The report is developed for the purpose of conducting a critical review of the given project ‘CHIE (Care and Health Information Exchange)’ project that is carried out by the National Health Service (NHS). The project is intended towards developing a secure system for sharing health and social care information received from the hospitals, social and community services centers. It was initially launched as Hampshire Health Record (HHR) that aims to develop a record of electronic health summary forpeople living across Hampshire, Portsmouth and Southampton. This would enable clinicians for accessing the relevant data of the patients and thus assisting in informed decision-making and therefore contributing inachieving improved healthcare outcomes (NHS CHIE, 2024).
Projects can be regarded as a task or assignment carried out for achieving a specified objective. It can be regarded as a temporary endeavortaken by organizations for fostering a change to meet the market opportunities or threats and thereby attaining a competitive advantage. In context with this, the project of CHIE aligns with the wider strategic aim of NHS to deliver improved quality of healthcare to the patients across the UK. As such, the project intends to deliver these strategic outcomes through integration of digital solutions and thereby addressing the gap of information sharing (NHS CHIE, 2024). The projects for delivering optimal outcomes should be tailored as per the strategic goals and objectives of the organization. The CHIE project as such is aligned with NHS goal of providing patient-centered healthcare services and improving the health outcomes.
The initiation phase of the project can be regarded as the preliminary stage that comprises of outlining the purpose, scope and objectives to be achieved that are aligned with the needs of an organization. The scope of the CHIE project as such is to develop a digital health record system for providing complete and updated information to the clinicians at the point of care. It also consists of implementing the theoretical frameworks such as stakeholder analysis that enables in identification of the relevant stakeholders that will be impacted by the project. In case of CHIE project, it consists of clinicians, IT teams and NHS leaders, government and project managers (Scott, 2020).
This is followed by the planning phase that intends to implement the relevant project managementtheories and frameworks for transforming the stated goals and objectives into achievable outcomes. This involves the use of methodologies such as Work Breakdown structure (WBS) for the purpose of segregating the project activities and allocating the resources accordingly. The communication plan and risk registers frameworks could be employed for developing the communication strategies and identifying and assessing the risks associated with the project.
Also, the relevant project management methodologies such as scrum, agile, Prince2 and others could be deployed for the purpose of managing the CHIE project. However, in relevance to this project agile approach seems to be suitable as it enables in driving continuous improvements and staying updated by taking into consideration the relevant market trends and opportunities.
Stakeholder management can be regarded as crucial aspect of the project management that involves identification, analysis and managing the diverse needs of stakeholders that have major stake within the project. This can be regarded as a formal and systematic process that involves conducting open communication with the stakeholders for managing their diverse needs and expectations. It involves developing relevant strategies for balancing the needs and expectations of the diversestakeholders (Eskerod et al.,2015). There are different tools and techniques such as stakeholder analysis matrix that can be used for classifying the internal as well as external stakeholders of a project on the basis of their power, interest and influence. The development of an effective stakeholder management plan is essential for ensuring alignment with diverse stakeholder groups and thereby improving the projectperformance.
In context with the CHIE project, the process of stakeholder management involves identification of relevant internal as well as external stakeholders and classifying them on the basis of power and interest with the use of Mendelow’s matrix also known as stakeholder mapping matrix. The internal stakeholders for the CHIE project are project managers, IT teams and NHS funding the project. The external stakeholders are healthcare professionals, patients, regulators, funding agencies and suppliers. Their relative power and interest within the project can be analysedon the basis of matrix as follows:
High power high interest NHS Project manager Regulators or funding agencies
|
High power low interest IT Specialists Suppliers |
Low Power High Interest Healthcare Professionals and organisations Patients
|
Low Power Low Interest Community groups |
The relevant stakeholders within the dimension of high power and high interests are NHS, project managers and regulators. This is because NHS is a public funded healthcare agency undertaking the project and as such defining its scope, providingresources for the purpose of achieving its strategic aim of improving the healthcare outcomes of the UK population. Also, project leaders or managers are appointed by NHS for managing the different aspects of the project while regulatorsprovide the relevant data protection laws or regulations to be complied for successful execution of the NHS project (NSW Government, 2024). The investors provide funds and as such their financial gain is linked with the success of the project. The IT Specialists involves development of digital health record system who have major power of decision-making and their success is aligned with the successful execution of the project but have low interest in the internal decision-making as it is a government funded project. The suppliers providing relevant IT equipment’s and tools have a major power while does not have relevantinterest in the success of the project as having the availability of different client base.
The low power and high interests’stakeholders are mainly healthcare professionalsand organizations who are highly interested in development of electronichealthrecord system to support informed decision-making practices and providing improved quality of healthcare services to the patients. The patients can get access to higher quality healthcare services by accessing their past healthcare records instantly. However, they do not have any power in the decision-making.
The successful stakeholder management cam be regarded as critical for managing the CHIE project by involving diverse range of stakeholder groups. There is effective involvement of the primary stakeholders such as clinicians or healthcare professionals and participatory organizationswithin the project. They provided key information such as accurate and up-to-date records of the patients to develop an inclusive healthcare plan. The semi-structured interviews were carried out from the healthcare professionals to explore their experiences regarding the effectiveness of using CHIE electronic information systems. Also, the patient consent process is adopted for the purpose of informingpatients about the CHIE platform and accessing their health information. Also, it complies with General Data Protection Regulations to promote transparency with the regulators (NHS, 2025).
Thus, it can be said in the context of the CHIE project that open communication with different stakeholdershave enabled to develop trust with the relevantstakeholders and thus handled well. On the other hand, there is need for promoting more engagement with stakeholders such as patients or healthcare professionals by conducting periodic surveys to understand their issues or concerns and addressing them in an effective manner.
In this context, it is recommended that there is need for NHS to conduct periodic surveys from patients and healthcare organizations or professionals for identifying the gap of improvement and subsequently addressing them. The active engagement of wide group of stakeholders such as regulators, suppliers and others can be ensured through disclosing the information about compliance with data protection regulations on the official website of NHS. This would enable in overcoming resistance from the stakeholders and improving collaboration (Scott, 2020).
Strong governance ensures the presence of authority as well as accountability over the different project activities and gaining the relevant benefit from the projects. It ensures that decision-making process stays accountable and are aligned in accordance with the objectives of the report. The major elements of good governance within the project includes defining the clear responsibilities, establishing guidelines for supporting decision-making, implementing relevantmechanisms for tracking progress of the project such as defining key performance indicators and implementing proper mechanism for identifying and managing the different risks associated with the project.
The governance system in the CHIE project consists of implementing relevantprotocols and procedures for sharing of data to protect the confidential information of the patients. For instance, there has been development of Data Sharing Agreements (DSA) that monitors the data flow across the healthcare organizations. In addition to this, there has been the development of Acceptable Use Agreements (AUA) that is applied to the users logging on to the web front ending into CHIE (CHIE, 2024). There is also implementation of multi-factor authentication for the users of the portal to secure the data and there is also relevant compliance with professional record standards and general data protection regulations to ensure that the right information flows across the systems for ensuring the welfare of the patients. CHIE system is accessed by variety of health care professionals from different organizations. The type of information accessed is dependent on the type of job role. For instance, a hospital consultant requires different type of information as compared to an administrative assistant and therefore will be accessing various type of information. In this context, CHIE holds complete records of everyone through conducting audit trial which is checked in regular basis for ensuring that any type of inadequate access is restricted and brought into the relevant attention of the concerned manager for conducting future investigation (Orion Health, 2023).
As such, it can be said that presence of adequate processes and tools enables in developing a system of internal control within the project. The governance frameworks enable in promoting accountability and ensuring alignment with the project goals and objectives that is promoting the well-being of the patients. However, there is still scope for enhancing the governance framework through aligning CHIE system with NHS databases and data protection regulations for ensuring proper monitoring and enhancing the visibility of the project (Scott et al., 2020).
In the future context, there is need for adopting real-time monitoring tools to review the performance of the project and assessing the scope of improvement. This can include implementation of real-time KPIs (Key Performance Indicators) such as patient satisfaction score, usage rate of portal by the patients, reduction in the errors rate of healthcare outcomes and such others (Choi et al., 2023).
Risk management can be defined as an effective framework that need to be adopted for identifying, managing and mitigating the associated risks that can impact the successful completion of a given project. The process typically consists of identifying the risks, analyzing them, prioritizing the risks and developing mitigation strategies for overcoming them. There are various tools such as risk registers or matrixes used for the purpose of categorizing the project risks(Rabechini Juniorand Monteiro de Carvalho, 2013).
Chie project involves establishing the electronic health record and thus consists of the risks related with technology use such as data security, training, adoption by the users and communication risks that need to be taken into consideration. The risk register can be regarded as the tool that is adopted for the purpose of identifying the different risks related with this electronic healthcare project. The major risk that is involved is loss of confidential information of the patients due to data breaches as the information is stored electronically. The risk mitigation strategy that is developed for addressing the risk involves using two-factor authentication system to ensure that the confidential information remains protected (NHS CHIE, 2024).
The effective management of data security risks through complying with relevant acts and regulations as well as using authentication system enables in effective management of data security risks. However, the absence of using relevant tools such as risk register to identify and categorize the different type of risk as well as outlining the mitigation strategies lacks in the present project. As such, it can be concluded that there is need for developing and implementing the adequate risk management process through investing in integrated risk analysis technique such as maintaining risk register. This would enable in identifying the unforeseencircumstances and getting prepared for managing them to minimize the risk of failure (Sadoughi et al., 2018).
The major factors that contributed to the effective management of the chosen project ‘CHIE’ are as follows:
There is wide inclusion of key stakeholders such as healthcare professionals and organizationsfor which the electronic health record system isdeveloped for supporting the decision-making of the patients. The patients are also involved with providing them a user portal to record and assess their information. The active collaboration of healthcare professionals and the patients resulted in aligning the daily workflow activities (Choi et al., 2023).
On the other hand, in terms of defining the clear governance structures the CHIE project has clearly defined the roles and responsibilities of the different project members. There is also establishment of the audit trial system for assessing the project risks and identifying the errors that needs to be addressed.
The project has aligned with the GDPR standards and the relevant data protection regulations to address the private security concerns. This helps in minimizing the legal risks (CHIE, 2024).
The factors that require improvement are adoption of effective risk management strategies such as adoption of risk register and contingency planning system. There is need for implementing risk management strategies such as addressing the resistance from stakeholders such as regulators, suppliers and others to involve them in decision-making process.
The recommendation for the healthcare sector is focusing on multi-stakeholder collaboration that involves actively engaging with patients, healthcare providers and regulatory bodies for effective implementation of the system. Also, there is need for maintaining an effective risk management framework to identify and manage the risks.
In context with other sectors, it can be said that there is need for leveraging the monitoring tools such as real-time dashboards and others for tracking the progress of the project and identifying the potential risks or challenges. The project management methodologies such as agile, prince 2 and others can be adopted for developing an effective robust governance framework and carrying out the project activities in an adequate manner (Scott et al., 2020).
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