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Transcript of Care Technology Governance (CTG) Committee Business Case Document (BCD) for: 3M Computer Assisted...
Care Technology Governance (CTG) Committee
Business Case Document (BCD) for:
3M Computer Assisted Coding (CAC)
Aug 7, 2014
2
The CTG presenter(s): SheRee Garcia, Kevin McLaren & Heidi Collins
The ask: At the end of this presentation, we will request this committee to approve project timeline (since the IT/CS shared resources will be paid from capital), contingent on identifying specific budget cuts to completely offset the additional operating expenses prior to signing the contract.
3M CAC
• Department(s): HIMs, Professional Billing and CDI
• Sponsor(s):
– Executive: Barrie Strickland and Roger Cameron
– Department: SheRee Garcia, Cliff Skinner and Brigid Ide
• IT/CS Leaders(s): Heidi Collins
The project: 3M Computer Assisted Coding (CAC)
3
Why 3M CAC?
3M CAC
• 3M Computer Assisted Coding (CAC) is a software application that analyzes health record documents and produces appropriate medical codes for specific phrases and terms within the document using NLP (Natural language processing) technology.
• 3M CAC will take our healthcare operation into an automated future allowing users to communicate with specificity and accuracy in a timely fashion.
4
3M CAC Drivers / Benefits
3M CAC
3M Auto Suggested Codes & Queries
3M Auto Suggested Codes & Queries
3M CDI and
Coding Content
3M CDI and
Coding Content
3M Natural Language Processing
(NLP) Engine
3M Natural Language Processing
(NLP) Engine
3M Data Dictionary
(as used by the DOD and
VA)
3M Data Dictionary
(as used by the DOD and
VA)
3M Optical Character
Recognition
3M Optical Character
Recognition 3M data integration
to APeX
3M data integration
to APeX
Optimize chart completeness Optimize chart completeness
Improve quality and accuracyImprove quality and accuracy
Compliance and Reporting analyticsCompliance and Reporting analytics
Hospital/HIMs
Gain efficiencies by reducing the amount of time locating, reviewing, analyzing multiple documents to find what is new in the chart.
Speed turn around; get correct DRG in place the first time.
Increase accuracy rates on basic and complex cases; enhance monitoring of the coding process.
Hospital/HIMs
Gain efficiencies by reducing the amount of time locating, reviewing, analyzing multiple documents to find what is new in the chart.
Speed turn around; get correct DRG in place the first time.
Increase accuracy rates on basic and complex cases; enhance monitoring of the coding process.
Professional Billing
Reduce expenses (*) by moving to a "coding by exception" model and by: - Replacing outsourced vendor costs - Allowing us to lower our per chart fee to vendors
* Savings has dependency on Physician adoption of coding.
Professional Billing
Reduce expenses (*) by moving to a "coding by exception" model and by: - Replacing outsourced vendor costs - Allowing us to lower our per chart fee to vendors
* Savings has dependency on Physician adoption of coding.
CDI
Improve clinical documentation (consistency, completeness, accuracy) and quality reporting, as health care moves toward quality-driven reimbursement.
CDI
Improve clinical documentation (consistency, completeness, accuracy) and quality reporting, as health care moves toward quality-driven reimbursement.
Benefiting
Patients
Improving our
bottom line
Across UCSFHS
Department Specific
APeX data integration
to 3M
APeX data integration
to 3M
Via
5
Operational impact:
3M CAC
Affected locations: •Hospital/HIMs: All IP, all AMB same day Surgeries, some interventional radiology, special procedures for urology. Driven by patient type/class of which we have 5.
•Professional Billing: Initial build to encompass mostly E&M service and a few surgical procedures:
– Adult and pediatric cardiology IP/OP visits
– Orthopedic surgical cases
– Neurosurgery surgical cases
– Hospital Medicine IP services
– Endoscopy unit
•CDI: Patient Safety and Quality Department
Personnel:
•End Users: HIMs (20-25 internal / external), PB (55 internal / 125 external), CDI Pilot (3) and if CDI (+12)
•Physicians: By PB Specialty
Training: •Hospital/HIMs and CDI: 3M uses a train the trainer model for coders and Patient Quality team
•Professional Billing: Physicians, by specialty, will be provided additional training by a PFS team on IMO - Intelligent Medical Objects (Epic’s).
•APeX Training team is not required; 3M will train the trainers from HIMs, CDI and PB.
6
Project scope:
3M CAC
• Hospital/HIMs: 3M 360 Encompass Release 2
• Professional Billing: 3M Code Ryte / Code Assist
• QI-CDI: 3M Continuous Document Improvement System• CDI product is included in 3M Package but UCSF QI-CDI use is TBD
IT footprint: Servers (virtual): 5-6 test, 5-6 ProdDatabases: 10 test, 10 ProdMemory: more than EpicNetwork configurations: MinorInterfaces: 6 – 14, dependingWorkstations: 120 net new (maybe)
CDI PilotPhase 3 (TBD)
Professional BillingPhase 1 & 2
Hospital/HIMsPhase 1 & 2
PM: Fei Zho (60-75%)PM: Fei Zho (60-75%)
IT/CS Teams: CS Leader (Heidi Collins) IT Server Team IT DBAs IT Network team IT Interface team CS Access/HIMs team + net new 3M Sys Admin CS Revenue Cycle teams
IT/CS Teams: CS Leader (Heidi Collins) IT Server Team IT DBAs IT Network team IT Interface team CS Access/HIMs team + net new 3M Sys Admin CS Revenue Cycle teams
Project team roles required for success
UCSF 3M CAC Implementation
3M CAC Steering Committee: HIMs, PB, CDI & CSExecutive Sponsors:
Barrie Strickland & Roger Cameron
3M CAC Steering Committee: HIMs, PB, CDI & CSExecutive Sponsors:
Barrie Strickland & Roger Cameron
* Department Sponsors (20 - 25%): SheRee Garcia & Cliff Skinner
* Department Sponsors (20 - 25%): SheRee Garcia & Cliff Skinner
SME: Julie Marshall (20-25%)Analyst: Hop Johnson (20-25%)SME: Julie Marshall (20-25%)
Analyst: Hop Johnson (20-25%)
Testing Lead: FeiTesters: Hope, Judie, Fei
Testing Lead: FeiTesters: Hope, Judie, Fei
Super User/Trainer: TBD End Users (testing/validation): TBD
Super User/Trainer: TBD End Users (testing/validation): TBD
Department Sponsor: Brigid Ide
CDI will participate in policy decisions, the design of the interfaces and high level testing, to ensure technical build occurs once.
CDI Pilot (3 users) is to be scheduled (TBD 2016) .
Full implementation of CDI will depend on pilot and development of current JATA tool.
Department Sponsor: Brigid Ide
CDI will participate in policy decisions, the design of the interfaces and high level testing, to ensure technical build occurs once.
CDI Pilot (3 users) is to be scheduled (TBD 2016) .
Full implementation of CDI will depend on pilot and development of current JATA tool.
PM: Kevin McLaren (50%)PM: Kevin McLaren (50%)
SME(s): TBD (20-25%)SME(s): TBD (20-25%)
Testing Lead: KevinTesters: Rev. Mng. QA Team
Testing Lead: KevinTesters: Rev. Mng. QA Team
Super User/Trainer: TBD End Users (testing/validation): TBD
Super User/Trainer: TBD End Users (testing/validation): TBD
IT/CS PM: TBD (75%)IT/CS PM: TBD (75%)
3M PM3M PM
*Department Sponsors
are key to workflow redesign, policy and procedure and system build discussions.
3M Team: Engagement Manager PM Implementation Analysts Integration Analysts CDI Consultants Trainers (to train the trainers)
3M Team: Engagement Manager PM Implementation Analysts Integration Analysts CDI Consultants Trainers (to train the trainers)
9
Project details:
• Assumptions:– Business absorbs their
labor costs, within operating budgets: Leaders, PMs, SMEs, Trainers & Testing Lead
– PMs
• Begin one month prior to project kick off.
• Business PMs: Fei 60-75% / Kevin 50%
• IT/CS PM 75%
TimelineFrom:
Nov 2014(IT/CS From:
Apr 2015)
To: Mar 2016
(IT/CS To: Sept 2016)
Project Size
Large ~ 3,865 IT/CS Hours
ImplementationCost
~ $1,011,498
3M 360 & Code Assist
Epic
IT/CS H/S
IT/CS Labor
Approved
Budget *
$ 800,000
$ 490,000
$ FY15 Capital (MedCtr)
$ FY15 Operating (MGBS)
Annual Costs (Operating)
~ $1,043,675
(Net change to budget = $0, due to offsetting cuts.)
3M 360 & Code Assist Fees
Addition to existing 3M Fees
Epic Fees
IT/CS Required Maintenance
Net new FTE = 0.9
ROI Identified
Efficiency Gains
Expense Reductions
Quality Improvements
KPI Identified
Marker 1: 6 months
Marker 2: 12 months
Marker 3: 24 months
3M CAC
• Caveats:– Cost estimates only; true
costs not to be known until contract signed and analysis performed
– Potential expansion of 3M to CHRCO not included
* Further discussion needed on Operating verses Capital
10
ROI/KPIs: Hospital/HIMs Target ROI Baseline Change Markers Measure by:
Coder Productivity Gain
22-25 Coders (Internal / External)
Increase10% over 2 years
IP Cases 30,404/year
OP cases 40,154/year
Increase coding capacity without adding staff
IP Cases + 3,000/year
OP Cases + 4,000/year
6 months
12 months
24 months
3M analytics
Coding Accuracy& Compliance
Increase overall accuracy scores by 5%
85 – 95 %
Goal: 95%
Improve accuracy; less rebilling
6 months
12 months
24 months
3M analytics
Coding Accuracy
Better capture of secondary diagnosis
88%
Improve to 95%; additional diagnoses will likely increase severity of illness, risk of mortality, & CMI.
6 months
12 months
24 months
3M analytics
Identification of HACs & PSIs
Reduce amount of resource time to correctly identify HACs & PSIs
5 FTEsRepurpose 2 FTE over 2 years.
6 months
12 months
24 months
3M analytics
3M CAC
11
ROI/KPIs: Professional Billing
• First level bullet. Arial bold, 22pt
– Second level bullet. Arial, 20pt
• Third level bullet. Arial, 18pt
– Fourth level bullet. Arial, 16pt
> Fifth level bullet. Arial, 14pt
Target ROI Baseline Change Markers Measure by:
Coding Expense
* Down 20-60%
FY14 Expense = $3.2M
$640K
$1.2M
$1.9M
6 months
12 months
24 months
Invoiced
expenses
& 3M analytics
Coder Turnaround
Up
60%FY14 Avg. TAT = 12.23 days
10 Avg. TAT
4.9 Avg. TAT
4.0 Avg. TAT
6 months
12 months
24 months
APeX coder productivity
Report
& 3M analytics
Improve coding accuracy rates
Up
15%
FY14 median accuracy at 75%
80%
85%
90%
6 months
12 months
24 months
Measured by quality assurance reviews
& 3M analytics
Provide enhanced ICD-10 CM translation tool
n/a n/a n/a n/a ICD-10
3M CAC
* Has dependency on Physician adoption of coding via IMO - Intelligent Medical Objects (Epic’s)
Recap:
12
We are requesting this committee to approve this project timeline (since the IT/CS shared resources will be paidfrom capital), contingent on identifying specific budget cuts to completely offset the additional operating expenses prior to signing the contract.
3M CAC
Appendix:
14
• CAC Flow, 3M’s CAC Annotation view, …,• Lessons learned: Multicare, River Valley Health, Henry
Ford Health Systems• Key Implementation stages• Diagrams:
• UCSF Interface Diagram• 3M Infrastructure / Interface Diagram
• Costs:• IT/CS High Level Cost Breakdown• IT/CS Detail Cost Breakdown
• Detail list of document types from HIMs, CDI, PB – draft
Housekeeping:• BCD Facilitator's Check List
3M CAC
3M’s CAC Annotation Only
16
• Once Auto Suggested is turned on, the ICD9 code will be sitting beside the term / phrase and ultimately ICD10 codes will too.
3M CAC
Lessons learned• Multicare (5 Hospitals, 1016 Beds, on Epic 2012, Cloverleaf engine, …,)
– Live on 3M: Hospital and CDI only; Multicare did NOT implement 3M Code Assist for PB
– Would do it again even though coders are still working from two applications:
• Epic: Vitals, Medications (pre-Mar for CDI), Mechanical bed times
• 3M: Notes, Results, Medications (Mar for HIMs)
– Cutover:
• In Patient admits stayed on old system (JA Thomas)
• New IP admits were coded via 3M
– Quarterly updates requiring ongoing maintenance to install and test and up to 2 service packs/year, …
– Not seeing impact of Epic SUBs on 3M work
– Didn’t use train the trainer but hear from other Epic sights its very good
– Document interface is special and requires additional hours
• It's different from the typical doc/transcription interface. This one is an RTF (?). And requires an RTF server. Each message opens the TCP-IP socket. So the server helps balance that across 8 threads.
– Resources: • Recommend adding a Lead Tester of workflows to relieve managers
• 1 PM: 100% until Go-Live then reduced to 75%
• Interface Engineers: 2 at 50%
• Application Analyst: 1 at 50%
• IS LAN: 1 FTE
18
3M CAC
Lessons learned• Baptist Health / River Valley Health
– CAC project with 3M took little over a year from discovery to Auto Suggested implementation
– Keep end user in mind at all times!
• CAC is for coders so it is important to involve them during the document configuration process and application set up and always advise business decision makers of any risks of decisions made, but final decisions rest with the content owners.
– Comprehensive code assignment doesn’t kick in until the NLP engine learns your documents
– Documentation collection is a complex process – quality and format issues
– Strong project team is key to success
– Expect the unexpected
– Be assertive with your vendor and hold them to your Scope of Work which you tailor for your own site.
– If scanned document is all typed (text), it can be sent to the OCR (optical character recognition) and converted to text so it, too, can be sent to the NLP for auto suggested coding.
– Technological issues (route based on account number except there is a document that is global – what then?
– Potential increase in coding errors (they are just suggestions! The process still requires the brain of the coder to apply more complex rules/guidelines).
19
3M CAC
Lessons learned
20
3M CAC
• Henry Ford Health System (4 acute hospitals, on Epic, ..)
– Live on 3M: Hospital and CDI only; Did not implement 3M Code Assist for PB
– Engage Project Management dedicated resources
• IT and Revenue Cycle
– Understand the change management process – there is always resistance, therefore, involve your staff early in the process.
– Understand this is a process that involves technology, people and time from both your facility, 3M and Epic (AM, AC & TS)
– Account for development of Epic WQs
• Assign accurate WQs: Workflow specific, Business unit specific
• Define WQ ownership and assign users – Important
– Figure out if need split provider types for Auto-Suggested Coding (Epic and 3M) and avoid an additional cycle of interface design, development and testing
• The solution uses the provider type from Epic to map the associated documents to the correct folder in 3M. The mapping occurs inside the interface engine.
– Verify Hardware: Epic needed dedicated resources to create documents from interfaces and EPS (Printing, server hardware)
– Considerations
• Assignment of appropriate security level for staff and leadership in 3M
• Validate log-ins prior to go-live
– Training
• 3M Encoder Training, 3M Code Assist Training, CAC annotation training, Report training, Superuser training, CV Config training, System Admin Training, Auto Suggest training
– Secure 3M and Epic HIM onsite resource for each implementation
– Benefits: Reduce pre-AR Days (DNB), decrease contracted coding usage, reduce denials, Improve accuracy of patient severity, increase coder effiecency
21
Key Implementation stages3M CAC
Pre ABASC / CTG Approval/Prioritization
Review and analyze current coding documents Vet coding document list with CDI. Prep Business Case Document
Project Initiation Confirm Operational Rollout schedule: PB (E&M and few specialties), HIMs, CDI
Sign ContractBusiness Requirements Confirm hardware and supporting software requirements
Review operational and departmental procedures and workflows. Review coding guidelines, coding practices and preferences. Review and analyze current coding documents Vet coding document list with CDI. Finalize plans for functions and interfaces
Installation / System Build Confirm required coding documents (dependency for interface build)
Stand up technical infrastructure: Deploy servers, complete hardware, network, database configuration and build interfaces
Install applications Interfaces/ System Testing / User Acceptance
Unit test system components Test performance, data completeness, automation and reporting. Test interfaces User acceptance testing of functionality and reports
Training Go Live Prep
Management and System Administrator Training Confirm user access and workstation readiness Provide Training materials On-site training:
o Coders on use of the coding application. o Management staff on reporting, auditing, user management
and reconciliation capabilities. Go-Live Transition production operations to the new system
Go-live support; Address and resolve issues as necessary
24
IT/CS Costs details: Timeline
From: Nov 2014
(IT/CS From: Apr 2015)
To: Mar 2016
(IT/CS To: Sept 2016)
IT/CS Size Large ~ 3,865 IT/CS Hours
Vendor Implementation Costs
$ 305,223 3M Vendor ($518,223)
Epic Vendor ($19,500)
IT/CS Hardware / Software Costs
$ 232,500 New Workstations ($172,500 – maybe less)
Virtual Servers ($60,000)
IT/CS Implementation Labor Costs
$ 473,775
IT:
Server team (160 hrs)
DBAs (80 hrs)
Network team (80 hrs)
Field Services (480 hrs - maybe less)
Interfaces (1,600 hrs)
CS/APeX:
Access/HIMs (200 hrs)
Rev Cycle (100 hrs)
PMO (1,165 hrs)
Annual Operating Costs
~ $1,043,675
(Net change to budget = $0, due to offsetting cuts.)
3M 360 & Code Ryte Fees ($841,027)
Epic Fees ($2,500)
IT/CS Required Maintenance
Interfaces (.4 FTE = ~ $74,600)
Access/HIMs (.5 FTE = ~ $125,798)
3M CAC
26
HIMs list of Docs Used by Coders - draft
3M CAC
APeX Enc Type APeX Note Type Chart Tab
Office Visit Addendum Note Outpatient RecordAnesthesia Event Anesthesia Procedure Note Operations/ProceduresAnesthesia Event Anesthesia Transfer of Care Operations/ProceduresAnesthesia Event Anesthesia Post-Op Note Operations/ProceduresAnesthesia Event Anesthesia Pre-op Evaluation Operations/ProceduresED to Hosp-Admission (Current) Brief Op Note Progress NotesED to Hosp-Admission (Current) Consents Operations/ProceduresED to Hosp-Admission (Discharged) Discharge Summaries Discharge Plan/SummaryAdmission (Discharged) Discharge Summaries Discharge Plan/SummaryED ED Attestation Note Progress NotesED to Hosp-Admission (Discharged) ED Attestation Note Progress NotesED to Hosp-Admission (Current) ED Provider Notes Progress NotesED to Hosp-Admission (Current) Face to Face Progress NotesED to Hosp-Admission (Current) H&P Progress NotesPre-admit (Canceled) H&P Progress NotesED to Hosp-Admission (Discharged) H&P Progress NotesED to Hosp-Admission (Current) H&P (View-Only) Progress NotesED to Hosp-Admission (Current) Interdisciplinary Monitoring And ObservationED to Hosp-Admission (Current) Interval H&P Note Progress NotesED to Hosp-Admission (Current) Operative Report Operations/ProceduresED to Hosp-Admission (Current) Plan of Care Progress NotesAdmission (Discharged) Plan of Care Progress NotesED to Hosp-Admission (Discharged) Plan of Care Progress NotesED to Hosp-Admission (Current) Procedures Operations/ProceduresED to Hosp-Admission (Current) Progress Notes Progress NoteseConsult Response Progress Notes Progress NotesOffice Visit Progress Notes Outpatient Record/Progress NoteED to Hosp-Admission (Current) Progress Notes Progress NotesAdmission (Discharged) Provider Consult Progress NotesED to Hosp-Admission (Discharged) Provider Consult Progress NotesED to Hosp-Admission (Discharged) Significant Event Progress NotesED to Hosp-Admission (Current) Student Note Progress NotesTelephone Telephone Encounter Progress NotesAdmission (Discharged) Progress Notes Progress NotesAdmission (Discharged) Consents Progress NotesAdmission (Discharged) Interdisciplinary Monitoring And ObservationED to Hosp-Admission (Current) Interdisciplinary Monitoring And ObservationAdmission (Discharged) Procedures Operations/ProceduresAdmission (Discharged) H&P Progress NotesAdmission (Current) Interdisciplinary Monitoring And ObservationAnesthesia Event Anesthesia Post-Op Note Operations/ProceduresAdmission (Discharged) Brief Op Note Progress NotesAdmission (Discharged) Operative Report Operations/ProceduresAnesthesia Event Anesthesia Pre-op Evaluation Operations/ProceduresAdmission (Discharged) Interval H&P Note Progress NotesOffice Visit Patient Instructions Outpatient Record/Progress NoteOffice Visit H&P Outpatient Record/Progress NoteED ED Attestation Note Progress NotesOP Visit ED Notes Outpatient Record/Progress NoteED ED Provider Notes Progress Notes
* Meds, Labs, Micro, Pathlogy, Imaing, Procedures, Cadiology, Other Orders, Scanned Documents, Outside Record
HIMs docs
27
CDI list of Docs Used - draft
3M CAC
• Both HIMs and PB lists appear close to what CDI needs.
• CDI is dependent on MD documentation, however they also use the information. Listed are the other areas CDI uses in addition to HIMS lists:
• Patient summary (Nursing info, MAR, I/O record)• Results tab (Radiology reports: includes many
specialized studies such as IR procedures, EGD, CT scans, MRI, lab findings)
• Cardiology reports, EPS studies, Cardiac Cath lab• Prepare Notes (preop Anesthesia)
Note: APeX records change a bit from in-patient to the discharged patient and CDI needs the interface of the in-patient records. HIMS is looking at discharged records.
28
PB list of Docs Used by Coders - draft
3M CAC
1Progress Notes 65Discharge Instr - Appointments2Consults 66Discharge Instr - Lab3Procedures 67Discharge Instr - Other Orders4H&P 68Discharge Instr - Other Info5Discharge Summaries 10000Code Documentation6ED Notes 10001Sedation Documentation7Initial Assessments 61251Inpatient Self-Administration Sheet
10OR Nursing 61252Outpatient Self-Administration Sheet11OR Surgeon 61253Inpatient Medication Chart12OR PreOp 61254Outpatient Medication Chart13OR PostOp 100000Psych14OR Anesthesia 100001Miscellaneous19ED Provider Notes 100002Code Status and Advance Directives23Note to Patient via Portal 100003Anesthesia Follow-Up24Anesthesia Pre-op Evaluation 1000000Brief Op Note25Anesthesia Post-op Evaluation 1000001Plan of Care26H&P (View-Only) 1000002Patient Care Conference27Interval H&P Note 1000003Treatment Plan28Anesthesia Procedure Notes 1000004Operative Report29Addendum Note 1000005Downtime Event Note33Subjective & Objective 1000006Pre-Procedure Instructions35L&D Delivery Note 1000007Significant Event36Telephone Encounter 1000008Anesthesia Transfer of Care37Patient Instructions 1000009Student Note38Assessment & Plan Note 1000010RN Note39Communication Body 1000011Interdisciplinary40ED AVS Snapshot 1000013Interfacility41Letter 10000010Provider Consult42Lactation Note 304000001Falls43Committee Review 304000002Athena Breast Cancer Risk Assessment44IP AVS Snapshot 304000003Athena Breast Health Consultation45MR AVS Snapshot 1020001001Anesthesia Post-Op Note61Discharge Instr - Meds 1120001002Non Apex Prior Anesthetics62Discharge Instr - Pharmacy 1600000001ED Attestation Note63Discharge Instr - Activity 3040000010Weekly Summary64Discharge Instr - Diet 3040000011Face to Face
PB list of docs
29
BCD Facilitator's Top 10 Check list -
3M CAC
1 Created BCD using standard template TEMPLATE - Project BCD as of 2014.07.22
2 Identified Executive Sponsors, Department Sponsors, Business Contacts/PMs TEMPLATE - Project BCD as of 2014.07.22, Project team slide
3 Confirmed project customer resource commitments by role and % of time TEMPLATE - Project BCD as of 2014.07.22, Project team slide
4 Identified IT/CS Leader, IT/CS skill sets and Vendor skill sets project is dependent on to be successful. TEMPLATE - Project BCD as of 2014.07.22, Project team slide
5 Obtained Hardware/Software cost and resource estimates from IT/CS managers and Vendor(s) TEMPLATE - Project cost sheet as of 2014.07.22
6 Confirmed timeframe with project customers and IT/CS project team managers TEMPLATE - Project timeline as of 2014.07.22
7 o Confirmed funding sources; supplied funding numbers on cost sheet. TEMPLATE - Project cost sheet as of 2014.07.22
8 Allowed for project start lead time, on timeline, if need negotiate Vendor contract / POs – post creation of BCD
9 Secured a CS PM to begin working with Business Partner PMs 1 month prior to targeted project kick off. Purpose is high level project planning, charter, …, etc. prior to involving the IT/CS skill sets
10 Scheduled 3 check point meeting(s) with the CS Project Portfolio Manager (PPM), to review together as the BCD is being created, completed and finalized.