Tying up loose ends with a lab project database
In 1999, while consulting on an LIS installation for Allina
Health System in Minneapolis, Gary Braley was stymied by how difficult
it was for the dozen or so committees overseeing the massive project
Although this was one of the "best-managed" projects he had ever
worked on, "organization of information was a major problem," recalls
Braley, a longtime consultant on lab management and president of
Braley Consulting Services, also in Minneapolis. Time after time,
he’d go to a meeting with one group of people and wind up dealing
with the same issues that another group had raised. "They didn’t
have convenient access to each other’s information and may not have
known others were discussing the same topic," he says.
Those who attended various meetings had to remember where subjects
had been discussed if the information was to be communicated well,
Braley adds. But relying on memory to link information from numerous
meetings wasn’t the best solution, and "meeting minutes are only
useful if you know the subject was discussed and have convenient
access to the minutes," he says. The problem only got worse when
the technical documentation resulting from the vendor selection
process had to be turned over to the contract negotiation team.
In conjunction with Allina, Braley developed software to track
the details related to the lab information system installation,
and he has just begun to market a "significantly enhanced" version
of it, he says. "I decided what you really need is a database to
link the information," Braley says. Traditional electronic files
consisting mainly of word-processing documents and spreadsheets
are "no better than paper files if you can’t remember where something
was discussed or documented. With a database you retrieve information
by subject or committee," he says. Most important, information about
a topic is integrated from all the discussions.
The program, called Management Tracker, is sometimes compared
with project management applications like Microsoft Project, but
the focus of Management Tracker is "entirely different," Braley
says. Project management programs make it easier to plan your work,
but Management Tracker "helps you accomplish the work," Braley says.
"A major task such as HIS-LIS interfacing shown as a single bar
on a project management chart might involve hundreds of issues and
dozens of meetings, and the Management Tracker records and tracks
the detailed content of these issues and the discussion and conclusions
of each meeting," Braley says. Project management is "only a small
part of what managers do," he adds, and Management Tracker accommodates
the other activities such as routine staff meetings, announcements,
frequently asked questions, proposals, complaints, reports for executives,
new system specifications, and contract documentation.
"I haven’t been able to find a management tool that works like
this in the lab, or any kind of business," Braley says.
The difference, he says, is that most project management software
assigns and schedules tasks that must be completed by certain deadlines.
Management Tracker, by contrast, uses a database (you must have
Microsoft Access to run it), and the user therefore can track not
only a single project but also agendas, work assignments, and daily
or weekly activities. For example, a problem that pops up, such
as a resource shortfall, can be identified as an issue, put in a
meeting agenda, assigned to a committee, and tracked to completion.
"The entire history of that discussion is immediately and permanently
available," says Braley.
A variety of reports are offered including executive project summaries,
numerous detailed listings, and statistical reports to help isolate
trouble spots. For example, if the chemistry team has 39 outstanding
issues on an LIS implementation or lab remodeling project and 10
of them are "go live critical," Braley says, something needs to
be done. Similarly, the complete maintenance record on any piece
of equipment or the status of issues with a client can be reviewed
on screen or on paper.
"Other programs facilitate movement of documents, organizing of
meetings, tracking of clients, et cetera. I have not seen one that
actually integrates the content of management work the way the Tracker
does," Braley says. In those programs that manage documents, the
information is still contained in word-processing or spreadsheet
files—not in a database. "That’s the big leap—to put
management information in a key word searchable database, not an
electronic filing cabinet that still has subject matter scattered
around to be collated with assistance from a better filing system,"
It took Braley two-and-a-half years to perfect his software and
to generalize it so that it applies to more than just an LIS implementation.
He looked at all the activities a manager engages in such as meetings,
projects, and client relations, and he integrated them.
Among the uses for Management Tracker: listing tasks by responsible person,
by committee, or by deadline, such as everything due in the next two weeks;
creating a meeting agenda and inserting notes attached to the various items;
preparing for periodic events such as a CAP inspection; logging equipment maintenance
problems; and monitoring interactions with clients.
Early users of the software say they’re intrigued by its
possibilities. Kathryn Holmes, the lead business analyst for the
Allina Health System’s project, which involves installing and integrating
an LIS in 10 hospitals and a large clinic, is one of the first users.
"I’ve seen Gary’s product evolve a lot," Holmes says. "We’ve used
it as a sophisticated issue log" for the four-and-a-half year project.
In particular, Allina has a number of teams with different accountabilities.
"We can put all the teams and all their issues in the software and
make sure each one gets followed up," she says. Each team can pull
out of the database its priority list and time frame, and Holmes
can follow all of them.
Although she has used Management Tracker only for the LIS installation,
"I certainly can imagine many ongoing uses," she says. One example
from her own experience at Allina: Teams are able to prioritize
all the multiple items they must contend with. Some items are reviewed
weekly or monthly, while others are "put in a parking lot" for future
evaluation. Compared with Microsoft Project, "this is just more
user friendly, more intuitive, and more flexible," she says.
To Holmes, the advantage of Management Tracker for lab managers
is its ability to organize multiple activities, everything from
instrument upgrades to meetings. In short, "any activity that requires
a diverse group of people who need to be coordinated," she says.
"If I were a lab director, I think I’d buy this software."
Another person evaluating Management Tracker is Frank Schafer,
manager of information systems for the Clinical Laboratory Management
Association in Wayne, Pa. Braley demonstrated the software and offered
CLMA the option to try it out in an open-ended way. Schafer bit.
"We have a bunch of committees that do everything from plan educational
meetings to setting up our annual conference," he says. "A lot of
times the communication between them isn’t very effective." CLMA
will use the software to keep a log of each committee’s meetings
and to avoid overlaps.
"From what I’ve seen of the software, it’s more robust and goes
into a project more deeply than something like Microsoft Project,"
says Schafer. Management Tracker can divide tasks into subtasks
so that "every little piece can be tracked and cross-pollinated
between different departments or committees."
That’s especially useful, Schafer says, for an organization that
relies on outside committees that don’t interact regularly with
each other. While Microsoft Project has only one main list of tasks
related to each project, Management Tracker enables significantly
more complex structures. "It also makes it easy to create agendas
or keep track of what you talked about and how you followed up,"
He’s not yet certain whether CLMA will purchase the software. "We’re going
to put it through its paces," Schafer says. However, he can see that "it will
be useful from an overall management perspective. It’s good for any business
that has to manage a lot of different tasks and departments."
Donald Connelly, MD, PhD, professor of laboratory medicine
and pathology and director of health informatics at the University
of Minnesota, was intrigued by the concept of Management Tracker
as a way to integrate information-rich tasks such as handling meeting
records, assigning and monitoring work, and managing projects. And
he can see the value of Management Tracker for laboratory directors
and others whose jobs entail juggling and following up on a lot
of details. But he has reservations about the software in his own
application, based on a few days of trial use.
"My problem is that it presumes a certain approach to handling
management activities," he says. "If you use that approach and ontology,
the software is probably intuitive and easy to use. But for me it
hasn’t been. I’m a physician who kind of fell into my own idiosyncratic
management approach with little formal training. I’m not saying
that my approach to management is better. I’m just saying it’s different
and may not match the tool."
Dr. Connelly also wonders if his current work, which involves
many unrelated activities, may be a poor match to an approach that
uses a database to bring things together.
He compares his initial efforts to use the software to attempts
to get physicians to use an electronic medical record. "Unless the
benefit is immediate, doctors see it as a roadblock and won’t use
it." With Management Tracker, "I don’t get far enough into it to
see the benefit before the barriers of learning new processes stop
me from using it."
Dr. Connelly, who recently undertook the added job of director
of the informatics core at the university’s Cancer Center, says
he will persist in using the software because it may have value
in tracking the Center’s multiple informatics projects.
"I recognize there are places where I really need help," he says,
"so I don’t want to give up. I may be missing the forest because
I get hung up on a few little saplings."
He suspects his Cancer Center activities may be a better test-bed
for Tracker because many of its projects are interrelated in terms
of functions or work groups being served. In addition, Tracker’s
shared database approach can effectively tie the members of the
informatics core team together and help keep everyone up to date.
He expects that Braley will refine the software as he gets feedback from early
users. "I know that Gary’s going to be very responsive and the software will
get better," Dr. Connelly says. "He’s worked with so many people specifying
what an LIS should do that I know he’s very capable of modifying something so
it will represent more than just his thinking."
Another longtime lab management consultant, Hal Weiner,
president of Weiner Consulting Services of Eugene, Ore., says he’s
impressed with Braley’s progress so far on Management Tracker. Describing
himself as a "friendly competitor" of Braley’s, Weiner says he hasn’t
seen another product that does everything Management Tracker does.
"There are other products out there that have similar task-management
capabilities," he says, or provide a mechanism to track documents
and schedules. But because Management Tracker is driven by a relational
database, "it’s more powerful and flexible" in offering a "global,
multilinear management tool."
Weiner says Management Tracker "absolutely has value for labs,"
especially if they’re implementing complex projects like lab information
systems. "Labs have been hindered for years by not having adequate
management tools," he says. "If you look at everything labs need
to do, whether it’s meeting the latest HIPAA privacy requirements
or scheduling the next CAP inspection, they could use better tools."
However, he cautions, laboratories should evaluate a range of
project management software before making a decision. Project software
ranges in price from free all the way up to $100,000. He lists a
few, all targeted to small and mid-size businesses: eproject.com,
None of these is aimed at laboratories, Weiner notes. In the past, vendors
have taken Microsoft Project and tweaked it for labs, "but that only covers
10 percent of the process that’s required in attempting to manage an implementation
like an LIS. What Gary has done is take the concept of collaboration and apply
it to more than just project management."
Braley’s first market is laboratories, "because they’re
the people I know," he says. But the software can be used in other
areas such as radiology and pharmacy. "If the executive over ancillary
services could call up status reports for all departments using
one program, that would be convenient," Braley says.
His aim was to structure it in a way that wasn’t limited to labs.
"I took all those things that managers do involving committees,
projects, people, and problems and put them into one database. So,
if you have a problem with a piece of equipment, you can use the
same approach that you would to track a management task. All this
is integrated via the database."
Learning to use the software isn’t difficult. Someone new can
be taught the basics in an hour and then have access to many different
records, he says. "There’s not one system to learn for meeting notes,
another for equipment logs, and still another for client service
problems," he says.
Management Tracker is not an additional program to learn, Braley
insists. "It’s a replacement for a variety of programs, templates,
and filing systems that are the cause of information confusion in
complex organizations." His design goals were to improve the quality
and availability of information and, at the same time, reduce the
effort required to process and retrieve that information.
Management Tracker can be shared over a network and works with
any PC that has the Microsoft Access database. It is not dependent
on a lab information system.
"You don’t need to change your LIS," Braley emphasizes. "This
runs in parallel. It’s a management production tool," similar to
what laboratory staff have been using for 30 years.
"You wouldn’t tell your lab staff to type test results into a
word-processing document," he notes. "Because we’ve implemented
new technologies to assist with our core businesses and management
is not a core business, we end up with the highest paid, most experienced
individuals using the least efficient technology.
“That needs to change,” says Braley.
Karen Southwick is a writer in San Francisco.
To sample the Management Tracker software, log on to Braley’s Web site at