Closure Report

Project Summary 

This project was to manage the implementation of the Provet Cloud Vet Practice Management System (replacement for Tristan) 

Background 

The Practice Management System (PMS) is the software supporting the commercial clinical activities at the Royal (Dick) School of Veterinary Studies. It is Integral to the business as it holds client records, patient details, laboratory results, case records, referring practice details and financial records. it is also essential for research purposes and undergraduate and postgraduate teaching. 

The legacy PMS (up to 2018) was Tristan which had been unsupported for some years and had no developmental work since at least 2010, as the system providers had withdrawn from the veterinary sector. The legacy software was hosted on University of Edinburgh Servers and viewed on either supported desktops or “kiosks”. The kiosks are PCs which allowed Tristan program access only. The Tristan platform contained 8 MSSQL Server Databases, the largest of which is the Small Animals database, holding around 60,000 animal records. Approximately 20,000 appointments per annum take place, of which approximately 70% are for referred cases; approximately 3000 clients were added to the database each year. The implementation of the replacement PMS would require migration of as much of the Tristan data as feasibly possible. 

A project was initiated in 2015 to procure a replacement Practice Management System (MVM009). The outcome of the procurement was the selection of the Provet Cloud solution and a contract was signed with Finnish Net Solutions in March 2017. 

This project was initiated to implement the selected solution, including the migration of data from Tristan and the associated filestore assets to the SAAS Provet Cloud solution. 

Scope 

The scope of this project was to include: 

  • Implementation of the new Practice Management System (Provet Cloud) 

  • Integration with EASE and Identity Management (IDM) 

  • Provision of local instance of UoE data for subsequent reporting and business intelligence capability 

  • Agreement on business continuity arrangements 

  • Review of incident escalation and support model including revised Operating Level Agreement (OLA) 

  • Review and update of Equality Impact Assessment (EQIA) 

* to be confirmed during analysis. It was agreed by the Project Board that the EASE integration was a "Must" deliverable, and that integration with IDM be a "Should" in that there should be consistency with UoE policy on user management with other centrally managed services where possible but not at the expense of the clinical functionality delivered. 

 

Objectives 

The objective of the project was to implement Provet Cloud, a new Practice Management System (PMS) to replace the Tristan system within the Royal (Dick) School of Veterinary Studies.  

Provet Cloud was to be rolled out across nine functional areas: 

Objective 

Achieved ? 

Comments 

General Clinical 

Yes 

 

Clinical Record 

Yes 

 

Pharmacy & Stock Control

Yes 

Rolled out but currently unsatisfactory as cannot provide stock control in a user friendly fashion  

Accounts & Finance

Yes

Rolled out but currently unsatisfactory  

 

Research 

Partial 

Locally Replicated Provet Database provides capability for analysis of Raw data. 

Management Information 

Partial 

Basic operational reporting in Provet Cloud. 

Supplier solution available (at additional cost) 

Locally Replicated Provet Database provides capability for BI using UoE supported BI tools (not in scope for implementation). 

Easter Bush Pathology 

Yes 

 

Dairy Herd Health and Productivity Services 

Yes 

 

Diagnostic Imaging 

Yes 

 

 

Deliverables 

The project was to implement a new Practice Management System (PMS). The Royal (Dick) School of Veterinary Studies, IS Campus IT, and IS Applications Division were to work together with 3rd party supplier Finnish Network Solutions (FNS) to implement the solution (Provet Cloud) to accommodate the business and functional requirements, and the non-functional elements required to deliver the service eg EASE, IDM, Business Continuity. 

The deliverables of the project are: 

Deliverable 

Achieved ? 

Comments 

Continuing the Project Governance arrangements agreed within the MVM009 procurement project 

Yes 

Project governance arrangements were continued from the procurement project. The main difference being that the Deputy Head of School agreed to take up the Project Sponsor role. 

Implementation of agreed software package Provet Cloud with FNS 

Yes 

Implemented in two main phases: 

  • December 2017 (Farm & Equine practices, Accounts) 

  • December 2018 (Hospital for Small Animals and Labs) 

Access to demo and production environments for Provet Cloud 

Yes 

Provet environments provided for Demo / Test / Live and an additional environment for initial testing of EASE / SHIBBOLETH authentication integration. 

Access to local encrypted copy of Provet Cloud application code under ESCROW arrangements with verified unencryption procedure 

No 

(But improved alternative solution implemented) 

The ESCROW arrangement detailed in the initial contract was reviewed and it was considered not to offer benefit to UoE, partially due to changed circumstances with FNS migrating the Provet Cloud platform to AWS. 

Snr Supplier and PM arranged with 3rd Party supplier NCC Group to work with FNS to set up ESCROW As A Service and put in place an instance of Provet on AWS that will operate when triggered by an event that meets the agreed ESCROW criteria, providing business continuity for R(D)SVS in those circumstances. The new ESCROW arrangement is detailed in a separate contract between UoE / FNS / NCC and was verified in December 2019.

Configuration, Authentication and Integration 

Yes 

 

Data migration from existing Tristan databases and filestore to Provet Cloud platform 

Yes 

There were some issues with the format of case histories, and attachments from the filestore, but it was possible to migrate most of the data. A number of migration cycles were carried out to ensure that the data in Provet was kept up to date (between the 1st and 2nd launches, and the continued use of Tristan during that period). 

Integration with EASE 

Yes 

The EASE integration itself was straightforward configuration work. Dealing with “logout” of Provet and ensuring that sessions were closed securely was not. There is currently no forced logout from Provet itself, the only way to guarantee sessions cannot be re-used / hijacked is to ensure the web browser is closed (and that the settings are set to remove cookie data on the closure of the browser). 

Integration with IDM - feed from IDM to Provet (tbc) 

No

(but separate solutions developed to manage import of Students and update of UoE Staff and Visitors)

 

As Tristan had no integration with UoE central systems, there are no flags in any of the HR / Student / Visitor systems to indicate entitlement to use a PMS. Therefore, there is no way to select staff or students automatically in order to set up a feed to synchronise with Provet. 

Instead, we proposed that FNS develop a customised application for the section that manage student users to allow them to load students securely. 

Staff are extracted from IDM using the staff organisational code and an extract file loaded to a secure FTP location for processing and upload into Provet; the technical work was completed on the UoE side early 2019; the project team received approval for to carry out the bespoke work in March 2019 and FNS provided access to a test ftp server and ran scripts from August 2019. However due to existing commitments Edinburgh staff had planned to carry out testing in July, after which they had very limited availability. This led to a lengthy time where progress and feedback on the script stalled. UoE are not currently in a position to accept this as production ready but it has been agreed to move final testing and acceptance into follow on project MVM528 as this is not a blocker to closing MVM509.

 

 

 

 

Customer functional and data review including testing of functionality within Provet Cloud 

Yes 

 

Staff functional training 

Yes 

The majority of training was carried out by R(D)SVS staff. 

Staff technical training 

Yes 

The majority of training was carried out by R(D)SVS staff and UoE Information Services staff. 

Cutover planning and preparation 

Yes 

 

Updated EQIA 

No 

An assessment into whether an EQIA is required has been carried out by R(D)SVS. 

Updated OLA 

Partial

Local IS Support team is agreeing OLA with Production Management and R(D)SVS as agreed with Project Board in 2019.

Deployment to LIVE 

Yes 

Provet Cloud was deployed in Q4 2017 and made available to staff December 2017 after the Single Sign On (SSO) capability had been signed off by UoE. 

Post live support by FNS 

Yes 

Post Launch support has been via a combination of jira issues and zendesk tickets. 

It has proved problematic, time-consuming, and costly for R(D)SVS to follow a straightforward process for raising issues which are related to break-fix problems – often these have been re-categorised as requests for new developments, not always in agreement with R(D)SVS. Improvements to Provet are to be progressed in MVM528.

Phase 2 deliverables (including access to local copy of raw UoE data, replicated to Provet Cloud, additional customisations not required for initial go live) 

Yes 

Local copy of Provet Database was installed at UoE in Q1 2019. The daily update (replication from the Provet Live database) was completed Q2 2019. This work took longer to complete as it was dependent on receipt of scripts from FNS and meant that the initial window of availability for UoE technical staff in Q1 was missed, but is now operational.

 

Benefits 

Benefit 

Benefits Realised ? 

Comments 

Intangible 

 

 

The implementation project will deliver intangible benefits including: 

  • Ongoing engagement with key stakeholder groups within the Royal (Dick) School of Veterinary Studies 

  • Ongoing relationship building between IS Applications and the College of Medicine & Veterinary Medicine which were developed as part of the procurement project.

There were also significant financial and reputational benefits related to the avoidance of running costs of the existing system, the avoidance of uncertain future costs associated with the failure of the existing legacy system.  

 yes 

 

Tangible benefits (primarily workflow and staff efficiencies) are expected in the following areas: 

  • Optimisation of data entry to allow accurate recording and support of reporting requirements (including comprehensive use of VeNOM terminology or similar fixed terminology where VeNOM not available). 

  • More efficient access of patient images and minimising errors via integration with Picture Archiving and Communications System (PACS) and delivery of a Radiology Information System (RIS). 

  • Charge capture, more rapid reporting, and minimising errors by integration with relevant equipment such as hospital and Edinburgh Pathology (EBP) / Dairy Herd Productivity Service (DHHPS) analysers and drug dispensing units. 

  • More efficient communications and enhanced client care via email and text capability, management of reminders, provision of estimates and healthcare module. 

  • Enhanced referring vet care and communications. 

  • More responsive updates and reduction in staff effort due to enhanced pricing update procedures. 

  • More efficient accounting and insurance claims management. 

  • More efficient information retrieval due to removal of duplicate client, animal, referring vet and user information during data migration process. 

Not completely  

VeNOM now functional but  PACS option not taken up, integration with analysers not complete. 

 SMS now used to contact clients and referring vets now emailed but not 100% reliable. 

Accounting isn't more efficient but pricing has improved 

NB it was not possible to baseline the current costs of the above. 

 

 

 

 

Analysis of Resource Usage: 

IS Staff Usage Estimate: 175 days 

IS Staff Usage Actual: 404 days 

IS Staff Usage Variance: 131% 

Other Resource Estimate: Not estimated 

Other Resource Actual: Not declared (not time tracked) 

Other Resource Variance: N/A 

 

Explanation for variance: 

The original budget approved for the project was 174 days (based on an initial objective to have the solution fully implemented in the summer of 2017). 

After the initial few months of the implementation project however, the supplier Finnish Net Solutions (FNS) acknowledged that they severely underestimated the amount of work to customise the Provet Cloud product in order that it be "fit for purpose" as per the initial requirements agreed in the procurement tender. Put simply this resulted in a number of high level delays to the delivery of the customised solution. The Project Board made the key decision to push back the rollout until the solution was not only "fit for purpose" but also "fit for use" in R(D)SVS; a series of decisions were made by the Board regarding the rollout schedule based on considerations including cost, quality, and the safety of patients, against a ticking clock ie the risk that the legacy PMS platform (Tristan) could fail irretrievably at any point; a key decision made in Q3 2017 was to phase the implementation of Provet in R(D)SVS, with the Farm & Equine practices to go live initially followed quickly (1 month later) by the lab services and Hospital for Small Animals (with the contingency plan being that should Tristan fail a decision would be made in that circumstance whether it would be possible to move quickly onto Provet Cloud); ultimately the re-planned Farm & Equine launch in December 2017 was a success but (mainly due to code quality and other factors, including UoE staff to be fully ready and geared up for launch) the Labs and HFSA would not launch until December 2018. All of this impacted on the costs of running the project, particularly the Senior Supplier and Project Management effort required to deliver the service successfully and ensure that the agreed UoE integrations were coordinated and fit for use.

 

Significantly more project effort than anticipated was used for: 

  • PM time, Snr Supplier involvement, Project Team meetings, Project Board meetings, and time with supplier. However, the project budget was managed efficiently considering the initial target launch date was summer 2017.

Agreed Budget changes: 

  • End of Planning (Apr 2017) agreed budget = 110 days (assumed Provet delivery Q3 2017, and pending decisions on User Management) 

  • Budget increase (Sep 2017) from 110 to 210 days (assumed delivery Q4 2017 including SSO integration) 

  • Budget increase (Feb 2018) from 210 to 295 days (assumed completion of MVP by Jul 2018) 

  • Budget increase (Oct 2018) from 295 to 350 days (assumed completion of MVP, Replicated Provet DB, ESCROW by Mar 2019) 

  • Budget increase (Apr 2019) from 350 to 395 days (assumed completion of Replicated Provet DB, ESCROW by Jul 2019) 

 

A number of changes to staff in R(D)SVS affected team project roles,and resulted in some time being spent supporting staff new in the role and helping get up to speed, handover, and often repeating some activities with the supplier. 

 

Key Staffing changes affecting Project Team: 

  • May 2017 (Business Lead left) 

  • May 2017 (New Business Lead) 

  • July 2017 (Business Lead left) 

  • July 2017 (Deputy Business Lead stepped up to Business Lead role) 

  • July 2018 (Business Lead left, HFSA Business Admin left) 

  • July 2018 (Head of Small Animal Internal Medicine seconded to Business Lead role) 

  • March 2019 (Project Sponsor left, with Dir of Clinical Services and Dir of HSFA taking on Project Sponsor role) 

  • May 2019 (Clinical Projects Officer to pick up Business Lead responsibility from Head of Small Animal Internal Medicine) 

 

Outcome 

Tristan was successfully switched to Provet in agreed stages: 

  • Farm and Equine practices (Dec 2017) 

  • Small Animals & Labs (Dec 2018)

 

 

Key Learning Points 

Positive Learning Points 

  • The Project Team and Subject Matter Experts worked constructively and professionally to deliver Provet, despite ongoing challenges. 

  • The Project Team were fully supported by the Project Board throughout the project who recognised the complexities of the rollout in R(D)SVS. 

  • The training and switch over from Tristan to Provet went relatively smoothly. 

  • Effective in-house support was developed and provided to staff.

  • The weekly Provet catch up meetings ensure that communication channels are open and any issues can be dealt with promptly.  

  • Good communication flow amongst the different departments to crystalize the key components .

  • Development of positive and constructive professional relationships between R(D)SVS and Information Services teams.

 

Challenges 

  • There were a number of changes to staffing in R(D)SVS including several changes to staff with key roles on the implementation project. Inevitably this impacted on the ongoing work agreed with FNS and the way it was managed internally, impacting on project momentum and significant impact on progress with the supplier at some points during the project.

  • It became clear during the early months of the implementation that the initial timescales were highly optimistic and subsequently it was obvious that the scale of the "customisation project" outlined by FNS was severely underestimated.

  • FNS stated their intention to deliver the required customisation to the Provet Cloud functionality would be consultative and would follow a rapid prototyping model; the project team put in place a set of tools and communications channels to support this however FNS failed to adhere to an agreed process during the first two sprints resulting in a number of QA related issues. The Project Board were forced to escalate this to the FNS CEO and at an early Project Board meeting were unable to get a guaranteed (revised) delivery date for the agreed work. 

  • There were ongoing and repeat incidents of defects in the LIVE Provet Cloud system which appeared to result from failure in regression testing and procedures. These incidents were escalated to FNS's CEO via the PMS Project Board who were given assurances that improved procedures would be put in place to prevent future problems.

  • Performance problems early in 2019 (a matter of weeks after the launch in HFSA) appeared to be an issue of scaleability, although the size of UoE's data and related files was known at the time of the contract award early 2017. FNS's solution to ongoing performance issues was to propose a move of the infrastructure to Amazon Web Services platform which could then be more easily scaled to fit UoE's needs.

  • ISApps resourcing availability became more challenging from Q4 2019 with the Senior Supplier leaving and the PM being conflicted against higher priority projects. The window to close the project in 2019 was missed with the additional time required to ensure that the ESCROW as a Service solution was fully in place to reassure the business; the PM then had to prioritise other projects due to workload.

 

 

Recommendations 
  • It was clear that although R(D)SVS liked the Provet Cloud product, it did require more tailoring in order to be ready for operational use than FNS had anticipated and their processes and procedures were not yet mature enough for the diverse demands of the University; the project team were willing to help the supplier however this process became very long and drawn out. 

  • The Senior Supplier and Project Manager had recommended the use of the Major Project Governance Assessment Toolkit as a means of surfacing issues that the Project Board would wish to be escalated in order to agree how to manage them. This had originally been agreed in 2016 during the procurement, but postponed in order to focus on the procurement outcome;  an online survey was distributed (initially to the Project Board) for completion and analysis but it was not possible to gain sufficient support from the Project Board as a group to continue the analysis; an observation would be that it may have been possible to manage some project issues that were already emerging or which subsequently emerged to a better outcome if this toolkit had been adopted.  

  • Some of the issues and challenges experienced later in the project it terms of what had been delivered were a result of FNS delivering to a specification that, despite approval by the Project Board prior to issue of ITT, was not sufficiently detailed and was open to interpretation in some functional areas. This resulted in a significant level of ambiguity later in the project. It was felt crucial that the supplier adhered to a rapid prototyping process and signed off each detailed requirement in agreement with the business. Some of these issues could have been reduced or removed had the more detailed aspects of the requirements been fully documented and agreed with the project team during the initial stages in March-June 2017; some of the decisions at that point were not fully recorded or shared with the team which proved problematic with the multiple changes to project staffing over those initial months.

 

Outstanding Issues 

A few issues to be carried forward by the Provet Service Team now the project is being closed (none that prevent the project from closing): 

  • Provet releases and process 

  • Several features / requirements that were implemented sub-optimally for the initial implementation but which are considered incomplete. 

  • Admin and procedural issues (invoicing handover, ongoing documentation of the service). 

  • EQIA.

Project Info

Project
Implementation of Vet Practice Management System
Code
MVM509
Programme
MVM Business Administration (MVMBUS)
Management Office
ISG PMO
Project Manager
Colin Watt
Project Sponsor
Sue Murphy
Current Stage
Close
Status
Closed
Project Classification
Run
Start Date
19-Dec-2016
Planning Date
07-Apr-2017
Delivery Date
27-Sep-2019
Close Date
03-Jul-2020
Programme Priority
2
Overall Priority
Highest

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