Detecting Early Warning your ICD Project - Medical …mindleaf.com/.../DetectingEarlyWarningSignsOnYourICD-10Project.pdf · Basics –Proj Mgmt ... B. Earned Value Management ‐Definition

Paresh K. Shah

Don Gleason

17Sep2013

Detecting Early Warning Signs on your ICD‐10 Project

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


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


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….


Tools to Manage – ICD‐10 Project

Know how you’re doing in the process ‐ anywhere, any time.


17 Sep 2013 8

Program Structure (example)


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.


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


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



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)


At given point (17Sep2013) What is the status?



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


Total Criteria for Earned Value (as per DoD)

1. Project Plan2‐5 Organization3‐6 Schedule9‐15 Budget16‐21 Performance22‐27 Variances28‐32 Change

How ?


Earned Value ‐ Lite

•Work•Cost

Establish

•Qualified & Responsible

Assign•Management Plan, including• Schedules & Milestones

Prepare

•Costs

Record•Relevant &Timely Info

Use


Project Plan (as Per CMS)

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


Case Study – Hospital IT System

Looks great ? Why ? Our actual costs = Budgeted costs.


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


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


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


What does it all mean?


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


C. Why an early warning?

Why

$ budgeted

Poor performance

Scope Creep

Other



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?


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.


Allocation on planning

Do – 60%Plan – 40%

Thank you And Questions


Movie Clip “Apollo 13” – Failure is not an optionhttp://cli.ps/SB5z

Thank you

And

Good Luck and Good Wishes in implementing ICD‐10.

Documents

Detecting Early Warning your ICD Project - Medical …mindleaf.com/.../DetectingEarlyWarningSignsOnYourICD-10Project.pdf · Basics –Proj Mgmt ... B. Earned Value Management ‐Definition