Project: Electronic Health Record (EHR) Implementation
Phase II: Execution and Closing (HIMS 661)
Scenario
One of the several job requirements of the health informatics professionals is to undertake health
information technology projects, like implementation of Electronic Health Record (EHR). You
have been hired as Health Informatics Manager by a local medium-sized healthcare organization.
Your supervisor told you that they were still using the paper form of medical record but had
decided to go digital through the implementation of the EHR and told you that you would act as
the Project Manager (PM). Thus, your assignment is to implement the EHR and transition the
organization from paper-based medical record to electronic health information. He also told you
that the EHR project will be implemented in three phases (Phase I – Initiation and Planning;
Phase II – Execution and Closing; Phase III – Change Management).
In HIMS 650, you completed “Phase I: Initiation and Planning” of the project with the following
deliverables:
1. Description of the existing paper-based medical record system.
2. Development of the Project Charter.
3. EHR implementation plan (projects tasks with completion dates, project milestones) using
a project management tool (e.g., Microsoft Excel).
4. Required resources: human resources, finances, Project Management software.
5. Change management plan (users’ training, data transformation, communication)
In this course (HIMS 661), you will complete “Phase II: Execution and Closing” of the project.
This is the main and the most important stage of the project management life cycle. Here your
team will implement all steps of the planning phase (Phase I), hence also called as implementation
phase. The goal of this phase is to prepare deliverables and motivate your team to complete their
assigned activities in time for the final project delivery as well as control each aspect of the
project progress. The phase II six deliverables are:
1. Work Breakdown Structures (WBS) – individual tasks to be completed in this phase; use
Gantt chart to list and schedule (duration) each task.
2. System Acquisition: RFI and RFP, selection of vendors, contract negotiation.
3. Project communication within the project team and with stakeholders: in-person meetings,
emails, conference calls, online project site communication.
4. Monitoring and Controlling Scope Creep, time, tasks, budget, quality.
5. Testing: component or unit testing, integrated testing, stress testing
6. Closing and signing off, also called completion: project review, dissolve project team,
take away or lessons learnt.
The final deliverable is a 15-20 pages APA formatted, double-spaced and typed in 12-point Times
New Roman excluding cover and reference pages report.
Your work will be evaluated using the competencies listed below. You can use this list to
check your work before submission.
1. Communication
1.1: Organize document or presentation clearly in a manner that promotes understanding
and meets the requirements of the assignment.
1.1.1: Present material in clear and/or logical order appropriate to task.
1.1.2: Articulate thesis and purpose clearly.
1.1.3: Support thesis and purpose fully.
1.1.4: Transition smoothly and develop connections from point to point.
1.1.5: Create coherent progress from introduction through conclusion.
1.1.6: Complete assignment in accordance with instructions.
1.2: Develop coherent paragraphs or points so that each is internally unified and so that
each functions as part of the whole document or presentation.
1.2.1: Create meaningful topic sentence for each paragraph or point.
1.2.2: Develop each paragraph’s single topic to the appropriate depth.
1.2.3: Supply relevant and original supporting detail.
1.3: Provide sufficient, correctly cited support that substantiates the writer’s ideas.
1.3.1: Use a variety of credible sources to support, extend, and inform an original thesis or idea,
integrating source material smoothly.
1.3.2: Summarize, paraphrase, and quote accurately.
1.3.3: Cite sources properly.
1.4: Tailor communications to the audience.
1.4.1: Identify target audience.
1.4.2: Explain unfamiliar terms and material.
1.4.3: Employ precise, appropriate language.
1.4.4: Use audience-appropriate, consistent tone.
1.4.5: Avoid language which indicates bias against individuals/groups their affiliations,
orientations and beliefs.
1.5: Use sentence structure appropriate to the task, message and audience.
1.5.1: Demonstrate variation in sentence structure.
1.5.2: Express ideas clearly and concisely.
1.5.3: Eliminate sentence-level errors such as run-ons/comma splices and sentence fragments.
1.6: Follow conventions of Standard Written English.
1.6.1: Adhere to standard usage rules of grammar.
1.6.2: Adhere to standard usage rules of word choice.
1.6.3: Adhere to standard usage rules of spelling.
2. Critical Thinking and Analysis
2.1: Identify and clearly explain the issue, question, or problem under critical
consideration.
2.1.1: Summarize the issue or problem, using supporting details to enable a deeper understanding
of the issue or problem.
2.1.2: Identify potential underlying causes or conditions contributing to the issue or problem and
consider the context.
2.1.3: Pose significant questions to inform the direction of the investigation of the problem or
question.
2.1.4: Scan the environment for cues to inform and direct search for information relevant to the
issue or problem.
2.2: Locate and access sufficient information to investigate the issue or problem.
2.2.1: Explore information sources to increase familiarity and achieve a manageable focus.
2.2.2: Develop and implement a search strategy that employs search engines, databases, and
inquiries to access the needed information.
2.2.3: Assess the search results to determine if there are remaining gaps; revisit strategy as
necessary.
2.2.4: Identify contradictory information or inconsistent data and seek to reconcile contradictions.
2.3: Evaluate the information in a logical and organized manner to determine its value and
relevance to the problem.
2.3.1: Evaluate reliability, validity, accuracy, authority, timeliness, and point of view.
2.3.2: Evaluate the structure and logic of arguments and methods.
2.3.3: Select and incorporate information that provides evidence for the topic.
2.4: Consider and analyze information in context to the issue or problem.
2.4.1: Articulate clearly and fairly others’ alternative viewpoints and the basis of reasoning.
2.4.2: Identify significant, potential implications, and consequences of alternative points of view.
2.4.3: Evaluate assumptions underlying other analytical viewpoints, conclusions, and/or solutions.
2.5: Develop well-reasoned ideas, conclusions or decisions, checking them against relevant
criteria and benchmarks.
2.5.1: Present and explain those inferences and deductions that follow logically from the evidence
provided.
2.5.2: Assert logical conclusions only when sufficient evidence supports them, and distinguish
between attainable and unattainable solutions.
2.5.3: Incorporate legal and ethical reasoning when formulating ideas, conclusions, and decisions.
2.5.4: Complete assignment in accordance with instructions.
3. Program Knowledge:
3.1: Analyze the health information technology (HIT) environment.
3.1.1: Analyze and describe the existing paper-based environment.
3.1.2: Perform SWOT (strengths, weaknesses, opportunities and threats) analysis.
3.2. Plan resource requirement for the EHR project
3.2.1: Compute resource requirement for implementing the project.
3.2.1: Draw the project implementation plan using project management tool – Excel.
3.3. Manage change
3.3.1: Develop the change management and control process.
3.3.2: Develop Implement plan for change management.
Phase II EHR Project Implementation Steps
The first step in project implementation is to identify the tasks and specify their
time of completion (milestones) as well as identify the task dependency (a task that
must be completed first before the second can start, like in building projects walls
cannot be erected unless foundation is in place and roof cannot be fabricated unless
walls are erected).
Step 1: Work Breakdown Structures and Milestones:
Your manager asked you to list all the tasks needed to be performed in this phase through the
Work Breakdown Structures (WBS), a diagrammatic representation of the project tasks to be
undertaken in sequence (in case of task dependency) or simultaneously. Beside listing the
individual tasks shown in steps 2-6 below, assign time to each activity. Your manager further
advised you to list Project milestones or yardsticks to monitor the project progress whether the
project is on schedule, early or late. He also indicated his preference for using Gantt chart to
schedule the tasks and their durations, tasks dependency as well as the milestones being the most
common IT/EHR project management tool.
Your manager also advised you to consult the following resources for guidance.
Health Information Management: Concepts, Principles and Practice. 6th Ed: Chapter 26 – Project
Management; pgs. 845-880.
A Beginner-Friendly Guide to Work Breakdown Structures (WBS)
https://www.workamajig.com/blog/guide-to-work-breakdown-structures-wbs
Work Breakdown Structures (WBS) https://www.workbreakdownstructure.com/
How to Make Work Breakdown Structures https://www.workbreakdownstructure.com/how-tomake-a-work-breakdown-structure.php
PMBOK – Work Breakdown Structures https://www.workbreakdownstructure.com/workbreakdown-structure-according-to-pmbok.php
Work Breakdown Structures using Gantt chart
https://www.bing.com/images/search?q=work+breakdown+structures+using+gantt+chart&qpvt=
work+breakdown+structures+using+gantt+chart&form=IGRE&first=1&cw=1129&ch=511
Work Breakdown Structures using Excel
https://www.bing.com/images/search?q=Work+Breakdown+Structure+Template+Excel&FORM
=RESTAB
Project Milestones Templates
https://www.bing.com/images/search?q=project+milestones+templates&qs=n&form=QBIR&sp=
-1&pq=project+milestones+templates&sc=828&sk=&cvid=82F87CA06BF44B10BDBA8E413AB28EE6
Step 2: System Acquisition: RFI, RFP, vendor selection, contract negotiation:
After you have identified the tasks and set the milestones as well as determined task dependency,
your next step is to decide whether to develop the system in-house or buy a standard system from
the market, also called off-the-shelf. Although the EHR systems, like the other IT systems used to
be built and still can be built in-house, they are now mostly acquired from the EHR vendors, like
EPIC, Cerner, Allscripts, etc. Your manger advised you to proceed with the RFI (Request for
Information), RFP (Request for Proposal), and vendor selection criteria as well as contract
negotiation points to be listed as clauses in the contract (e.g., after sale service to maintain the
system, provide updates, and undertake training) to initiate the project.
He also referred you to the following resources for guidance:
Health Information Management: Concepts, Principles and Practice. 6th Ed: Chapter 26 – Project
Management; pgs. 845-880.
What Is the Difference Between RFIP and RFI? https://www.reference.com/businessfinance/difference-between-rfp-rfi-ecabff43762373d2
and
https://www.bing.com/search?q=RFI%20and%20RFP&qs=n&form=QBRE&sp=1&pq=rfi%20and%20rfp&sc=8-11&sk=&cvid=0DDE73EA20B94D91A3A5AB3CB1510C68
How do I select a vendor? https://www.healthit.gov/faq/how-do-i-select-vendor
EHR Vendor Selection: The 5-Step Guide https://www.himss.org/news/ehr-vendor-selection-5step-guide
Step 3: Project Communication means and schedule:
Project communication is exchange of the project-specific information to keep the project team
and the stakeholders on the same page and keep them abreast of the latest developments in the
implementation. It is one of the essential skills of the PM and tool of any project management that
may take any form (daily/weekly face-to-face meetings, email communications, Project website
updates, project management software).
Your manager asked you to specify the means of communication you would use to communicate
with your team and the project stakeholders along with justification for each. He also directed you
to the following resources for more information.
Health Information Management: Concepts, Principles and Practice. 6th Ed: Chapter 26 – Project
Management; pgs. 845-880.
Manage and Monitor Communications https://www.greycampus.com/opencampus/projectmanagement-professional/communication-methods
Communication Methods In Project Management https://www.greycampus.com/blog/projectmanagement/communication-methods-in-project-management
5 Effective Communication Methods You Need to Know

Step 4: Monitoring and Controlling Scope Creep, time, tasks, budget, and quality:
The function of the project Monitoring and Controlling is to oversee the tasks and milestones to
ensure that they are being completed on time and within the budget. Three important components
of Project Monitoring and Control are: minimizing Scope Creep (addition of tasks when the
project is in progress), maintain scheduled tasks on time, and keep the project within budget.
Your manager mentioned to you that Scope Creep results in both delay in project completion and
hike in cost due to inflation and more work and advised you to ensure that the Scope Creep is
either avoided or minimized, project tasks are completed on time and within the budget.
He asked you to list the measures you would adopt to accomplish this step successfully (hint:
compare the completion of the scheduled tasks against the WBS in Gantt chart completed in step
1 to see if any activity deviates from the schedule).
He referred you to following resources also.
Health Information Management: Concepts, Principles and Practice. 6th Ed: Chapter 26 – Project
Management; pgs. 845-880.
Scope Creep https://www.techopedia.com/definition/24779/scope-creep
Project management and quality assurance for health care IT projects https://rsmus.com/what-wedo/industries/health-care/technology-solutions-for-health-care/project-management-and-qualityassurance-for-health-care-it-proj.html
Project Time Management Process Plan https://www.thebalancecareers.com/what-is-project-timemanagement-3879177
Project Monitoring & Controlling | 16 Best Practices for a Successful Project

Step 5: EHR Testing: Unit Testing, Integrated Testing, Performance Testing:
Now that your team has implemented the EHR, you will test whether it performs the desired
functions and meet the requirements. Three most common types of IT system testing are:
Unit Testing or Component Testing implies that the individual components (clinical,
administrative, pharmacy, lab., digital imaging, etc.) of the EHR system function as desired and
specified in the RFP; Integrated Testing means that these components function in harmony and
interoperate; and Performance Testing (also called stress testing or maximum load testing)
ensures that the system performs normal under maximum or significant load (happens in the
morning when all staff starts working with EHR) to check for robustness, availability and error
handling beyond the normal operational capacity.
You were advised by your manager to schedule these tests. Thus, your team will undertake the
above three types of testing before Closing or Signing off the project. He asked you to describe
the methodology and steps you would perform to accomplish this task.
You were asked to consult the following resources for guidance.
Health Information Management: Concepts, Principles and Practice. 6th Ed: Chapter 26 – Project
Management; pgs. 845-880.
Electronic Health Record (EHR) System Testing Plan
https://www.healthit.gov/sites/default/files/playbook/pdf/ehr-system-testing-plan.pdf
What is difference between Unit Testing and Integration Testing?
http://www.softwaretestingclass.com/what-is-difference-between-unit-testing-and-integrationtesting/ and https://stackoverflow.com/questions/5357601/whats-the-difference-between-unittests-and-integration-tests
What are Unit Testing, Integration Testing and Functional Testing?
https://codeutopia.net/blog/2015/04/11/what-are-unit-testing-integration-testing-and-functionaltesting/
What is Stress testing in software http://tryqa.com/what-is-stress-testing-in-software/
Step 6: Closing and signing off, also called Completion:
Closing and signing off the project or declare project completion means formally termination of
the project that involves three main steps: release of resources (dissolve the project team);
document lessons learned (lapses or shortcomings that will be used as references for future
projects); and celebration. Now that the project is completed you need to finally terminate it.
Your manager asked you to narrate the three tasks that you would perform to close the project.
He also told you to consult the following resources for additional information.
How to Close a Project https://www.simplilearn.com/how-to-close-a-project-article
Four Steps You Must Take When Closing Your Project https://www.quickbase.com/blog/foursteps-you-must-take-when-closing-your-project
4 Tips for Successful Project Closure http://meetings.hayesmanagement.com/blog/4-tips-forsuccessful-project-closure-why-it-s-a-crucial-step-between-go-live-and-optimization
5 Steps to Project Closure https://www.projectmanager.com/blog/project-closure
Steps
to
Deliverable Schedule
Step 1: Work Breakdown Structures (WBS) and Milestones
Step 2: System Acquisition: RFI and RFP
Step 3: Project Communication
Step 4: Monitoring and Controlling
Step 5: EHR Testing
Step 6: Closing and Signing Off
Week 2
Week 4
Week 6
Week 8
Week 10
Week 12

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