Lecture:  Implementation of Electronic Health Records

Merlin project videos:

• Download Merlin  Download►
• Create project plan from scratch using Merlin  You Tube► 
• Show changes in plan  You Tube►
• How to enter an activity in Merlin  You Tube►
• Change project start date  You Tube►
• Setting precedence (linking activities) in Merlin You Tube►
• Show GANTT chart  You Tube►
• Customize columns displayed in Merlin  You Tube►

Narrated slides and videos require Flash.  Download►

What you know?

Advanced learners like you, often need different ways of understanding a topic. Reading is just one way of understanding. Another way is through writing about what you have read.  The enclosed assessment is designed to get you to think more about the concepts taught in this session. 

1. Who was Gantt and what did he contribute to scheduling activities?
   
2. Which organization developed the critical path method and why?
   
3. What do the initials PMI stand for and what is the name of the book it created?
   
4. What makes 21st century project management different from management of historic projects such as the Pyramids?
   
5. What are the five phases of project management and what happens in the closing phase of project management?
   
6. For the following project, create a Gantt chart and show the critical path:
   • Use the PERT method to estimate the duration of each activities. 
     

     Activity	Description	Precedence	Pessimistic	Realistic	Optimistic
     A	Select satisfaction survey tool		5	2	1
     B	Print survey tool	A	5	3	2
     C	Obtaining list of patients		3	1	1
     D	Sample from list	C	3	1	1
     E	Mail surveys to selected patients	B,D	3	2	1
     F	Collect responses	E	5	4	3
     G	Analyze data	F	7	3	2

   • Use your project management software to create a schedule for these activities starting on June 1st this year, working 7 days a week and 30 days a month.  According to my analysis this should take 15 working days, assuming 56 hours of work per week and 30 days of work per month.

   • Display the Gantt chart and the critical path.  Your work may look like the following Figure:
     
     

   • Prepare a report which provides the schedule for each activity and shows the Gantt chart.  In the above Figure, Microsoft Project was used to show the Gantt chart.  The critical path is highlighted in red.  In Merlin, the critical path is usually highlighted in bold.
     
     

7. Given the following information, calculate the earned value, cost variance, schedule variance, and cost performance index for weeks one and two.  Calculate the Estimate to Completion.  Make a plot of planned, actual and earned values.  Show the Estimate At Completion on the plot.  See a guide on how to do this assignment:  Video► SWF► 
    

   	Week One	Week Two	Other Weeks	Week Ten (Project End)
   Rate of performance	50%	75%
   Planned value	$7,000	$27,000		$100,000
   Actual cost	$8,000	$29,000

8. Given the following information calculate rate of performance.  Solution►

   Task Code	Description of activity	Immediate Precedence	Duration	Start	End
   				(MM/DD)	(MM/DD)
   1	Strategic plan phase		9 months	1-Jan	1-Jun
   2	Team formation		3 months	1-Jul	1-Nov
   3	Master facility plan	1,2	8 months	2-Nov	30-Dec
   4	Space programming	Finish with 3	9 months
   5	Land acquisition analysis	4	6 months

9. Calculate rate of performance and visually show progress made in the following project:  Here is just-in-time advice on how to solve this problem:  Video► SWF►  You Tube►  Merlin► You Tube Merlin►  Please note that the video does not exactly correspond to the problem below.

   Code	Description of Activity	Immediate Precedence	Pessimistic	Realistic	Optimistic	Start (Month/date)	End (Month/Date)
   1	Strategic plan phase		9 months	8 months	6 months	1/1	6/1/
   2	Project initiation phase	1	Depends on duration of sub-tasks
   2.1.	Team formation		3 months	2 months	1 month	7/1	11/1
   2.2.	Master facility plan	2.1	8 months	7 months	6 months	11/2	12/30
   2.3.	Space programming	Finish with 2.2	9 months	7 months	6 months
   2.4.	Land acquisition analysis	2.2	6 months	4 months	3 months
   2.5.	Project budget & schedule	2.2	5 months	2 months	1 months
   2.6.	Joint venture analysis	2.1	5 months	2 months	1 months
   3	Building design	1, 2	Depends on duration of sub-tasks
   3.1.	Facility design		9 months	7 months	6 months
   3.2.	Equipment planning	3.1	6 months	4 months	3 months
   3.3.	Regulatory approvals	3.2	4 months	2 months	1 month
   4	Construction phase	3	9 months	6 months	5 months
   5	Occupancy	4	3 months	2 months	1 month

   
   

   Prepare a report of your project containing the following sections:

   1. The purpose of the project.  
   2. Show the Gantt chart, highlight the planned effort and the actual duration of tasks to date.
   3. Describe the total length of the planed project, the anticipated delay in the end of the project. 
   4. Introspection section (what did you learn from this exercise). 

   See example of work done by students  Bryant►  Jaskaran►  Nicole►  Marie►  See report by Marie►

10. Given the following table of activities and precedents, calculate rate of performance and the budget/schedule overrun at end of the project.  To obtain planned project duration, please use your software for Project Management, put in the tasks, put in the duration of tasks, put in the precedence for each task and note when the project ends.  Keep in mind that sufficient information may not be available to answer all portions of this question. Video►   You Tube►
     

    Activity	Description of Activity	Immediate Precedence	Planned Duration	Completion Duration	Planned Expenditure
    A	Obtain list of patients		2 weeks	4 weeks	$1000
    B	Sample patients	A	1 week	2 weeks	$500
    C	Print survey tool		3 weeks	3 weeks	$13,000
    D	Mail survey tool	B, C	4 weeks		$2,000
    E	Collect early responses	D	1 week		$3,000
    F	Collect late responses	E	3 weeks		$9,000
    G	Analyze data	E	2 weeks		$2,000
    H	Report findings	F, G	1 week		$1,000

    
    

    Prepare a report of your project containing the following sections:

    1. The purpose of the project.  
    2. Show the Gantt chart, highlight the planned effort and the actual duration of tasks to date.
    3. Describe the total length of the planed project, the anticipated delay in the end of the project, the original budget for the project and the current estimate of the budget for the project. 
    4. Introspection section (what did you learn from this exercise). 

    See report by Marie►

     

Do One: Plan an EHR Implementation

You can complete this project with another colleague, but it has to be a person you have not worked with so far.  If you submit a group project, please copy the email to all students involved and state in the email what each person's hands on contribution has been.  Not just we sat together and did this but that each of us did some part of the response on the software.

In this project you are asked to plan implementation of an electronic health record in an organizations using the the work break down tasks described below.  In the following tasks, training on a system can only be done if the system has been configured.  Your objective is to develop a schedule: 

1. Patient Information Management
   1. Admission, Discharge, and Transfer (requires configuration in subtask B, configuration lasts 30 days, training lasts 5 days) 
   2. Patient Registration (requires configuration of subtask C, configuration lasts 3 days, training lasts 5 days)
   3. Enterprise Master Patient Index (configuration lasts 3 days)
   4. Patient Scheduling (requires configuration of subtask B, configuration lasts 10 days, training lasts 5 days)
2. Clinical Information System (requires configuration of systems in tasks 1, 3-7)
   1. Clinical Alerts and Reminders (requires configuration of subtask B, D, E, G, configuration lasts 30 days, training lasts 5 days)
   2. Clinical Rules Engine (configuration lasts 10 days)
   3. Consults Tracking (requires configuration of subtask G, configuration lasts 3 days)
   4. Order Management (requires configuration of  subtask H, configuration lasts 30 days, training lasts 5 days)
   5. Results Reporting (requires configuration of subtask D, configuration lasts 3 days, training lasts 5 days)
   6. Clinical Documentation (requires configuration of subtask E, configuration lasts 3 days, training lasts 5 days)
   7. Computerized Provider Order Entry (requires configuration of subtasks F, H, I, and J, configuration lasts 45 days, training lasts 15 days)
   8. Intake/Output (configuration lasts 3 days, training lasts 5 days)
   9. Patient Education (configuration lasts 3 days, training lasts 5 days)
   10. Vitals/Measurements (requires configuration of subtask H, configuration lasts 3 days, training lasts 1 day)
3. Laboratory (requires configuration of systems in task 1)
   1. Anatomic Pathology (requires configuration of subtasks B and C, configuration lasts 10 days, training lasts 5 days)
   2. Microbiology (requires configuration of subtask C, configuration lasts 10 days, training lasts 5 days)
   3. Chemistry (configuration lasts 10 days, training lasts 2 days)
4. Pharmacy  (requires configuration of systems in task 3)
   1. Adverse Reaction Tracking (requires configuration of subtasks B, C, and D, configuration lasts 10 days, training lasts 5 days)
   2. Electronic Medication Administration Record (requires configuration of subtask D, configuration lasts 10 days, training lasts 5 days)
   3. Bar Code Medication Administration (requires configuration of subtask B, configuration lasts 30 days, training lasts 15 days)
   4. Inpatient/Outpatient Pharmacy (configuration lasts 3 days, training lasts 5 days)

Prepare a report of your project using word processing or Slides, containing the following sections:

1. Title page, your name and contact information
2. Purpose:  State the purpose of the project and the total length of the schedule from start to finish.
3. Schedule (high level tasks):  Show project Work Breakdown Structure showing high-level tasks, start time and finish time.  Please make sure that this information can be read clearly. 
4. Schedule (Sub-tasks): List the start and end of each task. 
5. Critical Path:  Make a list of activities on the critical path and show the GANTT chart
6. Introspection (what did you learn from this exercise): Is Project Management software useful and why?

Here are some examples of work done by others:  Nicole and Tonya►   Shirin and Olga►   Katherine and Robyn►   Tommy and Bridgette►   Bahareh and Ashley►   Elisabeth►   Alex and Merlyn►   Chris and Bank►  See an excellent example by Chris and Bernadette►  Laura and Margaret►  Meghan and Neda►

The instructor will grade your submission using the following rubric:

• Presentation:
  1. Were the sections requested present? 
  2. Was the presentation clear? 
  3. Were the graphics (GANTT chart) self-contained and informative. 
  4. Was any of the necessary text so small that one could not see it. 
  5. Was the use of color and font size judicious and helpful in communicating the schedule?
• Content:
  1. Did the project include various dependencies among the tasks?
  2. Was the project task duration correct? Was the total length of project correct?
  3. Did the project clarify its assumptions, specially the assumptions made about data not presented in the assignment.
  4. Did the project provide introspections about project management?  Note that students are expected to discuss the method of project management and not the particular schedule they had developed. 

More

• Technology projects demand process change (29 minutes).  Slides► Listen► SWF►
• See an example of high level milestones for implementation of VistA   Microsoft Project file►
• The ballad of going live  You Tube►
• The British Medical Journal has two relatively brief papers that describe “failed” implementation projects, one EMR in South Africa that was ultimately abandoned and another at Kaiser Permanete that was replaced by a different system.   Read 1►  Read 2►
• Abstracts of articles on implementation of Electronic Health records PubMed►
• How Do Integrated Delivery Systems Adopt and Implement Clinical Information Systems?  Search►
• Kartick Patel translates the lecture into Chichewa (Malawi's national language) Listen►
• Five rules of project management as proposed by Chapman You Tube►

Evaluations

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This page is part of the course on Information Systems.   This page was edited 05/16/2013 by Farrokh Alemi, Ph.D.  ©Copyright protected.