Many organizations have a Program Management Office and a Program Steering Committee to oversee all aspects of the EHR. Typically these include broad objectives like defining the functional and technical requirements, process redesign, change management, software selection, training, and implementation. Chances are that neither the PMO or the steering committee has ever selected or implemented an EHR. As such, it can be difficult to know how well the effort is proceeding. Simply matching deliverables to milestones may be of little value if the deliverables and milestones are wrong. The program can quickly take on the look and feel of the scene from the movie City Slickers when the guys on horseback are trying to determine where they are. One of the riders replies, “We don’t know where we’re going, but we’re making really good time.”
One way to provide oversight is to constantly ask the PMO “why.” Why did our productivity crash? Why did we miss that date? Why are we doing it this way? Tell me again, why did we select that vendor? Why didn’t we evaluate more options? As members of the steering committee you are responsible for being able to provide correct answers to those questions, just as the PMO is responsible for being able to provide them to you. The PMO will either have substantiated answers, or he or she won’t. If the PMO isn’t forthcoming with those answers, in effect you have your answer to a more important question, “Is the project in trouble?” If the steering committee is a rubber stamp, everyone loses. To be of value, the committee should serve as a board of inquiry. Use your instincts to judge how the PMO responds. Is the PMO forthcoming? Does the PMO have command of the material? Can the PMO explain the status in plain English?
So, how can you tell how the EHR effort is progressing? Perhaps this is one way to tell.
A man left his cat with his brother while he went on vacation for a week. When he came back, he called his brother to see when he could pick the cat up. The brother hesitated, then said, “I’m so sorry, but while you were away, the cat died.”
The man was very upset and yelled, “You know, you could have broken the news to me better than that. When I called today, you could have said the cat was on the roof and wouldn’t come down. Then when I called the next day, you could have said that he had fallen off and the vet was working on patching him up. Then when I called the third day, you could have said he had passed away.”
The brother thought about it and apologized.
“So how’s Mom?” asked the man.
“She’s on the roof and won’t come down.”
If you ask the PMO how the project is going and he responds by saying, “The vendor’s on the roof and won’t come down,” it may be time to get a new vendor.