Department of Veterans Affairs:
Streamlining Mobile Development
Shawn Hardenbrook, Director, Web and Mobile Solutions, Connected Health Office,
Office of Informatics and Analytics, Veterans Health Administration
Brent Dalton, Program Manager, Connected Health Office,
Office of Informatics and Analytics, Veterans Health Administration
MAY 15, 2014
VA Vital Statistics
8.93 Million VA Health Care System Enrollees
6.84 Million VA Supervised & Administered Life Insurance Policies
3.66 Million Veterans Receiving VA Disability Compensation
3.31 Million VA Maintained Gravesites
1.87 Million Active VA Home Loan Participants
950,000 VA Education Beneficiaries
300,000 Veterans Receiving VA Pension
300,000 Veteran family members receiving care
***
**
**
* **
**
**
**
through VA health care programs***
1,600+
131
56
VA Health
Care Sites
VA National
Cemeteries
VBA
Regional
Offices
VETERANS HEALTH ADMINISTRATION
*As of FY 2012
**As of 6/30/13
***As of FY 2013
2
Hospital System to Health System
In 1996, VA began the creation of Veterans Integrated
Service Networks (VISNs) to transform VA Health Care
• 151 Medical Centers
from a “Hospital System” to a “Health System.”
VHA currently has 21 VISNs.
• 985 Outpatient Clinics
820 Community-Based
151 Hospital-Based
8 Mobile
6 Independent
• 300 Vet Centers
• 70 Mobile Vet Centers
• 103 Domiciliary Residential
Rehabilitation Programs
• 135 Community Living Centers
VETERANS HEALTH ADMINISTRATION
Source: FY 2012-2013 End-of-Year Pocket Card
3
FY 2013 End-of-Year Totals
Enrollees………………………………………………………………......8.9 Million
Unique Patients Treated…………………………………............6.5 Million
Outpatient Visits………………………………………................86.4 Million
Outpatient Surgeries…………………………………………………..….292,600
Inpatient Admissions…………………………………………….……….694,700
Lab Tests (Inpatient & Outpatient)………………………….…266 Million
Prescriptions Dispensed (30-Day Equivalent)……......268.6 Million
Prosthetics Services Performed……………………..………..15.9 Million
VETERANS HEALTH ADMINISTRATION
Source: FY 2012-2013 End-of-Year Pocket Card
4
VA’s Health Care Expertise
VA is one of the largest civilian employers in the federal government
and one of the largest health care employers in the world.
288,000+ Total VHA Employees
177,000+
Clinical
Employees
88,000+
Veteran
Employees
VETERANS HEALTH ADMINISTRATION
5
VHA’s Current Priorities
• Patient Aligned Care Teams (PACT)
• Connected Health Care
• Access
• Homelessness
• Mental Health Care
• Standardization
VETERANS HEALTH ADMINISTRATION
6
500 million
Smartphone users will be using health apps by 2015
7
More Cell Phone Devices Than Any Other Computing
or Consumer Electronics Device Globally
5
5.0
4
Billions
MORE THAN 3
BILLION MORE
DEVICES
3
2
1.3
0.7
1
0.3
0
Cell
Phone
Users
TV
Households
Desktop
PC Users
Mobile PC
Users
8
• Leverages wireless/mobile technologies
to improve the health of Veterans
• Expands care for Veterans beyond the
traditional office visits
• Helps Veterans, Caregivers and VA health care team
securely coordinate all aspects of care
• Provides Veterans and their Caregivers with tools
to help lead healthier lives
9
The Potential of Mobile Health Technology
Decision support tools
Increased access
Self reporting
Range of media
Tailored information
Quality face-to-face visits
10
Dr. Robert A. Petzel
Origin November 2011
12
VA Mobile Health: Expanding Care for Veterans
Personalized, Convenient, Coordinated & Accessible
Increase Patient
Engagement
Expand Care for
Veterans
Governance
13
Care Plan App
Patient SelfEntered Data to
Health Team
Patient Decision
Support
(eCoaching)
Goal Setting
App
Personal
Inventory App
Increase
Patient
Engagement
SMS Messaging
14
Secure
Messaging
Video
Conferencing
Increased
Coordination &
Communication
Expand Care
for Veterans
Coaching
Notifications
from Health
Team
Display Clinical
EHR Data
15
Cloud Hosting
Mobile Device
Management
Mobile
Application
Environment
(MAE)
Governance
Data
Standardization
App
Certification
16
Veteran-Facing Apps
Summary of
Care
Mobile Blue
Button
VA
Launchpad
17
New Patient-Facing
Mobile Apps
• Texting for Health
• Patient Health Inventory
• Caring for Women
Veterans
•
•
•
•
•
Preconception/Prenatal
Maternity Tracking
Veteran Health Competition
Biosurveillance Reporting
Subscription Service for
Biometric Monitoring
18
18
VA’s Mobile Health Pilots
Veteran Patient/
Family Caregiver Pilot
June 2013
Mobile Health
Browser Pilot
April 2013
Clinician Pilot
January 2012
19
Family
Caregiver
Pilot Apps
Suite of 11 apps pre-loaded on iPads and
distributed to 1,120 Family Caregivers
and their post 9/11 seriously injured Veterans
20
VALaunchpad
Launchpad
VA
23
Summary of Care
Secure Messaging App
RefillApp
App
RxRxRefill
Journal App
Mobile Blue Button
Mobile Blue Button
Mobile Blue Button
30
Apps for Everyone!
IOS?
Hosted?
Android?
HTML5
Native?
Wrapped?
Windows
Modern?
31
Mobile
Application
Environment
(MAE)
32
Who is Building Mobile Apps?
33
Agile Development
Methodology
Strengths and Weaknesses
34
Mobile Development
PLANNING
DEVELOPMENT
Multiple Apps
MS
0
ORR/
IOC
Entry
Multiple Apps
MS
1
MS
2
IOC
Exit
IMPLEMENTATION
CONCEPT
DEFINITION
O&M
MAGB
1
Request
New
App
2
Approve
Request
3 Business
Requirements
Document
(BRD)
4
Fund
Effort
5
Assign/
Contract
Agile
Team
WMS
PM
7
Agile Development
6
Concept
Paper
Scope
Sprint
0
Sprint
1
Sprint
2
Sprint
3
8
Field
Testing
Sprint
4
9
Release
10
Product
Support
Sprint
5
VA OI&T
PM
35
Mobile Development
PLANNING
DEVELOPMENT
Multiple Apps
MS
0
ORR/
IOC
Entry
Multiple Apps
MS
1
MS
2
IOC
Exit
IMPLEMENTATION
CONCEPT
DEFINITION
O&M
MAGB
1
Request
New
App
2
Approve
Request
3 Business
Requirements
Document
(BRD)
Request
4
Fund
Effort
5
Assign/
Contract
Agile
Team
WMS
PM
7
Agile Development
6
Concept
Paper
Scope
Sprint
0
Sprint
1
Prepare
Sprint
2
Sprint
3
8
Field
Testing
Sprint
4
9
Release
10
Product
Support
Sprint
5
Approve
VA OI&T
PM
App Intake and Request Process
Request
Prepare
Approve
Register with VA by completing the
forms that are specific to your
request
App Intake Process
37
Request
Prepare
Approve
• Have VA build an app
• Certify an app you are building to carry the VA brand
• Start building a VA-branded app for which you have funds and resources
• Request a VA mobile app development environment (Tools setup)
• Request server resources for your VA mobile app development project
• Request a user account to participate in an existing VA mobile app
development project
App Intake Process
38
Request
Prepare
Approve
• You will be contacted by Web and Mobile
solutions to prepare request for Mobile
Apps Governance Board (MAGB)
• MAGB is responsible for reviewing and
approving request
App Intake Process
39
IMPORTANT!!!
• In order to obtain approval by the Governance
Board the request must answer 3 questions:
1. Meets the VA Mission
2. Has a Business Sponsor
3. Business Sponsor Commitment to
Sustain
App Intake Process
40
Request
Prepare
Approve
• Once MAGB approves your request, if
applicable a JIRA project will be created
App Intake Process
41
Business Requirements Document (BRD)
•
VA requirements documentation
•
Very detailed
•
Created by New Service Request (NSR) or agile
development team
•
Basic documentation
•
Less detail and greater focus on “user stories”
•
Created by agile development team
42
Mobile Development
• Agile Methodology
• Sprint meeting
every 1-3 weeks
• Review work
completed and
planned
• Business Owner
attendance
43
Mobile App Compliance
Mobile Application Classification
Certifying
Bodies
Certifying Body
1 - Very Low
2 - Low
3 - Medium
4 - High
Does not Read only Write Read and/or
utilize VA access to access to write access
resource
VA
VA
to VA
resources resources sensitive
resources
Software Quality Assurance
Assessment
Assessment
Testing
Testing
Patient Safety Assessment (OIA)
REQUIRED
REQUIRED
REQUIRED
REQUIRED
508 Accessibility (OIT)
REQUIRED
REQUIRED
REQUIRED
REQUIRED
Code Review
REQUIRED
REQUIRED
REQUIRED
REQUIRED
Usability Testing (OIA)
REQUIRED
REQUIRED
REQUIRED
REQUIRED
User Interface (OIA)
REQUIRED
REQUIRED
REQUIRED
REQUIRED
VA Branding (OPIA)
REQUIRED
REQUIRED
REQUIRED
REQUIRED
Sustainment Plan
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
REQUIRED
System Performance Impact Assessment
(OIT)
IV&V
Data and Terminology Standards
Compliance
REQUIRED
Privacy and Application Data Security (OIA)
REQUIRED
Enterprise Security
REQUIRED
VA Branding
Key Certifying Body
45
Mobile Project Management
Accountability System (PMAS)
MHED
Base PMAS Docs
32 Individual
PMAS
Documents
Covers All Mobile Apps
& Created Once
12 PMAS Docs
Covers each App
46
PMAS Documents
• Business Requirements
Document
• Concept Paper/Scope
Statement
• Requirements
Specification Plan
• Requirements
Specification Addendum
• Software Design
Document
47
Mobile Development Tools
48
OI&T MHED Release Process
49
Step 1: Validation and Verification (V&V)
Step 2: Final Compliance Review
Step 3: Review of Operation Readiness Report
(ORR) and Initial operating Capability
Lessons Learned So Far
51
Ask the Presenter
For more information, please visit
http://mobilehealth.va.gov
or email
Shawn.Hardenbrook@va.gov
Brent.Dalton@va.gov
52