UW Medicine ADTHospital Billing Project

1
UW MedicineADT/Hospital Billing Project

• Information Services Board
• March 6, 2008
• Ron Johnson, VP UW Technology
• Johnese Spisso, VPMA/COO UW Medicine
• Lori Mitchell, CFO, Harborview Medical Center

2
Status Report on IT Projects

• Future IT Project Planning
• ORCA Electronic Medical Record
• Lawson Human Resources
• ADT/Hospital Billing Project
• Requested Action

3
Future IT Project Planning

• No future major projects are scheduled at this
  time
• The ability of UW Medicine to implement the Time
  and Attendance application and further electronic
  medical record applications will be evaluated
  based on the organizational readiness criteria
  used by the external consultant for the
  ADT/Hospital Billing Project
• Future projects will be brought forward for
  consideration after consultation with the ISB

4
ORCA Electronic Medical Record

• Phase I August 2002-2005
• See supplemental information section
• UW Medicine New IT Leadership July 2005
• Phase II Stabilization
• See supplemental information section
• Phase III Modest Increases in Functionality

5
ORCA Electronic Medical Record Phase III

• July, 2006 Current
• Physician Documentation (UWMC)
• Patient Care Documentation (CIS-R)
• Deployment completed at HMC November, 2007
• Current pilot at UWMC proceeding as planned
• Full deployment at UWMC scheduled for March 25
• CIS-R on track to be completed four months ahead
  of scheduled date of July, 2008 and under budget
• Sierra Systems QA Consultant reports 100 green
  status for UWMC implementation as of January 31,
  2008

6
ORCA PowerChart Performance Average
7
ORCA Usage vs. Performance

8
ORCA Phase III Wrap Up

• Complete CIS-R at UWMC
• Customer Satisfaction and Enhancement Evaluation
  Focus
• Project Completion and Closure

9
Electronic Medical RecordNext Steps

• Evaluate and Prioritize Need for Additional EMR
  Functionality
• Retail Pharmacy
• Computerized Physician Order Entry
• Emergency Department Triage and Tracking
• Outpatient Clinical Documentation

10
Lawson Project Human Resources System

• Phase 1A Proof of Concept
• Approved ISB, September 2006
• Completed four months ahead of schedule and under
  budget
• Phase IB Parallel Pilot Implementation
• Approved ISB, September 2007
• January Independent QA report shows project
  status green on all indicators
• Milestones meeting or exceeding schedule. Last
  milestone to develop acceptance criteria for
  go-live was completed six weeks ahead of schedule

11
ADT/Hospital Billing Planning Project
Deliverables

• Resolution of Resource Contention Between
  Projects
• Assessment of Institutional Capacity to Conduct
  Simultaneous Projects
• Development of Detailed Project Plan
• Identification and Recruitment of Technical
  Resources
• Development of Vendor Contracting Template to
  Mitigate Risks

12
ADT/Hospital BillingFirst Consulting Group
Assessment

• Comparison of project readiness from first review
  done in May of 2007 to January 2008
• Executive Dashboard Status Change in status by
  major category
• Project Benefits Yellow to Green
• Organization/Governance Yellow to Green
• Change Management, Cost/Budget, Time Schedule
  Green to Green
• Resources/People Yellow to Green
• Strategies and Approaches Yellow to Green
• Infrastructure/Technology Green to Green
• Risk Management Yellow to Green

13
Summary of Major Expense CategoriesTotal Budget
- 53M

• Software licenses 7 million
• Hardware 2 million
• Project Staffing 21 million
• Contract Staff 21 million       
• Training 2 million

14
High Level Project Timeline/MilestonesProject
Duration 24 Months 4 Month Contingency
15
Requested Action

• ISB approval to proceed with ADT/Billing
  contingent upon the expected completion of ORCA
  implementation (CIS-R) at UWMC
• Funding requested for first phase of project -
  13.5M of 53.0M total
• Covers timeframe April, 2008 to October, 2008
• Deliverables
• Project kickoff completed
• Current state analysis completed
• Variances of model system determined with
  comparison to current state
• Build environment configured with variances
  between model system and current state

16
Requested ActionFirst Gate - 13.5M

• Categories of Cost
• Hardware 900,000
• Software Licenses 2,900,000
• Internal Labor 5,400,000
• External Labor 3,900,000
• Training 400,000

17
Supplemental Information Section
18
Supplemental Information - ORCA

• Phase I Timeframe and Functionality Implemented
• Phase II Timeframe and Functionality
  Implemented
• Ongoing Operational Projects
• Budget Summary, January 2008

19
ORCA Project Phase I

• August, 2002 December, 2005
• Implemented and Placed into Use
• Medical Records Systems Replacement
• Inpatient and Clinic Pharmacy System Replacement
• Results Reporting
• Document Imaging (HMC)
• Physician Documentation (Pilot)

20
ORCA Project Phase IIStabilization

• January, 2006 to December, 2006
• On time and under budget
• Implemented and Placed into Use
• Cerner Software Upgrade
• Hardware and Database Upgrade
• Failover System Implementation
• Physician Documentation (HMC)

21
Electronic Medical RecordOngoing Operational
Projects

• Tailored Clinical Notes
• UWMC Document Imaging
• Implement New Graphical User Interface
• Deploy use of Easy Script application

22
ORCA Budget SummaryAs of January, 2008

• Budget 66,592,000
• Actual 59,011,000
• Under Budget 7,581,000

23
Supplemental Information ADT/Hospital Billing

• Resolution of Resource Contention Between
  Projects
• Assessment of Institutional Capacity to Conduct
  Simultaneous Projects
• Development of Detailed Project Plan
• Identification and Recruitment of Technical
  Resources
• Development of Vendor Contracting Template to
  Mitigate Risks

24
Resolution of Resource Contention Between Projects

• VPMA/COO position created July 1, 2007
• Redirect resources
• Set priorities
• Cross organizational oversight committee chaired
  by VPMA/COO
• Major project decisions making on all major
  projects
• Organizational ability to be successful
• Consultation with UW Technology and ISB

25
Assessment of Institutional Capacity to Conduct
Simultaneous Projects

• Assessed at operational and technical resource
  levels projecting over 12 months
• ORCA/Cerner, Lawson/Workforce Management and
  ADT/Hospital Billing included in assessment
• Planned level of engagement across resources
  identifies potential conflicts to allow
  prospective resolution
• Heat Maps provided as documentation

26
Identification and Recruitment of Technical
Resources

• Development of detailed listing of positions
  required, HR recruiter hired (documentation
  provided)
• As of January, 2008, 21 staff have been hired
  contingent upon approval of project
• IT and Operations project managers have been
  hired Experienced in Epic and ADT/Hospital
  Billing
• Project Director being recruited contingency
  plan is to use experienced outside consultant
  until permanent position can be filled

27
Development of Detailed Project Plan

• Using Epic standard methodology, developed a task
  level work plan with major tasks, milestones, and
  timeframes (Project Plan Provided)
• Analysis of system interfaces (Documentation
  provided) resulted in addition of resources and
  change in implementation strategy

28
Development of Vendor Contracting Template to
Mitigate Risks

• Negotiated amendment reviewed with special AAG
  (specialist in IT vendor contracting), UW AAG, UW
  Procurement Services, and UW Technology
• Issues resolved satisfactorily
• Risk mitigation strategies included timing of
  payments, deliverables, and performance
  expectations

29
Lessons Learned From Other Projects

• Clear accountability
• Adequate project resources
• Optimal system performance
• Process Redesign
• Interfaces
• Current software upgrades

30
First Consulting Group AssessmentAreas of Focus

• Formalize commitment to achieve project benefits
• Complete recruitment for Project Director
• Follow through on commitment of operational
  resources
• Link data center expansion to this project
• Availability of Hospital-within-a-Hospital
  functionality
• Manage risks related to resource conflicts,
  management attention, project execution