South & West Devon Health Authority
The S&W Devon ERDIP Project was one of 17 projects in a national programme sponsored by the NHS Information Authority. Its aim was to demonstrate key aspects of an Electronic Health Record (EHR) so as to prove the feasibility of the following EHR concepts:
- synthesis of an EHR from current operational systems;
- patient consent to the use of the health record;
- role-based access to the health record by health care professionals;
- patient interaction with the health record;
- workflow co-ordination within the overall care process.
Full details are on the project web site at www.erdip.tmclimited.com/public/
The project made a slow start because of difficulties in mobilising a team with the expertise needed with the result that about one third of the time and budget available to the project was lost without any substantive progress being made.
Alec Fearon took on the role of Project Manager in August 2001 with the task of bringing the project to a successful conclusion. This has now been achieved and Alec continues to work on an extension to the project
A risk assessment concluded that it was no longer practicable to implement a pilot-scale operational system with the time and resources available. Difficulties over patient consent posed unacceptable risk to the original goal.
The project was re-focused to develop a prototype EHR operating in an R&D environment. This used real patient records drawn periodically from sources in the local health community, but anomymised the records before unifying them and attaching them to a fictitious population. The core EHR functionality was the same as for an operational system but was packaged within a simulator. This allowed local stakeholders to explore the use of the EHR in representative care pathway scenarios through interactive role play involving the creation of synthetic data and the 'fast forwarding' of time.
A disciplined engineering approach was adopted. The first stage addressed the definition of requirements in order to produce three key products:
- User Requirements Document
- System Requirements Document
- an outline of the Architectural Design Document
Production of the Architectural Design Document (ADD) was completed in the next stage to specify the Demonstrator System in terms of its:
- structure what the major components were, how they were to be organised and decomposed, their functionality and interfaces, and the ties to the System Requirements
- behaviour – the dynamic response of the system to events
- layout – the physical arrangement, packaging and location
The ADD also assigned requirements to the various sub-systems in the form of Sub-System Requirement Specifications. It thus formed the basis for the detailed design, build and test of the various sub-systems and their integration into a fully functional Demonstrator EHR.
The final stage began with the Demonstrators acceptance into operation and then focused on its evaluation by local stakeholders.
The NHSIA Programme Office agreed a revised suite of project deliverables to reflect the new focus of the project. Although early products in this suite were delivered a little later than planned, the remainder were on time and all were judged by the ERDIP National Evaluation to be of good quality. The project is now regarded as one of the most successful in the ERDIP Programme. Cost out-turn was within buget.
BAE Systems Astute Class Limited
The Astute Class is the next generation of nuclear powered ‘hunter-killer’ submarines for the Royal Navy. They are to replace the existing Swiftsure and Trafalgar classes, coming into service in the last half of this decade. GEC Marconi won the £1.8B design, development and production contract in April 1997. It was transferred to BAE Systems when the defence part of GEC was sold to BAe in 2000.
Andrew Moore joined the project in October 1997, taking over as full time Risk Manager in May 1998. He recruited Mark Alcock in June 1998 and Alec Fearon in January 2000. Alec Fearon moved off the project in August 2001 and Andrew Moore left in October 2001, leaving Mark Alcock as Risk Manager. The roles of all the TMC staff was as interim managers.
From an almost standing start, the TMC team developed an opportunity and risk management culture to meet the management needs of the company with a system of recognised ‘good practice’ processes, techniques and tools to support it. At the time (1998) the commercially available risk tools were incapable of meeting the Astute needs and therefore an Access database was developed to fill the need. The TMC team also carried out the training of the system users.
Particular elements of the risk system introduced included:
- A method of cross-validating top down analyses carried out by the senior management against the bottom up data provided by individual risk owners
- A risk register that was ‘open’ to the customer - the UK Defence Procurement Agency, and the major contractor - BAE Systems Marine, the shipbuilder, with common risk entries and processes for managing the risks
- Techniques to evaluate the effectiveness of the risk management work carried out.
The Astute approach became widely recognised as an industry ‘good practice’ standard and several national and international papers were presented. The paper presented to the PMI Europe 2001 Conference can be accessed via the link:
BAE Systems Electronic Warfare Division
The Defensive Aids Sub-System (DASS) is a major part of the avionics suite in the European Fighter Aircraft (EFA) and is an international design and development contract valued at about £1.4B. BAE Systems is the lead contractor and is joint design authority with Eletronica (Italy). The other production partners are Indra (Spain) and EADS (Germany). A reorganisation showed that the project was weak in Programme and Risk Management.
Andrew Moore joined the project in October 2001 as the interim Programme Manager. He handed over this position to a directly employed member of BAE Systems staff in June 2002. From October 2002 he has been retained as a part time Risk Management Consultant to set up a risk management system suitable for all 4 partners in the international collaborative project. A further member of the TMC Team has been offered to support the risk management work in a more full time role.
Initial investigations showed some weaknesses in scheduling and in related elements of customer and partner working relationships. The first task was to address these concerns, followed by initiating the development of an appropriate risk management system.
Key achievements were:
- Introducing uncertainty planning techniques to the business to clarify understanding of the project plan with the risks associated with its achievement and the likely completion dates of major activities.
- Identifying previously disregarded issues and initiating appropriate actions to resolve them, including recruiting 20 additional systems engineering staff within 6 weeks.
- Communicating issues and action plans to the customer and international partner organisations.
- Selection of a commercial risk register database and the introduction of appropriate processes and techniques to optimise its value (this work is continuing).
Infraco Sub-Surface Limited
Infraco Sub-Surface Limited (ISSL) is one of 3 support companies working for the London Underground, providing for the maintenance and improvement of the asset portfolios, i.e. trains, stations and infrastructure for the Circle, District and Metropolitan lines. An internal evaluation of ISSL processes had identified a weakness in the area of Risk management and a number of related Business Improvement Programmes were set up. After carrying out a Feasibility Study, TMC won one of these programmes covering the Asset Improve part of the business. The subsequent Fixed Price Contract has led to TMC becoming a preferred supplier to ISSL.
Andrew Moore started work on the Implementation contract in June 2002 and is to be joined by Mark Alcock from November 2002. The involvement of further members of TMC staff is planned for later stages of the work.
A fixed price proposal was submitted to cover 4 phases of work:
- Requirements gathering and analysis plus identification of appropriate processes and techniques
- Selection of a suitable commercial toolset to support the processes.
- Training of Asset Improve staff in the chosen processes. This would be carried out in conjunction with the tool supplier(s) training ISSL in the use of the tool.
- Implementation evaluation and after action review.
The Phase 2 work was accelerated and expanded to join in with the selection of a toolset for the whole of ISSL. The current intention is to expand the use the selected tool and processes to other Infraco companies and their suppliers.
The contract to supply the selected toolset is being placed in November 2002. The expansion of the requirement on TMC to cover elements of the whole of ISSL has led to a re-negotiation of the remainder of the contract, which is currently ongoing.
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