Lynn Sanders
VA Pharmacy Informatics Conference
April 2010
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Idea
Process to submit an idea
RAEM and Class 3
Program Office Role
◦ Request for business owner support
Approval, prioritization, funding
Project Development
Project Oversight and Governance
The Next Big Thing
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Ideas Usually come from a medical center as
a result of a Need
Needs come from an issue, such as a patient
safety incident or a legislative review.
Once a need is identified – some one needs
an idea.
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Ideas are developed in a number of ways
At the medical center by a person or group that
designs something locally.
In many cases this may simply be a tool used
locally such as a template or file man report
In some cases the design is shared and its believed
that other medical centers might benefit.
Ideas may also come from outside VA, other
hospitals and vendors
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There are a few ways that a idea for system
improvements to be developed
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New Service Requests
Class III Conversions
Innovations Program
Local Development
Request for Approval, Prioritization
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Pharmacy Re-engineering
New Service Requests
Class III Development
Innovations
Local Development
Incorporating Commercial Systems
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The Enterprise Systems Management (ESM) Office is part of the
Veterans Health Administration (VHA) Office of Health
Information (OHI) within the Department of Veterans Affairs
(VA). The ESM Office serves as a VHA advocate and facilitator in
the advancement of Information Technology (IT) and innovative
health information strategies that improve the services provided
to our nation’s Veterans.
The Office also serves as a liaison among clinical, business, and
IT communities to ensure technology enhancements and strategy
requirements are:
Identified
Communicated
Understood
Prioritized
Translated into IT investments that meet clinical, business, and
Veterans’ needs
Our primary goals are:
•Gathers, documents, analyzes, and evaluates clinical and business requirements.
•Analyzes and evaluates projects and programs designed to meet VHA clinical and
business requirements, including analysis of costs, benefits, return on investment,
cost effectiveness and suitability for meeting the stated requirements.
•Interprets and assesses the impact of new or proposed Congressional legislation
or Administration proposals on VHA user requirements.
•Provides business intelligence to support executive decision making during all
stages of project and program planning, policy formulation, and decision making.
•Translates user requirements into functional requirements through coordination
with technical resources, documents system Concepts of Operations, and defines
requirements for VHA enterprise architecture and compliance.
•Facilitates collaboration among various teams to address process improvement.
VHA utilizes a rigorous, seven-phase process
to evaluate NSRs:

Request Initiation

Assessment of Request

Analysis of Requirements

Technical Assessment of Request

Prioritization of Requests

Approval of Concept

Funding and Activation of Project.
New Service Request (NSR) Processing
NSR Submitted
Initiation
Is there
management
support?
Assist Customer
in Soliciting
Support
Not Supported
End
Request
Processing
Supported
High Level Assessment
ESM Office Screening and
HISEB Review
Assessment
Not Supported
Support ?
Urgent / Mandated
Work*
End
Request
Processing
Supported
Technical
Assessment
Quad (with
Technical
Analysis)
Software Solutions
Assessment
Common
Services HISEB
Prioritization
Signed Business
Requirements
Requirements Gathering &
Documentation
Analysis
Joint
Interoperability
Ventures HISEB
Requirements
Artifacts
Health Data
Systems HISEB
Health Provider
Systems HISEB
Customer
Program
ESM Office
Decision Boards
OED
(HISEB, IDMC)
Customer Initiates Request
● Customer identifies Information Technology (IT) need.
● Customer submits New Service Request (NSR) to Enterprise Systems
Management (ESM) Office.
● URL: http://vista.med.va.gov/pas/ITServiceRequest .htm
ESM Requirements Analysis and Engineering Management (RAEM)
● RAEM works with customer to secure endorsement from Program Office or
Veterans Integrated Service Network (VISN ) and identifies business owner .
● ESM may override the need for VISN or Program Office endorsement .
Key
Customer Identification of
IT Need
Registration ,
Enrollment &
Eligibility HISEB
Management &
Financial Systems
HISEB
ESM/RAEM Team
● Communicates with Business Owner and Stakeholders .
● Provides guidance to customer on completion of Customer Business
Justification (relates value to VHA’s strategic goals ).
● Defines high-level business needs .
● Assesses existing or current development initiatives .
● Consults with the Office of Enterprise Development (OED), as appropriate .
● VHA Office of Health Information (OHI) Health Data Informatics (HDI)
Patient Safety evaluates request for patient safety risks .
● RAEM presents findings to ESM .
● ESM presents findings to Health Information Systems Executive Boards
(HISEB).
*Note: Requests immediately move into the Analysis Phase if Patient Safety ,
the ESM Office, or HISEB support a fast track or mandated status . All three
groups are still required to review the NSR .
ESM Team
● Routine Analysis involves :
- Interaction with business owner , stakeholders and OI touch points to
document a comprehensive set of high level business requirements .
- Solicitation of business owner sign -off of business requirements .
- Collaboration with OED for security and infrastructure elements .
- Identification of applicable ‘standing’ requirements such as identity
management , 508 compliance , privacy , and security .
● Requests of high urgency or risk are handled through a fast -track process .
ESM/RAEM Team
● Business Requirements Packet (Business Requirements Document , Draft
Quad Chart with business sections completed ) is shared with OED for
technical assessment .
OED Team
● Completes Quad Chart with technical analysis recommendations , which
includes estimated cost and duration of the project . It could also include a
proposal for inclusion into an active project (change control ).
● Submits their findings to the ESM /OED Review Team for concurrence .
ESM Team
● Obtains concurrence from Business Owner .
ESM Team
● Facilitates development of requirements artifacts .
● Finalized artifact documents (business owner approved Business
Requirements Document , Customer Business Justification *, technical
proposal from OED , and Quad Chart ) are shared with HISEBs .
● Work is evaluated against strategic goals and value to the organization .
● HISEBs create two categories of work :
- Mission Critical Work .
- Ranked List of Mission Requirements – A ranked list is developed
reflecting business priorities .
Filter 4
Must Do
Ranked
Not
Supported
End
Request
Processing
Decision Boards
● HISEB listings are presented to the IDMC .
● IDMC may consult additional stakeholders such as the Health Services
Committee.
● IDMC recommends funding prioritization to NLB .
● NLB makes recommendations to USH .
● USH makes final decisions for Veterans Health Administration (VHA)
priorities .
Informatics & Data Management
Committee (IDMC)
Approval
National Leadership Board (NLB)
Under Secretary for Health (USH)
Funding &
Activation
Funding
Available ?
Yes
No
Approved but
funding
unavailable
OED
● Approved project is submitted to OED .
● Project is created in the Technical Services Project Repository (TSPR ).
● Project is scheduled for activation in accordance with approved project
schedule .
Project
Activation
Revised 6-23-09
Created By CR, PL , KF, & JM, Edited by DB/LBH /JH/JM
v. 3.7
Enterprise Systems Management Class III to Class I New Service Request Process (Analysis Phase)
Version .11
Class III Process Trigger
NSR Flagged as Class III
If Class III NSR is
not mandated
After ESM/RAEM NSR
Screening Call
If Class III NSR is PSI
Mandate or Suggested
Mandate
After HISEB Filtering
Requirements Analysis
Subprocess 6.0 for Class III
Input: Completed Class III Screening Call Record and
Customer Business Justification supporting the product
Elicit Business Needs and
Software Capabilities
Review
Needed?
No
Yes
Workgroup Functional
Review
Multiple
Solutions
Yes
Ranking of Solutions by the
Workgroup
No
Determine Program Office
Level of Support for
National Deployment
No Sign-Off –
Rework Documentation
Complete Class III Product
Summary Form & Initiate
Function Point Count
Activity
Program Office Decision on
Solution
Concurrent
Product
Selection
Analysis
EDM Preparation and
HSC Review
Obtain Sign-Off for the
Class III Summary Form
Sign-Off Obtained
Initiate SSF, TAF and SRR
Output: Class III Product Summary
Form and Customer Business
Justification Tool supporting the product,
Executive Decision Memo for NLB
signature, Product PowerPoint to be
used for IDMC presentation.
Enter NSR Process at
HISEB Prioritization
Class III Prioritized List,
separate from NSR
Prioritized List?
HSIEB, Patient Safety
Five Health Information Systems Executive Boards (HISEBs) have been
formed under the authority and guidance of the Informatics and Data
Management Committee (IDMC). Each HISEB provides senior VHA
management, leadership, and oversight to facilitate and advance the
functionality and operation of an IT portfolio in the Office of Health Information.
Responsibilities include:
Ensuring that the portfolio meets current and future needs of VHA
customers.
Ensuring effective resource utilization.
Ensuring that the portfolios are managed in compliance with VA and VHA
plans, policies, standards, infrastructure and architecture.
Establishing project specific sub-groups.
Overseeing the performance, planning and execution of systems within
each portfolio to ensure successful development and operation throughout
the system's lifecycle.
NSR #
NAME
20080916 Appropriate Use of Hold
ANALYST
Jevec
STATUS
DATE
STATUS
11/17/2008 PSI Mandate
Canned Report for Outpatient Prescription
20081114 Activity
Jevec
Suggested
1/13/2009 Mandate
Report to Identify Patients Prescriptions
20081115 for Recall Notices
Jevec
Suggested
1/13/2009 Mandate
20081123 Auxiliary Drug Information Enhancements Jevec
Suggested
1/13/2009 Mandate
20081124 Prescription Label
Suggested
1/13/2009 Mandate
Jevec
20070707 Cardiology Domain – Cath Lab Integration Sklar
2/3/2009 Bypass Filter
20081118 Printing of Non VA Meds as Prescriptions Jevec
2/3/2009 Bypass Filter
Comprehensive Risk Management
20080409 Program
Jevec
Suggested
1/29/2009 Mandate
20081126 Customized Drug Information
Jevec
2/17/2009 PSI Mandate
Change CPRS reports to include station
20081206 address in header
Lester
2/19/2009 Bypass Filter
HISEB
REVIEW
DATE
Health Provider Systems (HPS) provides IT tools that support clinical care
activities, both for direct care givers as well as ancillary service departments.
Health Provider Systems are information systems that help healthcare
providers care for Veterans by supplying information to main systems, such
as VistA.
The HPS portfolio focuses on:
•Electronic Healthcare Record (CPRS)
•Clinical flow sheets
•Laboratory, Pharmacy, Radiology, and Surgery departmental systems
•Clinical Image Management services
•The Enterprise Systems Managers (ESMs), in conjunction with the Health
Provider Systems Health Information Systems Executive Board
(HISEB), will manage and oversee the HPS portfolio.
Health Provider Systems – Active Projects
BCE – Positive Patient Identification
Blood Bank - VBECS v1.0 Updates
Blood Bank Application Maintenance
Blood Bank System
Anticoagulation Management Program
Mandatory Field in Consult Request Software “soonest appropriate date for this service to be provided”
CLIO v1
CPRS - Display Polytrauma Markers
CPRS GUI Development Version 28
EDIS v1
VistaWeb v11
Radiology HL7 Interface Update
Radiology Safety & Reporting Enhancements (previously known as Radiology Maintenance & EnhancementsRadiology)
RAI/MDS Maintenance
BCMA - Inpatient Medications Requests for SFG IRA - Phase 3 and Phase 4
FY 10 Annual Surgery Updates
FY10 Pharmacy NDF Maint and Data Updates
Document and Ancillary Imaging
Filmless Radiology (VHA will determine Leg. mandate)
VistA Imaging Core
VistA Imaging Storage
Laboratory System Reengeering Project (LSRP)
FDA Medication Guides Updates - Just approved to activate, project in startup
Ward Drug Dispensing Equipment (WDDE) Interface
Pharmacy Legacy QTR Enhancements
Pharmacy Re-Engineering (PRE) .5
National Teleradiology Program
VA/DoD Imaging
Paused – Blind Rehabilitation v5.1 (need to replace a contract lost in December)
Paused – Spinal Cord Injury v3.0 (need to replace a contract lost in December)
Paused - Mental Health Enhancements phase I (this defect repair effort requires two OI&T resources)
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Teratogenic Drugs
Supratherapeutic Dosages
Allergy Checks using COTS
CCHIT
Transfer In/Out/NVA
Order Checking Improvements
Complex Order Edit
Item #
39
40
51
62
134
193
341
NSR
2007110
2
381
Name
Pharmacy Reengineering (PRE)
0.5
Pharmacy Reengineering (PRE)
1.0 (Critical Safety Features)
Bar Code Expansion
Lab Reengineering
Product
Pharmacy
Reengineering
Patient Safety Impact

Necessary to reduce Adverse Drug
Events (ADEs)
Bar Code Expansion
(BCE)
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Lab Reengineering
Intensive Care Unit (ICU) -Critical
Care Information Systems (CCIS)
Other Health
Provider Systems
Tissue/Implant Registry
Registries
Identity Management
Identity
Management
Oncology National Solution
Oncology National
Solution
Prevents “wrong patient events” due to
mislabeled laboratory specimens and
biopsy samples...
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Will reduce delays in diagnosis, support
bar-coded samples, and foster better
sharing of diagnostic reports.
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Eliminates “data silos” of critical patient
information within Intensive Care Units.
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Allows providers to quickly identify the
specific implants for a patient and
provide necessary clinical actions.. .
Ensures compliance to Identity
Management data standards for
enterprise access to patient data.
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Standardizes and allows comprehensive
order entry of complicated
chemotherapy protocols. .
Subsequent to Prioritization and Cost
Assessment
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Sustainment
Core
Critical Patient Safety
Transitional – T 13 Initiative
Mission Critical
Other Mission Critical
Discretionary Mission Critical
Display
Line
Number
Project/ Proposal
1
Austin Enrollment Support
2
HEC IT Enrollment Support
3
Category
Sustainment
Sustainment
Maintenance
VHA
T13
Initiative
Initiative / Op Plan
Name
Office/Business
Sponsor
ESM
CBO/Phillip
Matkovsky, Tony
Guagliardo &
Lynne Harbin
REE
Sustainment
Maintenance
CBO/Phillip
Matkovsky, Tony
Guagliardo &
Lynne Harbin
REE
Home Telehealth
Development
Sustainment
Maintenance
PCS / Adam
Darkins
HDS-DS
4
Health Data Repository (HDR)
- Sustainment
Sustainment
Maintenance
PCS/ Stanlie
Daniels &
ROB/Gail Graham
HDS-DS
5
Blood Bank System
Sustainment
Maintenance
Blood
Bank/William
Triest
HPS-JS
6
Occupational Health RecordKeeping System (OHRS) Sustainment
Sustainment
Maintenance
Occupational
Health/Victoria
Davey
HPS-JS
7
My Healthe Vet Sustainment
Sustainment
Maintenance
PCS/Nichol, Paul
& Dr. Agarwal,
OHI, CHIO/
Hancock, Theresa
HPS-SF
Display
Line
Number
8
9
VHA
T13
Initiative Office/Business
Project/ Proposal
Category
Initiative / Op Plan
Sponsor
Name
C33 FLITE VBMS Crit Pat Safety
Positive Patient
Critical Patient
BCRO/Chris
Identification (PPI) - also
Safety
Tucker
known as Bar Code
Expansion (BCE)
ESM
HPS-JS
Lab Data Sharing &
Interoperability (LDSI) Anatomic Pathology /
Microbiology
Critical Patient
Safety
Dependencies
PCS/William
Triest
HDS-DE
10
Person Service
Critical Patient
Safety
Dependencies
OHI/ Gail
Graham, &
Elizabeth Franchi
REE
11
Wireless Upgrade
Critical Patient
Safety
Dependencies
12
Laboratory System
Reengineering Project (LSRP)
Critical Patient
Safety
PCS Diagnostic
Services,
P&LMS/William
Triest
HPS-JS
13
Pharmacy Reengineering
(PRE) 0.5
Critical Patient
Safety
PCS PBM/Michael
Valentino
HPS-JS
14
Pharmacy Reengineering
(PRE) 1.0
Critical Patient
Safety
PCS PBM/Michael
Valentino
HPS-JS
CS
IT $M
cumulative
(Non-Pay)
VA Initiatives / Programs
(IT Priority Categories from Highest to Lowest)
IT $M
(Non-Pay)
Sustainment of Existing Systems
CH-33, FLITE, VLER, VBMS, Other High Priority
Critical Patient Safety: Lab, Bar Code Expansion, Pharmacy,
Others
Core
VA T-13 Initiatives
Administration-Level T-13 / Op Plans
Other VHA Mission Critical (OI&T Development
Modernization & Enhancement)
Discretionary Mission Work (VHA)
$1,368.1
$337.6
$1,368.1
$1,705.7
$197.3
$438.5
$365.1
$87.7
$1,903.0
$2,341.5
$2,706.7
$2,794.3
$280.0
$0.0
$3,074.3
$3,074.3
Funding
Cut
Line
$2.7B
Example of PRE as a Project
Project Plan Before PMAS
PM Name: Mike Mims
VHA Biz Rep: Lynn Sanders
VHA Biz Owner: Jeff Ramirez
Program Summary:
Justification:
The Pharmacy Reengineering (PRE) project will replace all pharmacy applications with a system that better meets the current and expected business
needs for the VA. This product will deliver enhanced order checking functionality utilizing HealtheVet (HeV) compatible architecture to the field with our
first iteration addressing known patient safety issues. Other enhancements will include Dispense and Administration, Activate, Inventory, Clinical
Monitoring, and functions with final migration to the HeV environment.
Current Pharmacy functionality is not patient centric and does not include adequate decision support capabilities required for a modern healthcare system.
Approximately 124 requests for system improvement have been referred to Pharmacy Reengineering and are deemed not feasible to be implemented in Legacy.
The Pharmacy Reengineering project will provide the ability to respond to the ever-changing patient safety issues, medication treatment cost reduction and
containment, beneficiary service requests, and will provide the clinician with an improved work flow and process utilizing a scalable HDR/HealtheVet platform and
realization of One VA.
Business Value
Release
Number
Business Capabilities
Business Outcomes & Metrics
0.5
Improved Decision Support
• Enhanced drug-drug check to provide more clinical information
• Enhanced duplicate therapy check to utilize FDB Enhanced Therapeutic Classification which
allows for multiple classes per drug
• New maximum single dosage check
• New Daily Dosage Range check
• Ability to customize decision support data as required to meet VA needs
• APIs to support order check enhancements
• Integration of order checking services provided by a commercial drug database into support
Legacy VistA order processing functions
• Pre-Release patch for file mapping, setup and review to implement new dosage checks
• Quick identification of discontinue/hold action type (e.g. discontinued due to edit)
1.0
Pharmacy Enterprise Product System (PEPS)
(Replaces current National Drug File and Pharmacy
Data Management modules)
• Display of lab/vital information for pharmacy staff to aid in professional review of medication
orders.
• NDF mismatched items would be eliminated
•Implementation of dispensing limits (qty/days supply)
• Enhanced Do Not Mail functionality.
• Identification of Product Type and Storage Requirements
• Identification of High Risk Drugs for Follow up
• Increased frequency and streamlined distribution of drug database updates
• Improved Drug and supporting pharmacy file maintenance tools
• Manage pharmacy users/user roles functions (role based access and rules)
• Improved parameter management
Version Number: 1.0
Release
Number
1.0 (cont.)
2.0
Business Capabilities
Business Outcomes & Metrics
Pharmacy Enterprise Product
System (PEPS)
(Replaces current National Drug File
and Pharmacy Data Management
modules)
• Enhanced Reporting capabilities
Inventory
(Replaces current Controlled
Substances, Drug Accountability,
Automatic Replenishment/Ward Stock
and Pharmacy Data Management
(partial) applications
• Enhancements to PEPS Module to support new inventory module (and to finish up what was not done in the initial
version)
• Replacement of Legacy VistA PBM Inventory and drug data extractions
• Ordering Capabilities (includes prime vendor interface)
• Inventory accountability
• Receiving/Shipping
• Return/Recall Management
• Reporting and Forecasting Usage
• CS Discrepancy Tracking/Documentation
• CS Wasting
• Identification of Drugs Requiring Witness for Administration
• Check for Lifetime Cumulative Dose
• Check for IV compatibility
Release
Number
Business Capabilities
3.0
Order Entry, Activate, and Clinical
Monitoring
(Replaces Legacy VistA order
entry/finishing modules in
Outpatient Pharmacy, Inpatient
Medications (UD & IV)
Dispensing
(Replaces Legacy VistA dispensing
functions in Outpatient Pharmacy,
Inpatient Medications and Pharmacy
Benefits Management (partial) )
Administration and Final
Migration to HeV
(Remaining legacy pharmacy
modules retired)
Business Outcomes & Metrics
•
•
•
•
•
•
•
•
•
•
•
•
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Enhancements to PEPS Modules to support order entry, activate order and clinical monitoring activities)
Enhancements to Inventory Module if needed
Enhanced Patient Counseling Functionality
Enhanced Intervention Module
Integrated Patient Medication Profile
Single/Guided order entry dialog for medications/supplies
Enhanced Order Actions (e.g. Hold, renew, etc) processing
Enhanced order entry of specialty orders (TPN, Oncology, PCA, complex orders, etc)
Enhanced order pending lists and processing
Medication Order Reconciliation upon Patient Movements
Improved transfer of orders
Creating/Review of Clinical Monitors
Replacement of Legacy VistA PBM dispensing data extraction
Support for Barcode/RFID technology
System Order Tracking
Dispense Exception Tracking
Electronic Fill Lists
Real Time order tracking with CMOP
Enhanced communication between CMOP and remote facilities
Tracking of Lot numbers, NDCs and expiration dates with fill records
Create/Manage preparation lists
Enhanced Missing Dose Requests
Enhanced Virtual Due List
Display stability data for premixed sterile products
Witnessing of Controlled Substances and High Risk Medications
Improved medication administration documentation
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PMAS is the rigorous management approach VA instituted to
address IT development project performance shortcomings. PMAS
delivers smaller, more frequent releases of new functionality to
customers, ensuring that customers, project staff, and vendors
working on a project are aligned, accountable, and have access to
all necessary resources to successfully complete the project’s goals
and objectives. PMAS mandates that specific project resources and
documentation be in place before development begins and
mandates that approval processes be used during the system
development life cycle. It also ensures that development projects
are outcome-based by institutionalizing the use of standard, end-toend repeatable processes.
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Support delivery (IOC) of PRE components in
manageable increments not to exceed 6 months.
Increments must provide functionality to business
owners
Accelerate delivery of increments to field testing
Reduce duration of lab testing processes
Increase reliance on internal SQA and test accounts
at field sites for feature testing
Beat schedule for FOC delivery outlined in
approved June 2009 schedule
After PMAS
PRE PMAS Integrated Program Team
Agenda
03/22/2010 (Monday)
Facilitator: Mike Mims
10:00am EST (9 Central, 8 MTN, 7 Pacific)
Call number (audio) 1-800-767-1750
Access Code: 14063#
Note Taker: Gina Scorca
Live Meeting Link: https://www.livemeeting.com/cc/vaoi/join?id=DM22SM&role=attend&pw=d%2B.s3ZF
PRE Website link: http://vaww.itfo.portal.va.gov/svcs/itfopmo/pre05/default.aspx
Invitees/Attendees * in attendance T=Travel/Training N=Not in attendance L=Leave E=Excused R=Sent a representative
Name
Service
*
*
*
Mike Mims
LuAnne Barron
Michelle Ott
Program Manager
PBM
EIE Project Manager
N
Marilyn Hodge
Director, OED TS
N
*
*
*
John Lunden
Michaele Mahoney
Lyn Teague
Jim Weaver
ETS
National Support
National Support
Implementation Manager
N
Angela Chow
Implementation Manager
*
N
*
N
N
*
*
*
Richard Muse
Karen Lebo
Cliff Sorenson
Sanders
Craig Hunter
David Honeycutt
William Whitaker
David Lyles
Project Planner
ITALO
NTE&O
PBM
Implementation Manager
Program Manager
Project Manager
*
*
*
N
*
*
*
*
N
*
*
*
*
*
*
N
*
Name
Service
Ed Heitman
Robert Russo
Elisa McReynolds
NTE&O
OGC
Field Operations
Sarah Emerson
Laura Rowland
Tom Grohowski
Dan Soraoka
Jeanne Brych
Contract Representative
Project Planner (OED TS)
OED TS
Cathy Harris
ITALO
Gina Vece
Jennifer Freese
Kristina Lew
Arti Iyer
Jim Pollard
Gina Scorca
Steve Nagy
Kendra Miller
Project Manager
Development Manager
TAC Contract Specialist
SQA Testing
PRE Project Management
Technical Writer
Increment
#
Planned Start
Planned IOC
PRE Foundational Enhancements
1
10/09
12/09
Pharmacy Enterprise Customization
System (PECS)
2
10/09
3/5
Order Checks Phase 1 (Non-Dosing)
3
10/09
6/10
Order Checks Phase 2 (Dosing)
4
10/09
6/10
Pharmacy Enterprise Customization
System Enhancements
5
12/09
08/10
Enhanced Order Checks
6
07/10
12/10
PMAS/ Project Deliverable
37
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Current PRE Status.
◦
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◦
◦
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IOC for PECS (Increment 2) completed 3/5/10 as scheduled.
National Hardware Solicitation bids received 3/12/2010. Reviews start 3/15/2010.
Setup of Beta sites for Increments 3 and 4 completed as scheduled by 3/15/10.
UAT for Increment 4 is planned for the week of 4/12/2010.
Issues
◦ Existing SQA testing and Project Planner contracts supporting PRE expire on
3/31/10. If coverage in these areas is not maintained, PRE schedule may be
impacted. Indications are that these contracts will not be renewed.
38
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Pharmacy Legacy Quarterly Enhancements
CPRS
Inpatient Medication Orders
BCMA
BCRO
Lab Re-engineering
e-Pharmacy Claims
•
•
•
SM enables Veterans and their healthcare teams to exchange
non-urgent health-related information, attend to administrative
needs, and in some cases communicate in lieu of an office visit
or telephone call. SM is a patient-professional communication
tool that enables: 1) patient-clinician communication
management; 2) healthcare team management; 3) message
management; and 4) patient services/clinical operations
management. This e-health service, provided through MHV, is
the authorized means for VA staff and patients to communicate
electronically with one another.
Expansion of virtual medicine for Veterans is a critical
component of the Veteran Centered Medical Home model
transformation. SM through MHV is considered an essential
element of the Veteran Centered Medical model enhancing
virtual medicine activities and providing patients with access to
the care they need in a manner they desire.
Innovation Initiative
Remote Cardiology Consultations
Using Handheld Devices
Facility: DVA Medical Center
Initial Idea Submitted by: Edward Employee
Department of Veterans Affairs
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Main Ordering Screen
PBM, Patient Safety, ESM
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Purpose
The Business Relationship Meetings between Under
Secretary of Health and VA Chief Information
Officer provide a forum for weekly status reports
on various projects and activities. The primary
meeting activities are as follows:
•
The review and discussion of status of agenda
items as determined by VHA
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Discussion of various joint activities and
projects between VHA and OI&T
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Focus on development and operational issues
Approval of Project Phases
Issue Brief and Concurrence
◦ ESM, VA IT, PBM, Patient Safety
Advisories to Leadership and Medical Centers
Compliance Monitoring
Report of Contact for Problems
Workgroup Participation and Subject Matter
Experts with VA IT Project Leaders and
Developers
Knowledge Experts
Training and Education
Communications
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Issue:
Date of Report:
Point of Contact:
Desired Release Date:
Emergency Release:
Application Name(s):
Software Product Description:
Patch Release Dependencies
STATEMENT OF ISSUE:
SUMMARY OF FACTS /
BACKGROUND:
Impacts to Healthcare:
Impacts to Business Flow:
Solutions:
CURRENT ACTIONS:
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SUMMARY OF TESTING:
Testing Process:
Peripheral devices affected:
Outstanding Issues:
Exceptions to Testing:
Communications:
Proposed IOC Test Sites
IMPLEMENTATION ISSUES:
Recommend Approval/ Do Not
Recommend Approval
ECOMMENDATION:
BASIS OF RECOMMENDATION AND
EFFECTS ON EXISTING PROGRAMS
AND/OR FACILITIES:
CONCURRENCES:
VHA OHI IT Patient Safety:
Recommend Approval/ Do Not
Recommend Approval/ No review
required
Business Owners/Stakeholders
Signature:
EntMgr
HPS-S
HPS-F
HPS-S
HPS-S
RequestID
PRE
Version
Delayed
Request
Due to
Name
PRE
NSR
Request
Phase Date
20100118
Signature
Receipt for
Prescriptions
using
Asses
iMedConsent sment 3/15/2010
View alert
for expiring
Generic
Asses
(text) orders sment 1/25/2010
20100115
PRE
V2.0
BCMAComment
Icon on VDL
PRE
V2.0
View alert
for abnormal
microbiology
(mi
subscripted
lab test)
results
20100309
20100109
Asses
sment 1/22/2010
BRD
Age in Signed
Days
Date
(CYTD)
30
79
82
90
Asses
sment 1/14/2010
SITES NOT INSTALLED BY COMPLIANCE DATE OF
4/13/2010
EL PASO, TX
HINES, IL
15-Apr-10
MANILA OC, PI
ORLANDO, FL
14-Apr-10
Prioritization and Funding for FY 2011
The first part of this plan lays the foundation to transform VHA’s culture to be more patient
centered. Beginning in FY 2010, this effort will require a continuous investment over a number of
years. Ultimately, it will require every employee, from the physician to the housekeeper, to redefine his
or her role within this new context. The Universal Services Task Force laid a foundation for VHA’s new
models of care. Their April 2009 report laid out twelve principles that will begin to define this new
culture.
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1. Honor the veteran’s expectations of safe, high quality, accessible care.
2. Enhance the quality of human interactions and therapeutic alliances.
3. Solicit and respect the veteran’s values, preferences, and needs.
4. Systematize the coordination, continuity, and integration of care.
5. Empower veterans through information and education.
6. Incorporate the nutritional, cultural and nurturing aspects of food.
7. Provide for physical comfort and pain management.
8. Ensure emotional and spiritual support.
9. Encourage involvement of family and friends.
10. Ensure that architectural layout and design are conducive to health and healing.
11. Introduce creative arts into the healing environment.
12. Support and sustain an engaged work force as key to providing veteran centered care.
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Specific VA goals for VLER are to:
· Integrate VA with certified (NHIN-compliant and authorized)
community resources to enhance services to Veterans by
aggregating data from VA, DOD, and the private sector
· Establish a consistent universal view of a client’s electronic
record
· Become a recognized platform and leader in the nations
transformation to higher quality, continuous care services
supported by electronic records
· Enable a proactive, convenient, comprehensive, and secure
method of access to other VA services and benefits
OHI Organization
Chief Officer
Craig B. Luigart
Health Systems
Chuck Hume (Acting)
Deputy Chief Officer
Enterprise Systems Management (ESM)
Chuck Hume – Director
 Business Architecture
 Requirements Analysis &
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Engineering Management
Program Integration
VHA IT Portfolio Management
VA/DoD Health Information Sharing (HIS)
Cliff Freeman – Director
 Administrative & Operations Support
 Bidirectional Health Information
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Exchange Program Support
Clinical/Health Data Repository
Program Office
Liaison Health Information Network
VAMC Interoperability Liaison
Health Care Information Management
Gail Graham
Deputy Chief Officer
 Education and Training
 IT Patient Safety
 Program Office
Health Data and Informatics (HDI)
Vacant – Director
 Data Quality
 Health Care Security Requirements
 Health Information Management
 Information Access & Privacy
 National Data Systems
Business Operations
Bill Burrow (Acting)
Deputy Chief Officer
 Administrative Services
 Budget & Finance
 Committee Liaison Office
 Communications
 Contracting
 Human Resources
 Service Coordination
Marcia Insley – HDI Deputy Director
 Section 508 Compliance
 VACO Library
 VA Library Network
 VHA Forms, Pubs, & Records Mgmt
Chief Health Informatics Office (CHIO)
Linda Fischetti – Director
 Bar Code Resource Office
 Emerging Health Technology Office
 Health & Medical Informatics Office
 Standards & Interoperability Office
 Veterans and Consumers Health
Informatics Office
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