Your task: This is the second part of the project management skills assignment. You did part one in the last module. Applying the methods described in this module's materials and using Microsoft Excel

Section 8- Lesson Content & Rubric

Reading - Adaptive Health Management Information Systems, Chapter 8

AHIMA. (2010, March). RFP Process for EHR Systems (Updated). Journal of AHIMA. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_047961.hcsp?dDocName=bok1_047961

• Link to Article

Using Tasks and Assignments to Develop Budgets

Systems budget development - custom development

A well-prepared project budget developed by a vendor or in-house custom development team will delineate and estimate costs by task. This helps to assure the project can be delivered on time and within budget.

Using the task list that has been previously developed, staff members are now assigned to the project tasks. The hours that it will take a reasonably efficient, qualified person to achieve or complete the task are entered onto a spreadsheet table. Once these tasks and staff hours are estimated the project budget becomes a process of multiplying hours times hourly rates as billable. The hourly rates should include benefits costs, if internal staff is to be used.

For example, I may know that it takes a good technical writer an average of ten hours to write up one portion of a systems manual. If there are four manual portions to be written, and the writer's rate including benefits is $50 per hour, the cost of that systems manual writing task becomes

10 hours/module x 4 modules x $50/ per hour = 40 hours x $50 = $2000.

Extending this analysis across various tasks and staff results in a table allowing the per-task amounts to be summed.

Task List and Staff-hours by Task for Budget Development

*hourly rate including benefits

Contracting with Vendors

Aspects of Contracting with Vendors

Financial aspects of the information systems development or contracting with a vendor are of concern when hiring a systems vendor.

When comparing bids, be sure to ask about all of the following features of the total cost of ownership:

Hardware costs: Costs of computers, printers, network hardware and routers, scanners, workstations and servers should all be included. If server space will be leased rather than owned these costs should also be included with hardware.

Software Costs: Software can be purchased as a perpetual license; as an annual license; or priced as a leasing option based on the number of users. Make sure to include as system users not only each physician, but also the health information staff and ancillary staff who will use it. Asking each vendor to break down costs on an annual basis will help to compare on an apples-to-apples basis. Also ask about system upgrades and license renewals. What has been the history of license fee increases, annually, for existing users?

For a custom design system, the vendor should clearly lay out the timeline and budget for completion based upon the scope of work.

Maintenance Costs: Fees for maintenance may be billed separately from the licensing fee. Ask vendors about what hours of operation the maintenance and helpline will be available; how much system downtime is allowable, and the like. A Service Level Agreement (SLA) is a document becoming more commonplace that will specify performance standards. The SLA may specify that the system downtime will be no more than one-half of 1% of system operational time. Because a systems outage or unavailability not only results in financial costs to the healthcare organization, but very real risk of patient harm, system reliability and maintenance are very important.

Training Costs: Training involves both one-time and repeating costs. At the outset a new set of users will be trained and ideally several “super users” will learn and be able to train others. When new staff arrive on board, a plan for developing their capability on the system should have already been considered.

Full costs of training for the first year of operation should be provided.

Installation costs: The minimum level of service for implementation includes installing the system on customer equipment.

In addition, the vendor should run test applications and sample data entry at the outset of or prior to installation.

Implementation Phases, Tracking Progress, and Follow-up Needs

During each phase of the implementation of the system it will be necessary to monitor and evaluate needed progress. Regular status meetings with the vendor or project director can help cover areas where things are going as expected as well as those that encountered unexpected issues or delays.

The status meetings should use a prepared agenda that includes tasks completed, tasks remaining, staff and information availability issues needed toward project completion, and the like. The project director or manager is responsible for maintaining adequate communications about all project resources.

Staff Responsibilities at Each Project Phase

Project planning and schedule stage: During project planning and scheduling stage, the organization considers its needs and when these need to be met. Financial capability and costs for buying or leasing a system also need to be considered. Under-budgeting, or setting too short an implementation period, can result in problems or issues.

Detailed specifications stage: During detailed specifications stage, the IT director and implementation specialist work with various departments to identify what features the system absolutely must have, and communicates those in writing.

Training staff on the system: The Vendor and organization cooperate to make staff time available for learning the system features and applying them to their workflow.

System Delivery and testing: The system is installed and given a “dry run” with a sample load of patients and their data. Any glitches are identified and then resolved. The implementation specialist checks to make sure features are delivered as described. If the system is not adequately designed or tested for interoperability with other systems, it should be evident in this stage.

IT Director: The IT Director considers how the system will be tested for adequate interoperability at delivery. He or she should make sure all types of care and ancillary staff members are aware how the system will affect workflows.

Project Manager: At installation a great deal of hands-on time is required of the vendor. The Project Manager should be onsite at least several days during startup.

HIM Director: Developing a test set of records to initially load into the system for “stress testing” and conduct a test run, is a task for the HIM Director

ER Implementation Project Specialist: A hands-on approach during test runs of the system and installation will lead to greater success.