Disc 3 IT health Admin
BYSTANDER
GeraldLGlandonD_2020_Chapter10HealthInform_InformationTechnology.pdf
CHAPTER
361
HEALTH INFORMATION TECHNOLOGY PROJECT PORTFOLIO MANAGEMENT
Learning Objectives
1. Identify some of the primary causes of health information technology (HIT) project failures.
2. Describe the main differences between HIT project management, HIT program management, and HIT portfolio management.
3. Describe the five key processes of project management. 4. Understand how project metrics and portfolio dashboards can facilitate
HIT governance. 5. Describe the major roles and functions of the portfolio management
office. 6. Identify the actions and changes that are necessary in an organization to
reach the synchronized stage.
Overview
Healthcare in the United States now consumes more than 17 percent of the country’s gross domestic product and is projected to grow to more than 19 percent by 2027 (Centers for Medicare & Medicaid Services 2020), yet US residents generally do not live longer nor are they healthier than those in other developed nations that spend less than half that amount on healthcare (Papanicolas, Woskie, and Jha 2018). The reality of these statis- tics, along with the Institute of Medicine’s 1999 report (To Err Is Human) on preventable deaths in the United States, has energized federal and state governments in ways that will continue to put pressure on healthcare organi- zations. For example, plans for reduced reimbursement rates will counteract the increasing pressure for a healthy bottom line. Clearly, just by their sheer size—seven-, eight-, or even nine-figure expenditures—electronic health record (EHR) projects (depending on the size of the organization) should automatically create a heightened need for due diligence among healthcare executives; nothing can get an executive fired faster than spending $50 mil- lion with nothing to show for that investment.
10
C o p y r i g h t 2 0 2 0 . A U P H A / H A P B o o k .
A l l r i g h t s r e s e r v e d . M a y n o t b e r e p r o d u c e d i n a n y f o r m w i t h o u t p e r m i s s i o n f r o m t h e p u b l i s h e r , e x c e p t f a i r u s e s p e r m i t t e d u n d e r U . S . o r a p p l i c a b l e c o p y r i g h t l a w .
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In their presentation titled “IT Disasters: The Worst IT Debacles and the Lessons Learned from Them” at the American College of Healthcare Executives Congress on Healthcare Leadership, Hunter and Ciotti (2006) provided ample evidence that risks are associated with large-scale health infor- mation technology (HIT) projects. While inadequate planning and foresight are problematic in such projects, the single greatest cause of project failure is poor execution (Abouzahra 2011; Hunter and Ciotti 2006). Furthermore, historical studies have suggested that HIT systems may have caused, rather than reduced, medical errors (Han et al. 2005; Koppel et al. 2005) and more recently may contribute to physician fatigue and burnout (Downing, Bates, and Longhurst 2018; Shanafelt et al. 2015). However, a careful reading of these academic articles shows the obvious system design and implementation problems indicating that medical errors are caused by human error, caregiver fatigue and burnout, and workflow process design, and not the HIT itself.
In 2010, studies revealed that 65 percent of HIT projects failed to achieve anticipated benefits (Standish Group 2011). Organizations that fell into the category of the 65 percent who failed to achieve benefits often relied on the collective experience of the individuals who have previously imple- mented HIT at the organization but typically did not employ disciplined project management methodologies, such as those suggested by the Project Management Institute (www.pmi.org; discussed in more detail later in this chapter). As more and more organizations employ disciplined project man- agement practices, those metrics have started to turn around. A recent Proj- ect Management Institute (PMI 2017b) survey of more than 3,200 project management professionals found that only about 31 percent of HIT projects did not meet their goals, while 43 percent still exceeded initial budget esti- mates, and 49 percent were completed late (see exhibit 10.1).
EXHIBIT 10.1 IT Project
Success Statistics
60%
50%
40%
30%
20%
10%
0% Total Failure Failure to
Meet Goals Exceeded
Budget Completed
Late
Source: Data from PMI (2017b).
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Healthcare delivery is a complex business with incredibly multifaceted, interdependent workflows, yet the field as a whole has been inexplicably slow to adopt professional project management approaches. Organizations that fall into this category typically implement a go-live only to find that large stakeholder groups or key workflows have been overlooked. These organiza- tions must then scramble, after implementation, to reengineer processes that easily could have been proactively addressed had the organization followed disciplined project management methodologies. This chapter provides an overview of HIT project management and encourages healthcare organiza- tions to improve their project success rate by establishing an HIT project portfolio management office.
What Is a Health Information Technology Project Portfolio Management Office?
The following terms and their definitions are used in this chapter to clarify concepts related to portfolio management:
• A project is a temporary effort to create a unique product, service, or result (PMI 2017a).
• Project management is the application of knowledge, skills, tools, and techniques to project activities in an effort to meet project requirements (PMI 2020).
• A program is a group of related, often interdependent projects. • A portfolio is a collection of programs and projects. • Portfolio management encompasses managing the collections of
programs and projects in a portfolio. This responsibility includes weighing the value of each project, or potential project, against desired organizational strategic business and clinical objectives. It also encompasses monitoring active projects to ensure adherence to specified objectives and desired outcomes, balancing the portfolio with other investments of the organization, using resources efficiently, and balancing return on investment with risk (PMI 2017a).
• A portfolio management office (PMO) is a centralized organization dedicated to improving the practice and outcomes of projects via holistic management of all projects.
While definitions can help distinguish concepts, often the terms proj- ect management office, program management office, portfolio management office, and project portfolio management office are used interchangeably in the business press. All imply the professional management and oversight of
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an organization’s entire collection of current projects. PMO, however, spe- cifically refers to the activity of providing investment decision support capa- bilities to an organization’s overall HIT governance structure and processes. The term project management office or program management office does not necessarily mean that decision support capabilities for these investments are in place. Organizations that use the term PMO or project portfolio manage- ment office are intentionally and accurately referring to a more expansive concept, reflecting the methodology’s HIT portfolio investment decision support capabilities (Jeffery and Leliveld 2004). In short, effective PMOs are (1) aligned with and serve an organization’s strategic governance and investment decision-making processes and (2) practice disciplined project management in the successful execution of the organization’s projects. To be consistent, we use the term PMO throughout this chapter. Exhibit 10.2 illustrates how projects, and programs of projects, might interrelate in a typi- cal HIT portfolio.
Individual projects, such as a new inpatient EHR or a new pharmacy system, are grouped into a clinical applications program. Ideally, clinical application projects are led or championed by an influential stakeholder from the clinical leadership of an organization. Likewise, upgrades of an existing financial budgeting system and implementation of a new human resource system are grouped into a business applications program. Business application projects are ideally led or championed by an influential business stakeholder. Purely infrastructure–type projects, such as a network upgrade or implemen- tation of wireless technology, are grouped into an HIT infrastructure program
Inpatient EHR project
Pharmacy system project
Business Applications
Program
Human resource system project
Financial system project
Network upgrade project
Wireless project
HIT Infrastructure
Program
Clinical Applications
Program
Note: EHR = electronic health record, HIT = health information technology.
EXHIBIT 10.2 HIT Portfolio
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championed or led by the chief information officer (CIO) or one of the CIO’s key directors. All of the projects in all program groupings then make up the entire HIT portfolio that can be professionally managed via formal HIT portfolio management structures and practices—an HIT PMO.
Why Is a Portfolio Management Office Essential?
As indicated earlier in exhibit 10.1, there continues to be room for improve- ment with respect to projects meeting intended goals, remaining on budget and on time (PMI 2017b). One of the primary causes of failed HIT projects is a “silo” project management mentality, which occurs when projects are ini- tiated, planned, and fully executed without an effective consideration of their impact on other, preexisting systems or other parallel projects being planned and executed. As indicated in exhibit 10.2, contemporary healthcare appli- cations have significant interdependencies that, if not explicitly and deliber- ately addressed, can have unintended consequences. Exhibit 10.3 provides real-world examples of unintended consequences of HIT projects that were planned and executed in relative isolation.
While the examples described in exhibit 10.3 may seem to be obvious, common-sense mistakes, they are not uncommon because in reality health- care delivery organizations have thousands of cross-departmental interrelated workflows that must be considered when embarking on a new HIT project. Exhibit 10.4 depicts sample high-level application interfaces that are in place at a typical academic medical center that is representative of any medium-to- large integrated delivery system. This graphic conveys an incredibly complex web that relies heavily on interfacing applications wherever possible. The sheer volume of interdependencies shown in this exhibit clearly makes a case that individual projects or programs of applications should not be managed in silos but rather in a professional PMO focused on successfully achieving envisioned benefits of particular projects.
In many ways, allowing informal, silo-based project management to occur in a healthcare organization is somewhat like attempting to minimize collisions at an airport without the benefit of a flight control tower. Not inci- dentally, exhibit 10.4 resembles a typical major airline hub city with flights coming and going from all points on the compass, yet it depicts a real organi- zation’s current applications and how each is interfaced and interrelated. This level of interrelatedness strongly suggests the need for a professional control tower to manage HIT projects. An organization’s ability to implement large HIT projects successfully and efficiently increases as its project management maturity moves from no professionally managed projects to simple project management to program management and ultimately to portfolio manage- ment (PMI 2018).
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Typically, as an organization’s HIT project management matures, its overall cost of HIT projects decreases significantly and the success rate of these projects increases substantially. A nonintuitive overall time savings occurs as well, although one would suspect that it would take more time to accomplish the additional work of identifying and tracking interdependencies with other projects across the portfolio of projects. However, this additional
IT Project Project Outcome
New Pharmacy System
The pharmacy director sponsored a new best-of- breed pharmacy system project
The pharmacy system project was expertly managed and implemented on time and within budget. Unfortunately, only after the system was implemented did the pharma- cist realize that this new proprietary best-of-breed system could not be reliably interfaced with the hospital’s preexist- ing EHR system, which had built-in computerized physician order entry capability. As such, when a provider entered an order for a pharmaceutical into the EHR, that order had to be printed out in the pharmacy and then reentered into the new pharmacy system. From a pure project manage- ment standpoint, the project was successful. From an enterprise portfolio standpoint, however, a very inefficient, labor-intensive workflow was created to overcome the lack of integration that this silo-based project management approach created.
Voice Over Internet Protocol (VOIP) Project:
A telecommuni- cations director sponsored a switch to digital phone service
The telecommunications director of a large metropolitan hospital system wanted to save millions of dollars annually by switching from a basic traditional phone service model to a VOIP model, whereby the hospital system’s existing computer network would be used to provide digital phone service. Unfortunately, the project did not consider the robustness of the existing computer network, which had single points of failure in many of its buildings. The digital phone service was implemented, and soon thereafter, any network outage to one of the buildings affected all phone service for the building. More than an inconvenience, these outages eroded consumer trust and market appeal. Using contingency funds, the hospital system scrambled to redesign its computer network to provide the level of redundancy and reliability needed to ensure digital phone service. Had a portfolio management approach been taken for this project, computer network inadequacies could have been identified up front and computer network upgrades could have been built into the project plan.
EXHIBIT 10.3 Examples of HIT
Projects That Did Not Follow
an HIT Portfolio Management
Approach
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planning time, which is marginal, actually reduces the number of surprises and “gotchas” that occur later when unforeseen interdependencies invariably crop up in projects that are run in a more informal, silo approach, thus decreasing overall project time (Alexander 2015; Hadjinicolaou and Dumrak 2017). One of the main causes of time delays in projects is scope creep—when the original agreed-on requirements for a system are continually expanded by the project sponsors. With project management methodologies in place, added or new requirements are collected and saved for a future version of the system so that the original system scope can be implemented in the established time frames.
The next section addresses project management methodologies. Thereafter, managing the collection of projects is discussed, and we reiterate the suggestion that a PMO is a logical organizational response to the increas- ing HIT complexity in healthcare organizations.
Project Management
Project management entails the following five processes (PMI 2017a):
1. Project initiation: launch of a process that can result in the authorization of a new project
2. Project planning: definition of the objectives, scope, and plan of action to achieve the desired outcomes
3. Project execution: actions to complete the work defined in the project planning process
4. Project monitoring and controlling: measurements designed to assess how well a project is being executed per the budget and deliverables as well as to alert project managers to potential corrective actions that might be necessary from time to time
5. Project closing: actions to terminate formally all activities associated with the project either by delivering a finished product or by ceasing effort on a canceled project
Professionalizing project management at a healthcare delivery organi- zation means that each HIT project should follow these five key processes. While project management frameworks are important, hiring profession- ally trained and well-credentialed project managers is equally important. A number of project management credentialing organizations exist, including the PMI, which offers the Project Management Professional (PMP) certi- fication. The PMP certification ensures that an individual has mastered a requisite body of knowledge on project management (see exhibit 10.5 for a list of applicable knowledge areas) and has at least 60 months of project
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management experience. Furthermore, survey data suggest that increasing the number of individuals in the organization who have professional project management skills and experience and following an explicit HIT project management process framework raise the likelihood that the project will be a success (PMI 2017a); see exhibit 10.6.
Project Management Knowledge Area Individuals Must Know How To
Project integration management Develop project charter Develop project management plan Direct and manage project execution Manage project knowledge Monitor and control project work Perform integrated change control Close project or phase
Project scope management Plan scope management Collect requirements Define scope Create work breakdown structure Verify scope Control scope
Project schedule management Plan schedule management Define activities Sequence activities Estimate activity resources Estimate activity durations Develop schedule Control schedule
Project cost management Plan cost management Estimate costs Determine budget Control costs
Project quality management Plan quality management Manage quality Control quality
Project resource management Plan resource management Estimate activity resources Acquire resources Develop team Manage team Control resources
Project communications management Plan communications management Manage communications Monitor communications
EXHIBIT 10.5 Project Management Knowledge Areas
(continued)
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Project Management Tools A number of project management applications are available that provide the automated support to manage projects more professionally. While not intended to be an exhaustive list, the following are applications that Hen- derson, Stang, and Shoen (2019) rate highly for being able to provide auto- mation to support the five project management processes outlined earlier;
Project Management Knowledge Area Individuals Must Know How To
Project risk management Plan risk management Identify risks Perform qualitative analysis Perform quantitative analysis Plan risk responses Implement risk responses Monitor risks
Project procurement management Plan procurements Conduct procurements Control procurements
Project stakeholders management Identify stakeholders Plan stakeholder engagement Management stakeholder engagement Monitor stakeholder engagement
Source: Information from PMI (2017a).
EXHIBIT 10.5 Project
Management Knowledge
Areas (continued )
Note: PMO = portfolio management office.
EXHIBIT 10.6 Benefits of HIT
PMO
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many of these applications also carry the higher-level program and portfolio management capabilities discussed later in this chapter:
• Broadcom: Clarity PPM • Changepoint: Daptiv PPM and Changepoint • Microsoft: Project Server, Project Online, Project, Planner, and Teams • Planview: Enterprise One, PPM Pro, Projectplace, LeanKit, and Spigit • Planisware: Enterprise and Orchestra
Standardizing HIT operations on a set of project and portfolio man- agement tools provides a common way to establish the processes and business rules that an organization must follow for managing projects. For instance, a healthcare organization’s applications group uses one tool (say, Microsoft Project software), the infrastructure group uses a different tool (say, Broad- com’s Clarity PPM), and the informatics and analytics group uses no tool at all. Because there is no visibility into the total number of projects going on among these groups, it becomes incredibly difficult to establish standardiza- tion of project management processes that is a prerequisite for managing interdependencies between projects; thus, it is difficult to achieve program or portfolio management capabilities.
Entire textbooks have been written on project management (e.g., Coplan and Masuda 2011; Schwalbe 2016) and the tools that support it. For illustrative purposes, we discuss project plans and Gantt charts as examples of key artifacts that are easily developed in most project management and portfolio management tools.
Project Plans and Gantt Charts All project management applications should have the ability to create a project plan and display it in a way that easily shows task interdependencies. Exhibit 10.7 shows a simple example of a Gantt chart for some tasks in an infrastructure project of a hospital system. This list of tasks is known as a work breakdown structure in project management parlance. Note how the interdependencies are clearly visible by the linking arrows that show which tasks must be fully completed before their successor tasks can begin. Other tasks without these interdependencies can be accomplished in parallel (i.e., they have no interdependencies but must nevertheless be accomplished to complete the project). Project management applications have the abil- ity to collapse these tasks—these are all of the tasks that have predecessor (tasks that must be completed before the next tasks can be started) or suc- cessor (tasks that cannot begin until certain tasks have been completed) interdependencies— into the critical path of a project (see exhibit 10.8). The reason critical path analysis is important is that it provides a forecast of the shortest possible time in which the overall project can be completed.
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Program Management As noted earlier, organizations that put in place program management capa- bilities have moved beyond managing individual projects to managing the interrelationships between projects and preexisting applications and systems. While managing this level of complexity takes slightly longer to plan up front, the extra time expended is recovered during the execution phase of the project in the form of reduced surprises and cost overruns associated with unforeseen interdependencies. In essence, the critical dependency analysis and management depicted in exhibits 10.7 and 10.8 are simply extended beyond a single project to interdependencies that exist within a particular program of projects or even across the HIT portfolio (see exhibit 10.2).
Portfolio Management Along with the professional project management expertise described in the previous sections, organizations that employ a portfolio management approach also have tightly coupled HIT governance (essentially, making decisions about which information technology to invest in and which not to invest in) with its PMO. In other words, think of project and program management as ensuring that things are done right in a particular project, whereas portfolio manage- ment concerns itself with doing the right kinds of projects that align with the organization’s overall strategic goals and objectives. This distinction is why a PMO must work hand-in-hand with an organization’s HIT governance struc- ture (covered in chapter 4). Illustrating this point is exhibit 10.9, which shows an HIT portfolio of all the projects that are “in flight” at a for-profit healthcare organization. Prior to its annual HIT capital budget process, the particular organization, using the knowledge gained from professionally managing its portfolio of current HIT projects, put together a profile of all of the current HIT projects already in flight and rated them on the basis of value and risk. The organization further labeled each quadrant. The lower left quadrant, which represents low-value and high-risk HIT projects, is labeled “Think Twice (or More).” The upper right quadrant represents HIT projects that are deemed to both be of high value and have low risk associated with implementation; this quadrant is labeled “Ideal.” The size of the bubbles in exhibit 10.9 denotes the size in relative dollars of each individual project. Projects are categorized into nondiscretionary projects (e.g., some projects are mandated by law, such as the Sarbanes-Oxley Act) and discretionary projects. Much like an investor review- ing a portfolio of stocks before deciding which to divest and which to add to, an organization developing a graphic such as exhibit 10.9 gains a powerful and succinct decision-support means to evaluate proposed HIT projects.
In addition to decision support, an HIT portfolio management capabil- ity also provides regular portfolio status reports to the HIT governance of an organization. For instance, an HIT portfolio dashboard is typically created— sometimes via one of the project and portfolio management applications and
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sometimes via an organization’s overall quality or other enterprise dashboard tools—to give leadership a view of project progress. Exhibit 10.10 is a sample of one such view, showing all in-flight projects of the organization (listed in exhibit 10.9) grouped by strategic categories that are important to the organization, along with the dollar amounts budgeted for each category. The graph on the left of this exhibit, titled “Portfolio by Category,” depicts the monthly expenditures of each project category. The graph on the right of this exhibit, titled “Resource by Category,” depicts the amount of full-time equivalent resources being expended on each project category.
While an HIT portfolio dashboard can be set up to provide status along any number of dimensions, its greatest impact comes in providing strategic views of the myriad projects the organization is working on to benefit HIT governance decision-making. In the examples provided in exhibits 10.9 and 10.10, this for-profit healthcare organization is trying to balance strategically the need for greater regulatory compliance with the Sarbanes-Oxley Act and other legislation with the need for revenue growth. Therefore, the dashboard is designed to quickly provide a view within the past three quarters and the
Risky, But Worth it? Ideal
Low Risk, But Worth it?
Think Twice (or More)
5
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
Va lu
e
5 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0
6 1
2
11 8
23
22 16
20
2418
9 10 15
14
25
5 19
4 17
13 3
7
12
21
1 Connected 2 Diagnostic System (IDX) 3 Motion Tablet Deployment 4 Basic Relationship
Management 5 Smart Order (eProcurement) 6 Hyperion 7 DSL for Outpatient 8 Automated Bank Recon.
Project circle size determined by budget
Denotes Nondiscretionary Projects Denotes Discretionary Projects
9 People Soft Enforcer 10 HIPAA Security Regulation 11 Patcom 12 Property Tax Mgt. System 13 Business Cont. Planning 14 Policy IQ 15 Identity Mgt. System 16 Concuity Contract Mgr. 17 ISS (Black Ice, Server Sen.)
18 Sales Territory Mgt. System 19 Problem Mgt. System 20 TherapySource Patient Reg. 21 Corporate Web. Devl. 22 People Soft Financials 23 SIS Windows Conversion 24 Outpatient Document Imaging 25 CPSI
Key Risk
Source: Carpenter (2005). Used with permission.
EXHIBIT 10.9 Illustrative HIT Portfolio
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next six quarters of the amount of money being (or slated to be) invested in compliance-related projects, operational effectiveness projects, and projects the organization hopes will generate increased revenue. While this example is illustrative—not intended to be definitive—this example makes the point that organizations must be able to produce flexible data representations (such as exhibit 10.9) on the entire portfolio of HIT projects to aid their HIT governance bodies. Such data are essential to making informed investment decisions and monitoring progress.
The Portfolio Management Office
Generally, these high-functioning portfolio management capabilities are being formalized in many leading healthcare organizations via the establish- ment of an HIT PMO. Typically, the functions of a PMO include but are not limited to the following:
• Issuing regular communications to project stakeholders and the rest of the organization regarding progress or status, programs of projects, and the entire portfolio
Source: Carpenter (2005). Used with permission.
EXHIBIT 10.10 Sample HIT
Portfolio Dashboard
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• Providing authoritative management and oversight of all projects in the portfolio
• Serving as staff support to the HIT governance of the organization, including performing portfolio analyses as requested by HIT governance and recommending HIT investments
• Creating metrics and dashboards to facilitate transparency
These tasks can be accomplished without putting in place a formal PMO, but there is some evidence to suggest that organizations that institute a PMO may have a competitive advantage over those that do not (Caliste 2013). Do note that establishing a PMO is not a quick fix to whatever project management challenge the organization is facing, and it is an effort that likely will take between two and four years to generate significant benefits for the organization. Jeffery and Leliveld (2004), from data derived in their study of 130 Fortune 1,000 companies, created the useful IT Portfolio Management Maturity Model, which outlines the four stages of maturity of any organiza- tion’s portfolio management capabilities. Jeffery and Leliveld refer to these four stages as ad hoc, defined, managed, and synchronized; each stage indicates a higher, more capable PMO function.
In the ad hoc stage, no formal project management capability is in place at all. Projects are managed informally and inconsistently, and project results are equally inconsistent.
In the defined stage, the organization has created a centralized entity to maintain and inventory projects and to manage them centrally. In this stage, applications and infrastructure are well defined and documented.
In the managed stage, the organization has created processes for vet- ting and rationalizing or ranking projects on the basis of key strategic criteria. Furthermore, investment decisions employ financial metrics to help prioritize projects (e.g., return on investment, return on assets, net present value) and conduct at least annual reviews with business unit leadership on how well the HIT portfolio is aligned with overall organizational strategies.
In the synchronized stage, organizations conduct much more frequent evaluations of the HIT portfolio with business unit leaders and include a con- sistent assessment of returns versus risks in their project portfolios. Typically, organizations at the synchronized level of HIT portfolio management matu- rity have created PMO scorecards or dashboards that serve to communicate project status and value transparently. They also consistently conduct post- project benefits realization assessments to see whether benefits envisioned prior to the project’s adoption have been achieved.
Since Jeffery and Leliveld (2004) articulated this maturity model, there has been considerable debate in the project management community about the best framework to use for assessing an organization’s maturity
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(Pasian, Sankaran, and Boydell 2011; PMI 2017a; Zhang, He, and Zhang 2012). Each framework suggests more complex and granular approaches for assessing an organization’s project management capabilities. While the debate continues, Jeffery and Leliveld’s model continues to provide HIT leaders and professionals with a simple, quick way of assessing the maturity of their organization’s HIT portfolio management capabilities.
Summary
This chapter made the case that many HIT projects generally do not achieve the benefits envisioned and that implementing professional portfolio man- agement capabilities is an important first step toward mitigating this project risk. Furthermore, identifying and managing the cross-project interdepen- dencies that a portfolio management approach embodies is an important second step toward mitigating project risk. Finally, implementing an HIT PMO that is tightly coupled with an organization’s HIT governance struc- tures and processes and that provides the full complement of capabilities outlined in Jeffery and Leliveld’s (2004) IT Portfolio Management Maturity Model represents the greatest return on HIT investments for a healthcare organization.
Web Resources
A number of organizations (through their websites) provide more informa- tion on the topics discussed in this chapter:
• Vendors that provide project and portfolio management software include the following:
– CA Technologies: Broadcom, Clarity Project, and Portfolio Management software (www.ca.com/us/services-support/ ca-services/project-portfolio-management-services.html)
– Changepoint: PPM software (www.changepoint.com) – Planview: Project Portfolio Management (www.planview.com/
products-solutions/solutions/project-portfolio-management) – Microsoft: project software (https://products.office.com/en-us/
project/project-and-portfolio-management-software) • Other website references for project and portfolio management include
these: – CIO magazine, Project Management section (www.cio.com/
topic/3198/Project_Management)
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– Healthcare Information and Management Systems Society, Project Management Special Interest Group (www.himss.org/ project-management)
– The Project Management Institute conference paper on PMOs in healthcare IT organizations (www.pmi.org/learning/ library/project-management-office-healthcare-information- technology-8060)
Discussion Questions
1. Discuss some of the primary reasons an HIT implementation project might fail in a healthcare organization.
2. What are the main differences between HIT project management, HIT program management, and HIT portfolio management?
3. What are the five processes of project management? 4. What requirements should be considered when selecting project
management tools for an organization? 5. Why are project metrics and portfolio dashboards important to HIT
governance? 6. List and describe the major roles and functions of the PMO. 7. Which two project management knowledge areas described in exhibit 10.5
do you consider to be the most important? Why? 8. What actions and changes are necessary in an organization to reach the
synchronized stage of maturity of Jeffery and Leliveld’s IT Portfolio Management Maturity Model?
9. Even with the development of a PMO, will there be instances in which an HIT venture fails? Explain your rationale.
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