Most project managers have experienced projects with too few resources or a staff with insufficient skillsets. Specifically within the health care industry, the skillsets are in short supply due to the complex nature of health care; the ideal business analyst may be a nurse with an IT background. There is a sundry of knowledge, code sets, processes, jargon, and vendor systems that can differentiate one resource from another. How do you overcome all of that and find the ideal candidate that can hit the ground running? Developing a creative resourcing approach is usually a part of any project manager's role when resources are scarce.

1) Hire resources with a very strong IT background who will build their own knowledge about your environment and health care. Any health care background may be acceptable, even though it isn't directly within the same area. It will likely be easier to find someone with a strong IT background that will want to have access to the SME knowledge to make informed decisions or suggestions.

2) Hire resources with a strong background in the subject matter area, but don't expect SMEs to be technically savvy. You may find that negotiation with project sponsors is needed to acquire the time and knowledge of the SMEs to compliment a strong IT resource approach. Nurses, clinicians, and the subject matter experts need to be available to contribute some portion of their time to aid in building the system. Having the right practical medical knowledge is going to be critical to the success of the project.

3) If you can't have a resource with domain knowledge and an IT background, combine resources to produce the project deliverables. Between two resources, where one demonstrates a strong IT background and the other is subject matter expert, use the RACI matrix to divide the work for specific deliverables. An IT resource can produce the project artifacts, and a SME must approve the work. SMEs will still likely have a job to perform outside the project, but some portion of their time should be devoted to meeting with the IT staff.

4) Equip project resources to be successful. Everyone will need to understand the methodology being used, PMI or Agile, or some blended approach. A project sponsor may be concerned the IT resources need to know about admitting patients, recording SOAP notes, or the process for administering medication. The project sponsor should also be concerned that SMEs need to know how to best be involved in an IT project. The IT Staff needs to instruct the SMEs on the high level processes and methods for building IT systems. The SMEs need to assist the IT staff learn the process and procedures they will support or change within the IT system. The idea is to give people knowledge about these processes so they can bring more value to the team.

5) Don't believe the EMR hype. Electronic Medical Record systems are fiercely guarded by the vendor who creates it. These EMR system resources are incredibly expensive due to the intimate system knowledge they bring to the table. Hopefully, they understand enough about your hospital processes and procedures. Certainly a project will need to involve those resources in order to bring that information into the fold. However, the entire IT project staff does not require intimate knowledge of the EMR system. Take for example a large retail or manufacturing firms who run JD Edwards or SAP: project teams consist of those who are knowledgeable about the business, those who are knowledgeable about the system, and IT resources able to bridge the two together. Hospital budgets can be extended further by the combination of all three types of resources, just by learning the lessons from other industries.

6) Once you have resources with strong foundations, Training is the next phase of the strategy. There are federal health care IT training programs available. EMR Vendors will also provide some training on their systems. Learning the processes specific to a hospital, clinical, third-party, or payer setting are difficult because they are not documented. Business Analysts and System Test Engineers will need to understand what physicians, nurses, patients and office staff do. Giving IT resources the time to develop some domain knowledge will prove valuable and can bring about success.

7) Establish ground rules for how the project team will operate. SMEs and IT staff will interact, but will also require bandwidth to do the most important job at the moment, be it attending to the patient, or solving a critical system issue. The IT staff must be expected to observe and obtain the time and attention of SMEs. In return, those project SMEs will be essential with change management efforts to roll out system upgrades and changes to other users.

Combinations of resources with different strengths and knowledge areas are the key. Teams that do not have the right access to subject matter experts are ones that fail. The SME's, EMR system resources, or strong IT foundational resources must be one team. The health care projects of today require resources who believe in technology, are looking for improvements in their life and for the care and outcomes of the patient. Nurses and Office Staff, the SMEs and users, are critical because of their knowledge and involvement with a majority of data entry and processes. EMR knowledge is central to deploying a well-structured system architecture. The right set of IT Business Analysts, Developers, and System Test Engineers are essential to pulling all of those various stakeholder perspectives together. Look for resources with a passion about what they do and a passion for doing it well.