The State's Office of the Comptroller (OTC) and Department of Administrative Services (DAS) issued a request for proposal (RFP) to select an integrated Payroll/Personnel System. The selection process had to be completed within 3 weeks. OTC, which was responsible for the payroll function and DAS which was responsible for the personnel function were at odds regarding the architecture, functionality, and the operational responsibility for the envisioned system. As such, the system selection engagement required that the consultant: bring the parties together; develop a project plan that specifically detailed tasks, responsibilities, and deliverables; and selected a system that matched the State's technology direction (i.e. relational database management---IBM IMS Database).

My role was two-fold. First sell the engagement. Second manage the engagement to ensure successful completion. Ernst & Whinney (E&W) had no track record with the State (i.e. a non audit client). The Hartford Office had no experience with this type of engagement, especially one with such rigid time constraints. I convinced the Partner in Charge of the Hartford Office that E&W should gain a presence in the State of Connecticut, and this engagement was our opportunity. While, there were risks, the ultimate deliverable was a document recommending a system----not a functioning operational system. The key to success was to properly scope the engagement to fit the 3 week time constraint, and to make it "crystal clear" to the State their responsibilities for approving deliverables in a timely manner.

Selling the engagement required a technical approach that focused on the common objectives of the two divergent parties, while at the same time ameliorating the differences. The prerequisite for a successful bidders conference is well though-out engagement specific technical approach. My technical approach was on target allowing for me to "hit a home run" at the bidders conference.

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My management approach was to enforce adherence to the engagement work plan, and ensure that the both OTC and DAS were comfortable with our findings and interim recommendations. I also had to deal with E&W's report production unit ---- Typing turnaround went from 1 week to 1 day. We could not tolerate the typical report production cycle.

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A group of private and public sector citizens formed a commission to define the State's financial systems plan (Gengras Commission). This was the first time that a democrat administration worked closely with a republican philanthropist (Clayton Gengras) for the common good of the State. The commission membership included "high level" participation from both the private and public sectors. Egos were abundant and there were many hidden agendas in this group. To characterize this engagement as high profile, was at the very least an understatement.

Price Waterhouse was a member of the commission and as such was excluded from bidding on the implementation. All the other Big "8" firms plus other large international consulting firms were issued requests for proposals. Although E&W, had established a presence in the State, I did not believe we could beat Peat Marwick or Touche Ross. They had statewide financial systems already operating in other states. After consulting with E&W's national office to consolidate our expertise on a firm wide basis, I became convinced that best option was to have American Management Systems (AMS) subcontract to E&W. The "hot" municipal system at the time was the New York City System (NYC).

Although, other Big "8"s were involved (including E&W), AMS designed, developed, and implemented the NYC system.AMS was the major player, the Big "8"s were minor players. Beside, Touche would use NYC as their prime reference. Thus bringing AMS on board would eliminate Touche. AMS really wanted to be prime, but realized we had just enough of a positive personal relationship with the State decision makers, not to challenge us and propose by themselves. Once the strategy for winning the engagement was developed, the next step was to execute that strategy. The critical task was to develop a technical approach that differentiated us from the competition,focused on the resources we could bring to the engagement, matched the requirements and issues represented in the Statewide Plan, and matched the technology direction established for statewide financial systems.

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A first step was to study the Gengras Plan until I knew it better than the original authors. Secondly I interviewed the authors to make sure they knew I did my "homework", but to also bounce ideas and get feedback. Eventhough I had six weeks to write the proposal, I spent four weeks elapsed time re-reading the Gengras Plan and interviewing the authors. I wrote the technical approach, engagement plan, and cost sections of the proposal to make sure there was consistency. I had help with the "boiler plate" sections (i.e.references, resumes,firm profiles, etc.). AMS and E&W national office reviewed the proposal before it was submitted to the State. I also negotiated staffing rates and renumeration with AMS and other offices within E&W.

We had a very successful bidders conference. There were no surprizes. I was told that at that time it was the largest systems oriented engagement that E&W had ever won.

After winning the engagement, the next step was to negotiate the contract and have it approved by E&W and the various State agencies. This required the negotiation of per diem rates and expenses with the participating E&W offices as well as clearing contract legalize with E&W's legal counsel. Also the subcontract with AMS was developed, negotiated, and appended to the State contract.

The management of an engagement of this magnitude was a formidable and time-consuming task. There were over 100 consultants involved with varying levels of experience and responsibility. E&W nor myself had ever managed an engagement of this size or complexity.

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Also the engagement received a high degree of visibility and as such was a new experience for E&W to receive so much exposure in the local media. Looking back on the experience, I would characterize it as a daily high pressure "roller coaster ride". I not only had to manage the engagement in the traditional way (i.e. train and support staff, review and clear deliverables with the client, monitor and revise the engagement plan, invoice and collect from the client, and authorize distribution of per diems to the participant's), but also present our progress to the Gengras Commission, Other State Officials/Legislators, and E&W National Partners. Consequently, a major amount of my time required the cajoling of these outside "watch dog" groups to satisfy their diverse and hidden agendas.

This situation was made even more difficult, because concurrent with this engagement I was managing the engagement to install the personnel portion of the selected integrated payroll/personnel system. Fortunately, I had made a good technical hire, and this person was able to handle the technical implementation tasks without heavy supervision. As such all I had to do was present our progress to the Gengras Commission.

An additional difficulty was moderating the divergent system selection alternatives advocated by the various participating consulting factions. The AMS and E&W NYC group wanted to port the NYC system. The assistant project director on the State team was a Peat Marwick alumni and he favored the Peat Marwick FAMIS system. My position was to ensure that the requirements definition, conceptual design, and system selection phases would be performed in an unbiased and objective manner. As such, I made sure that all issues were discussed, debated, and evaluated openly with all the participating consultants.

The project was completed on time and budget. The Management Sciences of America (MSA----Now Dunn & Bradstreet) system was selected. The selected MSA system was installed by Andersen Consulting in a subsequent engagement that occurred after I left E&W.

After I left E&W and formed my own consulting practice, the State hired me on a personal services contract to assist the State implement the selected system. The original Project Director retired and the State asked if I would take his place. I declined because I was just starting my practice, but recommended a new Project Director that was already employed by the State. I continued assisting the new Project Director and developed the request for proposal to implement the selected system. We selected Andresen Consulting and I was retained to oversee their work.

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The Cheshire Medical Center (CMC) had a contract with Shared Medical Systems (SMS) that was up for renewal. I was well known at that time as knowledgeable in advising Hospitals on how to structure their SMS contracts. I also had the respect of the CEO of CMC, due to my performance on previous engagements at CMC.

My role in the project was to review the contract, make revisions, and negotiate the revisions with SMS. I also reviewed key technical issues of the SMS system with CMC and SMS to ensure the contract complied. Additionally, I recommended various financing scenarios for the contract given CMC’s financial position and the expected value of the hardware and software.

My recommendations were presented to CMC's CEO,COO, and CFO. I also presented final recommendations to the CMC's Board of Directors. The SMS system requirements and previous problem areas were also reviewed with CMC's CIO and various Users.

The engagement was completed on time and within budget. CMC saved about 40% of the original SMS contract. CMC still uses the SMS System. I performed subsequent engagements at CMC.

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Through my direct marketing efforts, I obtained a meeting with the CFO of Catholic Health Alliance (CHA). He was having difficulty with the Information Technology (IT) area of CHA and sought my advise on the problem. I solved the problem (which was related to disk storage capacity), but more importantly sold him on the need for establishing a Long Range Information Systems Planning (LRISP) function. See my web site (WWW.RFKA.COM) for a description of this consulting service.

My role was to work closely with CHA's CIO and CFO to install LRISP. I utilized and trained 4 people in the IT department to assist me in developing LRISP. We interviewed about 60 people including the CEO and developed "Application Summaries" for each of the major application areas.

We developed a five year engagement plan for IT detailing specific projects, resource requirements, and budget. The CIO concurred with project priorities and the five year operational plan's budget and resource requirements.

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I was referred to Lawrence General Hospital (LGH) due to a prior series of engagements I had performed for another Hospital. LGH had the classical application systems integration problem prevalent in many Hospitals. An attempt to develop a local area network (LAN) for the stand-alone PC's in the Emergency Room (ER) had failed. The ER's PC's were not linked to the LGH's Hospital Information System (HIS). LGH wanted these problems solved.

My role was to develop a proposal that would address LGH's problems and recommend an approach for developing the PC LAN, the LAN Gateway to the HIS, and integrating the PC applications. I prepared the proposal and cleared it with LGH's CIO and ER manager.

LGH like most IBM Hospitals have a product called PC Support (PCS), but do not know how to implement in an easy to use Graphical User Interface (GUI) environment. I developed a PCS Application Programming Interface (API) to allow the ER to gateway to the HIS. This API has become a standard for the Hospital. I also networked the 9 Standalone PC's utilizing Novell Netware, and integrated the standalone applications.

I also trained LGH's Information Technology (IT) staff and ER Users to utilize the developed application/systems integration methodologies.

The Emergency Department Management System (EDMS) operates 7 days a week 24 hours a day. LGH realizes that the cost to acquire a turnkey ER system would greatly exceed the cost of EDMS. More important, technologies already present at LGH were utilized to establish a standard application integration approach for LGH.

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When I arrived at KPMG there was no Health Care IT expertise. The Audit side was in need of IT expertise to compliment their Audit services. As such the objective was to resurrect IT credibility with the Audit management as well as with their clients.

My role was three-fold. First develop a product or service that would enhance the traditional Audit service. Second use the service as a vehicle for establishing credibility with the Audit Management and their clients. Lastly, use the service to identify potential opportunities for follow-on work.

The program that was developed was called Health Care Information Technology (HCIT) Profile. It replaced and expanded the traditional EDP Controls Review that had been become obsolete and ineffective given the rapid and evolutionary change in IT. The mission of the HCIT Profile was to develop a solution partnership for identifying opportunities for improvement. The specific opportunities were shared with the Client through the Management Letter.

The profile addressed the following major areas: Planning; Current Environment; Major Development Efforts; Controls; and Major Concerns/Improvements.

About 20 HCIT Profiles were performed the first year. The Audit side began to began to include myself in their proposals. We began to develop relationships with Clients particularly in the area of Long Range Information Systems Planning. HCIT was also included in the planning for future Audits.

Additionally the program spawned proposals for additional IT work. The program achieved our original objectives, and I recommended it be used throughout KPMG. Another 25 HCIT profiles were scheduled for the next year.

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There were no HCIT marketing plan nor a recognition on behalf of the market place of KPMG’s IT capabilities. As such, it was essential that a focused proactive marketing plan be developed and executed in a coordinated manner with KPMG’s overall IT strategy and capabilities.

My role was six-fold. First access the "marketplace" to determine HCIT consulting opportunities. Second network with HCIT leaders to define and correct the "marketplace’s" perception of KPMG. Third determine HCIT organizations for which KPMG should actively participate and provide leadership. Fourth determine the competition and specific "marketplace" targets. Fifth define and develop the specific products and services to be delivered. Sixth recruit resources to achieve marketing objectives.

Outcome:

A marketing plan encompassing the above six steps was developed and initiated. Proactive meetings with potential new Clients were initiated. Perception in the "marketplace" changed to a more favorable perception.

Recruiting accelerated and candidates became favorably disposed to the HCIT Marketing Plan.

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We obtained a request from our Reimbursement Experts for a System to automate the analysis of a Health Care Provider’s charge master file and compare it with Industry standard charge masters to determine if the Provider was maximizing reimbursement.

My role was four-fold. First design the System. Second develop the interface systems to capture the Provider and Industry Standard charge masters. Third train staff on the technology required to develop the CMA System. Fourth manage the CMA System development.

Outcome:

The CMA System was developed in four weeks elapsed time and was used for three reimbursement-maximization engagements. We recommended that the CMA System be used Firmwide in the support of reimbursement-maximization engagements.

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Two years into the engagement, E&Y realized that they had the following problems.

• The Interface implementation schedule lagged due to a lagging Invision Installations and uncertainty regarding the Ancillary Systems.
• The Project was over budget because the interface sub-contractors were unproductive awaiting for decisions regarding Invision and the Ancillary Systems.
• The Senior Manager was under pressure to build a practice in Atlanta and thus leave the Project.

My role was to take over for the Senior Manager and complete the project while curtailing the budget overrun. This was not all that difficult because:

• Ernst & Whinney "culture" experience.
• SMS Experience.
• Interface/Integration Experience.
• The Interface methodology, technology and architecture was sound.

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The outcome was positive. The Senior Manager had everything in order. The team just needed an opportunity to execute their implementation/deployment plan. Seven of the Nine Hospital’s were converted to Invision with the associated Interfaces.

Before taking the assignment I spent considerable time with the Senior Manager and the Interface sub-contractors. My assessment and subsequent strategy was to continue the original effort and not change the original Interface methodology or strategy. I believe this proved to be the best strategy. I had very little to do with the positive outcome ---- the "groundwork" had already been established.

The only recommendations I had for E&Y were:

• Document the OpenLink/Interface Design (HTML format---Web Based).
• Use the Approach on other E&Y engagements.
• Jointly market the approach with SMS.
• Reduce the dependence on Sub-contractors.
• Don’t recruit Implementers until the Interface Design and Strategy is committed to by the Client ---- Don’t fix-fee an Implementation before a Design is completed and accepted.

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Millennia III had an engagement to perform Y2K testing of certain applications, hardware/software platforms, and systems at BHS. During the initial review 125 Application Interfaces were identified for further review and compliance determination. I was retained by Millennia III to perform the compliance determination because of my expertise in designing, developing, implementing, and deploying Healthcare System interfaces.

My role was to define the specific project, hire additional project staff, determine the project methodology, and specify project deliverables. BHS was a large complex Health Network that had grown and expanded through merger and acquisition characteristic of the Healthcare Industry. In order to address properly the "laundry list" the initial interface list provided, required a knowledge base of how BHS truly functioned --- No one individual in the Enterprise could describe or document the true functionality. As such our mission required the establishment of this Knowledge Base in form that could be presented, analyzed, and maintained by BHS. This was required before we could adequately review and determine the compliance of the BHS Application Interfaces.

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A shared Access 8 Relational Database Management System (RDMS) was designed, developed, and deployed on a NT 4.0 system to provide the Knowledge Base required to review, determine compliance, and document BHS’s Systems. Major tables with accompanying statistics included in the RDBMS were:

• BHS Organizational Entities ---- 325
• BHS System Functional Areas ---- 175
• BHS External System Vendors --- 75
• BHS Applications --- 150
• BHS Interfaces --- 135
• BHS Transaction Recordsets (not normalized) --- 500
• BHS Transaction Recordsets (normalized) --- 20
• BHS Data Elements (not normalized) --- 10,000
• BHS Data Elements (normalized) --- 400

Interfaces were developed with External Systems and Inhouse Systems to populate automatically the RDMS. Additionally, schematics were developed using Powerpoint to describe the major Systems at BHS. A number of queries, forms, and reports were developed by the Project Team to present, analyze, and verify information contained in the Knowledge Base.

All the record sets for the 135 interfaces down to the data element level were documented. We found the majority of dates to be in the MMDDYY format and as such intuitive for service date, admit date, discharge date, and etc. Birth date with the exception of 3 cases was in the MMDDYYYY format. Most Vendors on the "other side" of the interface were leaving service date, admit date, discharge date as is because it’s intuitive that YY=00 means 2000 and not 1900.

The major outcome of our Y2K engagement was that Y2K was really a concern over the unknown. The lack of a Knowledge Base that sufficiently describes an Enterprise’s System precludes effective analysis and monitoring of System contribution to the Enterprise. Lack of a Knowledge Base also precludes System Re-engineering that will become the real need identified by the Y2K Projects.

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Computer Network Technology (CNT) had two engagements at PRTC to use their proprietary Enterprise Application Integration (EAI) to extend/enhance a number of IBM 3270 Host/Terminal Systems. The CNT Project Manager was becoming over burdened with both Projects. CNT retained me to take over the New Connects Project (Residential Telephone Line Order System). PRTC had recently been acquired by GTE becoming GTE’s International Division.

My role was to take the New Connects (NC) Project from the Prototype stage to a full deployment stage. The HS was migrated to a three tier browser (MS IE) based System using Java Servlets at the Client Tier.

The HS tier included 4 HS(s) that during the order entry process required logging on and off the four HS(s) while the Customer was still on the phone. This caused delays in taking the order plus asking the Customer the same questions for each HS. Additionally, while the Customer was on the phone a separate credit check procedure was performed using manual and terminal entry verification procedures. This also increased Customer order entry time.

The HS(s) remained as they were and a middle tier using CNT’s EAI software called Enterprise Access (EA) was used to map the HS(s) screens and provide a intranet web-based server for data that could be inquired and updated by the Client Tier. Additionally an interface was automatically provided for the credit check by the browser so the order taker could view a pop-up window of the credit check results.

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I reviewed the technology and Project Team that developed the Prototype. I found the design architecture, the EA product, and the browser forms adequate. The Project Team was proficient in Java and had a good grasp of the technical implications. The credit check process had to be designed and signed-off with by the User. I also had to replace one of the Project Team who was doing the credit check. He had developed this type of function in the past in C++, but was inexperienced in Java.

The critical factor to achieve a positive outcome was to perform standard project management keeping the Client informed and making sure expectations were reasonable. This was relatively an easy task, because the Project Team did a great job on the Prototype.

During deployment, we had some design refinement issues due to inconsistencies of data between the 4 HS(s), but these were easy to resolve because of the strong technical knowledge of the Project Team.

I developed Phase II recommendations involving Data Modeling and Re-engineering of the underlying 4 HS(s). The Phase I Enhancement/Extension although not completely solving the problems inherent in the underlying HS(s), postioned us for Phase II and provided a number of improvements.

• Cut the Customer order time by 100%.
• Introduced the Order Takers to MS Windows and Browser Technology.
• All new information that was consistent across the 4 HS(s).
• Improved the morale of the Order Takers because there work environment was similar to their personnel environment of using the www.

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