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EBR Labor Pains

EBR Labor Pains. Donna Calabrese Director, Office of Vital Statistics Center for Health & Environmental Statistics Division of Health Kansas Department of Health & Environment. Why Update our EBR?. In 2000, we began discussing and planning re-engineering our Vital Statistics system.

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EBR Labor Pains

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  1. EBR Labor Pains Donna Calabrese Director, Office of Vital Statistics Center for Health & Environmental Statistics Division of Health Kansas Department of Health & Environment

  2. Why Update our EBR? • In 2000, we began discussing and planning re-engineering our Vital Statistics system. • Birth registration topped the list • Using an antiquated DOS based system • Losing maintenance on outdated parts of the system

  3. Re-engineering Begins • Touched every facet of our electronic system: • Registration of births, deaths, marriages, divorces, ITOPs • Amendments • Point of sale accounting system • Certificate issuance • Internal workflow system with queues and audit trail • Database conversion • Incorporated certificate revision

  4. Pre-Labor Pains • Completed Needs Assessment • Appointed Steering Committee • Updated existing FileNet Imaging System • Wrote RFP • Contract awarded in mid-2003 to ManTech

  5. Contract Tips: • Ownership of Materials • Liability • Default • Liquidated Damages • Payment • Payment for all accepted deliverables not to exceed 50% of total Project payments and payment for all completed and accepted phases not to exceed 50% or total project payments. • Maintenance • 24/7 use of web-based system

  6. Do Your Homework • Know what you want • Conduct site visits to assess other state systems • Review NAPHSIS Use Cases and Artifacts • Meet with key office and IT staff • Review all desired functionality • Provide every detail possible to the vendor • Vendors do not know your business like you do • Thoroughly read every design and data flow document • These documents are used to verify processes and functions throughout the entire project • Avoid change orders

  7. Communication • Vendor • JAD Sessions • Conference Calls • Individual Calls, E-Mail • Provision of hardware/software needs for external partners • Develop good rapport with agency IT • Hospitals/Birthing Centers • Sessions held re: certificate revision • Requested feedback • Provided information on web-based system • Letters with hardware/software requirements for new system • Projected impact of effect on processing • Contact state medical boards, associations • Articles in weekly, monthly publications

  8. Heavy Labor Begins • Time commitment is critical • Your own staff must be committed • Key staff with detailed knowledge of processes and functions • A tremendous amount of time must be devoted to the re-engineering project – 60% of total time of key individuals. • Your agency IT must be committed • Responsive and knowledgeable of project • Your vendor • Ask about resources committed to the project • short and long term staff commitment

  9. Training & Pilot Testing • Train the trainer sessions conducted by vendor • Training sessions for pilot hospitals conducted by our staff • Selected 5 hospitals for pilot • Large, medium, small, city, rural • Testing conducted June, July 2004 • Required dual entry • On-site training for 82 hospitals • 1 and a half day sessions • 1st day – structured training; 2nd day – practice on mock-up worksheets • Hospitals continued pilot testing until system implementation

  10. Imminent Arrival • Testing by office staff, IT, and hospitals • IT advanced test system date to ensure birth certificate numbering started correctly • Tested every function possible • Planned for after-hours customer assistance • Registration Chief and Field Rep on call • Determined vendor availability after hours • Determined IT availability after hours • Installed a third party software that checks server processes on window server (status change) • Interruption in service • CPU usage problem (overload) • Disc space • Memory space (significant spike or none available) • Most resolutions done by IT remotely • On-site as necessary 24/7

  11. The Delivery • IT’S AN EBR! • The system went live January 1, 2005 • All critical issues with birth registration were addressed first • Second priority was data exports (SSA, NCHS, internal partners, state partners) • Next, internal functions of amendments, adoptions, foreign born and delayed birth filings • Negotiated and compromised with vendor on priorities, deadlines, resources, fixes, and changes

  12. Work With Your Vendor • Develop and maintain a good working relationship • Be firm when necessary • Negotiate when appropriate • Determine “bottom line” issues internally • Document conversations, verbal agreements

  13. Lessons Learned • Ensure design/functionality documents are updated throughout the project. • Require documentation of the completed system • Watch carefully the ease and cost of making changes to certificate data, formats • Subject to legislative changes every year • Certificate revision • Other program changes (i.e., Newborn Hearing Screening, PRAMS, etc.) • Stress importance of your office staff and agency IT carefully reviewing documentation and progress of the vendor. • Requires resource commitment

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