Pat Macy
Engagement Leader
July 13, 2015
Unity Project Startup
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What is your role as an attendee?
• Communicate gaps
• You will create a new future
• Reference your current state rather than replicate current state
Begin to understand the transformation of patient care delivery
• Did you see something to be excited about for the future?
• Do you have questions for your colleagues?
Communicate with your colleagues to validate what you saw and share the future vision
• Understand what deliverables are due in the next 30, 60 and 90 days
• Communicate any challenges to completing the deliverables
• Understand who you can reach out to should you have any questions or issues regarding deliverables
Understanding Next Steps and Deliverables
• Complete post-event survey
Feedback & Visibility
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Project Startup Objectives
• Provide overview of Consulting Framework,
Value Planning and initial project deliverables
• Begin Data collection and Regular Solution Group
meetings
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4
Agenda – This Morning
• Introductions and Overview
• Your Value Objectives
• Partnered For Success
• Project Framework
• Roles And Responsibilities
• Value Planning
• Adoption Approach
• Communication Strategy
• Project Reporting
• Learning and Training
• Administrative Notes
• Next Steps
• Wrap Up and Questions
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Welcome to the Cerner Millennium Migration
Project- Value Objectives and Project Scope8:30 9:00
Cerner Consulting Framework, Model System,
Data Localization Process review, Project Portal
and Project Reporting
9:00 10:00
Break 10:00 10:15
Project Governance, Communication Plan, Risk
Management and Gateways10:15 10:45
Learning Strategies 10:45 11:15
Virtual Walktrhough/Welcome 11:15 12:00
Day 1 Lunch 12:00 13:00
Agenda
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Agenda for the rest of the week
• Breakout Groups – Data Collection of Current State
• Site Walkthroughs / Tours
• Locations: All facilities including: Battle House, SHAC
• Please refer to Excel Spreadsheet
• Questions: See Pat Macy and John Cherry
Your Value Objectives
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Value Objectives
• One patient one record
• Empowering our providers and staff to be their best
• Optimize revenue cycle
• Aid development of value
• Supporting best practices
• Develop analytics infrastructure
Partnered For Success
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Positioned for the future
Cerner Consulting – Partnering with you—1183489876v1. Effective April 2013.
Project Framework
• Values, Scope and Project Approach
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� Assess current state� Define the value objectives� Identify stakeholders and governance
Align to the Vision
Engage Stakeholders
� Show the future state � Apply Transition change strategies� Localize system configuration and
workflow
Measure Value� Measure and communicate
value achieved� Identify opportunities for
improvement� Learn and adapt
Activate and Support� Activate new processes
and technology� Support the team� Monitor performance
Consulting Framework
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13
Consulting Framework
Str
ate
gic
Im
pera
tives
ALIGN ENGAGE ACTIVATE MEASURE
Valu
e A
ch
ieved
People
Process
Technology
Program Management
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Consulting Framework
Project Gateways Project status checkpoints at critical milestones to ensure value achievement
Evaluation of critical items and key risk factors across people, process and technology
Reviewed by Client and Cerner leadership teams
Assess risks to determine if they can be mitigated in time to prevent impact to the project and keep the project on its current timeline
For incomplete items, a risk mitigation plan will be documented with an owner and due date
Future
State
Validation
End User
Training
Leadership
Alignment
Project
Team
Readiness
Future
State
Review
Maintenance
Training
Integration
Testing
1 & 2
Go LiveHealth
Check
ALIGN ENGAGE ACTIVATE MEASURE
Project
Startup
Value
Achievement
Review
Value
Measurement
Workshop
Current
State
Review
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Key Events
ALIGNALIGN
Gateway
#1Project Startup
Project Startup
Duration: 6-8 weeks
Participants: Project Leadership
Objectives:� Identify key resources for project
� Prepare for Current State Review
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
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Key Events
Current State ReviewDuration: ~1 week
Participants: Various members of the leadership team, clinicians, IT
Objective: Review current state and organizational readiness for change, identifying opportunities and risks around people, process, and technology
� PEOPLE: Evaluate impacted audiences’ readiness to change behaviors
� PROCESS: Capture current state for key workflows
� TECHNOLOGY: Assess technical infrastructure, Capture data needed to begin localizing system configuration
Deliverables:
� Executive Summary
� PEOPLE: Draft Transition Change Plan
� PROCESS: Mapping of Current State Workflows
� TECHNOLOGY: Technical Assessment
ALIGNALIGN
Gateway
#1Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
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Key Events
Leadership Alignment
Duration: 1 Day ~11 day
Participants: Executive and project leadership team
Objectives:� Review the Current State Review results
� Define the Value Objectives:
• Understand the project goals
• Review the defined organizational imperatives
• Identify primary contacts
� Discuss The Cerner Approach to Organizational Adaptability: :
• Review draft Transition Change Plan
• Define support activities for the change leader
• Review project approach and key activities taking place
• Identify next steps to action the Transition Change Plan
� Plan for next steps and upcoming events
ALIGNALIGN
Gateway
#1Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
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Key Events
Value Measurement Workshop
Duration: 1 day
Participants: members of the leadership team, clinicians
Objectives: � Outline the measurement plan
� Identify the process metrics that meet our value goals
� Document the measure owners and required next steps
Deliverable: � Value Measurement Plan Draft
ALIGNALIGN
Gateway
#1Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
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Key Events
Project Team ReadinessDuration: ~.5 day
Participants: Project team
Objectives:Align project team to the vision
Review identified value objectives
Review project details
� Project plan/approach
� Governance structure
� Staffing model
� Communication strategy
� Project tools
ALIGNALIGN
Gateway
#1Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
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Key Events
Gateway #1Your organization and the project team demonstrates they are aligned in their
goals, resources and plan.
� Confirm change leader/s are assigned and engaged and the organizational adaptability plan is approved and published to stakeholders.
� Value objectives are defined.
� Confirm the governance structure and resources are in place
ALIGNALIGN
Gateway
#1Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
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ENGAGE
Key Events
Future State ReviewDuration: ~1 week
Participants: Project team
Objectives:
� Define future state workflows that support best practices
� Describe points of workflow integration with other departments and roles
� Apply client specific data to best practice workflows
ENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3… …
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ENGAGE
Key Events
Future State ValidationDuration: ongoing
Participants: Project team
Objective: � Demonstrate localized system
� Highlight system build that supports the value objectives
ENGAGEENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3… …
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ENGAGE
Key Events
Gateway #2Your organization confirms agreement on the future state workflows.
� Confirm Future State Workflows
� Future state workflows support the achievement of the value objectives
� Training Delivery Plan Finalized
ENGAGEENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3… …
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ENGAGE
Key Events
Maintenance TrainingDuration: ~1 week
Participants: IT Maintenance Staff
Objective: Train IT staff to support ongoing maintenance of the system
ENGAGEENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3… …
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Key Events
Integration Testing 1 (& 2)
Duration: 2 weeks (week 1: clinicals, week 2: revenue cycle) for each
round of integrated testing
Participants: Project team
Objective: Test end-to-end workflows to ensure proper integration
across the continuum
ENGAGEENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3… …
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ENGAGE
Key Events
Gateway #3Your organization confirms your people are ready to learn new workflows and
their supporting technology.
� Validate solutions are configured and aligned to best practices
� Model system is properly localized
� Training materials and TRAIN domain reflect future state workflow
ENGAGEENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3… …
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ENGAGE
Key Events
ENGAGE
End User
TrainingGateway
#4
Gateway
#3
Training
Duration: (dependent upon Training Plan)
Participants: Trainers, end users
Objective: Train all end users on changes in process and technology
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ENGAGE
Key Events
ENGAGE
End User
TrainingGateway
#4
Gateway
#3
Gateway #4Your organization demonstrates readiness for new workflows and technology.
� Verify user training and Go Live support plan are complete.
� Confirm value measure baselines are documented
� Post-Go Live support and issue management plan is in place.
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ACTIVATE
Go Live
Key Events
Go LiveDuration: 2 weeks +
Participants: Full Project Team
Objective: Baseline Value Measurements
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Key Events
Health Check (Previously Post Conversion Assessment)Duration: 2 weeks
Participants: Project Team
Objectives: � Week One: Onsite visit to complete data driven solution assessments
� Week Two: Clinically focused executive summary/debrief
� Solution resources most likely do not need to attend this week, just Cerner project leadership
Event should be data driven – review analytics data prior to event
Recommendations should be prioritized and used by leadership to roadmap upcoming projects (continuous process improvement)
Deliverable: � Summary of recommendations by objective
� End User Survey
Health
Check
Value
Achievement
Review
MEASURE
Gateway
#5
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Key Events
Health
Check
Value
Achievement
Review
MEASURE
Gateway
#5
Gateway #5Your organization achieved the value targeted by the project.
� Super-user and end-user’s competency, confidence and satisfaction targets achieved.
� Value measures trending toward goals.
� Performance and operational metrics trending positively and no unresolved significant solution issues.
� Issues and changes are being managed effectively.
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Key Events
Value Achievement ReviewDuration: 1-3 hours
Client Participants: Client leadership,
Cerner Participants: CRE, CE (optional), Clinical Strategist, EL
Objectives: � Review the post implementation Value Objectives data
� Identify the top successes and any remaining areas to improve
� Document the project story highlighting the value achieved
Deliverable: � Executive Summary of measured results
� Project story with value statements
Health
Check
Value
Achievement
Review
MEASURE
Gateway
#5
Roles and Responsibilities
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Consulting Framework
Event Duration of Event Location
Project Startup 6-8 weeks Client Site
Current State Review 1 week Client Site
Leadership Alignment 1 day Client Site
Value Measurement Workshop 1 day Client Site
Project Team Readiness .5 day Client Site
Future State Review 1 week TBD
Future State Validation ongoing TBD
Maintenance Training 1 week Kansas City
Integration Testing 11 week for Clinical
1 week for Rev CycleClient Site
Integration Testing 21 week for Clinical
1 week for Rev CycleClient Site
End User Training ~ 6 weeks (depending on training plan) Client Site
Go Live 1 week Client Site
Health Check 2 weeks Client Site
Value Achievement Review 1-3 hours Client Site
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CernerCernerCernerCerner
• Guide Workflow Discussions
• Lead with workflow
• Clinical consulting experience
• Define Expectations and due dates
• Begin with Standard and Provide Solution Specific Audits
• Troubleshoot Test Issues
• Support Integration Test Cycles
• Provide and maintain Project Portal Site
• Provide Conversion Support
Project Team Responsibilities
USA
• Provide experience based on current workflows and how that relates to Standard
• Lead practice changes
• Supply Facility-Specific Data
• Localize Documentation, Policies & Procedures
• Create Test Scripts/Testing
• Final Validation of System
• Facilitate Organizational Change
• Customize Training Manuals
• Facilitate End-User Training
• Provide Post-Conversion Support
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Cerner Roles (and Acronyms)
• Client Results Executive (CRE)
• Manages full client relationship and ongoing Cerner support
• Engagement Leader (EL)
• Equivalent to Program Manager
• Responsible for project delivery and management to scope, budget, and timeline
• Technical Engagement Leader (TEL)
• Responsible for technical project delivery and management to scope, and timeline
• Clinical Strategist (CS)
• Responsible for consulting of clinical adoption, change management, and workflow localization
• Clinical expert
• Integration Architect (IA)
• Responsible for planning around solution integration points, domain strategy, change control processes, testing strategies
• Solution Architect (SA) / Technical Architect (TA)
• Expert in design and build of a given solution
• Delivery Consultant (DC) / Technical Consultant (TC)
• Responsible for completion of all build for a given solution
• Revenue Cycle Architect (RCA)
• Responsible for revenue cycle design, build, and workflows
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Client Roles - Subject Matter Experts
• Collects information to be used in database configuration
• Provides solution and process knowledge in support of workflow localization, process changes and learning plan development
• Actively participates in Kansas City events where decisions are made and planned for implementation.
• Works with team to develop and execute test plans, report issues, certify readiness for conversion
• Provides conversion support
• Participates in training and conversion plan development and execution
• Helps develop and execute system downtime and recovery/fail-over procedures
• Participate in the localization of Cerner Standard to better fit current processes
• Supports end-user training
• Assists in defining a standardized work process
• Be visible as a strong proponent of the new EMR
• Reports to Clinical and Executive Leaders on project status and risks
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Client Roles – Analyst
• Acts as primary departmental/functional resource
• Actively participates in Kansas City visits where decisions are made and planned for implementation.
• Acts as liaison for Client and Cerner activities while in Kansas City, responsible for the completion of homework deliverables outside of the Kansas City events and engagement of those not traveling to Kansas City
• Works with the departmental/functional teams to develop and execute test plans and scripts
• Participates as an Integration Testing and Go Live team member.
• Provides application assistance to the departmental/functional team
• Attends Maintenance Training, investigates and helps resolve application problems with Cerner team
• Supports end-user training
• Provides ongoing post conversion solution support for the IS department
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Client Roles – IT Lead
• On-site hardware maintenance and management.
• Maintain networks and communications.
• Provides support for the facility’s information technology, devices and computer systems to include:
• Works with other departments to ensure IT needs are met.
• Attend and participate in project team meetings, as needed.
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Client Roles – Technical Analyst
• Actively participate in project events where decisions are made and planned for implementation
• Works with departmental / functional teams to develop the technology strategy and rollout.
• Provides consultation on technical risk factors that must be addressed to achieve a successful implementation
• Acts as the primary contact for technical issues
• Ensures on-going availability of systems
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Client Roles – Facilities and Engineering
• Engineering and IT resources:• Configures, installs, and mounts Cerner Connectivity Engines
and Device Adapters
• Device Maintenance
• Low Level CCE and DA troubleshooting and replacement
• Maintains and improves the efficiency of existing equipment and systems while overseeing the installation of new equipment and systems
• Custodial services - Supports patient service and operations by transporting patients and items; managing staff
• Bed Board management - responsible for the allocation and provision of beds within the hospital
Adoption Approach
Clinical Adoption is the adoption of new programs and/or processes that patients,
physicians and clinicians may use to support health and care.
Adapted From Clinical Transformation and Electronic Health Record
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Framework | Clinical Adoption
Quality
Safety
Cost
Leadership Alignment
Governance
Organization Change
Management
Agile Methodology
Data Driven
Training & Workforce
Development
Technology
ProcessPeople
Adoption | Critical Success Factors
Patient Centric – Decisions made with a central focus on the patient
Cri
tica
l S
ucce
ss F
acto
rs
Clinician Led – Engagement and leadership for initiatives provided by
physicians / clinicians
Organizational Leadership – Deep involvement and accountability by
organizations’ leaders
Change Management – Execution of training and adoption strategies to
advance learning organization
Governance & Program Management – Oversight, decision making
process, and management to execute on projects
Communication – Candid and frequent dialogue across organizations and
from CEO to project teams
Align Phase
Align| Adoption
• People
• Define Governance Model
• Identify Clinical & Departmental Champions
• Define Organizational Change Management Strategy
• Develop Communication Plan
• Process
• Develop Guiding Principles for the EMR
• Define Value Objectives
• Technology & Tools
• Support Device Assessment Activities
AlignAlignAlignAlign LaunchLaunchLaunchLaunchAlignAlignAlignAlign EngageEngageEngageEngage LaunchLaunchLaunchLaunch++ ++
++ ++
Align| People
• Define Governance Model
• Identify Change Leaders
• Provides leadership, energy, enthusiasm, and coordination for the EHR initiative
• Vital role in the success of the transformation of the organization
• Identify Change Champions
• Vital role in the success of the transformation of the organization
• Identifying Change Agents or other resources needed to support the project
• Resolving change management issues
• Gauge readiness and progress of stakeholders within their region, facility or entity
• Hold employees within their area accountable
AlignAlignAlignAlignAlignAlignAlignAlignALIGNALIGNALIGNALIGN
Align | People
• Identify Subject Matter Experts (SMEs)• Clinical domain experts
• Assist in Future State validation and Change Control
• Representation required for every department & specialty across all facilities/venues
• Accountable for design decisions, clinical process decisions and end-user adoption
• Responsible for communications between councils and end-users
• Change Leaders, Change Champions and SMEs must be identified by the end of the Align Phase
AlignAlignAlignAlignAlignAlignAlignAlignALIGNALIGNALIGNALIGN
Align | Process
• Define strategy and guiding principles for managing EHR change requests through Governance
• Must be clinically led and IT supported
• Must support agile process
• Process must be defined to manage custom, research & innovation requests
• Define communication process for requests across each Venue or Facility
AlignAlignAlignAlignAlignAlignAlignAlignALIGN
Release #X
Discover
Demo
Validate
Train
Align| Technology & Tools
• Device Assessment
• Define desired future state
• Assess Usability and Satisfaction
• Assess workflow for opportunities to reduce number of systems / devices end-users must access
• Identify optimal devices to support workflow
• Assess current state at current live sites
• Align device strategy with future state workflows
• Data Migration Preparation
• Determine Data & Timeline for to be Converted
• Engage SMEs and Super Users
• Communicate requirements and recommendations
AlignAlignAlignAlignAlignAlignAlignAlignALIGNALIGNALIGNALIGN
• Better outcomes• Improve user and workflow efficiency
• Optimize patient experience
• Ensure regulatory compliance
• Improve interdisciplinary communication
• Reduce variability • Predictable outcomes• Connect the Piecesdesigning without
seeing
STANDARD:
Optimized settings, content and recommended workflows that represent Cerner’s best practices across their base of clients.
Developed by Cerner clinicians and experts, it is continually updated based on implementation experience, client input, evidence-based content, and industry regulations.
Design Approach With STANDARD
STANDARD Settings & Configurations
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53
• Foundation for EHR Design• Content
• Documentation (Templates, iView, PowerForms)
• MPages
• Fields (code sets)
• Reports & Discern Rules
• Playbooks
• Recommended content and workflows for a specific rule, department, venue
• STANDARD Workflows
• Workflow Designer
• Design Quality Assessments
• Alignment STANDARD audit tools
• Solution and position preferences, privileges and security profiles
STANDARD Workflow Recommendations
• Workflow STANDARDS represent
• Workflows that impact patient safety, quality, cost and efficiency
• Complicated workflows that involve multiple interactions to complete an activity
• Department specific workflows impacted by the HER
• Localized to reflect client future state
• Workflow Approval Process
• Define sign-off criteria and process
EHR Guiding Principles: Example
• Design decisions will be patient centric, evidence based and will support revenue cycle operations, clinicians, and ensure patient safety.
• The acute and ambulatory EHR design and build assumes universal adoption of all care givers and a “Paperless” environment.
• “Customization" of Cerner Standard Model will be limited to factors that impact patient quality and safety.
• Any major deviation that will impact time, scope and resources will be approved through the Steering Committee.
• Whenever possible, workflow processes will be standardized to drive to consistent outcomes.
• Whenever possible Niche software applications will be replaced by Cerner, to preserve and enhance the integrity of the longitudinal patient record and revenue cycle integration.
• Make decisions and move on. Failure to attend a meeting is no reason to postpone a decision.
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EHR Guiding Principles: Example
• "Perfect " is the enemy of "Good“
• Design will be based on what is best for the patient, not what is best for individual facilities, clinics or departments.
• The EHR will be universally adopted and will be used as designed.
• Design will focus on improving operational efficiency and promote patient safety and clinical excellence.
• Design must balance the workflow with system performance considerations.
• Processes will be streamlined to optimize workflow and eliminate unnecessary steps.
• Every end user will receive training that will allow for measureable, objective outcome measures in order to ensure appropriate change management, adoption and accountability
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Engage Phase
Engage | Adoption
• People
• Launch Communication & Change Management Strategies
• Educate & Activate Change Leaders
• Develop and Approve Learning Plan
• Define Organizational Adaptability Strategy
• Process
• Collect baseline measurements for Value Objectives & KPIs
• Validate workflow impact and role changes
• Define and communicate organization and venue change control processes
• Monitor adoption and engagement reports
• Technology & Tools
• Communicate Technology and Device Strategy
LaunchLaunchLaunchLaunchLaunchLaunchLaunchLaunch++ ++
++ ++
Engage| People
Launch Communication Strategies• Solutions Gallery
• Provider, Facility and Departmental roadshows
• Focused workflow validation and education sessions
• Champions and SMEs learn to lead conversations and demonstrations re: Future state
Identify and Resource Super Users
• Ensure a smooth transition to the new care model
• Become the local expert on EMR capabilities that
support clinical care processes
• Provide coaching and support to end users as they
transition
• Must have time allocated to support role
AlignAlignAlignAlignAlignAlignAlignAlignENGAGE
Engage| People
• Educate & Activate Change Leaders• Create Champion Communication Toolkit
• Complete Influential Physician Assessment tool for all service areas
• Activate a Physician focused communication strategy
• CEO Updates
• Med Exec Meetings
• Departmental Meetings
• Division Meetings
• House staff meetings
• Affiliated providers
AlignAlignAlignAlignAlignAlignAlignAlignENGAGEENGAGEENGAGEENGAGE
ALIGNALIGNALIGNALIGN MEASUREMEASUREMEASUREMEASURE
Engage| Process
• Collect baseline measurements for Value Objectives (Imperatives), KPIs and defined metrics
• Validate and communicate workflow impact
• Workflow Validation Events
• Roadshows/Demos
• Monitor adoption and engagement reports
AlignAlignAlignAlignAlignAlignAlignAlignENGAGE
Documenting The Impact | Tools
Workflow DiagramsWorkflow Diagrams
Start/Stop/Continue-Workflow Summary Start/Stop/Continue-Workflow Summary
Data Collection WorksheetsData Collection Worksheets
Policy & Procedure/Job ImpactPolicy & Procedure/Job Impact
Downtime Procedure ImpactDowntime Procedure Impact
Test ScriptsTest Scripts
Training Tips/FAQs/Training GuidesTraining Tips/FAQs/Training Guides
Engage | Technology
• Technology and Device Fairs
• Communicate device strategy
• Provide hands-on sessions for clinicians if indicated
• Hands-on sessions for care team
• Incorporate multiple roles
AlignAlignAlignAlignENGAGE
Activate, Measure and Continuous Improvement
Activate, Measure & Sustain | Adoption
• People
• Learning principles, strategy and delivery defined
• Activate Organizational Adaptability Strategy
• Monitor End User Competency/Satisfaction/ Adoption
• Process
• Monitor Value Objectives and Key Performance Indicators
• Effective issue and change management
• Monitor Clinical, Operational & Financial metrics
• Continuously innovate and improve
• Technology & Tools
• Monitor adoption of tools and technology
AlignAlignAlignAlign LaunchLaunchLaunchLaunchEngageEngageEngageEngage LaunchLaunchLaunchLaunch++ ++
++ ++
Activate, Measure & Sustain | People
• Learning Key Success Factors
• Learning must be mandatory for all providers who do not demonstrate competent use of the system
• Pre activation competency assessment
• Ongoing competency evaluations
• Competency in tools, process and standards
• Completion of learning must be tracked and monitored
• Patient education must be a key component of the education strategy
• Ongoing education related to the EMR Initiative must become part of the ongoing organizational education program
AlignAlignAlignAlignAlignAlignAlignAlign
Activate, Measure & Sustain | Process
• Activation Key Success Factors
• Monitor Goal Progress/Achievement
• Continuous monitoring of workflow adoption and staff competencies
• Effective issue and change management
• Ongoing communication & reinforcement of workflow standards
• Data-driven with positive trends
• Monitor operational metrics
• Continuously innovate and improve
Activate, Measure & Sustain| Technology
• Pre-conversion personalization activities
• Ongoing roadshows
• Ongoing “refresh”, communication and education
• Engage Learning Teams to incorporate new technology into workflows and assess competence
• Manage & Communicate re: System Performance
AlignAlignAlignAlign LaunchLaunchLaunchLaunchAlignAlignAlignAlign
Artrice LovePhysician Strategist
Value Planning
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� Assess current state� Define the value objectives� Identify stakeholders and governance
Align to the Vision
Engage Stakeholders
� Show the future state � Apply behavior change strategies� Localize system configuration and
workflow
Measure Value� Measure and communicate
value achieved� Identify opportunities for
improvement� Learn and adapt
Activate and Support� Activate new processes
and technology� Support the team� Monitor performance
Our Value Driven Implementation Process
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Value Planning Objectives
• Introduce and define Value Planning within the project
• Clarify and communicate organizational priorities and the story you’re hoping to tell after the project
• Align your organization to meaningful data that allows for continued improvement
• Set Value Measurement expectations within your organization and assign appropriate ownership to your objectives
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Value
A successful project includes not only a not only a not only a not only a timely timely timely timely conversion, conversion, conversion, conversion, but
also measurable improvements to patient safety, quality patient patient safety, quality patient patient safety, quality patient patient safety, quality patient
care, and reduced care, and reduced care, and reduced care, and reduced costcostcostcost
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How do we know the project was a success?
We Measure.
“Measures light the way, showing where systems are breaking down and where they are succeeding to help patients get and stay well.”
National Quality Forum
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Good Measurement
Selecting the right tools for the job is essential
Good Measurement drives Improvement, informsconsumers, and influences payment.
Just as a ruler can’t determine air temperature, different measures are required for different jobs.
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Begin with the End in Mind
Different Measures result in different information, understand which items will benefit your organization and elevate accountability and world class patient care.
Measurement types: Measurement types: Measurement types: Measurement types:
• Process
• Structural
• Composite
• Experience
National Quality Forum
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Examples of Project Measures
• Denied Patient Claims
• Compliance with documentation requirements
• Reduced Late Charge Entry
• Supply Cost
• By Patient Type or Department
• Hospital Acquired Conditions
• Clinician Compliance with Evidence Based Recommendations
• Patient Throughput
• ED arrival to Patient Admission
• ED arrival to Patient Discharge home
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Questions to Consider
• What do you want to improve with this project?
• What do your clinicians consider as pain points?
• What do you measure currently?
• What would you like to measure in the future?
• What is working well today?
• What improvements could be made to your current measurement process?
And last but not least
• What story do you want to tell after our hard work is complete?
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Value Objectives
Guiding principles for value objectives selection:
• Aligned with your organizational imperatives
• Focused list
• Understand outcome vs. process measures
• Actionable
• Measureable
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Value Objectives
Value achievement for your project starts with:
• Executive ownership of each objective
• Broad communication of the project value objectives and expected outcomes
• Collaboration from stakeholders across the organization
• Clear measurement plans including pre- and post-conversion comparisons and actionable data
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Next Steps
• Validate objectives with executive leadership team
• Communicate your objectives
• Align the project team to a common purpose
• Continue to discuss and address any missing items or new information
Governance Structures: Project Teams
Pat MacyEngagement Leader
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Project Teams
Project Teams (Reports to Leadership Advisory Committee)
CPOE Orders Team/ Physician Advisory: CPOE Orders Team/ Physician Advisory: CPOE Orders Team/ Physician Advisory: CPOE Orders Team/ Physician Advisory:
Physician Champions, Pharmacy, CPOE
SA, Physician Strategist, Clinical
Transformation Lead
Clinical Advisory/Medication Process Teams: Clinical Advisory/Medication Process Teams: Clinical Advisory/Medication Process Teams: Clinical Advisory/Medication Process Teams:
Physician Champion, Pharmacy, SMEs,
PharmNet SA , Clinical Strategist, Clinical
Transformation Lead
Cerner Build/ Client Test Team:Cerner Build/ Client Test Team:Cerner Build/ Client Test Team:Cerner Build/ Client Test Team:
Cerner SA/ SDCs, Client IS,
Project Manager, Testing
Coordinator, Clinical Staff for
Testing
Training Team: Training Team: Training Team: Training Team:
Staff Development, Clinical
Transformation Team, Sub set
of Super Users/SMEs
Communication Planning: Communication Planning: Communication Planning: Communication Planning:
Executive Sponsor and Project
Manager
Technical Team:Technical Team:Technical Team:Technical Team:
Clinical Transformation Lead,
HIM, Biomed, and IS
Finance Sub Committee:Finance Sub Committee:Finance Sub Committee:Finance Sub Committee:
CFO, HIM, Patient Access,
Patient Accounting, Care
Management
Clinical/Department TeamsClinical/Department TeamsClinical/Department TeamsClinical/Department Teams
Clinical Transformation Lead,
Department Leads
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Project Teams/SME Representation
• Interdisciplinary Clinical Documentation
• Nursing
• Respiratory
• Nutrition
• Therapies/Rehab
• Care Mgt/Discharge Planning
• Maternity/NICU
• Long-term Care
• Laboratory
• General Lab
• Microbiology
• AP Team
• Blood Bank
• Perioperative/Anesthesia
• Surgery/Endoscopy Department
• Surgery Scheduling
• Supply Chain Management
• Anesthesia
• Integrated Medication Process
• Medication Process
• Point of Care/Barcode Scanning
• Specialties – Oncology, Peds, NICU
• Pharmacy
• Radiology
• Scheduling/Medical Necessity
• Patient Accounting
• Patient Accounting – Billing & Accounts
• Supply Chain Management
• Charge Services
• Patient Access
• ED Patient Access
• Inpatient Registration
• OB Patient Access
• HIM/Clinical Reporting
• EMPI/HIM/Medical Records/Transcription
• Physician Track
• CPOE, Orders, Medication Reconciliation, ePrescribe
• Physician Doc
• Ambulatory
• Office Practice Management
• Ambulatory Clinical/Physician Documentation
• Prescription and Orders
• Oncology Practice
• Emergency Department
• ED Nursing, ED Reg, ED Coding
• ED Physicians – CPOE and Documentation
• Quality/Regulatory
• Biomedical Engineering
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Project Teams And Sub-groups
• CPOE Order Sets/Orders Teams:
• IT Analyst for CPOE with Client Physicians and Clinical Leaders Develop Content and Design of Ordersets (PowerPlans and/or IPOCs)
• Develop Orderables, Order Sentences for Catalog
• Develop Common Folders Structure & Content
• Completes Design Decisions for PowerPlans and Order Management
• May Require Sub-Groups by Specialty
• Medication Process Team:
• Develops Medication Orderables and Order Sentences
• Develops Medication Protocol Order Sets
• Completes the Medication Integration Design Decisions
• Completes Point of Care Design Decisions, if needed
• Department & Interdisciplinary Documentation Teams:
• Completes Design Decisions for Department Orders and Documentation Content
• Completes Future State Workflow Decisions
• Completes Review of Specialty Content
• Develops requirements for Standard Reports
• Supports Workflow Validation through Testing
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Project Teams
• Build/Testing Team:• Approves the Build Model• Completes Testing Schedule and Reports Results to Physician and Clinical
Advisory Committees• Technical/IT/Reports Team
• Manages and coordinates development of operational reports
• Ensures system maintenance and support• Participates in Device Strategy• Provides Technical Support
• Education Team: • Develops Integration Testing Scripts & Participates in Integration Testing• Develop Education Plans for each venue
• Communication Team: • Develops and executes Internal and External Plan
• Quality (Value) Team:
• Ensures metrics are identified and built• Approves testing scripts for metric documentation
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86
Project Teams Discussion
• Build/Test Team: Must have Clinicians to test• Performs the Building for CPOE According to Design Decisions
• Completes Testing Schedule and Reports Results to Physician and Clinical Advisory Committees
• Education Team: Can be Clinical Advisory• Develops Integration Testing Scripts
• Participates in Integration Testing
• Develop Education Plans for each venue
• Communication Team: Can be Executive Sponsor• Develops and executes Internal and External Plan
• Technical Team: IT Department• Ensures system maintenance and support
• Participates in Device Strategy
• Provides Technical Support
Communication Strategy
The plan to disseminate information related to the project and the changes
that will impact users across the organization
and the community.
Communication Strategy ++ ++
++ ++
Communication Strategy | Approach
• Define the Communication Scope & Strategy
• Organization and Venues
• Assign a Communication Lead
• Facilitates internal and external messaging about the project
• Define Project Branding
• Communication Planning
• Define Governance communication procedures
• Issue and escalation communication procedures and schedules
• Project team communication roles & responsibilities
• Define communication owners for each stakeholder group
• Define Communication master plan, timeline & budget
• Develops communication toolkits
• Leadership, Facility/Venue
• Change champion toolkits
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Communication Strategy | Approach
• Communication Plan
Organizational Adaptability plan & tactics
Establish communication guidelines
Create communication templates
Assign communication owners for each facility/venue
Venues localize leadership messaging from communication toolkits
Define & deploy communication events and vehicles
Establish feedback mechanisms
Ensure communication plan aligned with Agile Methodology
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Communication Strategy | Key Roles
• Communications Lead • Facilitates internal messaging about the project from Executive Sponsors
• Coordinate planning of communication events and vehicles
• Manages the distribution of communication deliverables
• Defines communicate templates and standards
• Coordinates the distribution of communication to wider group of stakeholders
• Coordinates communication of leadership messages to project teams and governance
• Change Champions, Subject Matter Experts, SuperUsers
• Will represent the leadership team and be a source of information about the project
• Participates in broader communication strategies
• Identify issues on the front line
• Gather feedback on the communications campaign
• Help to identify key resistors of change
Communication | Vehicles & Events
• Future State Collateral
• Stop/Start/Continue; Job Impact; Policy & Procedure Impacts
• Solution Guides
• Training Content; Job Aids
• Tips and Tricks/FAQs at Conversion
• Communication Vehicles
• Executive Messages
• Newsletters
• Targeted e-mail announcements
• Internal website
• Stakeholder Suggestion Email
• Webinars
• Events
• Town Hall Presentations
• Physician & Department Roadshows
• Training Events
• Staff meetings
92
Cerner Project Communication
• Weekly• Solution Calls
• Project Management Meetings
• Monthly• Executive Status Summary
• Recurring• Project status reporting
Executive Status Summary
• Overall project status dashboard
• Items for Management Attention
• Project Milestones
• Value Objectives
• Key Accomplishments
• Activities Not Complete
• Scope
• Acceptance by Cerner and client
Communication Template: Solution Teams
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Immediate Next Steps
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• Leadership Alignment• Assign a communication lead• Define communication scope and strategy• Develop and distribute initial key messages about
the project• Create communication templates and plans for
toolkits• Define communication guidelines and project team
roles and responsibilities
• Future State Review• Outline governance escalation and issue
communication procedures
Lisa Jobes
OCM Lead, Transition Center
July 13, 2015
Learning and Adoption
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Competence. Confidence. Satisfaction. Adoption.
Organizational change management
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Create Commitment Build Competence
Organizational Change Management
Create change plan
Analyze stakeholder
commitment levels
Why
Execute communication plan Activate change
agent network
Localize learning materials
Host show and tell events
Provide coaching
Deliver web-based training
Utilize reward andrecognition systems
Target messaging based on commitment levels
Target help and remediation based on performance metrics
Enable competitions
Deploy super user team
Facilitate formal learning
Encourage ongoing practice
Define governance and processes
Value objectives
Survey and enhance the environment
Promote ongoing support tools
Coached
20%Formal
10%Informal
70%
Informal • Job aids• LearningLIVE™• Conversion support• Adoption coaches
Coached • Open learning lab• Practice scenarios• Performance support/
conversion coaches
Formal• eLearning• Structured learning lab• Simulation learning
assessment scenarios
Delivery approach
Learning and adoption
Learning scope
• Learning Strategy Assessment
• Project Team Education Courses• Millennium Fundamentals
• Architecture, Troubleshooting & Issue Management
• Learning Project Manager
• TRAIN Domain Configuration
• Train the Trainer
• LearningLIVE
• Adoption Coaching, Conversion Support
Organizational Change ManagementTransition Center activities and events
Change Plan Execution
Motivation Strategy/ Awareness / Champions / Rewards and Recognition / Communication
Learning Strategy
• Learning Assets
• Learning Labs and Adoption Coaching
• Conversion Support and Adoption Coaching
• Ongoing Learning
• Adoption Coaching with Lights On Network®
PLAN ALIGN ENGAGE ACTIVATE MEASURE
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Next steps
Lisa JobesOCM Lead, Transition Center
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Project Reporting
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10
5
Project Status Reporting - Weekly
• Overall
• Staffing
• Client Education
• Project Scope
• Project Budget
• Timeline
• Next Event
• Transformation
• Technical
• Financial
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6
Project Status Dashboard
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7
Cerner Terms (and Acronyms)
• Project Framework• Event Based • A SharePoint site specific to each project for communication and information sharing
• uCern • Online collaboration and networking tool for Cerner associates and clients
• uLearn• Access to online learning tools
• Web-Based Training (WBT)• Online class and assessment
• CernerWorks (CWx)• Cerner’s Remote Hosting Organization (RHO), a network of data centers around the
world that host client data
The Acronym List
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8
It Begins Now