1. 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

2. Welcome
Please silence all electronics
Remember to complete the session survey

3. 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

4. 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

5. 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

6. 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

7. Advocate Health Care Overview

8. 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

9. 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

10. 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

11. 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

12. 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

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

14. 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)

15. 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

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

17. 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

18. 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

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

20. 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

21. 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

22. 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

23. 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

24. 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

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

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

27. 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

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

29. 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

30. 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

31. Electronic Security Request Processing

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. 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?

42. 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

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

44. 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

45. 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

46. 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

47. 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

48. 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?

49. 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)

50. 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

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

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

53. 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

54. 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

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

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