Migrating from v.6 to v.9 - A Client's Perspective Jacob Krive, Project Manager - Information Systems Advocate Health Care Ken Hackl, API Healthcare Project Manager

Welcome Please silence all electronics Remember to complete the session survey

Advocate Health Care Overview Based in Oak Brook – largest IDN in metropolitan Chicago and the state of IL Related to both the Evangelical Lutheran Church of America (ELCA) and the United Church of Christ (UCC) More than 250 sites of care including: 10 Hospitals, 2 children’s hospitals, 3300 beds The state’s largest physician network Home Health Services/Hospice

Advocate Health Care Overview 5 Level One Trauma Centers; 2 Level II 4 Hospitals with Magnet Status 4 teaching hospitals Recognized as a Chicago Tribune Top Workplace in 2011

Advocate Health Care Overview 10 acute care hospitals 2 integrated children’s hospitals 5 level 1 trauma centers 4 major teaching hospitals 4 Magnet designations

Advocate Health Care Overview Over 250 sites of care Advocate Medical Group Dreyer Medical Clinic Occupational health Imaging centers Immediate care centers Surgery centers Home health / hospice Lab joint venture with Aurora Health Care

Advocate Health Care Overview

Advocate Health Care Overview 32,000 Time and Attendance users 12,000 Staffing and Scheduling users Staffing and Scheduling areas implemented to date: In-Patient Nursing Pain ED GI Cardiology Dialysis Radiology Imaging Centers Surgery Labs Respiratory eICU Sleep Non-Clinical areas

Past API Systems Configuration Time and Attendance on NT platform Staffing and Scheduling on LaborWorkx 8.02 platform All physical servers 29,000 users in Time and Attendance 10,000 users in Staffing and Scheduling

Past API Systems Configuration HR interface with Lawson via downloads of departments, associates, job codes 350 badge readers One large hospital on TimePC, badge readers removed

Reasons to Migrate to v.9 Rapid Advocate expansion led to massive additions of associates Hardware and software configuration could no longer support growing user count and diverse user needs / application utilization Frequent downtimes in Time and Attendance environment due to aging hardware and software not designed with so many users in mind (Microsoft and API) Inadequate system performance

Reasons to Migrate to v.9 Desire to enhance Time and Attendance and Staffing and Scheduling integration capabilities Migration to more modern technologies enabling virtualization of servers and faster disaster recovery More robust application security and security policy to match industry standards New modules: ActiveRoster, Request to Work, Employee Signoff TimePC  QuickBadge migration

Things to Consider - Migration Project governance Business owner communications moving forward Business process re-engineering Information technology review Security policy review

Things to Consider - Migration Time reporting methods Rollout strategy Change management User training approach(s) System support and collaboration with IT, Payroll, and Staffing help desk(s)

Project Governance Executive: Enterprise Connection Steering Committee Hospital Leadership Team Councils Project Sponsors: Information Systems and Finance Directors Technology Team Project Manager Deployment and Training Project Manager: Finance Leader and Outside Contractor Communications Team and Change Management Training Team

Business Ownership and Shared Governance Model Executive: Patient Care Council Nursing Operations Leadership: Nurse Staffing and Finance Committee Nursing/Finance Subgroup Information Systems

Business Process Engineering Current process review Time and Attendance rules Pay code review and integration considerations (PTO, Disability, FMLA, Low Census, Education/Training, etc.) Employee, department, job code downloads from HR system Predefined notes

Business Process Engineering System announcements to global user community QuickBadge vs. TimeCall rights Reporting New processes (such as employee signoff) Payroll close process (integrated versus separate) Payroll hotline and IT help desk

Information Technology Review Managed Services versus in-house solution Staff planning and support model Virtualization versus physical environment Storage planning Data center environment planning

Information Technology Review Telecommunications: digital versus analog lines, telecom software and budget Timekeeping devices (badge readers) QuickBadge Reporting TimeID, badge printers, and site printing process

Hardware Configuration 64 servers total configuration (virtual and physical) 41 Production and 23 Test Servers Production environment includes: 12 Agents 14 internal portal/Web servers 4 external portal/Web servers for remote access 2 clustered database servers 1 Telephony server (TimeCall) 2 Device Manager servers (badge reader management) 1 Primary Service server 2 Reporting servers 4 Calculation servers

Hardware Configuration Additional 2 servers for Citrix-based home connectivity Support for 45,000 Time and Attendance users and 15,000 Staffing and Scheduling users

Failover and Disaster Recovery Change from external vendor to in-house solution 2 Advocate-owned data centers in different geographical locations Test systems become Production in the event of declared disaster

Failover and Disaster Recovery No automated failover to prevent from initiation due to minor events Smaller but sufficient test environment to accommodate Production DR testing strategy

Failover and Disaster Recovery DR policy and documentation Document technical steps Document contact info Choose what modules require recovery Backup strategy

Failover and Disaster Recovery Recovery time reduced significantly, from 2 days to 2 hours Within production data center redundancy

Security Policy and Process Change from application to LDAP security for Time and Attendance module Migration plan for existing LDAP policy on the Staffing and Scheduling side User communication strategy: user id change Change from rule-based to role-based security

Security Policy and Process Definition of the new security framework Working with all key stakeholders Process automation: eForms

Security Policy and Process Decision on handling initial security tasks for massive user id loads Timing Custom scripting Exception process around the policy Getting the right people involved for user list and access reviews

Authorization System Administrator Security Framework Manager Customer Nursing Office Council Chair+ Backups T&A Manager/ Supervisor Time & Attendance Staff Scheduling I/S Applications Team Authorization System Administrator I/S Security I/S Security Team

Electronic Security Request Processing

Project Planning and Rollout Map Kickoff with all key stakeholders All-day global planning meetings with core project team (no site participation) Weekly status meetings established Detailed agenda and status report serve as main progress tracking tools

Project Planning and Rollout Map Master project plan in MS Project maintained, but is not the main tracking instrument Site plans had to agree and fold under the master plan Rollout map created

Project Planning and Rollout Map Phased approach, as follows: Move standalone LaborWorkx to new hardware and upgrade to 8.03 Pilot site up on the integrated platform New hospital go-live Phase I for existing hospitals and outpatient facilities (Group 1) Phase II for existing hospitals and outpatient facilities (Group 2) Phase III for existing hospitals and outpatient facilities (Group 3) Upgrade system to 8.03 SP4

Project Planning and Rollout Map Total 2-year project span, including training that went beyond implementation due to project scope and number of associates to train 6 months of configuration and super-user training work 9 months for rollout Another 6 months to complete training Managers and associates went live at different times

2010 2011 X X Technology Hardware Project Planning January February March April May June July August September October November December Technology Hardware Project Planning Application Installation and Testing Active Staffer Upgrade Downtime X Active Staffer Only Upgrade/Report Express (Mgrs) GSAM (Pilot) BroMenn Employee Portal (TimePC) GSAM (Pilot) 2011 January February March April May June July August September October November December Downtime X Upgrade/Report Express (Mgrs) Support Centers, IMMC, ACL ACMC, CHMC, TRIN, SSUB LGH, AMG, AHHS, HT, GSHP Employee Portal (TimePC) Support Centers, ACL ACMC, IMMC LGH, AMG CHMC, TRIN, SSUB HT GSHP, AHC AHHS

Site Councils Each site has its unique needs for support, training, user verification Localized efforts and unique approach for each site Executive team presentations Site Councils formed with every major Advocate entity/organization Leaders from most areas asked to join the Council

Site Councils Hospital Presidents and/or HR VPs in executive sponsorship roles Rollout and training schedules created for each site individually Only relevant information delivered at Site Councils – local approach Biggest concern is training availability and productivity impact Training plans to address productivity and associate satisfaction concerns

Site Councils Other issues reviewed: printers, badge readers and removal process, site communications Monthly Council meetings Local help desk support a few weeks prior and few weeks after go-live Sample site project rollout plan

Illinois Masonic Medical Center AdvocateWorks Deployment Time Line 2010 2011 Aug Sep Oct Nov Dec Jan Feb Mar Apr Project Planning & Organization Install & Test LaborWorkx System Develop and Implement Support Management Kick Off (week of 12/07/2010) Supervisor Training (01/17/2011 – 02/11/2011) LaborWorkx System Conversion (02/15/2011–02/17/2011) Supervisor Go Live Support 1st Live Approval (02/28/ 2011) Associate Kick Off (week of 02/03/2011) Associate Training (03/14/2011 – 04/08/2011) Associate Go Live Support Original Plan Original Milestone Version 1.1 as of 06/09/2010 Engineered to Plan v3.7 from 06/09/2010 Actual Progress Actual Completion

Time Entry and Badge Readers Advocate is the first API client to rely entirely on badge readers for time entry About 350 clocking devices removed from the wall as part of the v.9 rollout Analyze PC needs, availability, conflicts with other application use, network reliability Remote time entry considerations via external portals: available with QuickBadge, but is this functionality desirable by your organization?

Branding Strategy, Communications, Marketing Communications subgroup: Finance, IS, Communications, Marketing, Media Center members Internal brand: AdvocateWorks Graphics to supplement the brand Global and site-specific marketing efforts

Branding Strategy, Communications, Marketing Global and site-specific fliers, e-mails, printed communications Local communication subgroups at sites Coordinated downtime communications Invest in the “brand” – it is your workforce management platform and core IT application

Project Resources Huge demand during design, training, implementation Consider maintenance and further rollouts going forward: beware of your future success Risk of turnover Highly specialized resources in IT with understanding of the Finance business process, Nursing Office operations, hospital workflows Ensure proper external help to supplement internal resources during implementation

Reports Analyze reporting needs early – modifying and writing reports is a complex task Prioritize reporting needs Get potential major customers in the field involved with planning

Reports SharePoint use as communication medium during development process Ensure resources with proper knowledge – before and after the project Over 200 reports at Advocate; most are custom

Go-Live Planning 3 days of downtime for each Advocate rollout Remember: communication, communication, communication… Instruct users of available temporary business processes Ensure support for Q&A during downtime

Go-Live Planning Help desk communications and planning Offline mode for time reporting functionality for associates How much downtime will offline mode afford for you?

Challenges and Lessons Learned Phased vs. “Big Bang” rollout approaches Performance testing challenges External non-API system dependencies (such as LDAP and SAN) Resources and staff turnover Identify knowledge gaps early (for example, reporting)

Challenges and Lessons Learned Training approaches, budget, and organizational training culture Organizational and process change, emotional curve How do your business owners communicate? Start council and communication groups early – conflicting priorities at sites and within project

Outcomes Single workforce management platform Strong internal brand and identification Integration features Productivity boost Business process built on powerful software

Outcomes Opportunities to manage overtime and scheduling inefficiencies leading to savings Powerful reporting functionality Interfaces with other software platforms Performance to match organizational growth

Outcomes Better user buy-in and new partnerships Aggressive Staffing and Scheduling rollout map New Time and Attendance features in v.9 (such as employee signoff) Future product expansion

Future Ready integrated platform with capabilities to support overtime reduction efforts, other nursing and finance operations policies Options to add Analytics and Patient Classification Staffing and Scheduling roadmap, new pilots (Pharmacy, Labs, outpatient sites), going beyond clinical departments

Future Electronic training content delivery Closer collaboration with Finance and Nursing user communities to meet their ongoing and growing business needs

Thank you for attending. Enjoy the rest of Client Forum 2012!