Taking over a Health IT Project Already Underway

As a consultant, one of the realities of health IT project management is that you are not always there at the beginning. In many cases, by the time you arrive, the work is already well underway. Build is in progress, workflows have been defined, and teams are moving toward testing or implementation. 

Most organizations are working towards a fixed go-live date, so the project cannot pause to accommodate a new project manager. Things need to keep moving. That means getting up to speed quickly enough to support that momentum. 

The first couple of weeks are not about introducing disruption or resetting direction. They are about understanding where things stand so coordination can be effective from that point forward. That requires getting grounded in both the plan and how the work is actually unfolding in practice, in a way that feels collaborative rather than intuitive. 

Start with the people closest to the work

Before updating plans or building status reports, it is important to spend time with the project team leads. The purpose is not to walk through the full project history, but instead to understand where things stand right now. 

These conversations are usually informal and direct. That tends to be where they are most useful. Without the pressure of walking through every detail, leads are more likely to speak about how the work is actually progressing, not just how it is being tracked. 

As those discussions unfold, patterns start to emerge. You begin to hear where direction may not be fully aligned across groups, where priorities have shifted, or where dependencies exist but are not being actively managed. In some cases, work that appears stable on a status report feels much less certain when it is talked through. 

That context is what makes the conversations valuable. It provides a working view of how the project is functioning, not just how it is being reported. 

There are usually a few signals that stand out:

🤨 Work that sounds stable on paper, but carries uncertainty when discussed

🔄 Areas where direction or priorities are not fully aligned across teams

🔗 Dependencies that exist, but are not being actively managed

⏱ Early signs of pressure building as timelines continue to move forward

Review the plan against what is actually happening

At the same time, it is important to review how the work has been documented so far to understand how the project is currently being managed. The schedule, risk and issues log, and communication plan usually provide the clearest view of how the project is being tracked and coordinated. 

The question is simple: does what's documented line up with what the team is describing?

When it doesn't, there are usually a few things worth paying attention to:

📆 Deadlines that have passed, but are still being referenced as current

⚠ Risks with little or no recent updates despite ongoing progress

📌 Issues tied to completed phases, or future items without enough detail or ownership

🔊 Communication plans that do not match what is actually happening day to day

This is not about auditing the past. It is about determining whether these materials are helping the team move forward or creating gaps in how the project is understood. In some cases, the documentation is solid and just needs to be kept current. In others, it needs to be adjusted so it reflects how the work is actually happening and can be used more effectively by the team. 

If concerns have been raised, timelines feel tight, or the plan itself seems out of date, this is also where sequencing comes into focus. Not as a default step, but as a response to risk. In those situations, it becomes useful to look at whether work that was originally planned in sequence could move in parallel with the right coordination. The intent is not to force change, but to make better use of the time available as the project moves toward key milestones. 

Visibility changes how teams engage

When a new project manager joins mid-way through a project, there is usually a short period where people are trying to understand what will be different. Every project manager brings a slightly different approach, and without clear expectations early on, that shift can create some uncertainty. 

That is why it helps to address it directly, and a big part of that comes down to how visible the project is to the team. 

If key materials are hard to find, out of date, or only accessible to a small group, people start filling in the gaps themselves. They rely on what they last heard, what applies within their own area, or what they assume is still current. This is where misalignment begins, especially across workstreams that depend on each other. 

Making core materials accessible and keeping them current changes that dynamic. When the schedule, risk and issues, and communication approach reflect what is actually happening, the project becomes easier to understand as a whole. Teams can see how their work connects to others, where dependencies exist, and when something does not look quite right. 

That shared visibility also changes how concerns are raised. Instead of waiting for a meeting or a formal update, information can come forward when it needs to. Sometimes that is a quick message or a short conversation, but it happens in context and early enough to act on. The result is a more consistent, shared understanding of the project. Discussions become more focused, course correction happens earlier, and there are fewer surprises as the work continues. 

Aligning on where things actually stand

Once there is a clear read on the project, that view needs to be brought back to the team. This typically takes the form of a working session that includes the core project team and any stakeholders who need visibility. The purpose is to walk through the current state as it is understood at that point in time, based on both the documentation and recent discussions. 

That walkthrough brings everything into a single, connected view. It gives the team a clear picture of how the work is progressing and how the different pieces fit together, while also showing that time has been taken to understand where things stand before moving forward. 

The discussion should remain open and practical. If something does not align with how the work is being experienced, or if part of the picture is incomplete, it can be addressed directly in that setting. This helps ensure that the understanding being used to guide the project reflects what the team recognizes as accurate. 

From there, the project continues from a shared starting point, with a clear understanding of where things stand and how the work will move ahead.