1. Comp 14 - Special Topics in Vendor- Specific Systems Unit 8 - Vendor-Specific Go- Live Strategies This material was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.

2. Outline Big-bang vs. phased roll-out Staffing, command center, on-site consultants Monitoring system usage Change management Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 2

3. Big-Bang vs. Phased Roll-Out Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 3 All modules in selected locations All modules in all locations Typically used when replacing a legacy system Big-Bang Selected modules Selected locations Combination of both Phased or incremental roll-out

4. Big-Bang Pros: Short-term disruption No need for linking old and new Only one system to support Cons: Much higher risk to organization Requires comprehensive planning Mass training required Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 4

5. Phased Roll-Out Pros: progressively adjust implementation strategy Focused planningDisruptions are isolated Smaller groups of users affected Cons: Need to maintain two systems Risk of stagnation Need to correlate information from both systems Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 5

6. Staffing Greatly dependent on: –Product being implemented –Location, e.g. hospital or physician office –Implementation performed by vendor or consultants –Big-bang vs. phased roll-out –Hosted locally or remotely –Temporary staffing or permanent staffing Component 14/Unit 86 Health IT Workforce Curriculum Version 2.0/Spring 2011

7. Staffing Example EHR implementation team: Physician Champion Project Director Project Manager Enterprise Master Patient Index Cleanup Application Coordinator RN Application Coordinator MD Application Coordinator analysts Health Information Management Director Reporting Applications Coordinator Reports/Designer/Analyst Database Extract and Load Administrator 3rd Party Reporting Tool Administrator Programmer/Analyst Hardware/OS support Storage Support Enterprise Data Backup support Network Support Security Coordinator Workstation Management Workstation/Printer Systems Support Database administrator Principal Trainer Supplemental trainers Go live support Helpdesk support Risk Manager Chief Privacy Officer Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 7

8. Command Center Special location during implementation –Typically setup in a big-bang rollout –All project communications go through this center –Usually serves as project help desk and receives all user calls –Field staff meet at center at least 2 times per day –Project executives meet at center each day Component 14/Unit 88 Health IT Workforce Curriculum Version 2.0/Spring 2011

9. On-site Consultants EHR Selection EHR Implementation Meaningful Use EHR VendorsIT ConsultingEHR Review EHR Training EHR Certification Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 9

10. Monitoring System Usage System performance monitoring Application usage monitoring –Documents created –Orders written Orders completed –Prescriptions written Monitor calls to Help Desk –System issues –Application questions Component 14/Unit 810 Health IT Workforce Curriculum Version 2.0/Spring 2011

11. Change Management Typically, organizations undertake organization-wide change to evolve to a different level in their life cycle e.g., going from a highly reactive, entrepreneurial organization to more stable and planned development http://www.managementhelp.org/mgmnt/orgchnge.htm Organizational Change Typically refers to IT systems or other process changes in an organization This is the context that we will use in the following slides. System Change Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 11

12. System Change Management Typically instituted after go-live A structured approach to transitioning individuals, teams, & organizations from a current state to a desired future state The process during which the changes of a system are implemented in a controlled manner by following a pre-defined framework/model with, to some extent, reasonable modifications http://en.wikipedia.org/wiki/Change_management Definition: Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 12

13. System Change Management (cont.) A formal process used to ensure that changes to a product or system are introduced in a controlled & coordinated manner Reduces the possibility that unnecessary changes will be introduced to a system without forethought, introducing faults into the system or undoing changes made by other users of software Goals of a change control procedure usually include minimal disruption to services, reduction in back-out activities, and cost-effective utilization of resources involved in implementing change http://en.wikipedia.org/wiki/Change_Control Change Control Component 14/Unit 8 Health IT Workforce Curriculum Version 2.0/Spring 2011 13

14. System Change Management: Set of 6 Steps http://en.wikipedia.org/wiki/Change_Control Component 14/Unit 814 Health IT Workforce Curriculum Version 2.0/Spring 2011 6. Close / Gain Acceptance 5. Implement 4. Build / Test 3. Plan 2. Assess 1. Record / Classify