Sample Project Team Structure, Roles, and Responsibilities

Developing the appropriate staffing and communication plan during the implementation and ongoing support is key to the success of this project. A project manager who has demonstrated great success in managing other contracts and projects will bring this expertise to the EHR/HIE project. Collaboration between clinicians and the technology solution is essential. The implementation project teams are comprised of leadership, clinicians, and technologists from EHR/HIE participants. As part of the ongoing project management tasks, there must be a process to manage and report the project status, a problem resolution process, and a process to monitor the overall performance requirement of the contract. Proper assignment or resource is critical to the success of any project. As port of the scope of the project, we expect that qualified and skilled client resources will be assigned from each of the participating practices involved in the EHR/HIE project. The roles and responsibilities need to be clearly understood to ensure the success of the project.
Figure 1 - EHR/HIE Project Team Structure

Executive Management Roles

Executive Project Sponsor (EHR/HIE)
The Executive Project Sponsor is a member of the EHR/HIE executive management team who serves as the senior project executive/in-charge executive. The Executive Project Sponsor has ultimate authority and responsibility for the project. The Executive Project Sponsor is responsible for:

Contract execution for STATE GRANTOR AGENCY, EMR, hosting partners, data trading
agreements, and any other applicable contracts for the EHR/HIE project.

Planning and evaluation of contracted project deliverable and cost management. Participates in project oversight for risk assessment, executive relationship management, and
project status review.

Resource procurement and management to meet contracted project plan deliverables. Serves as an escalation point for identified project related issues. Provide support to Project Managers for the execution of their duties and responsibilities.

 Evaluates project status from a management perspective. Attends Project Steering Committee meetings as necessary, attends other clinical advisory
committee meetings as necessary.

Steering Committee (EHR/HIE)

The Steering Committee consists of executive level personnel and is responsible for the overall project oversight. They serve to ensure that the system will compliment the strategic vision of the institution and that the anticipated benefits are being realized from the implementation efforts. The committee will be the ultimate decision making mechanism to resolve issues related to the project. Responsible for:

Participate in project oversight for risk assessment, executive relationship management, and project
status review.

Serve as a final escalation point for resolving strategic project related issues. Evaluates project status form a strategic perspective. Decision Boards (EHR/HIE)
The Decision Boards are multi-disciplinary entities that are created to ensure that decisions are made in a timely and equitable way.

Physician Executives (EHR/HIE)

A physician executive serves as a liaison between the EHR/HIE physician community and the Implementation Team and to champion physician causes. The Physician Executive is responsible for:

Providing expert consultation to the client physician leaders to facilitate the implementation. Sharing experiences from other client sites. Setting physician expectations on long and short-term system plans and capabilities. Escalating issues. Providing expertise in leveraging healthcare information systems to improve care delivery Project Executive (EHR/HIE, EMR Vendor)
The Project Executive manages the overall implementation efforts. The Project Executive must be empowered to commit organization resources and has overall responsibility to manage the project budget and project schedule. Note that for the EHR/HIE implementation, the Project Executive and Project Manager roles are filled by the same person. The Project Executive is responsible for:

Contract administration for STATE GRANTOR AGENCY, EMR Vendor, hosting partners, data
trading agreements, and any other applicable contracts for the EHR/HIE project.

Leading project implementation planning. Organizing the Implementation Team and establishing appropriate decision-making bodies. Defining project standards and metrics for measurement. Monitoring overall project progress and milestones. Monitoring project budget from a cost and time perspective. Coordinating project resources and other vendor groups and resolving resource conflicts as needed. Ensuring project compliance with contract and project quality assurance standards.

 Overseeing project documentation to ensure comprehensive project records are maintained as

required by STATE GRANTOR AGENCY.

Attending Decision Board meetings as necessary. Developing and monitoring global workplan and schedules Identifying and managing risk and quality assurance issues which arise during the project. Setting and managing expectations regarding the project. Managing issue escalation and resolution.

Implementation Team Roles

Project Manager (EHR/HIE, EMR Vendor)
The role of the Project Executive and Project Manager will be filled by the same individual. The project manager role responsibilities include the following: Uses project management tools and measure compliance to standards Coordinate vendor development projects (CCD, Referrals), EMR integration project activities, including project design and scheduling and task and resource allocation and managing the team members and stakeholders responsible for carrying out those tasks Coordinate EMR integration projects for each participating practice including project design and scheduling and task and resource allocation and managing the team members and stakeholders responsible for carrying out those tasks Monitor ongoing installation, report plan progress to executive management, and provide feedback regarding the status of assigned projects weekly Participate in production and help desk activities, as required Identify, communicate, and initiate corrective action to resolve internal and external risks associated with new and existing customers Provide oversight of communication with vendors and stakeholders for the EHR/HIE implementation Assign work schedules and communicate responsibilities to project participants Support and contribute to the implementation processes Works with entities that provide data to the EHR/HIE to verify appropriate agreements are in place and standards are met

Application Specialist: Community Health System (EMR Vendor)

Provides content knowledge about the use, design, and configuration requirements Supports clinical system application specialist during the implementation Provides education on product features Advises on availability target time frames Reviews EHR/HIE-specific requirements and table coding Provides support for testing and activation

Application Specialist: Clinical Workflow Specialists (EMR Vendors/Practices)

Clinical workflow specialists are health process specialists with a deep understanding of the processes required to deliver healthcare and the experience to assist local staff in implementing new care processes. Clinical workflow specialists responsibilities include the following: Provide installation leadership and support to participating practices Coordinate and administer the implementation of new sites following the work plan with the support of the integration team, including: Working with practices to plan and complete site preparation tasks

Reviewing interface specifications with the practices and working with other project team members on integration issues Assisting EHR/HIE in developing an integrated test plan with test data and test scenarios Provides knowledge and guidance relating to the data exchange process Develops required coding for data exchange Supports clinical system application specialist during the implementation Advises on availability target time frames Reviews EHR/HIE-specific requirements and table coding Provides support for testing and activation

Integration Architect: Community Health System (EMR Vendor)

Integration Architects (EMRs/Practice IT Department)

The integration architects are responsible for the architecture, development, implementation, and production support for EHR/HIE integration. With strong technical expertise, the integration architects lead the integration team and collaborate in a cross-functional environment, including involvement with project stakeholders. Integration architects responsibilities include the following: Provide architecture, design, development, and implementation of EMR integration tools (EMR Vendors) Provide configuration and production support for the EHR/HIE integration environment Provide implementation support, including testing connectivity Automate implementation processes by working with cross-functional teams Interface with internal product teams and customers to gather and analyze requirements Evaluate development, administration, and monitoring tools associated with middleware applications

Customer Service Analysts (EHR/HIE)

Customer Service analysts provide first line responses for the EHR/HIE solution as well as the ongoing support tasks for data management (code mappings, data sources), patient identify resolution, and patient consent management. The analysts handle initial telephone calls from users, route callers to appropriate support personnel and vendors for questions, requests, or problems requiring a higher level of expertise or a site visit to the users department. Customer services analysts responsibilities included the following: Assist data sources in resolving patient identity issues Assist data sources in resolving data code mapping issues Assist in managing patient consent requests to be updated in HIE. Provide answers to users questions and resolving routine problems in cases where resolution can be done in a short time frame and without a visit to the users location Route user service requests, questions, and problems that cannot be addressed to the appropriate support personnel or vendor Log problems and service requests Follow up on calls referred to support personnel, including communicating status to users as required Maintain an online library of electronic reference materials for use in answering users questions and resolving problems

Training Specialists (EMR Vendor, EHR/HIE)

The training specialists create and deliver training for the EHR/HIE application. Responsible for the design and development of training curriculum for the EHR/HIE participant base. Additional responsibilities include the following: Develops training material specific to the EHR/HIE installation Provides on-site training, deployment, and support services Design, gather information on, and develop course materials

Conduct training needs analysis Design course materials and other documentation, and use e-learning technologies to support users in selfhelp training efforts Organize, set up, advertise, and deliver courses to meet the needs of learners Assess learner performance and competence Monitor, evaluate, and review the quality and effectiveness of training Conduct assessment and outcomes of courses delivered Share learner experiences with software developers and technical authors Serve as liaison to other entities, such as external course providers, employers, RHIO, and examining bodies Maintain hardware and software used for training purposes and recommending to management repairs and upgrades where appropriate Develop and implement user satisfaction and needs assessment surveys on a continuing basis Create training programs for internal and external education

Infrastructure Support Roles

In addition to the implementation team tasks, the following support roles are required to support the infrastructure for the CHS application in the test and production environments.

Database Administrator
Responsible for managing the CHS Central Clinical Data Repository (CDR) relational database with major responsibilities in the areas of monitoring database performance and file growth, database tuning, database maintenance, backup, verification, and recovery as well as software patches and upgrades for the databse.

Systems Administrator
Responsible for managing the CHS systems environment with major responsibilities in the areas of monitoring file growth, user provisioning, system tuning, maintenance, backup, verification, and recover as well as software patches and upgrades for the system.

Network Administrator
Responsible for conducting site assessments, assists in VPN installs, and managing the network configurations for bringing practices on board to the EHR/HIE project.

Vendor Support Roles

Design, Development, Testing Resources
The EMR vendors that are involved in the EHR/HIE project will need to supply development resources to meet the EMR to EMR CCD and EMR to EMR Referral transactions. As part of the development process, they will also provide design resources work as part of a consortium for the EMR to EMR Referral process to be done using standards that although are not final today, should be able to be agreed upon by the EHR/HIE EMR consortium. Additionally vendors will supply testing resources to expedite EMR to EMR testing.