If you Google the phrase "project implementation methodology" or anything similar, you get links to endless numbers of textbooks, classes, white papers and other helpful resources. These resources will tell you how to develop the absolute best project plan to ensure whatever you're implementing-whether it's electronic document management systems (EDMS) software, customer relationship management (CRM), roll-out of a wireless network, you name it-will go smoothly.

But in this late phase of our Healthport EDMS implementation, I learned something that most classes and books can't teach you: the wisdom of re-evaluating your project plan as you go.

Think about it: when your project team sits in the conference room and plans a lengthy, incremental roll-out, you're making assumptions about the future. Yes, you're also drawing from your expertise and experience with similar implementations, and you have the collaborative wisdom of your highly skilled project team. But aside from all that, there are factors you just can't predict. If "a" happens, will "b" definitely happen? Or is it possible that "c" will? You don't have a crystal ball, so you just can't know for certain.

Side Trips Along the Journey
Last month, I talked about how the HIM department had to "win friends and influence people" to change the culture in which physicians and other EDMS users were accustomed to working. The mantra popularized by Field of Dreams , "If you build if, they will come," doesn't necessarily apply to IT implementations in hospitals, but this, too, was a lesson you don't necessarily learn in Project Management 101, and we were fortunate enough to win the physicians' trust and adoption by listening to their concerns and needs-and making concessions, when appropriate. This month, we began a later phase of implementation; one where we made tweaks and fixes to the EDMS. In particular, we needed to tackle three things:

1)      COLD feeds to send lab and clinical documentation straight from Meditech into Healthport

2)      HIM Deficiency Tracking Workflow, which provides online analysis for deficiencies and physicians online completion. This included "tweaking" as well as managing physician roll-out.

3)      Going live with our last area, ancillary services (e.g., lab and radiology).

These three items are typical but critical initiatives that were scheduled for the later part of a large IT project. My instinct was to package all three with a neat bow and implement them together. After all, doesn't that make a nicer, cleaner picture on your implementation flow chart? Won't that ease confusion and stress by putting a neat beginning and end on this project phase?

That was the plan, and I was sticking to it.that is, until one afternoon when I'd had enough. I was thinking about coming in the next morning and facing another day of the same old thing: looking at a project almost within reach but not being able to grab it. Have you ever seen those big glass cases at carnivals and malls filled with stuffed animals and a big hook at the top? For a dollar, you can try to hook an animal that probably costs 50 cents. Ever noticed how difficult it is to actually grab the stuffed dog? Well, my stuffed animals were named Cold Feeds, HIM Deficiency TrackingWorkflow and Scanning Outpatient Records, and I was tired of them being out of my reach.

Scanning Beats Out Perfection
So we tackled project #3 and began scanning. And scanning, scanning and scanning. And I began kicking myself for not scanning sooner. It had an immediate impact on the HIM department's productivity, sanity and environment. No more piles of reports stacked around our office, no more "where do I look first?" when trying to locate data. Everything is paperless-just a few clicks away on our computer-and much, much neater. Our research on accounts is easier, and our revenue cycle will ultimately become shorter. We are becoming true analysts rather than paper shufflers, and we're all pretty happy about it.

At the end of the day, tossing out my preconceived notions about what a perfect go-live would be, with its perfect phased implementation and milestones, enabled us to have a big win, faster than we imagined. As an HIM director, you want things to be perfect for your staff and users .but sometimes, it's better to keep your eyes and mind open, and manage as you go. We now have one COLD feed under control, and have almost resolved the workflow deficiency. Things are working out well, even if they're not the way I initially envisioned-and we're realizing some very valuable benefits.

Traci Waugh is director of health information and compliance at North Valley Hospital, Whitefish, MT, and a client of SDS.