Billing and Electronic Health Record (BEHR) Upgrade

Billing and Electronic Health Record (BEHR) Upgrade

Department of Health

Public Health Division

Billing and Electronic Health Record (BEHR) Upgrade

Project Charter For Certification

Executive Sponsor – Jane Peacock, MS

Director, Public Health Division

Business Owner - Maggi Gallaher, MD, MPH
Medical Director, Public Health Division
Project Manager – Michael Snouffer
Original Plan Date: August 1, 2013
Revision Date: N/A
Revision: 1.0

About This Project Charter DOCUMENT

Permission to plan the projec t and setting the governance structure

The Project Charter provides the project manager and project team with permission to proceed with the work of the project, within the scope delineated in this document. The Project Charter should be the outcome of a number of documents that went into the pre-planning for the project, and in many cases the agency IT Plan, Business Case for appropriations, Federal funding requests and the like.

Project sponsors sign the Project Charter signifying that they have agreed to the governance structure for guiding the direction for the further planning of the project, discovery and defining the requirements, acquiring necessary resources, and within that context the statement of work for any related contracts including a contract for the Independent Validation and Verification.

The Project Charter is also the foundation for the creation of the project management plan, and much of the thinking and writing for this charter will be immediately usable for that project management plan.

Project certification Initial phase documentation

The Project Charter is also used within the State of New Mexico IT Project Certification process as evidence of the project’s worthiness for the Initial Phase certification. The Initial Phase certification is especially critical to many state and agency projects because of its related release of the initial funds required for the project.

Initiation Phase funding is requested by an agency for use in developing project phases, developing Independent Verification and Validation (“IV&V”) plan and contract; address project review issues and/or to develop an overall project management plan. Note: Waiver of the IV&V requirement requires specific written approval by the Secretary of the DoIT.

DoIT “Project Certification” Memorandum July 2, 2007

The Project Charter and the Request for Certification Form are meant to provide a comprehensive picture of the project’s intention and initial planning, that includes the project’s place in the context of the State of New Mexico’s IT Strategic Plan, Enterprise Architecture, and DoIT project oversight process. See “IT Project Oversight Process” Memorandum July 5th 2007 on the OCIO-DoIT web site.

table of contents

About This Project Charter DOCUMENT

table of contents

1. project background

1.1 Executive Summary -rationale for the project

1.2 Summary of the foundation planning and documentation for the project

1.3 Project Certification Requirements

2.0 Justification, Objectives and impacts

2.1 Agency Justification

2.2 Business Objectives

2.3 Technical Objectives

2.4 Impact on Organization

2.5 Transition to Operations

3.0 Project/Product Scope of Work

3.1 Deliverables

3.1.1 Project Deliverables

3.1.2 Product Deliverables

3.2 Success and QUALITY METRICS

4.0 Schedule Estimate

5.0 Budget Estimate

5.1 Funding Source(s)

5.2. Budget By Major Deliverable or Type of expense -

5.3 Budget By Project Phase or Certification Phase

6.0 Project Authority and Organizational Structure







6.5 Project management Methodology

7.0 Constraints

8.0 Dependencies

9.0 Assumptions

10.0 Significant Risks and Mitigation Strategy



13.0 Project Charter Agency Approval Signatures

14.0 Project Charter Certification Approval Signature

Revision History

Revision Number / Date / Comment
1.0 / August 14, 2007 / Initiation PCC Certification


Project Charter BEHR Upgrade ICD-101

1. project background

The project background section is meant to provide the reviewer with a picture of the development of the project from inception to its being submitted for certification.

1.1Executive Summary -rationale for the project

The Department of Health (DOH) Public Health Division (PHD) is initiating this project to upgrade the existing Billing and Electronic Health Record (BEHR) system. The BEHR system is the electronic medical record for all clinical services provided in public health offices. BEHR allows PHD to submit claims for services provided electronically and track compensation received for services performed, supporting revenue recovery.

The upgrade will allow PHD to comply with the United States Department of Health and Human Services (HHS) mandate that all entities covered the Health Insurance Portability and Accountability Act (HIPAA) implement the International Statistical Classifications of Diseases and Related Health Problems code set 10 (ICD-10) for medical coding by October 1, 2014. In addition, the upgrade will enable PHD to implement Stage 2 of Meaningful Use, part of the American Recovery and Reinvestment Act (ARRA), and apply for incentive payments offered by the federal government for adoption of electronic medical records.

The BEHR system was initially implemented in 2007 with all DOH public health offices using BEHR since early 2008. The system was first upgraded in 2010/2011 to meet Stage 1 Meaningful Use requirements. This will be the second major upgrade since the initial implementation.

1.2Summary of the foundation planning and documentation for the project

On January 16, 2009, the Department of Health and Human Services (HHS) published the final regulation (45 CFR 162.1002) that adopted the ICD-10-CM and ICD-10 PCS code sets as HIPAA standards. This rule required the user of the ICD-10 code sets in all HIPAA transactions. The original compliance date published in the final rule was October 1, 2013. On August 24, 2012, HHS announced a one year delay of ICD-10 implementation. As HIPAA covered entities, all states must comply with the use of ICD-10 code sets by October 1, 2014.

PHD BEHR program management, DOH IT and the BEHR hosting, maintenance and support vendor, MedNetwoRx, have outlined a scope of work for this required upgrade based on the successful first upgrade of 2010/2011. The process and deliverables will be identical. In addition to implementing the ICD-10 code set, the upgrade will also address Meaningful Use Stage 2 requirements should PHD decide to pursue federally funded incentives.

1.3 Project Certification Requirements

Does the project fit into the criteria for certification? Which and how?

Project is mission critical to the agency / Yes / The upgrade is required for the implementation of the ICD-10 billing code set. ICD-10 must be implemented by Oct. 1, 2014. In addition, the upgrade will allow for the implementation of Meaningful Use stage 2 should the agency wish to apply for incentives.
Project cost is equal to or in excess of $100,000.00 / Yes / The actual cost of the project is not yet known. The current estimate is approximately $250,000.
Project impacts customer on-line access / No / The project will not impact the customers’ on-line access.
Project is one deemed appropriate by the Secretary of the DoIT / No
Will an IT Architecture Review be required? / No / This is an upgrade to an existing system. The architecture will not be changing. A memo will be submitted the TARC committee chair to request and exception.

2.0 Justification, Objectives and impacts

The justification and objectives section relates the project to the purpose of the lead agency and describes the high level business and technical objectives for the project. The section also includes a high level review of the impact to the organization, and of the concerns for transition to operations.

2.1 Agency Justification


Number / Description
Department of Health Fiscal Year 14 Strategic Plan / Goal 1: Improve Health Outcomes for the people of New Mexico
Goal 2: Improve Health Care Quality
Goal 5: Ensure that Technology Supports Timely, Data-Drive Decisions; Public Information; and, Improves Business Operations

2.2 Business Objectives

Use the following table to list measurable business objectives

Number / Description
Business Objective 1 / Upgrade BEHR to meet federal requiredICD-10 code sets for HIPAA covered entities.
Business Objective 2 / Upgrade BEHR to meet Meaningful Use Stage 2 reporting requirements.
Business Objective 3 / Increase revenue recovery with the use of more specific ICD-10 billing codes.
Business Objective 4 / Train all staff on the use of both the new version of BEHR and ICD-10 coding.

2.3 Technical Objectives

Number / Description
Technical Objective 1 / Complete Requirements and Configuration documentation.
Technical Objective 2 / Implement upgraded PM and EHR application in test environment
Technical Objective 3 / Develop test plan and scripts. Execute test scripts in test environment. Track and fix defects.
Technical Objective 4 / Upgrade BEHR PM and EHR application in production.
Technical Objective 5 / Improve integration and data exchange between the medical record (EHR) and the patient demographics (PM).

2.4 Impact on Organization

The impacts on the organization are areas that need to be addressed by the project through its planning process. They may not be internal project risks, but they can impact the success of the project’s implementation.

Area / Description
End user / All end users will be required to attend additional training on new functionality and ICD-10 coding.
Business Processes / After the upgrade, PHD will be able to bill insurance companies using the required ICD-10 code set.
It Operations and staffing / Minimal impact. The Information Technology Services Division (ITSD) helpdesk will continue to be the first line of support.

2.5 Transition to Operations

The transition to operations areas include items that are asked in the certification form to assure that the project has accounted or will account for these matters in its planning and requirements specifications.

Area / Description
Preliminary Operations location and staffing plans / The upgrade project will have no impact on the existing operation location and staffing plans already in place for BEHR.
Data Security, Business Continuity / The upgrade project will have no impact on the existing data security and business continuity plans already in place for BEHR.
Maintenance Strategy / The upgrade project will have no impact on the existing maintenance plan already in place for BEHR.
Interoperability / The upgrade project will have no impact on the interoperability of the BEHR application.
Record retention / The upgrade project will have no impact on the existing record retention plan already in place for BEHR.
Consolidation strategy / The upgrade project will have no impact on the existing consolidation strategies already in place for BEHR.

3.0 Project/ProductScope of Work

In its efforts to move from the high level business objectives to the desired end product/service the project team will need to deliver specific documents or work products. The State of New Mexico Project Management Methodology distinguishes between the project and the product.

Project Deliverables relate to how we conduct the business of the project. Product Deliverables relate to how we define what the end result or product will be, and trace our stakeholder requirements through to product acceptance, and trace our end product features and attributes back to our initial requirements

3.1 Deliverables

3.1.1 Project Deliverables

This initial list of project deliverables are those called for by the IT Certification Process and Project Oversight memorandum, but does not exhaust the project deliverable documents

Project Charter / The Project Charter for Certification sets the overall scope for the project, the governance structure, and when signed is considered permission to proceed with the project. The Project Charter for Certification is used to provide the Project Certification Committee with adequate knowledge of the project and its planning to certify the initiation phase of the project
Certification Form / The Request for Certification and Release of Funds form is submitted when a project goes for any of the certification phases. It deals with the financial aspects of the project, as well as other topics that indicate the level of planning that has gone into the project. Many of the questions have been incorporated into the preparation of the project charter
Project Management Plan / “Project management plan” is a formal document approved by the executive sponsor and the Department and developed in the plan phase used to manage project execution, control, and project close. The primary uses of the project plan are to document planning assumptions and decisions, facilitate communication among stakeholders, and documents approved scope, cost and schedule baselines. A project plan includes at least other plans for issue escalation, change control, communications, deliverable review and acceptance, staff acquisition, and risk management. Plan.”
IV&V Contract & Reports / “Independent verification and validation (IV&V)” means the process of evaluating a project to determine compliance with specified requirements and the process of determining whether the products of a given development phase fulfill the requirements established during the previous stage, both of which are performed by an organization independent of the lead agency. Independent verification and validation assessment reporting. The Department requires all projects subject to oversight to engage an independent verification and validation contractor unless waived by the Department.
IT Service Contracts / The Department of Information Technology and the State Purchasing Division of General Services have established a template for all IT related contracts.
Risk Assessment and management / The DoIT Initial PROJECT RISK ASSESSMENT template which is meant to fulfill the following requirement:
“Prepare a written risk assessment report at the inception of a project and at end of each product development lifecycle phase or more frequently for large high-risk projects. Each risk assessment shall be included as a project activity in project schedule.” Project Oversight Process memorandum
Project Schedule / A tool used to indicate the planned dates, dependencies, and assigned resources for performing activities and for meeting milestones. The defacto standard is Microsoft Project
Monthly Project Status Reports to DoIT / Project status reports. For all projects that require Department oversight, the lead agency project manager shall submit an agency approved project status report on a monthly basis to the Department.
Project Closeout Report / This is the Template used to request that the project be officially closed. Note that project closure is the last phase of the certification process

3.1.2 Product Deliverables

The product deliverable documents listed here are only used for illustration purposes

Requirements Documents / The requirements documents will be completed during the implementation phase. This will include the configuration changes that will be included in this project.
Design Documents / The design documents will be completed during the implementation phase. This will include the configuration changes that will be included in this project.
Systems Specifications / The system being upgraded is a SaaS solution. System specifications may impact software needed on the desktop for connectivity with upgraded application. This will be determined during the planning phase.
Systems Architecture / This upgrade will not include any changes to the system architecture. This will be confirmed during the planning phase. If any changes are required, this will be documented.
System and Acceptance Testing / The implementation vendor and PHD staff will be involved in the testing of the upgraded applications functionality. Test plans will be created and followed during testing. This includes verifying data integrity.
Operations requirements / The transition to operations and application support plan will be updated.

3.2Success and QUALITY METRICS

Metric are key to understanding the ability of the project to meet the end goals of the Executive Sponsor and the Business Owner, as well as the ability of the project team to stay within schedule and budget.

Number / Description
Quality Metrics 1 / Data is converted properly from existing BEHR system.
Quality Metrics 2 / Billing and immunization interfaces are working properly and electronic claim submission is not interrupted.
Quality Metrics 3 / Implementation vendor and end user testing is successful by developing a test plan and test scripts.
Quality Metrics 4 / Independent verification and validation review will be conducted on all project deliverables.

4.0 Schedule Estimate

The schedule estimate is requested to provide the reviewers with a sense of the magnitude of the project and an order of magnitude of the time required to complete the project. In developing the schedule estimate, certification timelines and state purchasing contracts and procurement lead times are as critical as vendor lead times for staffing and equipment delivery. Project metrics include comparisons of actual vs. target date. At the Project Charter initial phase, these times can only be estimated.

initiation / September 2013 /
  • Prepare and present project certification documentation – initiation phase
  • Initiate project structure

planning / September 2013 /
  • Prepare and present project certification documentation – planning phase
  • Prepare schedule for upgrade process
  • Finalize project structure
  • Implementation vendor contract amendment negotiated
  • Negotiate and execute IV&V contract

implementation / October 2013 /
  • Prepare and present project certification documentation – implementation phase
  • Manage implementation vendor contracting preparation
  • Execute implementation vendor contract amendment
  • Implementation of upgrade
  • Vendor contract administration

closeout / June 2014 /
  • Prepare and present project certification documentation – closeout phase
  • Lessons learned
  • Closeout activities

5.0 Budget Estimate

Within the Project Charter budgets for the project can only be estimated. Original budgets requested in appropriations or within agency budgets are probably not the numbers being worked with at project time. Funding sources are asked for to help evaluate the realism of project objectives against funding, and the allocation of budget estimates against project deliverables.