1. Introduction to Project Management
An Overview of Health IT Projects
Welcome to Introduction to Project Management: An Overview of Health IT Projects. This is Lecture a.
Lecture a
This material (Comp19_Unit1a) was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC

2. An Overview of Health IT Projects Learning Objectives—Lecture a
Review the history of project management.
Define what a project is.
Define project management.
Identify reasons that more organizations are implementing HIT projects.
Identify key characteristics for project success and failure.
Describe the range and characteristics of health IT projects.
The Objectives for An Overview of Health IT Projects are to:
Review the history of project management.
Define what a project is.
Define project management.
Identify reasons that more organizations are implementing HIT projects.
Identify key characteristics for project success and failure.
Describe the range and characteristics of health IT projects.
 For Lecture a we will focus on all of the objectives.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

3. Brief History of PM Early Civilizations Great Pyramid
Great Wall of China
1910
Gantt Chart
Project Management
1956 – CPM
1958 – PERT
PMI
1980s
st PMBOK
2000s
Agile Alliance
2008 – PMBOK 4th Edition
This unit will provide you with a high-level overview of health IT projects.
Here is a brief history of project management.  Project management can be traced to early civilizations, including the Egyptian pyramids and the Great Wall of China.   The year brought the Gantt chart, a project management tool still in use today.  Project management was first considered an isolated concept in 1954.
The latter part of the 1950s saw great strides in the development of project management concepts and techniques. After the Soviet Union launched Sputnik in 1957 and with it, the Space Race of the Cold War between the United States and the Soviet Union, the US Department of Defense focused greater resources toward strengthening its space and defense project procedures. In the same year, the U.S. Navy created the Program Evaluation and Review Technique, or PERT, to help manage its Polaris missile submarine program. Around the same time, the DuPont corporation developed its Critical Path Method, usually referred to as CPM, as a project management tool for scheduling various processes or activities. Eventually, PERT was adapted to employ a work breakdown structure, or WBS), which we discuss in other units of this course. Private enterprises began to adapt some of these methods.
One of the most important guiding techniques to specify how a project should be managed is the Project Management Body of Knowledge or PMBOK, created by PMI in the late 1980s. The techniques outlined in the PMBOK standardize the practices of the development team, which makes it easier to predict, manage, and track projects. The 2000s brought the development of the agile alliance, along with an update of the PMBOK into its fourth edition.
The multi-project company environment of today requires more flexible and cyclical models than the critical chain models used in the past. Many of the critical chain-oriented project management techniques, which focus on the resources required to complete project tasks, are aimed at very large scale, one-time, non-routine projects, and are unnecessarily complex and costly for smaller projects. Modern project management, however, includes all kinds of projects and all kinds of management models and techniques.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

4. What is a Project? Temporary – has a definite beginning and end
Has Purpose – undertaken to create a unique product, service or result
The PMI PMBOK defines a project as, “a temporary endeavor undertaken to create a unique product or service.” You can consider a project complete when its goals have been reached, and you can consider a project terminated when its goals can no longer be reached for any reason or the project is no longer necessary.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

5. What Is Project Management?
Applied knowledge, skills, tools, and techniques to project activities to meet project requirements.
Project Management Institute, 2004
As a professional area of knowledge, project management provides a methodology for preparing, coordinating, and supervising people, supplies, and processes, from project initiation to closure, to achieve definite targets. While its scope is broad enough to apply to complicated, multifaceted concerns such as software development, the techniques of project management are appropriate to for any project.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

6. Impact and Importance of PM
Business advantage
achievement of goals
resource utilization
Information-based decision making
Competitive advantage
culture of execution and collaboration
getting the “right” results reliably
Accurate and timely information informs business decisions to maintain a competitive edge.
Effective communication increases productivity and enthusiasm
Clear roles and responsibilities helps minimize conflicts and confusion
Project management helps organizations achieve specific goals, use resources effectively and efficiently, and typically provides feedback or information that will impact future decision making. It helps an organization build a culture of execution and collaboration and achieve desired results reliably. Project management can also provide timely and accurate data that informs business decisions to maintain a competitive edge. Finally, project management ultimately increases productivity and enthusiasm among employees by developing and implementing effective communication processes.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

7. PM Community Resources
Association for Computing Machinery (ACM)
Institute of Electrical and Electronics Engineers (IEEE)
HIT
Health Information Management Systems Society (HIMSS)
American Health Information Management Association (AHIMA)
American Medical Informatics Association (AMIA)
Project Management Institute (PMI):
Because project management has such a broad scope, the literature on the topic is equally vast. We can study it in general terms as it is applied across domains, or we can drill down as our projects become more narrowly focused on such areas as IT projects, or even more specialized, IT projects in health care.
Each of these professional arenas foster communities of practice that include professional associations, publications, and meetings. Many are broad and/or influential enough to cultivate their own special interest groups or sponsor industry standards and guidelines.
The IT field offers such professional organizations as the Association for Computing Machinery and the Institute of Electrical and Electronic Engineers, better known as IEEE. Professional resources for the specific area of health IT can be found at associations like Health Information Management Systems Society, the American Health Information Management Association, and the American Medical Informatics Association.
The Project Management Institute, or PMI, is also a great source of information on project management. Along with its PMBOK guide, it offers a PMI health care special interest group.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

8. Project Management: Terms and Concepts
Scope
Scope Creep
Gold Plating
Constraints
Risks
Assumptions
Deliverables
Like any professional area of knowledge, project management comes with its own vocabulary and concepts. The first term you will need to understand is scope. Scope defines the boundaries of a project, such as schedule, financial resources, objectives, and staff.
“Scope creep,” refers to the tendency of most projects to shift boundaries as the project moves forward, and professionals often use the term, “gold plating,” when they speak of adding needless details to a project. Keeping a watchful eye and a firm hand on your project scope will help you avoid such project roadblocks as scope creep and gold plating.
Scope is considered one of the recognized project constraints, which also include schedule and funding.
Project risk refers to those factors that may delay or obstruct a project’s completion. Part of a project manager’s job is to plan for and reduce the amount of risk to a project.
Another primary part of your job focuses on communications. No project can run smoothly if expectations, responsibilities, objectives, and timelines are not clearly understood by all stakeholders, or those who are invested in your project. Stakeholders can include team staff, clients, or consultants. As a project manager, you may find yourself communicating with these stakeholders though a number of different media, including hardcopy documents, , or project websites.
Finally, the term, “deliverables,” refers to the project’s final product or results – the outcome that you “deliver” upon completion of the project.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

9. Process Areas
The five process stages of project management include the following:
Initiation,
Planning,
Implementation,
Monitoring and Controlling, and
Closing.
The initiation stage covers all the processes that define the project’s scope, objectives, and environment. Once the manager develops a comprehensive grasp of these details, he or she can begin the planning stage. This stage focuses on developing a schedule and budget, identifying necessary staff, resources, and supplies, and preparing for potential risks – all of this work is captured in the project plan. During the implementation stage, the manager will target the project’s staff, process, activities, and resources toward the project objectives. The monitoring and controlling stage includes supervising this entire execution, while constantly reviewing the current outcomes against the project plan and defined baselines, and controlling for risk. Finally, the manager presents the final deliverable for client acceptance or approval during the closing stage, while finalizing the project processes and activities.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

10. Why Process? Not an assembly line, but provides: Structure Consistency
Clear Communications
Efficiency
Why use process? A defined process technique is not an assembly line of automated steps. Rather, it provides structure, consistency, clear communication, and efficiency controls that improve the way you and your team work. It also minimizes risk and eliminates problems.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

11. Project Life Cycle
Key project characteristics determine appropriate life cycle. Defining the life cycle for your project is project-specific!
The literature on project management offers many approaches, or project life cycles, to the work. Based on certain project details, such as project scope, complexity, outcomes, and timelines, the project manager decides which life cycle best suits a project.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

12. Life Cycles
This unit provides a basic overview of project life cycles, but you will receive more in-depth information on various project approaches in later units. For now, briefly, project life cycles include a linear method, which is typically best applied to large, complex projects, while iterative and adaptive methods are more appropriate for rapid application development or projects that occur over short periods of time and require high levels of prototype development, feedback, modification, and redelivery. Agile techniques are best used in small-scale projects or on elements of a broader project that require a quick turnaround.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

13. Reasons for Initiating and Approving
Opportunity
Market demands
Technological advances
Challenges
Customer requests
Social Needs
Business Requirements
Legal requirements
Clinical Advances
Regulatory Requirements
This slide identifies several common reasons for initiating a project.
First, opportunity.
Market demands often call for a project.
Technological advances or challenges often inspire new projects.
Challenges include customer-requested tools or social needs.
The last category of drivers is business requirements.
In the field of health IT projects, these include legal requirements, clinical advances, and regulatory requirements.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

14. Meaningful Use American Recovery and Reinvestment Act of 2009 Results:
Additional funding
Must comply with core elements
Requirements
adopt, implement, or upgrade certified EHR technology
meaningful use in the first year
Over the next five years, Meaningful Use (MU) will become a major driver of health IT projects. Meaningful use is a new term that has come into the health care market in recent years. The American Recovery and Reinvestment Act of outlined the government’s expectations for meaningful use of health care technology. Implementing meaningful use initiatives nationwide improves quality, safety, and efficiency of patient care, engages patients and families in their own health care, improves care coordination, ensures adequate privacy and security for personal health information, and improves population and public health.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

15. HIMSS Survey: HIT at Present
51% of hospitals have IT strategic plan for health IT conformance to meaningful use as part of the overall organizational plan
36% have health IT plans separate but aligned with IT strategic plan
The rest have no plan
*(Based on HIMSS survey data* HIMSS analytics 2
Let’s take a look at the state of health IT implementation across the nation. The HIMSS survey of health care information technology noted that 51 percent of hospital respondents have an IT strategic plan for health IT conformance to meaningful use; 36 percent have health IT strategic plans that are separate from, but aligned with their IT strategic plan; and the rest have no plan at present.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

16. HIMSS Survey: HIT in the Future
64% planning increase IT staff in the next 12 months
76% will definitely and/or probably increase HIT budget
13 % have no plan for now
This slide shows the survey respondents’ plans for future projects: 64 percent plan to increase their IT staffs in the next 12 months, and 76 percent will definitely and/or probably increase their budgets for health IT initiatives. Clearly, we are on the edge of a big reform in health IT.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

17. HIT Project vs. MU Criteria
MU forces changes to management of health information
Focus on HIT knowledge and skills
Current and future workflow of information
Necessary HIT infrastructure
Project management capabilities
Achieving meaningful use requires necessary changes in the health industry. It demands changes to the way the entire information system in this industry is managed, distributed, and exchanged, by whom, how, and for what purpose.
It requires a realistic approach to the technological landscape that can capture the knowledge and skill sets necessary to achieve meaningful use. These include the current and future workflow of health information, the appropriate health IT infrastructure, and the ability to drive projects effectively.
This is where project management comes in. Meaningful use affects everyone in the health care strata. A small doctor’s office can receive tens of thousands of dollars in incentive payments from the government for implementing a health care IT system, while a large academic hospital could get millions of dollars for increasing its meaningful use of health care IT.
All of these organizations need someone who can understand and manage the demands, resources, processes, challenges, and benefits of these complex projects.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

18. Role of the Project Manager
Executing a vision through:
Planning
Execution
Monitoring
Control
Closure
Subject Matter Expertise
As a project manager, you will be driving the health IT initiatives. Although these projects can have specific and complex details, the basic lessons of project management apply: You are responsible for realizing the project’s vision by following the typical processes for project management: planning, execution, monitoring, and closure. And you will also provide a level of subject matter expertise. Since so many IT projects are supervised by committees unfamiliar with the specific issues and challenges of these jobs, the committees often hire project management professionals to oversee operations and achieve their objectives. You will function as that subject matter expert.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

19. Top Health IT Priorities
Achieving meaningful use
Focusing on clinical systems
Optimizing current systems
Implementing the ICD-10 into HIT systems
Your first job will be to understand this new landscape, so that you can define your scope and lead your team authoritatively. Project managers who come from a business or IT framework will need to learn the medical terminology so that they can discuss projects with health care professionals. At the same time, those who come from the medical side of project management will need to acquaint themselves with the technical requirements so they can have productive conversations with the technical groups. Project managers need to be able to work on both sides of the tracks.
According to the HIMSS survey, hospitals’ health IT priorities include achieving meaningful use by focusing on such clinical systems as computerized practitioner order entry, electronic health records, and e-prescribing, and by optimizing current systems. Nearly half of all respondents noted that their health IT projects will focus on implementing the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, better known as the ICD-10. The ICD-10 includes the medical classification list for the coding of diseases as maintained by the World Health Organization.
The HIMSS website is a great resource for information on health IT.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

20. Current Information System
Gather information to develop baseline for comparison
Quality
Safety
Efficiency
Hire skilled and creative IT professionals
You will need to gather details about the organization’s current information systems and how they perform on the meaningful use intended outcomes of quality, safety, and efficiency. This information will provide your baseline to track your new system’s improvement. As you begin developing your new system, the choices you make will impact future information systems, so it is important to employ staff with the appropriate skill sets who can design with an eye to future use.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

21. HIT Information Sharing
94% clinical Information
89% patient demographics
49% billing code information
What kind of information does health IT share? It breaks down as 94 percent clinical information, 89 percent patient demographics, and 49 percent billing code information. These kinds of details will help your IT staff tailor the system appropriately.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

22. Return to Process Planning Assemble your team
Develop time line and resources
Break down large projects into smaller, more manageable ones
Execution
Coordinate resources
Supervise project activities
Communicate wisely with team members re. timelines, deliverables, expectations
Monitoring and Controlling
Mange specifications
Control scope creep
Be flexible re. others ideas, but maintain scope
Closing the Project
Present the project to stakeholders; receive official approval/acceptance
Finalize project activities: file paperwork, formally close contracts, etc.
Hold post-mortem with team: Review project processes, resources, budget, time lines, and outcomes
Once you’ve done the legwork in developing your scope, the rest of the process should be very similar to other project management work. During your planning stage, you’ll assemble a team of skilled, creative professionals and develop a time line and resource allocation. It is important to know that because health IT projects are so complex, they tend to become unwieldy. One way to tackle an overwhelming project is by reducing it to a number of simpler goals. So, you might take a complex project, such as digitizing a medical office’s paperwork, and break it down into manageable parts. These might include one project for converting records to digital format, another for training personnel to use the digital database, and then a final project to post the database online. This process allows you to step up to meeting the overall objectives of the project by reaching achievable goals and charting your progress.
A major part of your job requires a constant vigilance regarding your project boundaries, so don’t let a project grow in complexity beyond its scope. Your stakeholders, especially those on the client side, often propose “improvements” to your project that would ultimately tax your budget and resources without offering truly beneficial functionality. You will need to weigh these requests against your project constraints and objectives, and thoughtfully consider only those that bring true value to your project.
A large part of project management is personnel management, so you must communicate time lines, deliverables, and expectations to your staff. Be willing to implement motivation or negotiation techniques, and maintain a respectful awareness of others’ politics and cultures.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

23. Project Success Factors
Strong executive support
Plenty of user involvement
An experienced project manager
Clear business objectives
Project success factors include the following:
Executive support can make or break a project, particularly in regard to resource allocation.
From the very beginning of a project, user investment and participation is essential to your success. If you don’t have a comprehensive understanding of your user’s requirements or how they hope to use the product, your project will fall short.
A profitable undertaking often depends on an experienced project manager, especially in a highly specialized field like health IT. Their background and familiarity with the demands of the specific environment and its users can help a project reach successful completion. For instance, an experience project manager will take a clinical provider’s hectic schedule into account when planning meetings or requesting feedback. Unlike the fairly predictable schedule of a business environment, the demands on a clinician’s time can be irregular and urgent. To accommodate the changing schedules of these stakeholders, meetings must be short, efficient, goal-oriented, and above all, flexible.
Using a clear set of business objectives to frame and focus your project are critical elements in your success. Why are you undertaking this project? What do you hope to achieve? How will it help the organization’s business? These are all questions that can help you define your business objectives for this project.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

24. Key Challenges Lack of planning Lack of resources Unwieldy scope
Skills
Time
Money
Unwieldy scope
Phases
Factors contributing to failure include lack of planning, lack of resources, and an unwieldy scope—but if you have planned correctly in your early stages, these should not become major issues.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

25. An Overview of Health IT Projects Summary—Lecture a
Health IT projects and approaches vary widely.
Projects develop a needed product or service.
Project management is an approach to planning and guiding a project process to a successful outcome.
There are various key success and challenge factors that are common across all projects.
This concludes Lecture a of An Overview of Health IT Projects. In summary, health IT projects and the approaches to those projects vary widely in terms of scope, critical need, and risk factors, but they all have one aim: to produce a needed product or service.
Understanding that certain factors are common across all projects can help you manage those differences to achieve success in any kind of project. The project management process is not magic: it is built on a sure combination of technique and experience, and if you educate yourself on the details of the health IT scope of your institution, it will lead you to a successful outcome.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

26. An Overview of Health IT Projects References—Lecture a
A User’s Manual to the PMBOK® Guide, Stackpole. Wiley:2010. Hoboken, NJ
Avova. Project Management. c Available from:
Health Care Projects: PMI Healthcare Special Interest Group (
Houston S, Bove LA. Project management for healthcare informatics. Springer Science + Business Media, LLC; 2010
Infoglow. Iterative & Incremental Software Development: A Brief History. c Available from:
Kerzner H. Project management: a systems approach to planning, scheduling, and controlling. 10th ed. Wiley; 2009.
Knowledgerush. Project Management. c2009. Available from:
Projects: Project Management Institute (PMI), and its Guide to the Project Management Body of Knowledge (PMBOK® Guide) , 4th Ed., 2008.
Schwalbe K. Information technology project management (with Microsoft Project 2007 CD-ROM). 6th ed.; 2009.
Whitten N. Neal Whitten's let's talk! more no-nonsense advice for project success. Management concepts; 2007.
Wiefling K. Scrappy project management, 12 predictable & avoidable pitfalls every project faces. 1st ed. Happy About; 2007.
Wikia. Engineering: Project Management. Available from:
Wikipedia. Project Management. c2011. Available from:
Wysocki, RK . Effective project management: traditional, agile, extreme. 5th Edition. New York: Wiley; 2009. .
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Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a

27. An Overview of Health IT Projects References—Lecture a
Images
Slide 9: Flow chart of Process Areas. Image courtesy Wikipedia, Creative Commons.Available from:
Slide :Iterative Life Cycle. Creative Commons Wikipedia: :User:Westerhoff. Available:
Slide 12.2 :Agile Life Cycle Creative Commons VersionOne, Inc. (and trimmed by User:Mdd). Available from:
No audio.
Health IT Workforce Curriculum Version 3.0/Spring 2012
Introduction to Project Management An Overview of Health IT Projects Lecture a