VistA Evolution Community
Briefing
January 26, 2015
Dr. Aaron Drew
Senior Enterprise Solutions Architect
Office of Information and Technology (OI&T)
U.S. Department of Veterans Affairs (VA)
VistA Evolution Community Briefing Overview
• Two topics
– Interoperability
– Enterprise Health Management Platform (eHMP)
– There will not be any time for questions and answers. Please direct all
questions to matthew.schultz@va.gov
VistA Evolution Community Briefing: Welcoming Remarks
Presented by Dr. Aaron Drew
VistA Evolution Community Briefing: Interoperability
A key objective of the VistA Evolution Program is to enhance cross-Agency
(DoD/VA) interoperability by providing all clinically relevant data at the point of
care for Veterans. Improved interoperability will enhance communication among
VA health care partners by ensuring that authorized beneficiary and medical data
are accessible, usable, shared, secured and sufficient to meet the needs of
Veterans and their care team in real-time.
Timely access to all clinically relevant patient records, regardless of the institution
that provided the care, is critical in order for Veterans to have efficient, safe and
effective care coordination. Enhanced interoperability will also allow provide the
foundation for better clinical decision support, which providers will use to improve
Veterans’ health.
The overarching goal of VistA Interoperability is to enable more efficient clinical
workflows and improved patient care.
VistA Evolution Community Briefing: eHMP
The next evolution of VistA requires a world-class, open, modular, and extensible user
experience. eHMP will develop a new web-based clinical application that migrates the
current functionality in VistA’s existing user interface, Computerized Patient Record
System (CPRS).
eHMP will leverage and integrate the enhanced graphical user interface, standards-based
data, and core clinical applications deployed during the User Experience project, Joint
Legacy Viewer (JLV), and Health Informatics Initiative (Hi2).
VistA Evolution Community Briefing: Interoperability
Presented by Dr. David Parker, MD
Interoperability: FY14 NDAA Interoperability Requirements
VA Interoperability: A standards-based Electronic Health Record (EHR) with integrated display of data.
VA will meet the requirements of Public Law 113-066 (P.L. 113-066), SECTION 713 – “ELECTRONIC HEALTH RECORDS OF THE DEPARTMENT
OF DEFENSE AND THE DEPARTMENT OF VETERANS AFFAIRS,” of the National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2014 by
December 31, 2016, by achieving an interoperable EHR with an integrated display of data with the Department of Defense (DoD) and
private providers. The interoperable EHR will provide all relevant heath care data of DoD and Veterans Affairs (VA), computable in near real
time and complying with the national standards and architectural requirements identified by the IPO, in collaboration with Office of the
National Coordinator (ONC) for Health Information Technology (HIT) of the Department of Health and Human Services (HHS).
Requirements:
1) DoD/VA interoperable standards based EHR with integrated display of data (NDAA 2014 Sec 713 (b)(1))
2) Ensure the continued support and compatibility of the interoperability platform (NDAA 2014 Sec 713 (b)(2))
3) All relevant health care data of both Departments’ EHR systems shall be computable in near real-time and comply with, and able to
evolve with, existing national standards and use proven life-cycle sustainment planning (NDAA 2014 Sec 713 (c)(3) (a) (b) (d) Sec 713
(g) (1))
4) Achieve Gartner Generation 3 EHR (NDAA 2014 Sec 713 (c) (4))
Additional principles where feasible, VA’s interoperable EHR will also:
1) Will comply with the requirements, where practical, of the Joint Executive Committee (JEC) (NDAA 2014 Sec 713 (c) (1))
2) Create an authoritative health data source with standardized input, which can be used by multiple providers (NDAA 2014 Sec 713 (c)
(5) (a))
3) Enable patients to download, or otherwise receive electronically, health care records (NDAA 2014 Sec 713 (c) (5) (b))
4) Enable patients to upload health care records and allow DoD/VA medical providers access to such records (NDAA 2014 Sec 713 (c) (5)
(c))
Interoperability: Joint Interoperability Efforts
• VA’s interoperability efforts are being coordinated with DoD, the DoD/VA Interagency
Program Office (IPO) and Office of the National Coordinator for Health Information
Technology (ONC):
o DoD – Defense Health Agency (DHA), Defense Healthcare Management Systems (DHMS)
Program Executive Office, Defense Medical Information Exchange (DMIX) Program Office,
Defense Healthcare Management Systems Modernization (DHMSM) Program Office
•
•
VistA Evolution Interoperability Plan (VEIP)
o
Currently being updated and pending release to Veterans Affairs Intranet Quorum (VAIQ), a
portal for obtaining document concurrence, upon Senior Leadership approval.
o
Participants: VA (OI&T, VHA), DoD/DHA/DMIX, DoD/DHA, DoD/VA IPO
The VEIP and its high-level summary are in alignment with the DoD/VA IPO’s :
o
Joint Interoperability Plan (JIP)
o
Health Information Interoperability Technical Package (I2TP)
o
Health Data Interoperability Management Plan (H-DIMP)
Interoperability: Strategy and Steps
• VistA Evolution Interoperability Capabilities are being achieved within
the overarching VistA Evolution product delivery schedule.
• The path to interoperability evolves and builds upon existing
interoperability to satisfy the FY 2014 NDAA directive to provide
“seamless electronic sharing of medical health data” between the
Departments by December 31, 2016.
• Interoperability is a path of continual improvement and a permanent
commitment, not an end-state.
• Continued work as new health discoveries are made, new use
cases are identified, and as interoperability standards evolve over
time
Interoperability: Approach
• VistA Evolution capabilities requires that we modernize VA’s Interoperability
infrastructure.
• We are modernizing the legacy Health Information Exchange (HIE)
interoperability infrastructure using a proactive systematic process approach:
• Technical, and Functional Reviews of the legacy interoperability
infrastructure
• Identifying systems for decommissioning or are in need of functional and
technical enhancements
• Close coordination with Clinical Informaticists with regards to national
standards
Interoperability: Capability Transitions
Legacy Viewers
eHMP
(+ JLV Interim)
Legacy
Interoperability
Components
VistA Evolution
Interoperability
Components
Local Data
Formats &
Terminologies
National
Standards
Interoperability: Feature Set Capabilities
VE Feature Set
(1, 2, 3 or 4)
Product Name or Deliverable
Delivery Date
1
Enterprise Messaging Infrastructure (eMI)
Delivered August 2014
1&2
NDAA FY14 Joint Legacy Viewer (JLV) Release
Delivered October 2014
Enhancements September 2015
2
VistA Site Standardization Phase II
Delivered December 2014
2
New DoD/VA Gateway (Connection to DoD’s Med-COI)
Delivered December 2014
2
Enterprise Health Management Platform (eHMP) Initial Release
v1.1
Delivered December 2014
2
Consolidated Clinical Document Architecture (C-CDA)
July 2015
2
VistA Site Standardization Phase III
September 2015
2&3
VistA Exchange
September 2014 – December 2016
3
VIE Transition to eMI
December 2016
3
FileMan Enhancements
December 2016
3
Completion of NDAA FY14 interoperability requirements
December 31, 2016
3
Data & Terminology Standardization
4
Interoperability of digital radiological images to include HAIMS
October 2014 – Ongoing based on new
standards
January 2015 - December 2016
Interoperability: Feature Set Capabilities
VE Feature Set
(1, 2, 3 or 4)
Product Name or Deliverable
Delivery Date
1
Enterprise Messaging Infrastructure (eMI)
Delivered August 2014
1&2
NDAA FY14 Joint Legacy Viewer (JLV) Release
2
VistA Site Standardization Phase II
2
New DoD/VA Gateway (Connection to DoD’s Med-COI)
Delivered December 2014
2
Enterprise Health Management Platform (eHMP) Initial Release
v1.1
Delivered December 2014
2
Consolidated Clinical Document Architecture (C-CDA)
2
VistA Site Standardization Phase III
September 2015
2&3
VistA Exchange
September 2014 – December 2016
3
VIE Transition to eMI
Viewers
&2016
Apps
December
3
FileMan Enhancements
December 2016
3
Completion of NDAA FY14 interoperability requirements
December 31, 2016
3
Data & Terminology Standardization
4
Interoperability of digital radiological images to include HAIMS
Delivered October 2014
Interoperability
Enhancements September 2015
Infrastructure
Delivered December 2014
Components
National Standards
July 2015
October 2014 – Ongoing based on new
standards
January 2015 - December 2016
Interoperability: Schedule
Interoperability: Roadmap, FY14-FY16
JLV
NDAA 2014 signed Prioritize data
domains
by President
Obama (Dec 26)
(Feb 28)
Stage 1 – Analysis
Stage 2
Begins
(Dec 17)*
JLV Go Live at
San Antonio
(Jul 31)
FY 15
System Data needs to be
IOC Delivered computable in real-time in VistA
and AHLTA
(Sep 30)
(Oct 1)
JLV Go Live at
Hampton
(May 9)
NDAA FY 14
Interoperability
Complete Dec 31 2016
Stage 1 Complete
(Jun 27)*
Stage 2 Complete
(Nov 28)*
Stage 2 – Correction
Stage 3 Begins
(Jun 3)*
FY 16
Stage 3 - Implementation
Stage 3 Complete
(May 29)*
Stage 4 Begins
(Nov 18)*
Go Live w/ Context
Mgmt. Feature
(Sept 3)
Stage 4 Complete
(May 22, 2020)*
Stage 4 – Sustainment
Integrate HAIMS
images and artifacts
Integration of JLV’s functionality
to eHMP
(TENTATIVE – early FY 15)*
Minimal Development and Sustainment through FY18
DAS
HealtheConnections Exchange Increment Exchange Exchange
Go Live in Production
1 Milestone 2
Increment 3 Increment 4
(Mar 17)
(Apr 12)
(Nov)*
(Jan)*
VLER DAS Ver 4.5 (Large Data
Streaming) (Apr 25)
Milestone Complete
VLER Health Direct
and VLER Health
Exchange
Exchange 2011 Specification Direct v.1.4
Direct v1.0 Release Direct Release 1
with HealtheWay Release
(Feb 27)
Production (Mar 26) Certification
(Mar 18)
(Aug 26)
VLER DAS v5.0 (Walgreens Immunization
ingestion) (Aug 22)
(Formerly known as VLER DAS)
BHIE (Technical
Interop.) & CHDR
(Semantic Interop.)
VE PS3: eMI,
Data & Terminology
Standardization,
VistA Exchange
Sustainment
ESB
eMI: ESB Test & Implementation Deployment
eMI: Maintenance, Migration / Integration of Business Capability
Data Term. and Standardization: Continue identification, adoption and implementation of interoperability standards in conjunction with the IPO and DoD
Rls 1
(*) Denotes Tentative Dates
Data Domains:
Stage 1 - Analysis
Stage 2 - Correction
Stage 3 - Implement
Stage 4 - Sustainment
FY 14
Upcoming Milestone
Deadlines as stated in
2014 NDAA
Rls 2
Rls 3
VistA Evolution Community Update: Enterprise Health
Management Platform (eHMP)
Mr. Keith Michael, eHMP Lead Architect/Product Manager
Ms. Betsy Green , eHMP Project Manager
Dr. Paul Nichol, MD, Deputy Chief Informatics Officer, Veterans
Health Administration
eHMP Architecture
The eHMP architecture is displayed in the next slide.
17
eHMP Schedule
1.
eHMP initial release (eHMP v1.1) accommodates the implementation of foundational infrastructure
and patient synchronization. Subsequent releases will provide additional and more robust
functionality and will be implemented nationally across the VA
2.
The graphic below provides the CY15 dev schedule for eHMP. OSEHRA code drops are expected after
sufficient testing is complete on code for each eHMP version.
Calendar Year 2015-2016 eHMP Development Timeline*
*This timeline is in a planning phase and subject to change
19
eHMP Clinical Experience
20
VistA Evolution Community Briefing
• Please direct all questions to: matthew.schultz@va.gov