IMIT Portfolio Management Office

1
IM/IT Portfolio Management Office

• HSPM J713

2
Portfolio Management

• Context failures
• We want to avoid failures

3
Learning objectives 1 and 2

• What causes IM project failures
• What differentiates
• Project management
• Program management
• Portfolio management

4
Learning objectives 3 and 4

• Project management 5 key processes
• Project metrics and portfolio dashboards

5
Learning objectives 5 and 6

• The portfolio management office
• Roles and functions
• What actions or changes are needed to reach the
  synchronized stage

6
Hunter and Cotti presentation

• IT Disasters The Worst IT Debacles and the
  Lessons Learned from Them ACHE meeting 2006.
• Poor planning
• But mainly, poor execution

7
Hunter and Ciottis disaster stories

• Runaway vendors
• One healthcare systems partner vendor had 50
  full-time consultants on-site at 1200/day each,
  for years. (HC Consultants should be there
  for months, not years.)
• Getting sold stuff you dont need. A vendor
  convinced a healthcare system to get a whole new
  information system to deal with Y2K.
• The new system had not before been implemented on
  that scale.

8
Hunter and Ciottis disaster stories

• Outsourcing the CIO
• A multihospital system outsourced its IT to an
  offshore company
• Low price low-salary programmers
• Cultural and language differences bad
  communications
• CIO was with vendor approved vendors expenses
• Service-level agreements TBD (to be determined)
• Costs rose, system didnt fit needs

9
Hunter and Ciottis disaster stories

• Rushing to start, leaving details and deadlines
  for later
• An academic medical center bought new electronic
  medical records and computerized physician order
  entry (EMR and CPOE)
• Years went by, and in consultants.
• Building, testing, finding bugs, patching,
  building,

10
Hunter and Ciottis disaster stories

• Rushing to start, leaving details and deadlines
  for later
• Better
• Have CIO with knowledge of how long things should
  take.
• Fix fee or cap

11
Hunter and Ciottis disaster stories

• Over-centralization
• A multi-hospital system consolidated IT
• But systems were disparate
• Single help-desk for the whole enterprise
• Lacked knowledge of local systems and conditions
• Distant reporting led to loss of sense of team
• Us vs. them
• Decentralization with on-site staff (cash rewards
  for good reviews) improved things

12
Hunter and Ciottis disaster stories

• Over-reliance on in-house expert
• A CIO said he could write a better CPOE than they
  could buy
• Costs started low, but then rose
• System crashed
• The CIO had no one to help him find the trouble
• Commercial systems have had the bugs worked out,
  or at least documented hopefully
• Let someone else be the pioneer, or, at least,
  pilot projects first.

13
Hunter and Ciottis disaster stories

• Do involve users in choosing the vendor
• Nurses, physicians, staff,
• Pay attention to staff training
• But too many involved may be counterproductive
• Snow job by vendors

14
Hunter and Ciottis disaster stories

• Avoid cutting edge
• Budget overruns
• Bugs
• Delays
• Dont expect technology to solve all problems
• EMR and CPOE can create new problems

15
Risky

• 29 of IT projects achieve anticipated benefits
  according to a 2004 survey

16
whether bad IT systems cause medical errors

• Two sentences on this
• obvious design and implementation problems
  indicating that medical errors are caused by
  human error, not the IM/IT itself.
• True, perhaps, in the sense that computers always
  do exactly what they are told to do, unless there
  is a hardware failure.
• If thats what is meant by the IM/IT itself

17
Examples

• http//hspm.sph.sc.edu/courses/J713/CPOE20facilit
  ates20errors201197.pdf
• http//hspm.sph.sc.edu/courses/J713/CPOE
  increased mortaility 1506.pdf

18
What is an IM Portfolio Management Office?

• First, some terms
• Project
• Temporary effort to get something done short-term
• Project management
• Planning, organizing, directing a project

19
Defining some more terms

• Program
• A group of projects
• Portfolio
• A collection of programs and projects

20
Defining some more terms

• Portfolio management
• Prioritize projects and programs
• Monitoring
• With an eye to the overall goals and needs of the
  organization
• Portfolio management office
• Centralized organization to manage all projects
  and the portfolio of those projects

21
The PMO is essential

• Because most projects fail
• Isolation (silo mentality) is blamed, because
  there are interdependencies, as shown on next
  slide
• (Are all failures of this type?
• Their examples are of this type
• But the articles above indicate problem of
  centralization without knowing the user
• Compare Ruth Messinger I see you)

22
IT Portfolio
23
What can happen if you dont manage the portfolio

• New pharmacy system
• Best of breed system
• Not easily interfaced with electronic health
  records system
• Orders to pharmacy had to be printed and then
  typed into electronic medical record

24
What can happen if you dont manage the portfolio

• Switching phones from analog (old-fashioned
  regular) to voice-over-IP (sounds digitized, then
  carried using internet-protocol packets to
  receiver over existing network)
• Network switch problem meant no phone service to
  building

25
Advice

• Measure twice, cut once. More time spent
  planning means less time lost later.
• Like much in this book, its organizational
  behavior theory applied to IM.

26
Project management5 key processes

• Initiation define and authorize
• Planning Objectives, methods
• Execution Do it
• Monitoring and controlling measure results and
  spending ongoing, mid-course corrections
• Closing declaring that the fat lady has sung

27
Long list of project management knowledge areas,
p. 102

• Initiation and integration
• Scope management
• Time management
• Cost management
• Quality management
• Human resources management
• Communications management
• (continues )

28
Long list of project management knowledge areas,
p. 102

• Risk management
• Procurement management
• And cute diagram showing that, with a PMO,
  integration and quality go up, time and risk go
  down a lot, cost goes down

29
Project management software

• Several vendors, including Microsoft Project
• Screenshot on next slide shows Gantt chart from
  Microsoft Project
• Henry Gantt was a management theorist from the
  early 1900s.

30
(No Transcript)
31
PERT diagram

• Program evaluation and review technique

32
Gantt chart

• critical path is in red
• non-critical activities are blue and thin black,
  with the thin black representing slack.

33
Dashboards

• Show all programs/projects so that they can be
  compared
• 2-D risk and value diagram
• Portfolios also displayed by
• Expenses
• Category of resource use
• http//www.enterprise-dashboard.com/2007/10/30/das
  hboards-from-an-it-operations-portal/

34
Portfolio management office

• Communications
• Project stakeholders with rest of the
  organization
• Management and oversight of programs and projects
• Staff to produce analyses that go into
• The dashboard
• http//www.google.com
• dashboard portfolio management

35
(No Transcript)
36
Portfolio management 4 stages of maturity

• Ad-hoc
• No formal, consistent, management
• Defined
• Projects are known and listed (inventory)
• Managed
• Projects are evaluated and prioritized
• Financial metrics like return on investment used
• Regular reviews

37
Portfolio management 4 stages of maturity

• Synchronized
• Frequent evaluations
• Consistent assessment of return vs. risk
• Scorecards or dashboards
• Lesson learned assessments after projects complete

38
Summary

• Lots of pitfalls for IT improvement projects
• Most projects fail, at least partly
• Identify cross-project dependencies to reduce
  failure risk
• A portfolio management office with a dashboard
  can dynamically shift resources to most
  worthwhile projects
• Do the dashboards show interdependencies?

39
Web resources

• Online stuff, including
• http//pmihealthcare.org
• http//ache.org/SEMINARS/ontime.cfm link no
  longer works