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How to measure the value of the ICT projects:
the HUG methodology
B. Debande, MD, MHA
CIO
University hospital of Geneva
Agenda
Reason for project value measurement
Collaborative design of a methodology
Overview of the tools
Is it used in « real life » ?
Future developments
Conclusions
Reason for project value measurement
IT support nearly all hospital activities
Critical for operations : without IT just close the hospital doors !
Mandatory for evolution and growth : each service needs IT to
support/optimize their working processes, better billing,…
There are many « bosses » in an hospital
CEO
CMO
CNO
and each head of medical service
IT resources are not following the demand
Budgets nearly flat
C* view : IT is expensive but dont give us a financial return to fund it
Reason for project value measurement
Multiple and contradictory constraints on the CIO’s head…
To survive, we need to prioritize projects
Reason for project value measurement
What is mandatory to prioritize projects
Governance : many things to say about that….. next time !
Decision support tools
Which tools
Portfolio : mandatory but not easy to set up : also many thing to say
about that….. next time !
Indicators to support the governance decision process : a tool to
help not a tool to choose in place of governance !
An alternative to ROI
In healthcare, ROI = financial = the devil !
We need to measure the return both on quality AND on investment
Collaborative design of a methodology
There are more ideas into two heads than one
Don’t reinvent the wheel
Keep it simple to be sure the tool is really used
There are more ideas into two heads than one
In 2011, we started a collaborative work with PMO of 3 other swiss
french speaking public hospital ( 2 general hospitals and 2
university hospitals), leaded by HUG PMO
Don’t reinvent the wheel
Adapt 2 existing methods in the hospital context
Keep it simple
First time we ask our project managers to evaluate their projects
All projects managers are NOT professionnal PM
We must have only ONE methodology adopted by EVERYONE
Collaborative design of a methodology
Utilitas
Used for evaluation of swiss e-government projects
Easy to understand, graphical view of results
Needs to be adapted to hospital context
Avalis
Designed for the evaluation of healthcare projects by ANAP
(Agence Nationale d'Appui à la Performance des établissements de santé et médico-
sociaux)
Too rich and too complex (115 multiple choice questions), won’t be
adopted by our project managers
Suitable for our needs but must be simplified
The group of PMO’s worked nearly 6 month to merge, simplify and test
on the field the new methodology
Overview of the tools
An excel file with 38 multiple choice questions, a tool to calculate ROI
and some macro to produce graphical results
All multiple choice questions inspired by ANAP questionnaire
Needs (5 questions)
• Strategic alignment
• Consequences if we don’t start the project
Benefits (21 questions)
• Impact on quality of care
• Impact on working processes, efficiency
Risks (12 questions)
• Do we have all condition of success ?
• Are there already potential blocking points ?
Cost effectiveness – ROI (8 questions)
• ROI calculated on 4 years, including all costs and revenues
Overview of the tools
Utility score : calculation and graphical representation coming form Utilitas
qualitative utility (needs + benefits) vs cost effectiveness
Overview of the tools
Overview of the tools
Overview of the tools
Graphical view of the results, with a special focus on « benefits »
Quality ofservice
Efficiency (opsand economic)
Workingcondition
Impact
Benefits forextra-hosp
Acquired skills
0
1
2
3
4Needs
Benefits
Risks
Costeffectiveness
UTILITAS Result A2
Is it used in « real life » ?
HUG
First try of the method on 20 running projects
• Positive return of projects managers (IT and non IT)
• More difficulties on economic evaluation, even with the tool
Since 2013, each new project must evaluate his utility
• Graphic view and Utilitas score are mandatory for decision
process
But, till now, there is an evidence that governance doesn’t use the
utility to prioritize the project
• Lack of maturity of our governance concil (less than 1 year in
this configuration)
• Politic reasons vs real needs in the prioritization process….
Other hospitals
Method and tool validated
But not really used because lack of real governance process
Future developments
Continuous improvement
Less multiple choice questions : from 38 to 29
• Easier to fill but risk of being non discriminant (to be evaluated
and improved if necessary)
Include real estate assets and medical equipment in questions
about benefits
Risk assessment not only at the beginning of the projet but
evaluated during all the project cycle
Extension of utility measurement
By consistency with the global project methodology (Hermes)
Use the utility measurement for all HUG, project IT and non IT
Conclusions
Our utility measurement methodology is the result of a collaborative
work of PMO from four swiss french speaking hospitals
Inspired by Utilitas and Avalis methodologies and adapted for
healthcare, the usability of the tool has been validated by professionnal
and non professional hospital project managers
Altough further work is needed to refine and extend the scope of
methodology, it is already used since 2 years in HUG
Next challenge is to convince governance to take in account these
objective data to prioritize project portfolio !
Interested to learn more about methodology ?
Interested to participate in the further development ?
Join us : [email protected]
