Implementation Of Health Smart Modernization Program In Victoria

Question

Task: The primary purpose of this assessment is to help you to develop and demonstrate your skills in the use of project management concepts, principles, theories and arguments about the project management execution phase.
• Demonstrate your understanding of the real application of Control Systems.
• Analyse and argue what type of Control Systems will enable better or worse project outcomes.
• Assessment 3 is due in Week 12 but you need to get started earlier on this assessment as it is worth 40%.
• Research and choose a real-life failed project or a project which failed to meet the deadline, exceeded the allocated budget etc.
• Ideally, you should have worked on the failed project or someone you know may have worked otherwise google through for it from the industry of your interest.
• Discuss and finalise the failed project name with your tutor.
• Assessment 3 (report + presentation) is a group work for on-campus students and individual for distance (online) students.
• Form your group (maximum of 3 students).
• Email the project name and your group members names to your tutor by end of week 5.
Understand the project context, issues and control systems applied during the execution phase. Find out the causes of its failures and analyse the control systems applied.
Critically evaluate the effectiveness of applied control systems and stakeholder’s management. Make recommendations for how its failure could have been avoided.

Answer

Introduction
The project deals with the health smart modernization program in Victoria which was one of the greatest projects planned in Victoria. In 2003, the project was implemented under the guidance of the Bracks Labor Government having a budget of AUD 323 million. The efforts made to initiate the project were properly supervised by the Bracks Labor Government. The project was mainly implemented to maintain the health records of the patients and construct more hospitals and health care units so that treatment remains widely available for everyone but it was finally stopped because the expenses and the cost of the project exceeded the total budget by over AUD 240 million. Other things that were stopped apart from keeping the health records of the patients were proper functioning of the management of resources, management of patients, financial management and so on. These were the main reasons for the failure of the project.

The major issues faced in the health smart modernization program, the reasons for the failure of the project, critical analysis of the budget and cost of the program in detail, critical analysis of the project team, relationships between overruns and stakeholders will all be discussed in the project. The health smart modernization program was originally planned to be scheduled in 2007 but since it had a negative impact and drastic increase in the costs and expenses, the program had to be banned completely. It was observed that out of 10 agencies, four agencies shifted away from the plan. The health smart modernization program planned to purchase a few systems from the USA to meet the basic requirements but unfortunately, it was seen that there was much difference between the expectations and the actual implementation of the program. The leading agencies which planned to remain under the health smart modernization program were Royal Victorian Eye and Ear hospital and Eastern Health and Austin Health and Peninsula Health. The six other agencies that were under the program decided to abandon the program. The state government as well planned to abolish the project by not later than February 2013.

Major issues
The first major problem faced while implementing the health smart modernization program was the budget. As we have discussed earlier that the cost required to introduce the program exceeded the budget estimated to implement the health smart modernization program, the whole program got canceled in Victoria (Patil & Technology, 2017). The budget estimated was AUD 323 million but it was informed in July 2010 that another AUD 37 million will be required to add in the total budget to get it implemented and due to this, the due date got extended. However, it was calculated finally that the cost and the expenses would exceed the budget estimated as another AUD 243 million was required to be added to complete the final health smart modernization program.

The project was planned to be implemented to reduce the complexities in keeping the health records of the patients and make the process simpler taking the help of modern and digital technologies and applications used in the health clinics. Having signed various agreements with TrakHealth and, e-health vendors, the health smart program strongly focused on using the latest health skills, technologies and techniques so that it becomes easier to maintain health records (Ginige, 2017). However, the Auditor General of Victoria became too concerned and started feeling if Health Smart program would be able to meet the requirements successfully. In April 2008, the Auditor General of Victoria wrote an article where it was mentioned that the sources of the funds and the costs of the health agencies were completely uncertain which got the implementation of the health smart modernization program delayed.

David Davis, the health minister of Victoria in May 2012 started finding ways to cancel the health smart modernization program. It was clearly stated that the hospitals would start demanding IT and technological requirements individually for the future. It was also said by the health minister that health-related projects would no longer be implemented and they would be cooperating with other health services to meet the needs and requirements that would be targeted in the upcoming days (Shi, Li, Zhu, & Ning, 2018). It was found that the rural and small health care units could not be benefitted much from the health care service providers as the smaller health care units demanded for more functions so that they could be successful in getting fully benefitted from the modern applications and technologies. This made the health smart modernization program less capable of using modern applications properly.

The modern systems and techniques that were purchased from the USA seemed to be very difficult for the health smart modernization program to use because the systems sent by USA were made in such a way that it came very tough to get those systems modified in their way. As a result, this led to drastic cost overruns for getting the systems of the USA written and designed again at a large scale. The systems purchased from the USA were designed in such a way that it became very difficult for the health smart modernization program to get the program implemented as the designs were not clear to them. The program was found to be unorganized and unplanned by an audit who mentioned that the program would not be analyzed properly due to poor planning for taking the best decisions.

Control systems
There were several issues faced by the health smart modernization program in Victoria related to cost, schedule, quality, and scope. In 2003, the government decided to distribute the Information and Communication Technology known as ICT systems among the hospitals of Victoria. The department of Health or DH wanted to give these properly organized and integrated ICT systems to all the health clinics. The DH failed to implement these systems finally.

1) Cost issues
The total budget of the program was estimated to be AUD 323 million but it was seen that the cost exceeded the total budget of the program. This was a very serious problem faced while the health smart modernization program was getting implemented. This was one of the main reasons for the program getting canceled. In July 2010, it was informed that another AUD 37 million has to be added to the total budget to get the project implemented which got the due date extended. As a result, the expenses exceeded the budget so much that the program was forced to be canceled. There was an increase in over AUD 240 million another AUD 243 million was required to be added to the total budget of the program.

The systems bought by the health smart program from USA were designed in such a way that the designs seemed very difficult to understand for them to understand and implement properly. Proper modifications could not be done on those systems and hence the whole thing had to be rewritten in their way which resulted in cost overruns massively. As the designs given by the USA were not at all clear, the whole had to be modified again and this made the cost exceed the budget of the health smart modernization program.

2) Schedule
Another major problem faced by this health smart modernization program was the problem of scheduling the program properly and punctually. It was originally planned that the health smart modernization program would be scheduled in 2007 but due to several reasons especially increasing costs and expenses got the due date extended (Tropea, LoGiudice, Liew, Gorelik, & Brand, 2017). When a budget is planned, then the time taken to be implemented would also be planned but when the cost becomes more than the budget then it is quite obvious that the implementation of the project would be delayed. Finally, the project had to be canceled in 2012 due to a drastic increase in the expenses of the health smart modernization program.

 As the budget of the health smart modernization program was made fixed to AUD 323 million, it was expected by the team to complete the project by June 2007. It was found at the end of 2007 that most of the money that was 57% had already been invested in completing just a small portion of the project that was only 24%. The final cost got increased to AUD 427 million which made the team expect the due date at the end of 2007. Before getting the project completely canceled, it was decided by the government to make continuous efforts to complete the project.

3) Quality
It was observed by an audit of the program that the program was not properly planned and organized and thus it would be difficult for an audit to analyze the program due to the lack of planning and proper organization. Improper planning will not help in taking the most strategic and best decisions for the implementation of the health smart modernization program (Ahamed, Lederman, Bosua, Verspoor, Buntine, & Hart, 2016). A huge gap was created between the actual implementation and the expectations of the program because the systems purchased by the program from the USA were not easy to understand. Hence, it became difficult to meet the basic requirements of hospitals and health clinics.

The systems sent by the USA seemed very difficult for the health smart modernization program to modify in their way so that it becomes easier for them to understand and apply the systems properly. As the designs given by the USA were not clear to the health smart program, the whole thing had to be redesigned and written again by the health smart modernization program so that it can be easily understood by the team. The full system provided by the USA had to be modified in their way. This lack of governance, improper planning and organization led to the deterioration in the quality of the program as a whole. 

4) Scope
The health smart modernization program was introduced under the guidance and supervision of the Bracks Labor Government in 2003. It was considered as one of the most ambitious projects planned in Victoria. The efforts made in the project came to limelight under the Bracks Labor government. The program aimed at building more number of hospitals and health care units to make the treatment facilities available easily. The goal of the program was to reduce the number of patients suffering from HIV and depression (Lal, et al., 2019). The primary focus of the project was to maintain the health records of the patients easily with the help of the digital and modern technologies and applications used by most of the health service providers nowadays.

The program was strongly committed to using modern applications and techniques to make the process of health record-keeping much easier. The health smart modernization program signed many contracts with the vendors of TrakHealth and, e-health for being able to use modern technologies and clinical applications more efficiently (CARE, 2020). The team involved in the health smart modernization program started working with the purpose to increase the number of hospitals and health clinics along with the development of financial management, client and patient management, systems of archiving pictures, resource management and so on. However, it was found in the end that the costs required for these functions to get implemented exceeded the budget to a great extent and the project failed.

A critical analysis
Cost and overrun schedules
The reason behind the failure of Victoria's most important IT project for the health sector, the ‘HealthSMART’, is inappropriate budgeting and schedule structure. The main problems in cost and overrun schedule in a particular project, especially in health-related programs are in the lack of planning for every work, poor budget structure and delayed in conducting scheduled works. The total allocated budget in the 'HealthSMART’ program in Victoria was around $300 million. But after examining the records for potential patients and other management teams, over 50% of the budget was spent only in these initial stages. It was no appropriate to make an absurd assumption for the project without even calculating the overall cost. Moreover, the main program system came from the USA without any modification. It costs out of the budget top modify that system for Victoria’s people. This first allocated budget was introduced back in 2007. In 2009, the actual budget became over $400 million and in 2010, it increased by $544 million.

Later, the government of Australia have announced a different plan for this health smart modernization program in future and cancelled the ongoing one. The 'HealthSMART’ project has failed to meets its projected success, so the government decided to help in the development of the health and hospital sector. They are not giving up on this project and planning a new structure for a better version of the 'HealthSMART’ program (Deshmukh & Menkudle, 2018). The government is claiming this IT project as a mixture of a positive and negative outcome. According to them, the ‘HealthSMART’ program has developed the hospital and health sector by adding different health and hospital departments at the same place, but it failed to provide the health services which are rare, special and critical. For further research and work behind this project, they allocated an additional $100 million with the previous estimate of $420 million for next four to five years, for the improvement of the communication system in this health smart modernization program.

The government has failed to provide the appropriate details and information for this ‘e-health’ project. The Australian health and hospital sector need to develop their digital record system to provide full data for this project (BARNETT, LIVINGSTON, MARGELIS, TOMLINSON, & YOUNG, 2019). This health smart modernization program has been running longer than its estimated time and still hasn’t received a successful key to run this project any longer. People from other sectors are criticizing this program as ‘a waste of money’ as they believe that the money could have helped in the betterment of the hospital sector in Victoria. The government has taken the criticism as a constructive one and ready to develop the health sector for digital programs to meet its future. They have planned to secure all investment for IT programs in the health sector, like developing digital recordings for patients and different important files. They are not willing to invest any more large number of money for further experiment for the 'HealthSMART’ program. They are now mainly focusing on their existing digital and IT developing systems for their further development and growth.

Project execution team
The actual problem relating to this particular planning was at its initial stages. The team behind developing the ‘HealthSMART’ program has acquired the system from the USA. But they did not plan about the consequences they would face after running the software which was made for a completely different region and country. The team had to modify the entire health smart modernization program according to Victoria’s health sector’s requirements (Van de Vreede, McGrath, & de Clifford, 2019). The system's program itself was very complicated to rewrite and in the end, it costs over the estimated price. The files of this particular project have pointed out the lack of planning behind executing this project.

There are some potential reasons behind failing this project and the execution team is also one of the main reasons behind it. The possible reasons behind the lacking qualities of the execution team,

1) Lack of communication: It is the most essential quality behind a successful team for any program. This health smart modernization program needed a strong IT team who had a good understanding among its team members. Different opinions matters but when the response is too overwhelming, it is smart to appoint a strong team leader.

2) Lack of understanding: It is important to brief the entire project over and over again, to make sure that every team member understands the project and their allocated works. This particular project had many flaws from the system purchasing to modification of that new system. That costs a lot of money and time in the completion of the health smart modernization program.

3) Lack of Leadership: A good leader can reduce to problem of communication and understanding over a certain plan. A good leader would make a well-structured plan for executing the health smart modernization program, divide the structure equally among the team members, and brief the work part to those who are allocated for each part (Heagney, 2016). It is also important to make a good communication environment to allow the team members to express their doubts for improving their work.

4) Lack of Meeting Deadlines: The ‘HealthSMART’ program was one of the main reasons behind the failure of this program besides cost structure. Because this system needed a complete modification, the team was not able to make any potential schedule time. Even they have failed to meet their allocated deadline, which resulted in uneven budget planning, delay in presenting the health smart modernization program and government's final step of cancelling this project.

5) Proper Counseling: It is important to cheer up the teammates, even after missing an important deadline. It is important to keep a constant focus on the subject and work according to it. In this particular case, the teammates were unable evaluating their mistakes behind missing deadlines or considering the weaknesses of the team members. These evaluations will help during the division of works according to the teammate's familiarity over that particular part.

6) Frequent Plan Change: This particular project was a complete disaster from its initial planning days. The frequent changes in budget planning make the whole process hard to conduct within its planned deadline. A good executing team would not change the plan at every step while working on it.

People have criticized this IT project as a concept only, without having any practical usage.

Relationship between overruns and stakeholders
The cost and time overruns in this project had a direct connection with its stakeholders. The main reason behind the cost overrun was the unexpected modification of the new system. It was also the main reason behind the time overrun among other reasons. The lack of proper structure in work planning, division and allocated deadlines made it impossible the complete this health smart modernization program. The executive team failed to meet several deadlines and the government was also restricted themselves from investing anything further into this project.

The possible major factors behind the relationship between cost and time overruns with the project’s stakeholders are,

1) Poor Design Structure: It is important to make a proper design or structure for a project. This will help in executing the project easily. The executive team takes the responsibility to make a proper design. Poor planning will lead the team to not meet the work’s deadline and causes overrun in both cost and time.

2) Improper Planning: The initial stages of the project are very important because it includes the budget, plan, work schedule and hypothetical outcome discussions. Depending on this stage, a company will create a budget and an estimated time for this project (Mano, et al., 2016). In ‘HealthSMART’ program, the government allocated money at every stage of the changed plan, because the planning was flawed. Frequent changes in initial planning lead to overrun in budget and time, various risk-taking situations and wrong hypothesis for future development. It is important to evaluate the performance of each teammate according to the deadline to keep the work updated with the plan.

3) Lack of Addressing: It is important during the plan to address every possible element related to the project. Ignorance for any little detail can lead to incompletion of an important job. This will add cost and time to the estimated structure. On the other hand, delay in payment also caused missing deadlines and poor working structure (Baker, et al., 2017). An executive team always makes plans according to the allocated budget, or sometimes makes the budget structure for the investors. It is the investor's responsibility to pay the budget within the time. In ‘HealthSMART’ program, the government stopped investing in the project because the executive team failed to present the health smart modernization program within the scheduled time.

4) Lack in Simplification: The main job of an executive team is to make a plan as simple as possible to create a focus. This helps in understanding the work easier and reduces the time for the extra briefing. A complicated plan can overshadow the potential goals of a project and divert team member's interest in the less important elements. This can lead to overrun in the scheduled time and allocated money.

5) Lack of Documentation: It is also an important part of planning. The documentation of every detail during various stages of a project can help in future references and development of the project. In this particular project, the executive team failed to document important external information like rare health problems, special health care and other health sector-related elements, which resulted in incompletion of this project.

Possible actions for success
After analyzing the above possible reasons behind the failure of this project, this is the part for evaluating possible factors that could have been helped in executing this health smart modernization program successfully within the scheduled time and allocated budget. The other obvious aspects like overrun in budget and time, poor management team and the bad relationship between the management team with the resources, it is also important to implement possible actions to make a better team and planning to get success.

The possible actions for the successful production of a project are,

1) Selection of an Appropriate Team: This is the first stage before conducting a big project. It is very important to choose a deserving, successful and dedicated team to conduct a project successfully (Sosa-Reyna, Tello-Leal, Lara-Alabazares, Mata-Torres, & Lopez-Garza, 2018). People, who have such experience in conducting or executing similar works before, can be the potential team members. This will help in creating a proper plan, with a definite budget and schedule structure. In the 'HealthSMART' program, the first flaw in the planning was the exportation of the main system from the USA, without checking any background. An experienced team would have never taken serious work without doing any research.

2) Good relationship: The executive or management team is not the only person who makes the budget. The first step is always to make a proper plan which includes every possible and relevant element such as schedule structure, work details, hypothesis, alternative hypothesis and various risk-taking situations (Ibrahim, Morsy, & Sustainability, 2016). An investor would trust only on the planning before giving money. In this particular project, the government has given up on the frequent changes in planning and schedule, so that they had to stop investing further money.

3) Lack of Concentration: An executive team's priority should be working on one particular project. If production has got many projects to work on, it will be very difficult to maintain a work schedule. Also, if an executive team makes a very complicated plan, it is possible to divert the attention towards less important part of the project. An executive team should create a proper work schedule to produce high-quality work within time. In this particular project, the executive team had failed to meet deadlines to present the 'HealthSMART' program on time.

4) Simplification of Briefing: During executing a project it is important to always keep the briefing short and clear. The team members always should be on one page and cleared about all doubts. A good executive team would have appointed a strong leader who will supervise the whole project, brief the planning to everyone in simple forms and keep their concentration on the important elements of the project. On the other hand, it is also important to make progress according to the budget and plan and make simple documentation for them.

The above actions would have helped in meeting the deadline within the time and budget. It is important to always keep everything under control and make valid documentation for every work. These small details have an effective impact on the execution of a big project. 

Conclusion
In the end, it can be further concluded that the health smart modernization program failed due to several reasons. The government declared in 2003, to distribute all the clinical applications and Information and Communication Technology abbreviated ICT systems among all the leading hospitals of Victoria. The department of Health wanted to provide all health clinics with modern ICT systems. It was found in October 2019 that these clinical ICT systems were installed in just four health agencies instead of installing them in all the nineteen health agencies of Victoria which was planned initially. Finally, the system was seen successfully installed only in one of the hospitals among all the other hospitals. In 2008, the health smart modernization program was analyzed and examined by VAGO. Due to the improper planning and less understanding of the applications and clinical systems, the DH completely failed to implement the clinical applications and systems in all the nineteen health agencies of Victoria.

The schedule of the health smart modernization program got shattered completely due to unexpected increasing costs and expenses of the program. The scope and quality of the program got hampered and affected as well due to the improper planning and drastic rise in the cost of the program. The other ICT related projects faced many unexpected issues as the ICT systems and applications were not that simple and easy. Those systems were too much complicated. The medication done electronically was the most complicated element of the ICT system in the health smart modernization program in Victoria. This particular element has been introduced by only three websites of the health smart modernization program. These issues have put the lives of the patients into more risks and danger.

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