PM FPX 4030 Assessment 1

Executive Summary

Patient safety and physician satisfaction are top priorities for the Preventative Care Healthcare Organization (PCHO). In the past five years, PCHO grew from one to five facilities. To meet the changing needs of its patients, physicians, shareholders, and community, PCHO will be implementing an Electronic Medical Record (EMR) System to replace its current manual systems. Because other similar competitors in the region will soon be adopting EMRs, PCHO needs to get ahead with the installation of an EMR system to remain a health pioneer. Benefits of an EMR system are as follows:

• Eradication of cumbersome paper files
• Enhanced access to clinical information
• Enhanced clinical workflow
• Decreased medical errors and enhanced patient safety
• Streamlined Meaningful Use, Patient-Centered Medical Home (PCMH), and other quality program attestation
• Increased data gathering and analysis capacity
• Seamless interaction with network hospitals, clinics, laboratories, and pharmacies (Athenahealth, Inc., 2018).

In addition, our independent accounting firm projects a 25% increase in profits during the first two years and thereafter a consistent growth of 10% to 15% annually. PCHO will seek bids from qualified EMR providers at a cost of $250,000 per project. The successful bidder must complete the project within 12 months, subject to doctors’ approval. Timeliness, cost, project scope, and quality will be ensured through a Project Change Control Committee. Doctors and Health Information Management (HIM) personnel will access the EMR system using PCs, laptops, tablets, and cell phones, thus improving the speed of service and patient satisfaction. The project manager shall be assisted by a risk management team to carry out possible troubleshooting. Currently, the threat of completion of the project in time and at cost is zero.

Statement of Work

The elements of the Statement of Work include:

• Approvals of the project
• Vendor selection
• Project Charter
• Project Scope Statement
• Application installation
• Testing of the application
• Application training
• Rollout of EMR to all five facilities of PCHO

Approval of the next quarter budget is needed so that the project is done within the current fiscal year without disrupting current operations and other projects.

Project Scope Management

Project Title: Preventative Care – Electronic Medical Record (EMR)

Prepared by Angelo Riccio

Date: 04/15/2018

Overview

Preventative Care, a five-location healthcare company with headquarters in Peoria, Illinois, intends to implement an Electronic Medical Record System. The company has grown from one to five locations over the past five years and requires a vendor capable of managing its increasing business needs. The company invites bids from both mature vendors and design- or development-stage vendors.

Business Objectives

• Fetch patient records from the five locations
• Web application with little hardware requirement
• Scheduling of doctors centralized
• Clustering of application servers in a single location

Project Description

The EMR system should include the following elements:

• Patient information
• Patient insurance information
• Patient visits
• Doctor information
• Doctor appointments and schedule
• Patient billing
• Patient allergies
• Patient diagnosis
• Patient vaccinations
• Patient medication orders and prescriptions
• Patient laboratory orders and results

Project Scope

In Scope

• Budget: $250,000
• Installation at each of the five preventative care sites
• 12-month cycle time
• Interface integration between all sites
• Documentation needed from vendors: Project Charter, Scope Statement, Project Schedule, Project Costs, Project Risks, Technical Requirements, Labor Requirements, Communications Plan

Out of Scope

• Bids in excess of the $250,000 budget
• Physicians’ remote access
• Third-party vendors without PCHO permission

External Dependencies

No external dependencies have been identified.

Assumptions

• Vendors will honor bid deadlines.
• Vendors will stay within the budget.
• Doctor approval of vendor choice

Constraints

• The $250,000 budget will not be overrun.
• The vendor must be from the US in order to control travel expenses.

Project Milestones

• Vendor Selection: 06/01/2018
• Approval of Vendor: 06/08/2018
• Project Start Date: 07/15/2018
• Project End Date: 12/15/2018

Primary Plans

The project shall have:

• Project Scope Management Plan
• Project Time Management Plan
• Project Cost Management Plan
• Project Quality Management Plan

Authorizations

Project Scope Statement Approval / Signatures

This document is used to capture initial planning effort and to gain mutual understanding of the project objectives and scope prior to investing significant resources.

Project Time Management Plan

Introduction

The provided Work Breakdown Structure (WBS) document summarizes the number of detailed tasks, durations, and interdependencies required to finish the Preventative Care – Electronic Medical Record (EMR) Project. The WBS must be adhered to by all the vendors according to the Project Management Office specifications.

Project Schedule Plan

The Gantt Chart below is a graphical representation of the EMR Project Schedule. The chart documents task deadlines, deliverables, and baseline data, which reflects the original scope, cost, and schedule. Any change from the baseline has to be approved by the Project Change Control Committee (PROJECT-MANAGEMENT.COM, 2018, January 25).

Critical Path Analysis Summary

In the analysis of the critical path, we have pinpointed activities that are essential for the timely delivery of the project. Any delay in the activities on the critical path will affect the project schedule overall (Schwalbe, 2016).

Project Cost Management

Cost Management Plan

Project Name: Preventative Care – Electronic Medical Record (EMR)

Introduction

The Preventative Care program needs an EMR system to replace its existing manual processes. Since the company is growing, it must hire a vendor that can accommodate its growing needs. New and experienced vendors are solicited for bids.

Units of Measure

• Budget: $250,000
• Labor: 12 months / 261 business days

Level of Precision and Accuracy

Three vendor bids have been received:

• Vendor A: $225,000 in 11 months
• Vendor B: $225,000 in 11 months
• Vendor C: $250,000 in 12 months

Control Thresholds

The authorized budget stands at $250,000 with a tolerance level of ±10%. Control will be determined on the basis of a Microsoft Project comparison of planned vs. actual values (Biafore, 2007).

Performance Measurement

Earning Value Management (EVM) will be utilized to evaluate performance at milestones. The vendors will be required to react to critical questions of project progress and completion (O’Reilly, 2017, May 11).

Documentation

Business Case, Project Charter, Scope Statement, WBS, Project Schedule, Risk Register, Communication Plan, and Lessons Learned are the essential project documents.

Reporting

Weekly status reports will be provided to the major stakeholders, whereas monthly reports will be provided to executives. Risk reports will be prepared as and when required.

Project Quality Management

Introduction

Quality measurements like pass/failure percentages, service availability, and customer satisfaction will be tracked during the EMR project (Schwalbe, 2016).

Quality Planning Tools

• Fishbone Diagram
• Control Chart

The Fishbone Diagram will aid in the diagnosis of quality problems, whereas the Control Chart will indicate information on process stability (DeBenedetti, 2017, September 26; Usmani, 2015).

Fishbone Diagram

The diagram highlights causes and effects of project problems. The process entails setting the problem statement, brainstorming, and identifying root causes.

Control Chart

Control charts are employed to monitor process variations over time to determine whether processes are stable or require changing (American Society for Quality, 2018).

Out-of-Control Signals and Quality Metrics

In assessing control charts, it is important to document any “out-of-control signals.” The signals must be documented on the chart as soon as they are detected, and an analysis of the causes of the signals should be done. The process used, findings yielded, causes established, and corrective action implemented should be documented.

As mentioned earlier in the project timeline, Earned Value Management (EVM) will be used to measure project performance. EVM improves communications of project work and offers greater visibility and responsibility. The fundamental concept of EVM is that the value of work completed should equal the amount of money spent on work completed (Deshpande, 2014). In the Preventative Care – Electronic Medical Record (EMR) project, the following quality metrics will be utilized:

• Planned Value (PV)
• Actual Cost (AC)
• Earned Value (EV)
• Schedule Variance (SV)
• Schedule Performance Index (SPI)
• Cost Variance (CV)
• Cost Performance Index (CPI)
• Estimated at Completion (EAC)

PM FPX 4030 Assessment 1 Project Management Plan 

EVM determines three measures that capture the essence of the Preventative Care – Electronic Medical Record (EMR) project:

• Planned Value (PV): This is the portion of the approved total cost estimate to be spent on an activity within a specific time (Schwalbe, 2016).
• Actual Cost (AC): This is the total of the direct and indirect costs spent on the performance of work within a specified period (Schwalbe, 2016).
• Earned Value (EV): This calculates the value of the work actually accomplished on the basis of the initially planned costs and the rate at which work is being accomplished (Schwalbe, 2016).

Assuming the project is midway through its one-year timeline with an overall budget of $250,000, the budgeted value at the 6-month interval is $130,000. The actual cost here is $115,000. Thus:

• Planned Value (PV): $130,000
• Actual Cost (AC): $115,000
• Earned Value (EV): $125,000 (calculated as $250,000 * 0.5)
• Schedule Variance (SV): EV – PV = $125,000 – $130,000 = -$5,000 (negative, the project is behind schedule)
• Schedule Performance Index (SPI): EV / PV = $125,000 / $130,000 = 0.96 (less than 1, the performance is poor)
• Cost Variance (CV): EV – AC = $125,000 – $115,000 = $10,000 (positive, indicating the project is under budget)
• Cost Performance Index (CPI): EV / AC = $125,000 / $115,000 = 1.08 (greater than 1, indicating good cost performance)
• Estimated at Completion (EAC): Total Project Budget / CPI = $250,000 / 1.08 = $231,481

Summary and Quality Concern

The project is currently behind schedule, indicated by the negative Schedule Variance (SV) and a Schedule Performance Index (SPI) of less than 1. To counteract this, an urgency to speed up progress in the second half of the project emerges. Positively, Cost Variance (CV) is positive, and the Cost Performance Index (CPI) is greater than 1, indicating that the project is under budget. Having the Preventative Care – Electronic Medical Record (EMR) project under my management, I am hopeful that we would be able to get the project on track again without compromising on the quality as well as budget targets.

Project Quality Tools Evaluation

Pareto Chart

A Pareto chart is a key quality tool that identifies the most frequent defects or problems by sorting and counting them (American Society for Quality, 2018). It is particularly useful for analyzing problem frequency data so that teams can rank the most critical problems.

Advantages:

• Emphasizes significant inputs
• Has a straightforward, visual structure for importance
• Enables comparison of change in processes

Disadvantages:

• Does not identify causes
• Cannot measure the severity of problems or the effect of changes (Wilhite, 2017)

Histogram

A histogram is a graphical representation used to demonstrate the variable distribution through the use of bars, each of which represents the frequency of a quality (Schwalbe, 2016). It is ideal for comparing large data ranges.

Advantages:

• Enables easy comparison of information
• Applicable for big data sets

Disadvantages:

• Not convenient when comparing several categories
• Difficult to pull exact data values (Acampora, 2013)

Scatter Diagram

A scatter diagram is used in finding correlations between two variables by plotting numerical pairs of data against a graph (Schwalbe, 2016).

Advantages:

• Displays correlations between variables
• Can be used in determining non-linear patterns

Disadvantages:

• Does not indicate exact correlation extent
• Only applies to displaying relationships between two variables (Usmani, 2014)

Flow Chart

A flowchart visually represents project steps, illustrating associated processes and steps throughout the entire project duration (Westland, 2018).

Advantages:

• Visually clear
• Communication and problem-solving aids

Disadvantages:

• Complete redrawing may be required for changes
• Reproducibility difficulties due to symbols that cannot be typed (EdrawSoft, 2018)

Project Lessons Learned and Reflection

Lessons Learned:

• Vendor Selection: The six-month period for evaluating vendors was inadequate; two additional months would have been preferable.
• Budget: The original budget of $250,000 was not sufficient; an additional $50,000 was needed to cover project requirements.
• Physician Training: More time was needed because fewer physicians than anticipated participated.
• Communication Plan: Major stakeholders failed to attend meetings, which created scheduling issues.

Reflections:

This course has greatly contributed to my understanding of project management principles, particularly Earned Value Management (EVM), and taught me valuable knowledge regarding various project documents and tools. I have come to understand terms and meanings that will enhance my career capabilities. Although I continue to have problems with Gantt charts, resources such as video training have been incredibly helpful. Overall, this experience will make a great impact on my work in project management in the future.