vendor selection process. vendor selection process.

�� They reviewed written proposals, attended the They reviewed written proposals, attended the vendor demos, and scored various components of vendor demos, and scored various components of the proposals. the proposals.

�� In the end, the hospital picked the EHR. It In the end, the hospital picked the EHR. It wasnwasn’’t Bent Ben’’s EHR or the Projects EHR or the Project’’s, it was s, it was selected by the hospital staff. selected by the hospital staff.

�� This created huge buyThis created huge buy--in.in.

OSH Staff ParticipatingOSH Staff Participating


�� The Project Administrator came to me The Project Administrator came to me

with with ““good newsgood news””. The first wing of the . The first wing of the

hospital would be done one year early. hospital would be done one year early.

There are There are no paper chart file roomsno paper chart file rooms in the in the

new hospital, because of the highly new hospital, because of the highly

anticipated EHR. She wanted to know if anticipated EHR. She wanted to know if

I could have the EHR software ready to I could have the EHR software ready to

go go one year earlyone year early??

�� What would you tell your do?What would you tell your do?

HereHere’’s what I dids what I did

�� Asked software vendor if they could have the software Asked software vendor if they could have the software

configuration done a year early. They said configuration done a year early. They said ‘‘yesyes’’..

�� Reviewed the schedule and found that the vendor took Reviewed the schedule and found that the vendor took

out most of the dependencies. The schedule was now full out most of the dependencies. The schedule was now full

of risks.of risks.

�� Went back to the project administrator and told her that Went back to the project administrator and told her that

we would not be able to get it done a year early. we would not be able to get it done a year early.

�� Honest communication, no matter how hard it may be, Honest communication, no matter how hard it may be,

is the best approach.is the best approach.


�� Had to train 1,500 clinical staff prior to Go Had to train 1,500 clinical staff prior to Go

Live. Had an extensive training plan. Live. Had an extensive training plan.

�� About 4 weeks into the training, we noticed that About 4 weeks into the training, we noticed that

some staff were not showing up to their class.some staff were not showing up to their class.

�� Go/No Go gate stated that 90% of staff needed Go/No Go gate stated that 90% of staff needed

to be trained before go live. Our projections to be trained before go live. Our projections

were showing that at current pace, only 60% were showing that at current pace, only 60%

would be trained.would be trained.

�� What would you do?What would you do?

What we didWhat we did

�� Presented the problem to the Hospital Executive Team. Presented the problem to the Hospital Executive Team.

�� Superintendent told staff: Superintendent told staff: ““if you donif you don’’t get trained, you t get trained, you dondon’’t workt work””. .

�� Had support staff do Had support staff do ““reminderreminder”” calls the day before.calls the day before.

�� Overbooked all the classes (15 in 12 seats).Overbooked all the classes (15 in 12 seats).

�� Had my team teach extra classes (lots of OT)Had my team teach extra classes (lots of OT)

�� Identified non clinical staff that could be trained after go Identified non clinical staff that could be trained after go live.live.

�� ResultResult: 97% received training.: 97% received training.


�� Constant communication.Constant communication.

�� Open and honest communication.Open and honest communication.

�� Use the right Communication Method / Use the right Communication Method /

Distribution Tool at the right time.Distribution Tool at the right time.

�� Perform ongoing stakeholder analysis to make Perform ongoing stakeholder analysis to make

sure you target the communication.sure you target the communication.

Success!Success!Went live 11/1/11,Went live 11/1/11,

in 2 hospitals,in 2 hospitals,

with 1,500+ users.with 1,500+ users.

Avatar EHRAvatar EHR

Top 3 Lessons I LearnedTop 3 Lessons I Learned

1.1. DonDon’’t assume.t assume.

2.2. BuyBuy--in is critical to success.in is critical to success.

3.3. Be honest.Be honest.

Thank you!Thank you!

Ben Kahn, MBA, PMPOregon Health Authority

COMPASS [email protected]