Scope Creep on a Patient Portal Rollout
You are the project manager for a patient portal rollout across a 4-clinic group. Baseline scope: portal registration, appointment scheduling, and secure messaging. Budget is $180,000; timeline is 5 months; the team is 6 people (2 analysts, 1 trainer, 1 integration engineer, 1 communications lead, you). At month 3, you are 55% through the schedule and 70% through the budget. The medical director now wants online bill pay added before launch, saying 'it's just one more module.' The integration engineer is already at capacity on scheduling.
1. Assess the project's health using earned value reasoning, and decide how to handle the bill-pay request.
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Health check: 55% schedule complete at 60% elapsed time (3/5 months) means the project is behind schedule. 70% of budget spent for 55% of work means cost performance is worse than schedule performance - CPI ≈ 0.55/0.70 ≈ 0.79, SPI ≈ 0.55/0.60 ≈ 0.92. The project is trending toward overrun on both dimensions.
Bill-pay request: 'Just one more module' is a classic scope-creep framing. Online bill pay touches payment processing (PCI considerations), the billing system integration, and patient communications - likely 3-5 weeks of integration engineer time the team does not have.
Decision: Do not absorb it silently. Take it through change control:
- Estimate the incremental cost, schedule, and the specific resource (integration engineer) it requires.
- Present the trade-off explicitly to the medical director: bill pay or on-time launch of the baseline scope, not both without added budget/time.
- If bill pay is genuinely required for launch, propose a phase-2 release with a defined date, or a funded change order.
2. The medical director says 'we can't launch without it.' How do you re-plan?
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If bill pay is now a launch requirement, it's a baseline change, not a favor. Re-plan explicitly:
- Re-baseline. Update scope, schedule, and budget with the medical director's sign-off. New estimate should include integration engineer time, payment vendor onboarding, and compliance review.
- Resolve the capacity constraint. The integration engineer is the bottleneck. Options: (a) contract a temporary integration resource, (b) sequence bill pay after scheduling stabilizes, (c) descope something else. Pick one and document it.
- Protect the launch date if possible. Consider launching baseline features on the original date and adding bill pay in a fast-follow release (e.g., +6 weeks). This preserves patient value and avoids a slip.
- Communicate. Tell clinics the revised plan and the reason. Stakeholders tolerate change better than surprise.
- Add a change log entry. Every scope change gets a paper trail - this is what protects the project and you.
3. What early-warning indicators should you have been watching, and what will you put in place now?
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Indicators that were missed or underweighted:
- CPI/SPI trend, not just a single snapshot. The overrun was likely visible by month 2.
- Resource utilization of the integration engineer - a single point of failure at capacity is a schedule risk.
- Scope change requests per month - a rising count signals the baseline is unrealistic.
- Defect/issue backlog - growing backlog often precedes schedule slip.
What to put in place now:
- A weekly dashboard with CPI, SPI, resource utilization, and open issues.
- A formal change-control board (even lightweight) with the medical director as a member.
- A risk register entry for the integration engineer as a single point of failure, with a mitigation (cross-train an analyst or pre-qualify a contractor).
- A monthly stakeholder status report that states schedule and budget health in plain language, not just 'green.'