Unity Project Startup Project Startup . ... Your organization and the project team demonstrates they are aligned in their ... Highlight system build that supports the value objectives

Pat Macy

Engagement Leader

July 13, 2015

Unity Project Startup

BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.

This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner

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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



3

Project Startup Objectives

• Provide overview of Consulting Framework,

Value Planning and initial project deliverables

• Begin Data collection and Regular Solution Group

meetings



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



5

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



8

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



10

Positioned for the future

Cerner Consulting – Partnering with you—1183489876v1. Effective April 2013.

Project Framework

• Values, Scope and Project Approach



12

� 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



13


Str

ate

gic

Im

pera

tives

ALIGN ENGAGE ACTIVATE MEASURE

Valu

e A

ch

ieved

People

Process

Technology

Program Management



14


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



15

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



16

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



17

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


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


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


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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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

© 2011 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner. 35353535

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



37

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



41

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


This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.

43

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


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


• 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



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.



55

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



56

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


• 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


• 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



70

� 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



71

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



72

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



73

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



74

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.



75

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



76

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



77

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?



78

Value Objectives

Guiding principles for value objectives selection:

• Aligned with your organizational imperatives

• Focused list

• Understand outcome vs. process measures

• Actionable

• Measureable



79

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



80

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



82

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



83

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



84

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



85

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



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



89

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



90

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



95

Immediate Next Steps



96

• 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



Competence. Confidence. Satisfaction. Adoption.

Organizational change management



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



Next steps

Lisa JobesOCM Lead, Transition Center



Project Reporting



10

5

Project Status Reporting - Weekly

• Overall

• Staffing

• Client Education

• Project Scope

• Project Budget

• Timeline

• Next Event

• Transformation

• Technical

• Financial



10

6

Project Status Dashboard



10

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



10

8

It Begins Now

Documents

Unity Project Startup Project Startup . ... Your organization and the project team demonstrates they are aligned in their ... Highlight system build that supports the value objectives