Electronic Health Reporter

Guest post by Judy Chan, consultant, HealthPro Consulting.

The little spacecraft that flew for 10 years crossing millions of miles in space, bounced on a comet hurtling 84,000 mph, transmits tons of data for 64 hours, finally tells its handlers that it needs to take a nap. Hitting any kind of target after 10 years in space is an amazing feat by itself, but this project had many hurdles and changes since its inception.

Healthcare is transforming at a rapid pace. In the past 10 years that the Rosetta orbiter traveled with the Philae lander strapped to its side, electronic health records have been implemented, meaningful use instituted, the diverse and multiple roads of interoperability have been examined, but progress has been slow.

The Rosetta project had to plan for executing tasks 10 years in advance. The team also had to anticipate the problems that it would find when Philae did something that had never been done before—landing on a comet. Nearly all projects on Earth have been done before but the nature of a project’s progression varies.

Here are three events that occurred on the Rosetta project that analogous Earth-bound healthcare projects also face.

Major change pre-launch. A problem was discovered that caused the launch to be delayed. This in turn caused the chosen comet to be abandoned because the orbit window was missed. Another comet whose gravity and other differences were not accounted for in the design of Philae was selected. Would the lander survive the descent? The craft would need to be put in a 3-year hibernation to conserve energy on the new flight plan.

Response: Adjust to the change. A large health insurance company discovered a security flaw in a new application to enroll customers during dry run tests. The problem would have caused multiple HIPAA violations and the company would be subject to expensive fines. The project had to be delayed until a fix was in place in spite of publicity of the go live date.

Major changes prior to the launch of a project are best addressed immediately. There is much better control in the early stages of a project. Changes may affect scheduled milestones, but it is better to adjust dates early in the project and explain changes to executive supporters.

Interim hurdles. When the team saw pictures of the comet’s surface, they had difficulty finding the best place to land. The project team had to choose the best of multiple poor landing choices. A flat desert surface was selected, but when the harpoons designed to anchor Philae to the comet failed, the lander bounced and landed in an unknown area.

Response: Minimize the risk. Meaningful use Stage 2 objectives were harder to meet than expected. The Centers for Medicare and Medicaid (CMS) extended the deadline so that providers and hospitals had extra time to qualify for incentive monies.

Evaluate the options and determine the pros and cons of each using a quantitative method.

Ensuring success. There was no way to know whether Rosetta and Philae would land on the comet and complete its mission. It was a big unknown since a comet landing had never been done before. The revised flight path to the new comet was further from the sun so there wasn’t enough energy from the solar panel wings to maintain power. The orbiter had to hibernate for three years and then it had to wake up. If it made it that far, landing was a big risk. The Philae’s 10 cameras were turned on as soon as it separated from Rosetta. It would capture images of the comet’s nucleus while its sensors would report on the comet’s surface

Response: Maximize the opportunity for success. The disastrous implementation of Healthcare.gov insurance web site could have demonstrated smaller early success by going live with a few states initially, fixing issues, then rolling out the remainder of the states.

Look at and put into action everything that can be captured to move the needle to success. Small successes are better than no success. There is a lot of information to be learned by engaging in the process. It doesn’t need to be perfect to be successful.

Changes are the norm and constant in all projects. The key is to be flexible and adapt to the challenges by minimizing risk and maximizing success.