Cerner has changed its implementation project methodology from a waterfall to a more agile method known as TIP. As a Program Manager for a beta TIP project, some of the lessons learned with this change are these:
TIP methodology-outlining a project plan, with tasks and hours is much more challenging.
Core applications which include Organizations/Facilities/Locations and access security should stay in Core. These were separated as part of TIP, and this created miss-matches in locations, and not all teams assisting in decision making were using actual legal names. This created some rebuild to align them with CLIA, CAP agencies which require the information to be exactly as approved by the governing agency. This is something that Cerner agreed would be done, as it impacts the hospital and the ambulatory locations, and can have a ripple effect on Faxing/Referrals/Consults/Message Center to name a few of the tools.
Do not underestimate:
A Key decision process-use of documenting decisions and why the group agreed to the decision.
Mapping out current state workflows-do this with your working staff. Often time’s managers are SMEs, and what they perceive is the workflow is often different than those that carry out the tasks each day. If possible have lunch in the breakroom and have the staff walk thru the processes, you will be amazed at what the staff is doing to get processes complete. Listen to what they are doing, and talk about what would make their workflow easier, write down those ideas to be discussed at the workshops.
Applications with no Test or Build domain, and building and validating processes would occur in the production domain. Ex: Clairvia-the organization can and should request a test or build domain. This can be made available, and the organization has to require it. This will allow you to have a separate domain to validate the new build or changes requested. This is needed to be certain there are no concerns, as changes occur because they will change in the non-prod domain, and can be thoroughly tested.
Nursing/Patient Ratio tools, like Clairvia, should have workshops that should start earlier in the process, as it takes time to gather the information associated with this tool a long time. As you need time and attendance numbers, as you will need to utilize HR tools, rev. cycle tools and scheduling tools.
Please come back to review more lessons learned in our next Cerner blog, with regard to future state.