The Best Way to Manage Your EMR Project

Last summer, Ocala, a city in central Florida, was struck by two of the four hurricanes which barrelled through in that year. Long power outages and significant structural damage caused many practices to close; some of the coastal practices couldn't even conduct surgeries for several weeks following the hurricanes.

Our original time line placed our electronic medical records (EMR) system launch date at late summer of 2005. Unfortunately, the effect of the hurricanes forced us to push the date back two months. This delay then coincided with some other big events at the practice, the construction of another satellite office and the addition of a new associate. We knew that the success of the EMR project would require our ongoing commitment of time and resources - we opted to move the go-live date to the beginning of 2006.

Frank E. Polack, president of the Project Management Institute (PMI) chapter in Atlanta, helps explain the methods which a project manager can use to help with an EMR plan that must integrate unforeseeable events. The second article of this series describes the ten Change Management principles regarding a particular organization's culture. Implementation of a sound change management project is a huge factor in ensuring the success of a project.

A great change management project can ensure that an office culture will successfully adapt to a new system, and implementation requires an overseeing Project Manager (PM). The Project Management Institute (PMI) defines a project as a "temporary endeavor undertaken to create a unique product or service." Most system vendors have their own PM assigned; you may want to consider this option as well.

It's a good idea to begin with a Project Charter. The Charter documents exactly why we're doing what we are doing, what we're implementing, the anticipated schedule and the budget. The Project Charter should also include potential risks, constraints, and outline any other concurrent projects and their anticipated milestones.

Microsoft Project is another great scheduling tool. Really even Microsoft Excel is able to be used for task tracking. It's often a good idea to keep a log which includes the probability, projected impacts and mitigation plans for certain risks. This scheduler should include an issue log, where items that require attention are entered. The PMI publishes standards which include important knowledge areas for a project manager, who should be employing processes from the nine areas to ensure full project coverage.

Of the nine areas, three are identified as triple constraints. These triple restraints are: Cost (budget), Scope (work), and Time (schedule). If any of these are changed, the others will also be affected. For example, increasing the scope of the project will result in an increase in implementation time and cost. By attempting to lower the cost, the quality must also be lowered and the scope will also need to decrease. Possessing fewer resources can mean it will take more time to complete the work. It's important to stay conscious of dependencies, as in when task B cannot be started until task A is done.

QUALITY MANAGEMENT
Requires making intermittent inspections to be sure that you are implementing strategies which satisfy established requirements. Instead simply waiting to see if all turns out correctly is a bad idea.

INTEGRATION MANAGEMENT
Includes all elements listed above along with assurance that they are managed during the entire project cycle.

PROCUREMENT MANAGEMENT
Understand vendor contracts and the terms you're entering into, be it cost-plus, fixed-price, or time&materials.

COMMUNICATION MANAGEMENT
What must be communicated, at to whom and how? Important team members may require frequent updates, while others receive information less often. Will updates be distributed by memo or e-mail? When will meetings take place, and who should attend?

RISK MANAGEMENT
Identify, qualify and account for potential impacts. Next calculate costs in terms of schedule and money. A risk management plan should be developed to deal with identifying and mitigating potential risks as they occur. Risks should be monitored regularly, as something with a low probability may have a greater potential for impact later on.

RESOURCES MANAGEMENT
Who are the SMEs, the subject matter experts? Who's on the project team? Will the manager have full authority over the allocated resources?

Project managers can reduce the pains and costs associated with implementation. They are available for hire, and your local PMI chapter can be a great place to start if you're trying to find the right one for your plan: www.pmi.org.