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Case Study: Solving Interoperability for a City Agency

Scope of Engagement

A public hospitals corporation; was awarded the ‘Heal 17’grant. The goal of this grant was to improve Coordination between primary care and behavioral health clinics. State had very stringent selection process for awarding this grant. Our client’s goal was to transform existing business processes of their Behavioral Health departments. This required a major over haul of their existing IT infrastructure and business operation. Total budget of this project was $22 million in capital spending.

The team at Bonova Advisory assisted this client in  IT program management. The team engaged closely with CTO, CMIO, CMO & CIO. Our  focus was to assess the current state, define & implement the target state at 16 hospitals, 6 nursing homes & 5 Community Based Organizations (CBO). The end to end implementation was phased out into two phases.

Phase I:


  • Assess the deliverables of the grant.
  • Assess the current operating state by interviewing business stake holders, registration specialists, social workers, clinicians and doctors
  • Hire a dedicated team for this project. Oversaw 22 direct reports and 30 in direct reports
  • Create a blue print of current workflow by visiting various Psychiatric Emergency rooms & Medical Emergency room
  • Conduct process discovery workshops with staff to identify the current state
  • Understand the Workforce & Union policies
  • Create a Project Management Office & Governance structure for this program
  • Develop charters for Governance, Operations & Compliance committees
  • Establish Key Performance Indicators
  • Develop a project plan based on Project Management Body of Knowledge (PMBOK) pmi.org & such as Project Plan, Business requirement Document, Functional Requirement document & Target Operating Model
  • Flag all processes that require a change
  • Flag all personals that need to be reassigned or released
  • Promulgate Phase 1 artifacts & obtain approvals

Phase II:


  • Define Target Operating Model (TOM), and, obtain HHC executive, NY State DOH sign off
  • Conduct Target Operating Model seminars with Central Office Leadership, State & Hospital Leadership
  • Provide Feedback on Personal and Processes, ‘What working – Not working?’
  • Report Key Performance Indicator
  • Execute a support model for the new operating state
  • Communicate new policies, procedures, org chart by means of hosting town halls, & broadcasting news letters
  • Build connectivity between all Registration systems, EMPI, EMR, RHIOs, EDW, State Registries, Referral Management systems, IBM BI tool
  • Implemented: Microsoft Amalga, Get Real Health Patient Portal, GSI Health Care Management Platform, Oracle Data Warehouse, MDM

Deliverables provided as part of this engagement

  • Customer surveys: Patients were sent surveys after their visit asking them for their valuable feedback. Upset patients took time to respond to these surveys and provided us valuable information on where our Emergency Rooms were failing. Response rate for this survey was 30%


  • KPI: Key Performance Indicators were established and a process to measure them was implemented. For eg: Normal ER wait time, Patient Readmission rate, Numbers of duplicate patients generated etc.


  • Current Operating Model: A blue print of current operating model was created for internal Heal17 committees. The goal was to develop a ‘Same Page’ understanding for all committee members. This blue print would then allow in creating the Target Operating Mode. Blue print was created after surveying all HHC Hospitals & 5 partner sites.


  • Target Operating Model: By developing an understanding of current operating model our consultant worked with the committees & department heads to define the target state. This ultimate goal for this new target state would be to satisfy the Heal 17 grant. As one of the goal of this grant was to make processes more effective it was necessary to build a target operating model that would address areas such as registration work flows, doctor’s workflow, patient triaging process, roles and responsibilities of all administrative staff etc.


  • End to end implementation: Our team implemented the entire solution from start to finish using best practices provided by PMI and Waterfall SDLC.


  • Audit Readiness: Grants these large are bound to an audit from the state. A detailed ‘audit log’ was created. This log memorialized location of all project documents.

Our Solutions

Primary deliverable for this assignment was to identify and implement ‘Target Operating Model’. Areas of improvement and re alignment were defined when the GAP analysis was provided to HHC. Our consultant managed vendors & internal resources to successfully implement the GAP findings.

  • Retrain Registration Staff: Roles that were identified as under performing were later found to be under trained or trained inappropriately by the trainer. This had caused many bottlenecks into the system. Many members of the team were not utilized correctly. With help of Human Resources, Finance & Labor Unions, these staff were restructured and trained.

Key Performance Indicator Measurements: KPI’s were not measured as part of day-to-day operations. With assistance from our consultant it was made part of the Project Management Office’s charter. KPI were integrated in their current project status reports and management reports

Success of engagement / benefits recognized

  • Work from our engagement was submitted as part of the grant. Since disbursement of funds from the state was tied to deliverables, this allowed the Health and Hospitals Corporation to receive funds for these milestones.
  • 2% of redundant processes were eliminated. Although the number may seem small, it saved the organization millions of dollars in wasteful expense.
  • 80% of the target-operating model was implemented. 20% was not implemented due to complex organizational challenges.

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