1. "High, big and empty" are the distinctive features of project failure
question
Some hospitals have not been objectively analyzed, such as market conditions, current domestic HIS development status, hospital financial status, human resources, awareness of all staff, basic level of computer, degree of hospital process standardization, intensity of urgent need to change, etc.
Situations that are likely to occur:
1. As soon as the project is established, it will be based on lofty goals. It must build a fully digital hospital, and it should be a complete system covering every corner of the hospital.
2. The project initiation report is very vague, a simple analysis and then list some online system modules
3. Finally, make an online schedule, and a huge HIS system project is completed.
Solution
The project is operated with an idealized thinking from the very beginning, and it is destined that there will be a lot of foreseeable difficulties in the successor of the project. How to ensure the success of the project?
1. The content of the project is the general outline of the HIS project construction. The general outline is not clear, and the goals are not clear. The set goals do not need to be too advanced, mainly to meet the current demand for HIS functions. The contents are all included in one project. If the hospital is currently only to solve the problem of charging, it will only build a financial-centric HIS project.
2. The investigation and research must be in-depth. It is difficult to determine which level of the hospital should be built by hearsay or observation of some hospitals. There are two methods for reference at this stage. One is to ask a professional consulting company or a team of experts from the province to According to the specific situation of the hospital, make an appropriate HIS construction plan. The second is to carry out step-by-step, steady and steady, and it is not good to be too ambitious. Only build the most mature part of the current HIS product, so as to ensure the success of the HIS project from the beginning.
Second, the selection failed. There is no best in the world
question
"Choosing software is like choosing a wife", this is the common voice of many HIS projects, which shows how difficult it is to choose software. There are also some lazy hospitals. For example, they only choose companies certified by the Ministry of Health, the Department of Health, or companies approved by the Municipal Health Bureau. This has at least two advantages. First, if the project really fails, the responsibility can be attributed to the higher authorities. , my own responsibility can be lighter, and secondly, the company certified or recognized by the higher authorities is not too bad. There should be no problem with the company being our hospital. In fact, software is like a wife. Maybe you can't find a suitable one in a certified and recognized company? Only when you are married can you know if it is suitable for you, but it is not too late.
How to ensure the success of the selection, just follow a principle: "There is no best, what is suitable is the best".
Solution
How do you feel suitable? The hospital must do enough to:
1. What problems does the hospital urgently need to use information technology to solve?
2. What problems exist in the hospital's existing software?
3. What are the advantages and characteristics of the hospital's existing software?
4. What special requirements do hospital leaders have in informationization?
5. What special requirements does the hospital information department have for software?
6. What are the special requirements for the software of the planned online use department?
Analyze the above questions, and check whether the software company's products can meet these questions to the greatest extent, or the company that can be expected to meet the greatest extent in the future is the most suitable company you are looking for.
The commonly used methods and tools for selection work are:
survey
Brainstorming
Expert assessment
Product Demo
site visit
Online verification
The most important point is to customize the list of questions. During the selection work, our hospital customized 424 scoring criteria to select software, which has achieved very good results.
3. The contract fails. Both sides are stuck.
question
The contract is one of the most important legal documents for HIS projects. Many projects are sloppy when signing the contract. During the implementation process, the two parties have great differences in the understanding of the contract, resulting in constant disputes between the two parties and even the failure of the project.
1. Hospitals often feel that they are completely trapped after signing a contract. (It is not ruled out that some companies in the market use contracts to trap hospitals)
2. The company also feels trapped by the contract. The hospital often uses vague words in the contract to maximize its own interests, which leads the company to think that the completion of the contract will never end.
Conventional HIS project contracts are signed with a fixed amount. This method is the most risky for the company, which is equivalent to buying out the right to use the HIS at a fixed price. As for how to use it, the hospital has the greatest right to speak. Doing according to the hospital's requirements and not paying is the most fatal weakness of the HIS company. The failure of the HIS project is the first failure in the contract.
Chinese tradition is a society where love outweighs law, and the HIS project shows it most vividly. Before the contract, everyone is very easy to talk and everything is negotiable. If the details are discussed in depth, both parties will feel ashamed and do not trust each other, so the contract is generally in Signed in a friendly atmosphere.
In addition, the marketing personnel of some companies do not understand the company's products or blindly exaggerate the product functions in order to obtain the contract, and promise the hospital's requirements casually, but these requirements are not written into the contract. Many failed HIS projects start to fail from the very beginning, all thanks to the contract.
Solution
How to sign a complete contract to ensure the success of the HIS project? According to the author's research on contracts of many companies and combined with the experience of HIS project implementation, the following points are proposed for the attention of the hospital and the company.
1. The responsibilities and obligations of both parties must be clearly defined.
2. The scope of the software product must be clear, and the key data table structure, the way, method and degree of realization of important functions must be clearly stated.
3. The payment standard must be clearly stated. It is not allowed to write in the contract such as, "30% after the contract is signed, 30% after the system is activated, 30% after the system acceptance, and the remaining 10% after one year of acceptance". There seems to be no problem with this content. Once there is a problem in the early stage of contract execution, the company will only receive 30% of the payment. For example, 30% will be paid after the system is activated. What is the activation standard? Will the outpatient billing system be activated, or must the entire system be activated? System acceptance is all projects passed the acceptance, or the main project passed the acceptance? If the hospital does not want to pay, and delays one or two subsystems from going online, or finds many problems after going online and asks you to solve it, will it never be accepted? How long does it take one year after acceptance, it can be 3 working days, or it can be forever, anyway, after one year, these details are often not specified in the contract.
4. The acceptance criteria must be clarified. The HIS project is a huge and complex system. It is almost impossible to accept all the problems after solving it. Therefore, the acceptance criteria only need to focus on the larger ones and the smaller ones, and there is no problem with the main operation. (The company needs to further refine the operation of the main body), it can be regarded as acceptance.
5. The liability for breach of contract must be clearly defined, the situations in which a breach of contract may occur, and the solution should be expressly stated in the contract, which cannot be simply negotiated or submitted to arbitration or a court for settlement.
6. If the contract is difficult to describe clearly, there must be an annex to the contract and it must be stated in the contract that it has the same legal effect as the contract, such as: functional requirements confirmation sheet, project duration plan, project changes, list of interface instruments, acceptance criteria, etc.
4. The project plan failed. The project is difficult to complete.
question
A good plan is the guarantee of project success.
The project plan includes:
Project scope statement (function description of each subsystem in the contract)
project schedule,
Project Quality Plan
project cost plan
Project Resource Planning
Project Communication Plan
Risk Countermeasure Plan
Project Procurement Plan
Change Control Plan and Project Closure
According to the requirements of project management, the above is the necessary homework for the overall management of the project. According to the author's knowledge, there are very few companies that can achieve the above three points. Generally, the engineering personnel of the company only make the project duration plan, and the duration plan is just a simple system The operability and controllability of the launch schedule is very weak, and the lack of good project managers or relevant project management knowledge in HIS companies has always been one of the important reasons why the project cannot be completed for a long time.
Solution
How to make a project plan? It is the guarantee of the success or failure of the project.
1. First of all, you must confirm the functional scope of the software with the hospital, and sign a functional requirement confirmation form for the scope. This is an important basis for the quality and acceptance of the project in the future. One of the biggest reasons for the unsuccessful project is the spread of the functional scope. The following It will be described in detail and will be omitted here.
2. The progress of the project should be in line with the actual situation of the hospital and the company's support for the project, and the impact of legal holidays and various policies on the progress should be taken into account. Part of the time must be reserved to deal with unforeseen circumstances.
3. The quality of the project must have a clear understanding of both parties before going online. For example: the data accuracy of the western pharmacy inventory management, the error is considered to meet the requirements within a few ten thousandths, and it is almost impossible to completely achieve the monthly accuracy of the quantity and amount.
4. Project cost is very important but no one cares. Many companies made a lot of orders by the end of the year, but did not make any money in the end. The important reason is that they did not pay attention to or scientifically control project costs. It is also an important reason that HIS projects have more instability, which makes it difficult to control costs. Another important reason is that HIS companies are unwilling to abandon projects that have suffered serious losses. Doing HIS is like a bottomless pit, occupying the company's original resources that were not rich. The use of earned value method to control costs is a good technical means, and it also makes the hospital feel that the company has a lot of cost pressure, and if it does not actively cooperate, the project may fail. When calculating the cost, the hospital often only considers the cost of purchasing software, and often does not care about its own labor cost, implementation cost, time cost, management cost, risk cost, etc. If both parties are cost-conscious, the HIS project will fail. Probably not so much.
5. There is no plan for project resources, including the company's manpower arrangement plan and the hospital's manpower plan. If the project is tight, there will be more personnel, and if the project is small, the number of personnel will be reduced. The randomness is very large. The materials, equipment, information and funds required for the implementation of the project are also There is no overall plan, and it will only be dealt with when it is needed. The time-consuming work will also bring dissatisfaction to the relevant departments.
6. Communication is one of the most important tasks of the project, especially the project manager, who probably needs to spend more than 80% of his time on communication, which will be described in detail below, but will be skipped here.
7. Risk countermeasure plan, any project has risks, how to identify potential risks and take countermeasures, try to make unfavorable risks into favorable ones, transfer risks or avoid risks, is an important means to reduce project losses and improve the success rate of projects.
8. Project procurement plan, prepare the materials, equipment and intellectual products required for the project in advance to speed up the project progress.
9. Change control management. The requirements of HIS system are complex and changeable, and it is common to change day and night. The formulation of a strict change control process can reduce unreasonable demands by at least half, which is also of great benefit to the stability of the system.
10. The project is closed, and it is easy to start the construction and difficult to close. The main problem is that the engineers and the hospital do not know how to close the project, formulate the project closing process, sort out the documents of each process, deliver the product documents, and then accept the internal acceptance first and then the joint acceptance.
To sum up, the success rate of the project will be improved only if the project is managed with the thinking of overall project management and the project plan is well done.
Five, software scope failure. Add or modify endlessly.
question
The biggest reason for project failure is scope spread. We said before that the project contract is signed with a fixed amount. Almost all departments in the hospital that run the software want to modify the software in their own way, resulting in the unrestricted spread of the software function scope, and the departments do not pay attention to it. How about the company's existing products, they only focus on you now to modify the software according to their ideas.
For example, for a surgical anesthesia system, the price in the contract may be 20,000 yuan, but the surgical anesthesia department requires the company to connect all the anesthesia machines and collect the anesthesia record curve. In fact, there are very few companies that can connect to the anesthesia machines. If the scope of the contract does not express this Point, the department will not sign it to you during the acceptance, of course, the hospital supports the department's point of view, and believes that this is a function that should be included in the contract.
There are many examples such as scope spread, which has led to the endless revision of company projects. In the past, HIS companies tried to use the platform to solve the endless demand problem of hospitals. In fact, if the scope spread is not fundamentally limited, no matter how big No matter how good the platform is, it still cannot solve the huge and complex HIS needs.
Solution
The best solution is to define the scope of software functions at the beginning of the contract, and then add or expand the scope and recalculate the cost separately. Although the hospital is reluctant to accept it in operation, it is clear that both parties can reach a consensus on the basis of understanding.
6. The test failed. Remediation is more laborious.
question
The test mentioned here is the beta test. The test is very important, but it is quite cumbersome. Many people are reluctant to spend time on the test, thinking that the company has tested it and there will be no problems, or just switch to the test environment to simply hack the modified parts. Box testing, as soon as the new program is replaced, problems occur immediately in the departments below, and they keep fighting for rescue. Sometimes they have to switch back to the old program to restore the normal operation of the hospital. Over time, the medical staff in the hospital are afraid of upgrading, or once there is a problem with the software They all think that the upgrade is the fault. In fact, the software has not been upgraded at all in the near future.
Solution
The risk of upgrading is proportional to the scale of hospital software applications and the number of software subsystem interfaces. The deeper the level of hospital applications, the greater the impact of the upgrade, and the longer the testing time, or even longer. The time for software modification, the designed test cases, unit testing, integration testing and stress testing are necessary. If the conditions are good, it is best to build an identical testing environment and call clinical personnel for public testing. Before upgrading, it is necessary to Prepare training, upgrade timing, upgrade time, and contingency plans.
7. Human resources failure. Progress and quality are not guaranteed.
question
Any project is completed by people, and people are the decisive factor for the success or failure of the project.
There are three kinds of people in the hospital that are indispensable.
First, the leader of the hospital in charge of information must be the first-in-command or vice-president
Second, the director in charge of information must have a good understanding of the hospital's management process, medical operation process, the function of HIS software, the development status of the HIS industry and certain project management experience.
The third is the core technical personnel, there must be engineers with problem-solving ability in database and HIS software
If the above three kinds of people are missing, or if the above three kinds of people are lost during the implementation of the project, the impact on the project will be considerable. HIS company mainly has an experienced project manager, engineers with strong implementation ability and technical support from the company's R&D strength. Any weak link will affect the progress and quality of the project.
Solution
For the hospital, if human resources are insufficient, try not to expand the project; for the company, if human resources are insufficient, try not to undertake complex projects, otherwise the project will fail.
Eight, communication failure. The conflict escalated.
Principles of communication:
The first step is to communicate with each other
The second step is to communicate with each other's superiors
The third step is to communicate with your superiors
The fourth step is to communicate with the superior of the other party
Communication is very important. There are many ways to communicate. Communication is an effective way to resolve conflicts. A project without communication or poor communication is doomed to failure.
A successful project manager must be a master of communication. He must be familiar with hospitals and products, accurately grasp the scene, be honest, credible, and think clearly. This requires the accumulation of his own knowledge and rich project management experience.
9. Cost failure. Lose money and make a profit.
question
The survival of domestic HIS companies is very difficult for all to see. First of all, HIS company is a technology-based company. The pursuit of technical perfection and dedicated customer service is the corporate culture of almost every company. Almost one project loses one project. In order to survive, it takes on more projects and falls into a vicious circle. In the end, the company is not profitable, the hospital is not profitable, and the entire industry is not profitable. Cost out of control is a common problem in the HIS industry.
To really cure it, we need to start with the overall management of the project, gradually guide ourselves, and guide the hospital to approach formal management.
10. Failed to close the project. Never look forward to completion.
question
Project closing is the most troublesome thing for all HIS companies. Some projects will never see signs of closing. Both the company and the hospital drag the project on each other, which is neither good nor bad. No money was made.
Solution
The solution is still to use the overall management method of the project, do every step carefully, and naturally solve the problem of difficult closing.
Information system project management is a subject integrating management and technology. The National Computer Qualification Certification Examination has been conducted for three years. It is believed that more information system project managers entering the HIS industry will bring new vitality to HIS.
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