Post on 25-Jan-2017
HITECH-Meaningful Use and
The Benefits of the
PMI and ITIL Relationship
May 20, 2011
William ‘Buddy’ Gillespie, ITILv3 Certified
Vice President & Chief Technology Officer
WellSpan Health
The Journey
Meaningful Use
Introduction• Since the HITECH Act was passed in February,
2009, healthcare executives have felt the pressure to implement the electronic health record and achieve Meaningful Use status resulting in the flow of incentive dollars over the next five years.
• In the rush to purchase and implement EHR solutions, healthcare executives are finding that Project Management Standards (PMBOK) and best practices for IT Service Management (ITIL) need to blend together in order to establish a reliable roadmap to achieve and sustain the objectives of HITECH.
Objectives• Introduce the requirements of the HITECH-MU
objectives;
• Identify the challenges facing healthcare executives relative to the achievement of Meaningful Use;
• Share the commonalities between PMBOK and ITIL;
• What approach should be taken to blend the two practices into a seamless process & avoid gaps;
• What are the expected benefits;
• Share lessons learned and recommendations for success
Agenda
• HITECH & Meaningful Use
• Challenges
• PMBOK & ITIL
• Project Process vs. Operational Process
• Approach & Implementation
• Benefits
• Lessons Learned
• Recommendations
Myths
• Service Management plays no part in the
project planning process
• The only touch point between project
management and service management is
at the go-live hand-off to production
• The ITIL Release Management best
practice is the only guidance that ITIL
provides the project
HITECH-MU Objectives
• Adoption of certified EHRs
• Meaningful use of EHRs
• Incentive payments to eligible professionals and hospitals
• Investment in nationwide HIT infrastructure
• Grant money for demonstration projects
HITECH-MU Outcomes
• High quality, safe, effective, and equitable
care for all
• Seamless patient-centric care
• Realigned incentives and measures that
foster prevention, intervention,
coordination, effectiveness
• Regional clinical information
interoperability on a national backbone
Meaningful Use is a Journey
3-Stages over 5-Years
Challenges• Only 20% of Physician Practices have an
EHR
• Competing projects on the horizon– MU
– ICD-10
– HIPAA 5010
• Cost of IT Infrastructure
• Lack of Best Practices Use for PM & ITSM
• Current focus on implementing vs. sustaining technology
The Big Picture• Many IT organizations around the
world are turning to PMBOK® best practices to help them achieve improved capabilities in meeting the needs of their business.
• Another best practice frameworks that is sweeping the globe is ITIL® –Information Technology Infrastructure Library™.
PMI-PMBOK
• PMBOK
– “Project Management Body of Knowledge”
– Universal Standard for PM in US and the
Globe
– Foundation for PMP Certification
– PMBOK® Guide1 4th Edition
ITIL V3
• ITIL
– “IT Infrastructure Library”
– UK Office of Government Commerce
– Growing Popularity for ITSM
– ITIL®2 v3 as framework
Definitions• Project:
– PMBOK: “A project is a temporary endeavor undertaken to produce a unique product, service or result”
• Services:– ITIL: “Services are a means of delivering
value to customers by facilitating outcomes customers want to achieve without taking on the ownership of specific costs and risks.”
ITIL Best Practice
• What is ITIL?–The Information Technology
Infrastructure Library-V3.0
–Provides a systematic-best practice approach to the delivery of cost effective and quality IT services
Alerts, Exceptions & Changes
-Inquiries-Communication
-Reports and updates
-Availability plan
-Targets / thresholds
-Reports
-AMDB
System Management Tools
IT Infrastructure
-Capacity plan
-Targets / thresholds
-Reports
-CDB
-Financial plan
-Types & models
-Costs & charges
-Budget & forecasts
-IT continuity plan
-BIA & risk analysis
-Define requirements
-Disaster recovery contracts
-Security plans
-Intrusion prevention
-Security event logging
-SLAs, OLAs, SLRs, UCs
-Service catalog
-Requirements, targets, achievements
Source: W. CookUsed with permission.
Service LevelManagement
Availability Management
Capacity Management
IT Financial Management
IT Service Continuity
Management
Information Security
Management
Customers & Users
ITIL Service Level Management
Service Desk (Function)
Service Design & Support: The Operational Processes
Configuration Management CMDB-CI records & relationships -Entire IT infrastructure -CMDB reports & statistics -Audit reports
-Incidents -Problems -Known Errors -Changes -Releases
-Difficulties
-Questions
-Requests
-Workarounds
-Incident status and updates
-User communications
Incidents
-Service reports
-Incident statistics
-Audit reports
-Trend analysis
-Diagnostic aids
-Problem reports
-Problem statistics
-Problem reviews
-Audit reports
-Process Request for
Changes (RFCs)
-Forward schedule
of changes (FSC)
-CAB minutes
-Change statistics
-Change reviews
-Audit reports
-Release schedule
-DSL & DHS
-Test standards
-Release statistics
-Release reviews
-Audit reports
Customers & Users
Incidents
-RFCs from IT staff,
users, customersNew releases
RFC
RFC
Automated Tools
Source: W. CookUsed with Permission
Incident Management
Problem Management
Change Management
Release Management
Service Delivery• Four Main Components
–Service Catalog (Transition
Catalog during project cycle )
–Operational Level Agreements
(OLAs)
–Underpinning Contracts
–Service Level Agreements (SLAs)
–CI(s) & CMDB(s)
Service Catalog• Listing of services provided to
customer
• Can include varying degrees of
service (e.g. gold, platinum, bronze,
etc.)
• Many application catalog entries
encompass entire application
“platforms.”
Operational Level Agreements (OLAs)
• Agreements between
respective areas of the I.S.
department with each other
• Must be able to commit to
each other before committing
to customer.
• Needed to be able to build
SLAs with Customer
Approach
• Inclusion of ITIL Service
Management Activities in the Project
Life Cycle Tasks
• Identify stakeholders across the
continuum
• Establish OLAs between PMO and
Service Design & Support team
Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Service Portfolio
– Financial Mgt
– Demand Mgt
• Project Plan Tasks
– Service Definition
– Budget
– Business Case
Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Service Catalog Mgt
– Service Level Mgt
– Supplier Mgt
• Project Plan Tasks
– Service Definition
– Service Level Rqmts
– RFP & Select
Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Availability Mgt
– Capacity Mgt
– Continuity Mgt
– Security Mgt
• Project Plan Tasks
– Impact, Risk & Plan
– Plan & Measure
– RPO & Plan
– Design & Validate
Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Change Mgt
– Asset & Config Mgt
– Release Mgt
– Knowledge Mgt
• Project Plan Tasks
– CAB & RFC
– CI(s) to CMDB
– Version Control
– Documentation
Integration of ITIL Activities
and PMBOK Tasks
• ITIL Activity
– Event Mgt
– Incident Mgt
– Request
– Problem Mgt
– Access Mgt
• Project Plan Tasks
– Monitoring
– Categories/Escalation
– SR Forms/Procedure
– Work Around(s)
– Approval/Procedure
Impact of No Collaboration
• A project deliverable which is difficult
to support and sustain
• A solution which is a vertical
deliverable and difficult to “fit” into the
Service Catalog
• Lack of consensus of all stakeholders
Lessons Learned
• ITIL is a journey not a sprint
• Credibility is achieved in increments
not a big-bang
• The move from a project focus to a
holistic view of project plus service
management is not an over night
change
Benefits
• Increased opportunity to service and
sustain the EHR and MU deliverables
• Position organization to expand
foundational systems for the next big
wave of change: ACO, Medical Home, etc.
• Achieve consistent quality of project
deliverables beyond the project closure
Recommendations• PMO updates Project Work plan to include
ITIL Activities
• ITSM Core Team to engage with PMO
• Request PMs to become ITIL V3 Foundations Certified and engage with ITSM Leadership
• Establish Collaborative View of Project Success between PMBOK and ITIL
• Establish Milestone check-points to monitor PMBOK and ITIL Integration
Thank You