CHARMS Project Leadership Team

The challenges were great in April 2008 when UW Medicine launched the Clinic and Hospital Access and Revenue Management System project, also called CHARMS.

A 35-year-old legacy computer system was responsible for hospital admissions, discharges, transfers and $2 billion in annual billings. But CHARMS would be one of the largest and most comprehensive information technology projects in UW Medicine’s history. It would require two years to complete and a $50 million budget. More than 3,800 employees needed training to support a simultaneous deployment at three major institutions: Harborview Medical Center, UW Medical Center and the Seattle Cancer Care Alliance.

In recognition of their outstanding work to overcome these challenges, Johnese Spisso, chief health system officer, UW Medicine, and UW vice president for medical affairs, nominated the CHARMS project leaders – Lori Mitchell, Paul Ishizuka, Charles Brown and Tammy Ayyoub – for the Distinguished Staff Team Award.

While all of the leaders are quick to give credit to the thousands of hours of hard work put in by hundreds of other project members, their leadership exemplifies excellence and a spirit of innovation.

“The CHARMS leaders exhibited great skill, tenacity and vision in guiding the project to a successful launch in August 2010,” Spisso wrote. “They were available to the entire project group seven days a week for two years. Along with a shared commitment to exceed expectations, they challenged themselves to tackle hard problems, find new solutions, and make accommodations when appropriate to keep the project on track.”

Individual roles included:

Lori Mitchell, financial operations officer for UW Medicine, led the project as executive sponsor. She received high praise from team members for her leadership, support, tenacity and vision, and for creating a transparent decision-making process.

Paul Ishizuka, financial planning officer for UW Medicine, served on the steering committee and was instrumental in articulating a shared enterprise-wide vision for the project’s overall goals.

Charles Brown, associate administrator for revenue cycle, developed and implemented an outstanding training plan and worked superbly with site coordinators to complete hundreds of business requirements prior to the go-live date.

Tammy Ayyoub, director of financial reporting and operations at Harborview, displayed outstanding abilities to build consensus and overcome roadblocks for accounting and policies at the three sites.

In a supporting letter, Dr. Paul Ramsey, chief executive officer, UW Medicine, and dean of the School of Medicine, highlighted the leaders’ teamwork. “The project leadership team epitomizes the very best of the UW Medicine teamwork ethic,” he wrote. “Their task was not easy: to implement software applications that would permit the most efficient and effective patient admissions, discharge, and transfer, and seamless financial billing across UW Medical Center, Harborview Medical Center and the Seattle Cancer Care Alliance.”

Since going live, CHARMS has been a resounding success. According to Sierra Systems, the project’s external quality assurance provider, CHARMS achieved all of its stated and enhanced objectives at a final cost that was $14.8 million below the original budget. Epic Systems, the software vendor, adds that UW Medicine’s implementation of their software has been one of the best ever by their national customers.

“Our patients and their families will receive great benefits from this and will be able to better understand the billing statements they receive for services,” Spisso wrote. “Our accuracy of revenue cycle information is also improved. Faculty and staff who work in the facilities have noted the improvements in their work flow with more efficient patient registration systems.”

Perhaps no one is better positioned to appreciate what the CHARMS leaders accomplished than UW Professor Edward Lazowska, Bill and Melinda Gates Chair, Computer Science and Engineering. As higher education’s representative on the Washington State Information Services Board, which oversees the state’s information technology investments, Lazowska knows firsthand that not all large IT projects go smoothly.

“CHARMS was exemplary from start to finish,” he wrote in support of the nomination. “It is never entirely smooth sailing with these things, and indeed, one of the most impressive things to me was the way the team dealt with those issues that did arise in the course of the project. The result is a superb implementation of an extremely complex system, a smooth transition from the legacy system to CHARMS, and strong user acceptance.

“The CHARMS leadership team has done something really quite amazing. And, speaking personally, because of them I can attend Information Services Board meetings with my head held high.”