Waverly Family Health

EHR Implementation Project Plan

University of San Diego © 2016. All Rights Reserved.

Document Control
Document Information

Information
©

Document Id 0001
Document Owner Thomas Noonan
Issue Date 1/25/2021
Last Saved Date 1/25/2021
File Name Waverly Family Health EHR Project Plan

Document History

Version Issue Date Changes

Document Creation – Page 5, Section 1.1-1.2, Page 11-12
[1.0] 1/25/2021
Appendix A
Sections 1.3 – 2.4 added. Revisions made from previous
[2.0] 2/2/2021
version. Gantt chart added to Appendix B.
Sections 3 added. Revisions made from previous version.
[3.0] 2/3/2021
Appendix C and D added.
[4.0] 2/16/2021 Appendix E added
[5.0] 2/22/2021 Appendix F added
[6.0] 3/1/2021 Appendix G added

Document Approvals

Role Name Signature © Date

Project Sponsor
Dr. Berkovich

Project Manager
Thomas Noonan 1/25/2021

i
Table of Contents

1 PLANNING BASIS............................................................................................................. 1
1.1 PROJECT CHARTER.......................................................................................................................................... 1
1.2 SCOPE.......................................................................................................................................................... 1
1.3 MILESTONES.................................................................................................................................................. 1
1.4 PHASES......................................................................................................................................................... 2
1.5 ACTIVITIES.................................................................................................................................................... 3
1.6 TASKS........................................................................................................................................................... 4
1.7 EFFORT......................................................................................................................................................... 5
1.8 RESOURCES................................................................................................................................................... 6

2 PROJECT PLAN...................................................................................................................7
2.1 SCHEDULE(GANTT CHART)............................................................................................................................... 7
2.2 DEPENDENCIES............................................................................................................................................... 8
2.3 ASSUMPTIONS................................................................................................................................................ 8
2.4 CONSTRAINTS................................................................................................................................................ 8

3 QUALITY AND TEST PLAN..................................................................................................9

4 GO LIVE PLANNING...........................................................................................................9
5 PROJECT CLOSURE REPORT.............................................................................................10
APPENDIX A. PROJECT CHARTER.............................................................................................11
APPENDIX B. PROJECT WORK BREAK DOWN STRUCTURE........................................................13
APPENDIX C. PROJECT FMEA RISK REDUCTION.....................................................................14
APPENDIX D. TEST PLAN.........................................................................................................17
APPENDIX E. STAKEHOLDER ANALYSIS....................................................................................19
APPENDIX F. GO-LIVE CHECKLIST..........................................................................................21
APPENDIX G. PROJECT CLOSURE DOCUMENT..........................................................................22

ii
1 Planning Basis

1.1 Project Charter

The project charter provides a brief overview of the EHR implementation plan for Waverly
Family Health. The information listed here provides critical information on project planning
and logistics.

Appendix A. Project Charter

1.2 Scope

Practice Fusion EHR system is being implemented for Waverly Family Health to help modernize
records and improve organizational efficiency. This project will be completed within 6 months. The
project will cost $20,000 to complete.

1.3 Milestones

Milestone Description Delivery Date

Charter approved The Business Case has been documented 01/31/21
and was approved by the Project Sponsor.
Project Team Team is selected 02/05/21
appointed
Work Break Down WBS approved and task delegation complete 02/08/21
Structure(WBS)

Project Quality and Plan to test quality of project approved by 02/11/21

testing plan approved sponsor
Software/Hardware Technology for EHR implementation is in 02/26/21
Installation complete place and runs across all devices
Medical Data All paper charts are transcribed to electronic 04/27/21
Transcribed form
Project evaluation Plan to determine if project meets needs is 04/28/21
plan approved approved
Training Staff training completed and updated prior to 06/18/21
“Go Live’
System fully Technical difficulties have been worked out 07/010/21
operational and project is complete

1
1.4 Phases

Phase Description © Sequence

Project Initiation Defining the project by developing a Project Phase # 1
Charter as well as recruiting the project team.
Project Planning Developing the WBS, project quality testing Phase # 2
plan, and determining technical requirements
Installing necessary technology, transcribing Phase # 3
Project Execution medical data, forming evaluation plan, and
training staff.
Project Closure Working out remaining technical difficulties, Phase #4
ensure system is running smoothly, and
evaluating the overall success of the project in
meeting requirements.

2
1.5 Activities

Phase Activity Description © Sequence

Project Produce Define all critical elements of the project. First step of the project
Initiation Project Determine the needs and requirements
Charter the new system is to meet.
Project Recruit Recruit people to the team. Determine all After Charter is finished
Initiation Project Team key players and the roles they will have but before Project
on the team Planning Phase
Project Determine Break down the work to be completed by After the Project
Planning WBS the team to ensure project objectives and Initiation phase but
deliverables are met before quality testing
plan is formed
Project Develop Produce a document describing Quality After the WBS is
Planning Quality Plan Assurance and Quality Control and completed but before
process review activities to be the technical
undertaken. requirements are
established
Project Technical Identifying hardware needs for the After Quality testing plan
Planning Requirements practice and configuring the software for is complete but before
Established EHR implementation Project Execution phase
begins
Project Installing Hardware is installed with configured First step of the Project
Execution technology software in necessary areas Execution phase

Project Transcribing Paper charts are transcribed into Following hardware

Execution Medical Data electronic record form installation but before
evaluation plan is
formed
Project Evaluation An evaluation plan is drafted to determine Following the
Execution Plan the success of the project in meeting transcribing of data and
Completed needs before staff training
Project Staff Training Staff are trained to use new EHR system Final step of Project
Execution by super user Execution phase. Before
Project Closure phase.
Project Technical Technical difficulties are identified and First step of Project
Closure Difficulties fixed. Determine plan if EHR system goes closure after training of
Resolved down. staff is complete.
Project Evaluate Using evaluation plan, determine if the Final step of the project.
Closure Project project was successful in meeting the Project is now complete.
needs and requirements of the client

3
1.6 Tasks

Phase Activity Task Sequence

Project Produce Draft Charter 1st
Initiation Project
Charter
Project Recruit Identify targets for team 1st
Initiation Project Team Recruit team members 2nd
Determine key stakeholders 3rd
Project Determine Draft WBS 1st
Planning WBS Assign Roles 2nd
Project Develop Identify Quality Targets 1st
Planning Quality Plan Identify Quality Assurance 2nd
Techniques
Identify Quality Control 3rd

Techniques
Document Quality Plan 4th

Project Technical Identify Hardware needs 1st

Planning Requirements Configure Software 2nd
Established
Project Installing Install hardware 1st
Execution technology

Project Transcribing Organize paper charts 1st

Execution Medical Data Transcribe data to electronic 2nd
records
Project Evaluation Identify evaluation metrics 1st
Execution Plan Identify analytical techniques 2nd
Completed Document Evaluation Plan 3rd
Project Staff Training Ensure super user is well 1st
Execution trained
Begin training staff 2nd
Test knowledge with examples 3rd
Ensure staff are well prepared 4th
to use new system
Project Technical Determine system issues 1st
Closure Difficulties Resolve issues before launch 2nd
Resolved Draft plan for system outage 3rd

Ensure staff understand 4th

procedure for a system outage
Project Evaluate Utilize evaluation plan to 1st
Closure Project assess the system

4
1.7 Effort

Task © Effort
Draft Charter 1 day
Identify targets for team 3 days
Recruit team members 2 days
Determine key stakeholders 1 day
Draft WBS 5 days
Assign Roles 1 day
Identify Quality Targets 1 day
Identify Quality Assurance Techniques 1 day
Identify Quality Control Techniques 1 day
Document Quality Plan 1 day
Identify Hardware needs 4 days
Configure Software 5 days
Install hardware 3 days
Organize paper charts 14 days
Transcribe data to electronic records 50 days
Identify evaluation metrics 1 day
Identify analytical techniques 1 day
Document Evaluation Plan 1 day
Ensure super user is well trained 7 days
Train staff 35 days
Test knowledge with examples 3 days
Ensure staff are well prepared to use new system 7 days
Determine system issues 3 days
Resolve issues before launch 3 days
Draft plan for system outage 2 days
Ensure staff understand procedure for a system outage 7 days
Utilize evaluation plan to assess the system 1 day

1.8 Resources
Task © Resource

5
Draft Charter Thomas Noonan
Identify targets for team Thomas Noonan
Recruit team members Thomas Noonan
Determine key stakeholders Thomas Noonan
Draft WBS Thomas Noonan
Assign Roles Thomas Noonan
Identify Quality Targets Dr. Waverly/Dr. Jones
Identify Quality Assurance Techniques Dr. Waverly/Dr. Jones
Identify Quality Control Techniques Dr. Waverly/Dr. Jones
Document Quality Plan Dr. Waverly/Dr. Jones
Identify Hardware needs Mr. Lawrence
Configure Software Mr. Lawrence/Mrs. Wright
Install hardware Mr. Lawrence
Mrs. Wright
Ms. Smith
Organize paper charts Mrs. Johnson
Transcribe data to electronic records Ms. Felps
Identify evaluation metrics Mrs. Jones
Identify analytical techniques Mrs. Jones
Document Evaluation Plan Mrs. Jones
Ensure super user is well trained Mrs. Wright
Begin training staff Mrs. Wright
Test knowledge with examples Mrs. Wright
Ensure staff are well prepared to use new system Mrs. Wright
Determine system issues Mr. Lawrence
Resolve issues before launch Mr. Lawrence
Draft plan for system outage Mr. Lawrence
Ensure staff understand procedure for a system outage Mr. Lawrence/Mrs. Wright
Utilize evaluation plan to assess the system Thomas Noonan

6
2 Project Plan
2.1 Schedule (Gantt chart)

The Gantt chart provides a visual timeline of this project. Each task occurs sequentially
within the assigned phase. There are four phases. Each phase has between five and ten
tasks to be completed.

Appendix B. Project Work Break Down Structure

7
2.2 Dependencies

Activity Depends on © Dependency Type

Recruit Project Team Produce Project Charter Finish-to-start
Determine WBS Recruit Project Team Finish-to-start

Develop Quality Plan Determine WBS Finish-to-start

Develop Quality Plan Finish-to-start

Technical
Requirements
Established
Installing technology Technical Requirements Finish-to-start
Established
Transcribing Medical Installing technology Finish-to-start
Data
Evaluation Plan Transcribing Medical Data Finish-to-start
Completed
Staff Training Evaluation Plan Completed Finish-to-start
Technical Difficulties Staff Training Finish-to-start
Resolved
Evaluate Project Technical Difficulties Resolved Finish-to-start

2.3 Assumptions

 The project will not change in scope

 The resources identified will be available upon request
 Approved funding will be available upon request.
 All staff will be available for the duration of the project.
 No human resources will be needed besides those listed.
 Weekends are valid work days.
 Task leads will direct initiatives for their tasks

2.4 Constraints

 The project must operate within the funding and resource allocations approved
 The project team must deliver the EHR implementation and “Go Live” on the agreed
upon date with no requirement for additional hardware
 Staff must complete the project within normal working hours to avoid unbudgeted
overtime expenses.
 Each activity must be completed sequentially and cannot be started until the prior activity
is completed.
 The project must be started and finished within the allotted time frame

8
3 Quality and Test Plan

Quality Plan
The quality plan or FMEA Risk Reduction plan aims to boost the quality of the project
through risk mitigation initiatives. Hardware analysis was conducted, and potential failures
were identified that could affect usage of the EHR system on a day to day basis. This report
includes what to do in the event of a Wi-Fi outage, hardware breakdown, hardware
depreciation, and hardware inefficiency. These events are documented, and a plan was
drafted to counter these events.

Appendix C. Project FMEA Risk Reduction

Test Plan
The quality testing plan will conduct testing on four critical areas. Unit & Functional testing
will be conducted throughout May and June of 2021 to ensure that all system functions are
running smoothly, and all necessary updates can be made to system units before launch.
System testing will begin in late April and run through late May of 2021. This will ensure the
system is fully operational before we test for functions and system units. Integrated Testing
will be done starting in June and running through the month. This will allow users to get a
sense of the system in action at least one month before “Go Live.” Performance & Stress
testing will be done during this time frame, one week less. This will give the team the ability
to view performance and system stress, make adjustments, and test them before launch.

Appendix D. Test Plan

4 Go Live Planning
Stakeholder Analysis
An overview of all stakeholders of the project, how they are influenced, and the needs they
have. Stakeholders needs must be kept in mind throughout the project. Not all stakeholders
need or want the same things, so it is important to consider how decisions might affect the
different stakeholder groups.

Appendix E. Stakeholder Analysis

Go-Live Checklist
The “Go Live” Checklist presents critical objectives that should be completed in
chronological order. The checklist includes objectives for staff, hardware and downtime
procedures. The checklist helps track process towards completion of the project and can be
utilized to increase the likelihood of a successful launch on “Go Live” day.

Appendix F. Go-Live Checklist

9
5 Project Closure Report
The closure report addresses project success, staff reviews, and analysis of the system as a
whole. Overall, the project closure report indicates the project was a success. The staff are
enthusiastic with performance and the system as met the goals that were established. The
system has increased operational and organizational efficiency, patients are more content
with care, and the staff have noticed a significant increase in their productivity. The full
project closure report can be found in Appendix G.

Appendix G. Project Closure Report

10
 Appendix A. Project Charter

Waverly Family Health EHR Implementation

Project Charter
A. General Information
Project Sponsor: Dr. Berkovich
Project Manager: Thomas Noonan
Prepared by: Thomas Noonan
Date: 1/25/2021

B. Purpose
Establish and implement the Practice Fusion EHR system for Waverly Family Health. The goal is to
transfer paper chart medical data to an electronic form. This will boost organizational efficiency and
allow the practice to provide better care to patients. The project is to be completed in 6 months.

C. Constraints and Assumptions

Constraints:
- Budget of $20,000
- Practice has no prior experience implementing an EHR system
Assumptions:
- Temporary decrease in organizational efficiency during implementation due to training
learning curve
- Project will take no more than 6 months to complete

D. Project Scope Statement

Practice Fusion EHR system is being implemented for Waverly Family Health to help modernize
records and improve organizational efficiency. This project will be completed within 6 months. The
project will cost $20,000 to complete.

E. Resource Requirements
$20,000 will be needed to finance the project. EHR access must be provided in all four exam rooms
and for the offices of all eight individuals listed as part of the implementation project.

F. Risks
Team members underestimated the complexity of the EHR system. Practice experiences employee
turnover as some may not want to adapt to a new system. The practice experiences increased stress
and loss of business due to initial decrease in productivity. Important documentation is not carried
over correctly in the transcription process.

G. Success Metrics: Criteria for Evaluating Project Success and

Milestones
1st month: Install software and prepare hardware for EHR implementation. Ensure system is running
smoothly across all devices
2nd month – 4th month: Transcribe all paper chart medical records to EHR
5th – 6th month: Train staff, work out technical difficulties, ensure that EHR system is meeting
expectations of the practice.

H. Key Stake Holders

11
Dr. Waverly, clinic owner and medical director
Dr. Jones, physician and clinic partner
Mrs. Jones, clinic director

I. Executive Summary
Throughout the duration of this project, we expect to establish and implement the Practice Fusion
EHR system for Waverly Family Health. The goal is to transfer paper chart medical data to an
electronic form. This will boost organizational efficiency and allow the practice to provide better care
to patients. The project is to be completed in 6 months. Constraints include a budget of $20,000 and
the fact that the practice has no prior experience implementing an EHR system. Assumptions include
a temporary decrease in organizational efficiency during implementation due to training learning curve
and the 6-month project completion window. A total of $20,000 will be needed to finance the project.
EHR access must be provided in all four exam rooms and for the offices of all eight individuals listed
as part of the implementation project. There are several risks that must be accounted for. It is
possible the team members underestimated the complexity of the EHR system. The practice may
experience employee turnover as some may not want to adapt to a new system. The practice may
experience increased stress and loss of business due to initial decrease in productivity. It is possible
that Important documentation is not carried over correctly in the transcription process. The time frame
for this project is broken down as follows: 1st month: Install software and prepare hardware for EHR
implementation. Ensure system is running smoothly across all devices. 2 nd month – 4th month:
Transcribe all paper chart medical records to EHR. 5th – 6th month: Train staff, work out technical
difficulties, ensure that EHR system is meeting expectations of the practice. Our key stakeholders
include Dr. Waverly, clinic owner and medical director, Dr. Jones, physician and clinic partner and
Mrs. Jones, clinic director.

12
Appendix B. Project Work Break Down Structure

13
 Appendix C. Project FMEA Risk Reduction

Process analysed: Hardware systems

Team leader: Thomas Noonan

Team members:

Name Position Name Position

Back office medical

Thomas Noonan Project Manager Ms. Smith
assistant, IT assistant
Physician and clinic partner, end
Dr. Jones
user
Clinic accounts and billing, IT team
Mr. Lawrence
leader
Back office medical assistant, IT
Mrs. Wright
assistant

How the clinician would utilize the EHR to conduct an initial interview of a patient:

Ask for
Identify
Start
Name and
Call patient’s
process DOB
patient issues

Utilize EHR Provide

Document
tools to aid information/schedul Finish call
patient with End
patient e appointments process
encounter patient

Possible Issues/Errors:
1. Wifi outage – internet access is out, and the system process can’t be started
2. Hardware breakdown – monitor, computer, and other hardware fail, process
cannot be started
3. Hardware becomes obsolete – the hardware becomes dated and the software
can no longer be run on current hardware
4. Inefficient storage – the practice grows and 8GB of ram becomes an
inefficient store of data. Clinician cannot input new records/ system slows due
to overcrowding of data files

14
 Severity and outcome:
1. Wi-Fi outage – Outcome (5) Probability (3)
2. Hardware breakdown – Outcome (5) Probability (2)
3. Hardware becomes obsolete – Outcome (5) Probability (1)
4. Inefficient storage – Outcome (3) Probability (1)

Specific Actions to
Process Root Cause of Responsible
Reduce or Eliminate Completion Time Frame
Failure Process Failure Individual/Group
the Failure

Technical issues
with provider, loss
Conduct monthly Mr. Lawrence, Mrs.
Wi-Fi outage of connection to 1 Day, monthly
connectivity tests Wright, Ms. Smith
provider services,
power goes out
Technical issues
with provider, loss
Wi-Fi outage of connection to Install a generator 1 week Mr. Lawrence
provider services,
power goes out
Hardware usage is
Hardware Monthly hardware
not properly 1 day, monthly Mr. Lawrence
Breakdown checks
monitored

Assess need for new

Hardware
Hardware is not hardware over time
becomes 1 month, yearly Thomas Noonan
updated routinely utilizing monthly check
obsolete
data

15
Measures of Success

Measure(s) of Success(How we Reporting Schedule and Individual or

will know if this action is
successful)(Consider measures of Group Responsible for Reviewing
Corrective Action how often the failure is still Results
occurring after process changes
and the incidence of adverse
events related to the failure)

Conduct monthly Ensure that download and upload Mr. Lawrence, Mrs. Wright, Ms.
connectivity tests speeds are maximized Smith

Test generator by shutting down

Install a generator power after hours and booting up Mr. Lawrence, Thomas Noonan
with the system with the generator

Ensure all hardware is properly

Monthly hardware
functioning and all defects are Mr. Lawrence, Dr. Jones
checks
reported

Assess need for Ensure that hardware meets

new hardware over minimum industry standards and
Mr. Lawrence, Thomas Noonan
time utilizing update as needed to meet
monthly check data requirements

Signature of FMEA leader/facilitator: Thomas Noonan

Date: 2/8/21

16
 Appendix D. Test Plan
Exhibit 1: Table of Components to be Tested

Test Components Date Responsibility Accepted

Unit & Functional Each major function performs 6/15/21 Mr. Lawrence 6/30/21
Testing as specified in user manual.
Design 6/1/21 Thomas Noonan 6/15/21
changes/customizations are
present & work as requested.
Document all changes for
reference.
Screens appear as expected 5/10/21 Mrs. Wright 5/15/21
(content and placement of
fields, codes, drop down
menus, and messages).
No spelling errors or color 5/10/21 Ms. Smith 5/15/21
changes. Readable icons.
Appropriate representation of 6/1/21 Thomas Noonan 6/30/21
content can be printed if
necessary for legal purposes.
Entries that have been 5/15/21 Ms. Smith 5/30/21
corrected and their corrections
are both displayed accurately.
Fields edits (e.g., valid values, 5/15/21 Mr. Lawrence 5/30/21
options, defaults) function as
expected.
Alerts and clinical decision 5/1/21 Mrs. Wright 5/20/21
support provides appropriate
reminders and prompts. Use
scripts to test various
scenarios.
System Testing Workflows send and/or receive 5/15/21 Mr. Lawrence 5/30/21
data properly between
systems (e.g., between EHR
and pharmacy or billing, PMS
messages and EHR). Use
scripts to test various
scenarios.
Interfaces between 4/20/21 Mrs. Wright 5/1/21
applications move data
correctly and completely. Test
both sending and receiving
when interfaces are bi-
directional.
Connectivity with external 4/20/21 Thomas Noonan 5/1/21
organizations is accurate and
complete as authorized (e.g.,
portal access to/from
hospital/clinic, continuity of
care record to referrals,
personal health records for
patients, disease management
to/from health plan).
System access is appropriate 5/20/21 Ms. Smith 6/1/21
per assigned privileges. Test
attempts to gain access when
not authorized.
Data are processed 5/1/21 Mrs. Wright 5/10/21

17
Test Components Date Responsibility Accepted
accurately, in graphs, tables,
claims, client summaries,
reports, etc.
Data correctly populate 5/1/21 Mrs. Wright 5/10/21
registries, reporting
warehouses, etc.
Integrated Ensure all system components 6/15/21 Mr. Lawrence 6/30/21
Testing that share data or depend on
(simulates live other components work
environment) together properly.
Ensure that workflows reflect 6/1/21 Thomas Noonan 6/15/21
actual new processes and
workflows.
Ensure that usage is defined in 6/1/21 Mrs. Wright 6/15/21
and follows policies and
procedures. Reinforce training
as applicable.
Ensure that help desk, support 6/1/21 Ms. Smith 6/15/21
personnel, and other aids
function properly.
Ensure that EHR works with all 6/15/21 Mr. Lawrence 6/20/21
forms of human-computer
interface devices and
modalities being used (e.g.,
tablets, PDAs, voice
recognition, and speech
commands as applicable).
Attempt to break the system 6/15/21 Mr. Lawrence, 6/25/21
by testing mission critical and Thomas Noonan
high risk functions, such as
situations requiring exception
logic (e.g., overrides to clinical
decision support), handoffs
from one process to another,
and when you may have a
series of events over a period
of time (e.g., assessments
performed at designated
intervals).
Performance & Measure response times for 6/1/21 Mrs. Wright 6/10/21
Stress Testing key transactions or
interactions with the system,
and assure they are within
acceptable limits, which may
be defined in the contract.
Simulate an extremely high 6/15/21 Mr. Lawrence 6/20/21
volume of activity on the
system such as would exceed
anticipated peak loads of
system usage.
Measure the time it takes to 5/20/21 Ms. Smith 6/1/21
generate reports and data
dumps, and the impact on
system performance.

18
 Appendix E. Stakeholder Analysis
Stakeholder Interview

Category Name Objectives/Questions

Topics to Cover (adjust as necessary):
 Special Interests
 Influence
 Dependencies
 Critical Timelines / Risks
 Actions required
Nonclinical Staff Require a smoothly working system to
(could be listed by Operations/IT facilitate daily clinic activities
department or System must be functional for this group
agency) before go-live date
Must be appropriately trained
Clinical staff (could Require an improved medical record
be listed by Dr. Jones keeping system
department or Nursing Staff Must be appropriately trained
agency) Must be able to provide care to patients
more efficiently than before
Admin staff(this Require a system that can boost clinic
might include your efficiency
practice manager Dr. Waverly Must see growth in the practice in terms of
and medical Mrs. Jones patients seen and treated
director)
Vendors Require a system that allows easy tracking
Rx and device of supplies and equipment within the
providers practice

Patients Patients Require efficient and effective service in a

time sensitive manner

Finance Require a system that can easily track

Finance Department billing and reimbursement recognition

19
 Influence/Interest Grid

High Finance Department Dr. Waverly

Operations Department Dr. Jones
IT Department Mrs. Jones
Nursing Staff

INFLUENCE

Rx and device vendors Patients

Low

Low INTEREST High

20
 Appendix F. Go-Live Checklist

☐ Staff

☐ Two months prior to “Go Live”, begin training staff

☐ One month prior to “Go Live”, ensure super user is trained in all complex aspects
☐ Three weeks prior to “Go Live”, ensure all staff have met training requirements
☐ Two weeks prior to “Go Live”, address any issues staff may be having with system
☐ One week prior to “Go Live”, test run system with staff and address any issues after
the testing is complete

☐ Hardware

☐ Five months prior to “Go Live”, install all required hardware

☐ One month prior to “Go Live”, test hardware specifications real time
☐ Two weeks prior to “Go Live”, determine and evaluate system issues
☐ One week prior to “Go Live”, resolve issues before final evaluation
☐ One week prior to “Go Live”, ensure all equipment has passed final testing and meets
specification for operating with the EHR.

☐ Down Time Procedures

☐ One month prior to “Go Live”, test high load times and low connectivity on the system
☐ Three months prior to “Go Live”, test backup generator and ensure system can run
smoothly using only generator power
☐ Two weeks prior to “Go Live”, assess and revise plan for system outage as needed
☐ One week prior to “Go Live”, conduct maintenance and apply any necessary
updates/patches/upgrades to the system
☐ One week prior to “Go Live”, develop plan for continued scheduled maintenance
during future system downtimes.

21
 Appendix G. Project Closure Document

PROJECT CLOSURE REPORT

1 INTRODUCTION

1.1 Project Identification

Waverly Family Health EHR Project Plan. Document 0001. Waverly EHR System

1.2 Project Sponsor

Dr. Berkovich

1.3 History of the System

The system was preceded by paper charting. Waverly Family Health needs a more efficient
electronic system that will improve organization operations. The system will provide accurate
and timely record keeping and allow users to quickly access critical patient information.

2 EVALUATION SUMMARY

2.1 General Satisfaction with the System

Users describe the system as “wonderful,” “convenient,” and “helpful.” Members of the team
feel they can “do more, however it feels that there is also more to do as well.” The rate at
which tasks can be completed on a daily basis has increased, thus making it a useful tool to
have.

2.2 Current Cost-Benefit Justification

There is likely going to be a decrease in productivity at the start, but this can be mitigated
with proper training and testing periods. This decrease will likely lead to some lost revenue,
but it will be recuperated in the long term. The system makes it much easier to track
expenses, payments and billing. This will lead to an increase in reimbursement recognition,
ultimately yielding greater profits for service provided. Long term, the cost of the system is
worth the boost in recognized revenues.

2.3 Needed Changes or Enhancements

One system user reported that the Edit Encounter/Add Addendum function is not working
properly. This is a critical element for communication between team members, doctors and
patients. This function must be added for the system to maintain system success.

22
3 ANALYSIS AND IMPLEMENTATION

3.1 Purpose and Objectives

One user reported that the workflow of the new system was somewhat cumbersome in the
first two weeks. Once the learning curve was passed, they felt more comfortable and the
workflow had definitely been changed for the better. Patient wait times have decreased
overall. Staff reported less mistakes. Overall, the primary goal appears to have been met.
This system has provided an increase in operational and organizational efficiency that the
team was hoping it would provide.

3.2 Scope

Ultimately, the project scope was adhered to appropriately. Paper charts were replaced with
electronic records within the six-month allotted time frame. The budget of $20,000 was not
exceeded. Risks were properly evaluated and acknowledged throughout the project.
Success metrics were noted and reached at established times and key stakeholders were
identified. The executive summary of the project scope provided an accurate assessment of
the project and the overall goals were met.

3.3 Benefits

The benefits associated with this project include increased operational efficiency, increased
organizational efficiency, better quality care for patients, improved revenue recognition, and
a more cohesive health care team. The benefits were largely met by project end. The system
has allowed the practice to expand its care base due to the increases in efficiency and boost
in recognized revenue. The team is better able to communicate with one another and patient
satisfaction has increased by nearly 50% based of previous surveys.

3.4 Development Cost

Project costs were well assessed, and the team did not go over budget. Analysis of future
revenues, risk mitigation techniques, and strict adherence to balance sheet allowances
created an environment for successful budgeting. The team utilized all of their resources
properly and the full budget of $20,000 was used.

3.5 Operating Cost

The cost here is comprised of the lost revenue within the first three months of operation,
necessary upgrades and updates to the system, and general system maintenance costs.
These costs were calculated from similar projects done at other practices and using a
expense schedule determined through project research. Roughly $2,000 of the original
budget was contributed to research in this category. All costs were found to be covered by
incremental increases in revenue as the practice grows.

3.6 Training

Training of the superuser was critical in this project. The superuser developed a masterful
understanding of the system and the complexities of each function. The superuser played a
critical role in training staff and was capable of training all users in the allotted time frame.
This played a large role in enabling the staff to be well prepared for go live day. Training was
efficient and successful.

23
4 OUTPUTS

4.1 Usefulness

Users have found the system to be “far more efficient than it used to be.” “Medical errors
have been reduced,” “the billing process is much smoother,” ‘generating a new medical
record is quite easy,” and “patients are happier with the e-prescription and scheduling
process.” These reviews all speak to the quality of the system. One user reports that the
system is, “still a little overwhelming, but it gets easier with each interaction.” With time, it is
likely that the usefulness of the system will be realized in an even greater capacity. It
appears to be providing both strong short term and long-term grades in the usefulness
category.

4.2 Timeliness

Timeliness has increased vastly. It has never been easier to pull up a chart, generate a new
medical record, download imaging, or send files to team members for review. Billing and
reimbursement collection have become exponentially faster. Instant communication via the
EHR system has reduced delays and driven the time it takes to care for a patient down.

4.3 Data Quality

Data accuracy and reliability are much stronger in the new system. With security checks,
automation, and fast processing times, data and information management have contributed
to the increase in operational efficiency. Having a system in place to scan for duplicate
records has made record keeping much easier.

5 SECURITY

5.1 Data Protection

The EHR system meets the security requirements specified by HIPAA and the standards of
the practice. The security officer monitors all use of the system and enforces corrective
action if needed. The system is backed up offsite to ensure all data is safe and can be
recovered if the main server is lost. In the event of a restart, all lost data will have been
backed up for recovery on reboot. Staff is required to complete security training before use
of the system to ensure the likelihood of misconduct is mitigated.

5.2 Disaster Recovery

In the event of a disaster, safe data recovery has been ensured. All files are backed up on a
secure, external server in a safe location. In the event of an outage (disaster or planned),
team members can remote into the secure server and access files directly from there. The
team had a generator installed in case of a power outage so that operations can continue
effortlessly. All staff received training on correct procedures in the event of a disaster.

24
5.3 Audit Trails

Security and compliance officers are capable of tracking all interactions within the system. In
the event of an audit, system use can be recalled and displayed to ensure compliance with
HIPAA and practice standards are met.

5.4 System Access

The security and compliance officer are responsible for monitoring all system use. All
interactions can be tracked by the officer. The officer also can see who has access to what
information and can delegate access as needed to certain individuals.

6 COMPUTER OPERATIONS

6.1 Control of Workflow

Collecting and analyzing data appears to be more efficient according to users of the system.
“Scanned paper records are still easily accessible,” “electronic files can be easily located
and distributed,” “workflow is more efficient,” “patients’ complaints have been reduced,” “we
have significantly increased clinical workflow efficiencies.” Workflow control is much more
manageable, and results show that users are reaping the benefits of the system. Data is
secure and capable of flowing easily between appropriate users.

6.2 Scheduling

So far there have not been any issues with scheduling. It is much more efficient to enter
patient information in the system and have certain fields auto populate into the schedule.
One issue that is affecting scheduling is the lack of the Edit Encounter/Add Addendum
feature. Without this feature fully operational, clinicians and administrators cannot
communicate to their fullest potential. This lack of communication hinders the ability of
schedulers to have timely interaction with clinicians who would like to see recurring patients
again within the calendar month.

6.3 Computer systems

Computer systems are fully functional currently. As part of the system maintenance process,
software and hardware will be evaluated on an ongoing basis to check for failures or
inefficiencies.

6.4 Peak Loads

The general consensus of users it that, “there have not been any significant connectivity
issues.” Users appear satisfied with load times and have not noticed any hindrances during
increased system use. The team has praised the system for is ability to handle a large
volume of users and data requests. The full capacity of the system does not appear to have
been reached.

25
7 MAINTENANCE ACTIVITIES

7.1 Activity Summary

The system is functioning as intended at the go-live date. There will be ongoing evaluations
of efficiency and use every month. Hardware will be tested each year and assessed to
ensure it has not become obsolete. Tests will be run bi-monthly on software use to ensure
that all elements are capable of being utilized properly.

7.2 System Maintenance

Downtime for maintenance will occur after normal working hours to ensure no processes are
interrupted. Updates, upgrades, and maintenance of the software will be assessed monthly.
Issues submitted by staff will be reviewed daily by the IT department heads to ensure that all
issues are acknowledged in a timely manner.

26