IT Project Management @ GW: Analysis of DOD’s Electronic Health Record Initiatives

This is the slide deck for the analysis paper I did on the DOD's several attempts at a unified EHR system for its many stakeholders. There is a 20 page research paper that goes along with this presentation if you are interested :)

Transcript

1. PROJECT DATE BY 26 FEB 2013 MARK SILVERBERG ELECTRONIC HEALTH RECORD THE DEPARTMENT OF DEFENSE’S FAILED 2nd
2. Project Overview HISTORY 1988 - DOD begins to acquire an EHR (“Composite Health Care System”) 1993 - deployed but lacked many features like integration b/w systems and did not use data standards “perpetuated the reliance on paper- based record” 1997 - new project (CHCS II) with nearly identical scope as 1988 but w/ emphasis on worldwide, 24/7 access, common data standards KEY INPUTS requirements were first of many problems; delayed multiple times => delay in creating WBS COMPONENTS client-server architecture client-side apps server software/hardware clinical data repository DELIVERY Like CHCS I, development and implementation contracted out 26 competitive RFPs which resulted in contracts for T&M & FFP 11 non-competitive contracts later found to be unnecessary by FAR guidelines 2009 - deployment with overwhelming negative feedback “Intolerable” - congress hearing “slow, difficult to use, unreliable” “EHR Way Ahead” = CHCS III
3. Challenges POOR PROJECT PLANNING “comprehensive project management plan was not established” - GAO “poor planning and execution and a failure to appreciate the ‘significant complexity’ of the program” - health industry analyst REQUIREMENTS GATHERING Essential to establishing and controlling scope End users of the system were only engaged at the beginning and end of the project lifecycle so when they did provide feedback at the end, it was too late to inform development LACK OF BUY-IN AND NO FEEDBACK LOOP WITH USERS Army’s Surgeon General “faced a near mutiny of our healthcare providers, our doctors, our nurse practitioners, physician assistants” USAF Deputy Surgeon General: “low productivity and provider morale [from] working around the system trying to find new solutions” GAO: “[DOD] stopped measuring user satisfaction levels in July 2007 after overall user satisfaction had declined to its lowest point in more than 2 years.”
4. What Project Management? Costs were neither minimized nor benefits maximized (or in many cases realized) $2 BILLION OVER 13 YEARS