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Basics – Proj Mgmt
17 September, 2013 2
Session Objectives
Background – MindLeaf
A. Project Management on ICD10
B. Earned Value Management (EVM), an ICD‐10 project Case Study
C. Is EVM needed for ICD‐10?
“In preparing for battle, I have always found that plans are useless, but planning is indispensable.”
‐ (Former President) Dwight D. Eisenhower
17 September, 2013 3
Background Services We Offer Customer
• Founded in 1993 headquartered in Bedford, MA
• Financially stable with controlled growth
• Approximately 175 associates
• Operations in 40+ States
• Seasoned leadership team, executive experience at Digital Equipment Corp, SAIC, IBM, Ingenix and other leading healthcare companies.
• Medical Administrative Support (Medical Coding, Auditing, Records Mgmt., Appointing, Release of Information)
• Health Information Management (EDI, HIPAA 5010, ICD‐10 )
• US Air Force Hospitals
• US Navy Hospital
• State of MA
• Others
• INC 500/5000 fastest growing companies in the US (2007‐2012)
• Boston Business Journal (Fast 50) 2009‐2011
About MindLeaf
Basics – Proj Mgmt
17 Sep 2013 4
Key Issues to Successful ICD‐10 Implementations
Transitioning will involve many hurdles…including
Interruption of
hospital(s) revenue stream
Lack of clarity
across ICD‐10 projects
Cost Overruns/ Cash Flow
Schedule Slippage
Increased Operating Costs
Inadequate resources
Does this resonate with you?
Specifically, this transition will impact “People, Process, and Technology”
Offerings:
Technical Remediation,Quality Management ‐ TestingProgram Management ‐ PMO‐Lite• Work closely with executives and staff (business &
IT), regulators, vendors, providers, and other business partners.
• Capture status and progress of all ICD‐10 initiatives across the enterprise and with partners.
• Implement well‐defined risk assessment and risk mitigation.
• Implement best practices in governance and contingency planning.
• Evaluate analytic tools and methodologies to aid ICD‐10 implementations.
• Conduct a comprehensive awareness and training program.
• Share ICD‐10 understanding: from analysis to remediation to process optimization
5
MindLeaf can help
617 September, 2013
Tools to monitor – ICD‐10 Project
Strong candidate tools that we can quickly apply to your needs….
17 September, 2013 7
Tools to Manage – ICD‐10 Project
Know how you’re doing in the process ‐ anywhere, any time.
Basics – Proj Mgmt
17 Sep 2013 9
Keys to Successful ICD‐10 Implementations
PMO‐Lite & IV&V• Work closely with executives and staff (business & IT), regulators, vendors, providers, and other business partners.
• Capture status and progress of all ICD‐10 initiatives across the enterprise.• Implement well‐defined risk assessment and risk mitigation.• Implement best practices in contingency planning.• Evaluate analytic tools and methodologies to aid ICD‐10 implementations.• Conduct a comprehensive awareness and training program.• Share ICD‐10 understanding: from analysis to remediation to process optimization
• Test extensively internally and externally.• Communicate! Communicate! Communicate!
Oversight, Coordination and Communication
The PMO “Lite” model ‐ is where most PMOs start. Responsibilities are focused on a mission‐critical program (like ICD‐10) and effective methods, standards, tools & techniques.
Basics – Proj Mgmt
PersonResponsible
Define the sub‐tasks, tasks
Define the boundaries
What constitutes 25% complete ? 50% complete?
Detail Task schedule
Master Schedule
1. Scope 2.Schedule
3. Budget4. Project Manager
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A. Project Management on ICD‐10
How much each task will cost. Allocate resources.At sub task level
At Task level
At Project Level
Steps
Basics – Proj Mgmt
17 September, 2013 11
Basic Project Metrics – Measurement(s) on ICD‐10.
Scope Schedule Budget
Plan What are the deliverables ?
When are they due ?
How much is the cost ?
Is this all we are going to measure until the compliance date?Is your project green? Or yellow? Or red?(Source ‐ A practical guide to Earned Value Project Management)
Basics – Proj Mgmt
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B. Earned Value Management ‐ Definition
Earned Value Management:
“What we are getting …for what we are spending” in a nutshellSource – Earned Value Project Management / Quentin Fleming & Joel Koppelman
“Earned Value is a concept—the concept that an estimated value can be placed on all work to be performed, and once that work is accomplished that same value can be considered to be “earned.” “
—A. ERNEST FITZGERALD February 28, 1965
Will you be able to use Earned Value in your ICD‐10 Project.....Yes
32 Criteria for Earned Value Management
System
Use Earned Value “Lite” ….5 Simple Steps
17 September, 2013 14
Total Criteria for Earned Value (as per DoD)
1. Project Plan2‐5 Organization3‐6 Schedule9‐15 Budget16‐21 Performance22‐27 Variances28‐32 Change
How ?
17 September, 2013 15
Earned Value ‐ Lite
•Work•Cost
Establish
•Qualified & Responsible
Assign•Management Plan, including• Schedules & Milestones
Prepare
•Costs
Record•Relevant &Timely Info
Use
Scenario #1:
Budget $ 3MTotal number of IT application systems 126
Number of IT applications evaluated for ICD‐9 41
Number of vendor responses received 38
Number of vendor systems impacted 33
Number of vendor systems not impacted 8
10 vendors non‐compliance and alternatives were being sought
Total Number of real‐time HL7 interfaces 109
Total Number of HL‐7 Interfaces transporting ICD‐9
37
Total Number of Payors evaluated (high % of cash)
24
A hospital health system with owned Physician practices and a health plan
Extracts: 20 custom extract programs generate files containing ICD‐9 data
Reports: 75 custom reports developed by the IT Programming Team currently contain the ICD‐9 codes
• 60% of these reports have specific ICD‐9 codes that are hard‐coded within the generating program
• 35% of these reports are “soft coded”
*Work effort will be driven by the file structure in the ICD‐10 compliant version
Forms: 30% of the end‐user departments surveyed responded that they have forms (paper and electronic) that contain the ICD‐9 data element today
17
A Case Study
Looks great ? Why ? Our actual costs = Budgeted costs.
17 September, 2013 19
Case Study – Q2 2013 Results
Budget by Tasks Budget by Time Period Actual Cost
Amountby Qtr.
Cumulative Amount Amount
Cumulative Amount
Planning $ 550K Q1 ‐ 2013 $ 600K $ 600K $ 600K $ 600k
Communication $ 150K Q2 ‐ 2013 $ 250K $ 850K $ 250K $ 850K
Testing $ 1700K Q3 ‐ 2013 $ 550K $ 1400K
Training $ 600K Q4 ‐ 2013 $ 500K $ 1900K
Q1 ‐ 2014 $ 500K $ 2400K
Q2 ‐ 2014 $ 300K $ 2700K
Q3‐ 2014 $ 300K $ 3000K
Is it really?
Tasks Plan at end of Q2 Status (results) at end of Q2
I. Planning Completed 90% done
II. Communications 15% Completed 10% done
III. Testing 10% Completed Not started
17 September, 2013 20
Planned vs. Actual Status
Tasks Plan at end of Q2
I. Total Costs (forecasted) $ 3,000,000
II. Actual Costs to date $ 850,000
III. Planned Value (Work schedules + budget for work schedules)
Planning 100% + Communications 15% + Testing 10% = (550k + 22.5K+ 170K) = $ 742,500
IV. Earned Value(Measure of work performed @ budgeted amt.)
Planning 90% +Communications 10% +Testing 0% = (495K + 15K) = ONLY $510,000 of the work is completed
17 September, 2013 21
Primary Earned Value Metrics
Earned Value – Planned Value =$ 510K – $ 742.5K =($ 232.50K)
Unfavorable Schedule Variance
Planned to accomplish$ 742.5 in work but onlyAccomplished $ 510K.
Earned Value – Actual Cost = $ 510K – $ 850K = (340K)
Unfavorable Cost Variance
Spent $ 850K to achieve work related to $ 510K
Schedule slippage + Cost Overruns
Project is having Problems.
Earned Value – Planned Value =$ 510K – $ 742.5K =($ 232.50K)
Unfavorable Schedule Variance
Planned to accomplish$ 742.5 in work but onlyAccomplished $ 510K.
Earned Value – Actual Cost = $ 510K – $ 850K = (340K)
Unfavorable Cost Variance
Spent $ 850K to achieve work related to $ 510K
Schedule slippage + Cost Overruns
Project is having Problems.
Schedule VarianceSchedule Variance Early WarningEarly WarningCost VarianceCost Variance
17 September, 2013 22
What does it all mean?
17 September, 2013 23
Report Card
Project Name: ICD‐10 Transition Budget To Date (Q2 – 2013) ‐ $ 850K
Performance Assessment to Date – Q2 Negative Schedule Variance
Negative Cost Performance
Can we recover ?
Forecasting a range of Cost estimates Low‐End
High‐End
Basics – Proj Mgmt
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Why Earned Value is needed on ICD‐10?
Scope Schedule BudgetPlan What are the
deliverables ?When are they due ?
How much is the cost?
Progress What tasks have been completed?
How long has it taken to complete the work accomplished?
How much have we spentto complete the tasks reported as finished?
Projection Will all project specificationsbe met?
When will the project be completed?
What is the estimated total cost atcompletion?
Source : A practical guide to Earned Value Project Management
Based on the Progress …You want your Project to be Green?
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Key takeaways. Detecting Early Warning
Effective Project Mgmt. (Scope, Schedule, Project Mgmt., Base Plan)
Create a Report Card
Make Adjustments or corrections
A
B
C
Plan –10%
Do –90%
Traditional Approach
Recommended Allocation between Planning & DoingIf your plan is thoughtful and complete, it will take less time to implement ICD‐10.
17 September, 2013 27
Allocation on planning
Do – 60%Plan – 40%
Recommended