Mark Jahn

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	If you think building or remodeling a home on time and within budget is challenging, try managing a substantial IT project. Unfortunately, without proper guidance and management, IT project failures in healthcare can occur with alarming frequency.

	Think it can’t happen in your organization? Astoundingly, just 2.5% of companies successfully completed 100% of their IT projects, according to a massive 

, which reviewed more than 10,000 projects from 200 companies in various industries in 30 different countries.

	Historically, the IT project failure rate for healthcare has been equal to, if not worse than, other industries, according to 

 of health IT successes and failures published in the 

Journal of the Medical Informatics Association

	The cost of such failure can be substantial. In a 

 found an average cost overrun of 27%, but noted this was only part of the story. One in six of the projects studied went 200% over budget (on average) and had a schedule overrun of nearly 70%. It’s the budget- and time-busting outlier projects like these that are the most perilous to organizations, the study’s authors contend.

	Complexity comes with the IT project territory, given the inherent need to balance competing stakeholder interests with limited resources and time. It’s also necessary to factor in the increasing rate of technology changes and external factors, such as regulations and the risk of increasing data intrusion threats.

	That’s why, foundationally, healthcare organizations must have sound IT project management practices in place to sensibly manage both human and financial resources, and help deliver successful clinical and business results. Here are nine best-practice recommendations for proper IT project management:

	Proper IT governance is not just a “feel-good” exercise, but critical to the mission and success of your organization. As Peter Weill and Jeanne Ross documented in their seminal book, “IT Governance: How Top Performers Manage IT Decision Rights for Superior Results,” organizations with superior IT governance have 25% higher profits than those with poor IT governance, given the same strategic objectives.

Connect IT and administrative relationships

	Today’s top healthcare organizations must have alignment and understanding between their organization’s executive and IT leadership. The overwhelming majority of IT projects, even those which are seemingly “small scale,” are not just “technology issues” but rather typically complex and multifaceted. They invariably affect a significant swath of personnel in an organization-even sometimes housekeeping and parking!

	Business strategy devoid of an integrated IT strategy is as nonsensical as a business plan lacking revenue projections. In other words, it’s a non-starter. Your baseline integrated IT strategy need not be complicated, at least not at a 30,000-foot level. What often suffices to start is having a simple multi-year IT roadmap that aligns with your organization’s business strategy. If your organization doesn’t have a usable business strategy for IT planning purposes, then align your IT strategy to high-level business goals or pillars of success. Considerable IT-related angst and issues can be mitigated through this one best practice alone.

Develop a standard and open planning process

	Start with well-defined project objectives and requirements, define your project scope, delineate necessary roles and associated responsibilities, and identify available resources (including any of which may be needed outside of your organization). Establish your baseline standards, identify the timing of success stages, and be sure to measure and re-measure progress throughout the entire effort.

	Ensure all team members have access to proper tools-such as those that centralize project-related information, aid communication and provide tracking/historic data. This effort will be aided if you’re able to secure sufficient workspace and/or allow staff to occasionally work from home (if permitted by your organization’s policies). By centralizing project information into a common resource such as a project management system, you can also decrease the likelihood of team members accessing inaccurate and/or outdated information and data.

	Create and maintain a communications environment in which all individuals, in IT and elsewhere, feel empowered to voice their opinion on the status and progress of projects. Too often when timing and budgets are tight, team members will not speak up about unrealistic expectations or “scope creep.” Don’t let that happen in your organization. Instead, provide all team members with the latitude to push back when requests could ultimately derail a project.

	In complex healthcare organizations, technical skills and experience are often a baseline minimum for IT personnel. IT staffers must also be adroit in planning, time management, communications, and relationship skills. If you’re understaffed in this regard, consider outsourcing for the necessary assistance and/or employing IT consultants. Your external hiring costs will likely be more than offset by the productivity gains made possible through an on-time project delivery.

	The unexpected is practically a given in any IT project. Despite all of your diligent planning and preparations, infrastructure changes, technology advances, interoperability issues and more can crop up at any time to potentially torpedo your efforts. Don’t be caught flat-footed. Within any IT project, bake in contingency plans to address likely challenges.

	After you’ve made sure that your business and clinical users have accepted all deliverables, be sure to document and share your lessons learned and decide which improvements to make on the next project. And don’t forget to celebrate your successes by recognizing and rewarding your project team members. Happy team members will want to continue to work for you and produce high-quality results, again and again.

A moving target               

	When striving for “best practice” IT project management, be mindful that “best practices” are a moving target-intended to be more guidelines than gospel. In fact, depending on the scope and scale of your IT project, you’ll find some best practices far more relevant and useful than others. Ultimately, determine which best practices are more useful to the individuals working on an IT project, to their teams, and overall to the entire organization.

	Finally, keep the importance of supplemental IT training in mind for clinically educated team members (e.g. physicians, pharmacists, lab technicians, etc.). They may be eager to learn more about IT process design, analysis, estimating, impact analysis, project management, and so on.

 has a background in healthcare analytics, ICD-10, IT strategy, IT governance, package selections, assessments, PMO implementations, and program and project management. 

Articles

Healthcare organizations must have sound IT project management practices in place to sensibly manage both human and financial resources. Here are nine best practices to follow.

Author | Mark Jahn

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Nine best practices in healthcare IT project management