FROM ENCODERS TO electronic health records (EHRs), health information management (HIM) professionals are often tasked with
enterprise-wide project management including new technologies,
changing workflows, and centralized operations. Information technology (IT) system implementations and enterprise-wide HIM standardization initiatives are two of the most common examples.
These massive projects require strong HIM skills, expanded
partnerships, and greater collaboration among vendors, HIM,
IT, and others. Though HIM professionals have always managed projects, enterprise-wide endeavors raise the bar for communication, organization, and leadership. HIM professionals
have unique abilities to manage enterprise-wide projects. With
leadership skills, specialized education, and peer-to-peer relationships, HIM is perfectly positioned to promote collaboration
among all stakeholders, secure executive support, ensure timelines are met, and cover every detail of an enterprise-wide initiative. Equally important, HIM professionals can help team members solve problems, achieve their goals, and enjoy the journey.
In this virtual roundtable, three HIM experts discuss how to
map out enterprise-wide projects, meet milestones, and resolve
common challenges. The discussion was moderated by Angela
Rose, MHA, RHIA, CHPS, FAHIMA, director of client relations
and account management at MRO, a health information disclosure management company, based in Norristown, PA.
Rose: Please provide a high-level overview of a recent enterprise-wide project and define your role.
Pat Biesboer, RHIA, MSS, PMP, senior project manager, based
in Minneapolis, MN: Having worked in HIM my entire career, I transitioned to full-time project management in 2000. I served as the
overall project manager for enterprise-wide EHR implementations
along with numerous targeted projects in compliance, new facility
acquisitions, application upgrades, and application rollouts to other facilities within an integrated health system. While each project
scope varied, my role remained consistent across each assignment.
Susan Carey, MHI, RHIT, PMP, FAHIMA, system director of
HIM at Norton Healthcare, one of Kentucky’s largest healthcare
systems with more than 40 locations in and around Louisville,
KY: We implemented our current EHR in 2012, so most of our projects relate to gaining operational efficiencies through technology.
The latest enterprise-wide project was construction of an HIM contact center to handle a growing number of stakeholder inquiries that
increased once we implemented all the EHR capabilities, especially
the patient portal. The project scope included implementing new
processes and technology to handle the volume of internal calls for
release of information (ROI), portal support, information exchange,
record amendments, and requests for system access. My role was
executive sponsor for the project with two other HIM professionals
serving as program manager and project business owner.
Emilie Sturm, MA, RHIA, CHPS, senior revenue management consultant at Trinity Health, a national Catholic health
system with 93 hospitals and 122 continuing care facilities,
home care agencies, and outpatient centers in 22 states:
Standardizing operations for ROI is our current enterprise-wide
project, designed to create standard tools for all Trinity HIM di-
rectors. The goal is to ensure a consistent experience for patients
across our ministries while adhering to legislative and regula-
tory requirements for ROI. I serve as the project manager with
chief responsibility to facilitate discussions, gather expertise,
and solidify best practices in place across the health system.
Rose: How did you map out your goals for these projects?
Biesboer: Each enterprise-wide project includes defined leader-
ship goals that add value to the customer, their organization, and
their patients. These goals are documented in a project definition
document or scope document. Changes require sponsor approval.
Leadership goals often correlate with an organization’s vision,
mission, or strategic annual goals. The senior leadership team
vets and prioritizes those goals. However, targeted interviews
with sponsors and business owners help to solidify the actual
real-world goals of any enterprise-wide project.
Actual goals are often not the same as those defined by senior
leadership in the original project charter. Tried processes and
situational leadership are used to pull the entire team toward
the desired results.
Carey: The project manager interviewed all internal stakeholders and developed a goal statement. Once the statement
was approved, a current-and-future state session was facilitated. In this session there are no rules, unnecessary questions, or
limits. The group worked together to answer a single question:
“In a perfect world this need of our HIM stakeholder would be
met by __.” Project objectives were then extrapolated from the
defined future state and broken down into work packages during a work breakdown structure (WBS) session.
Sturm: Taking HIM’s competing priorities and projects into
consideration, we began by establishing short- and long-term goals for the project. Next, we prioritized goals against
strategic objectives and timelines for the organization as a
whole. Internal and external factors influenced our decisions
for each phase. Key leaders provided feedback on our project
plan to ensure effective use of resources.
Rose: How did you ensure timelines and milestones were met?
Biesboer: I identify the work of the project using a WBS. The
WBS is a block diagram of the key buckets of work broken down
into one or two levels. From the WBS, a list of tasks is created and
sequenced into a project schedule with brightly colored Excel bar
graphs if the detail of a Microsoft Project tool isn’t warranted.
This grid of tasks by calendar weeks drives the project team’s
weekly meeting agendas, ensuring the right tasks are done at
the right times without missing key steps. If a milestone ever appears to be in jeopardy, the whole group is aware and we quickly
discuss options to get back on course.
Beyond this process, three specific tactics ensure all projects
meet established timelines and milestones:
1. Set expectations early and repetitively.
2. Be proactive by negotiating options and alternative solutions.
3. Focus on achieving milestones during every phase—avoid
Carey: A project schedule was developed from the work packages
identified in the WBS session similar to the process described above.
Dates, durations, and responsible parties were assigned to each
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