Defense Healthcare Management Systems
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1 Defense Healthcare Management Systems C5ISR Government and Industry Partnership Summit Mr. Christopher Miller 3
2 Mission To efficiently improve healthcare for the active duty military, veterans, and beneficiaries by: Establishing seamless medical data sharing between DoD, the VA, and the private sector Modernizing the Electronic Health Record (EHR) for the Military Health System Continuous Increase in Level Of Care Provided at Sites 2
3 Military Health System Continuous Increase in Level Of Care Provided at Sites 3
4 Continuity of Care 4
5 Operation Enduring Freedom In 2010 Marine Cpl. William Kyle Carpenter was rocked with a grenade blast that left him clinging to life. He d sustained catastrophic wounds to his face and arms, and dozens of broken bones. 5
6 The Journey Home Cpl. Carpenter underwent emergency surgery at the military hospital at Camp Bastion in Afghanistan, and was moved to the military s Landstuhl Regional Medical Center in Germany. He received further care at Hunter Holmes McGuire VA Medical Center in Richmond, VA. 6
7 One of America s Finest Cpl. Carpenter has undergone about 40 surgeries, improving to the point that he can run marathons, do pull-ups, and sky dive. He is the youngest living Medal of Honor Recipient. 7
8 In attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records fit for any purpose of comparison. If they could be obtained, they would enable us to decide many other questions besides the one alluded to. -Florence Nightingale, 1854
9 Value of Interoperability 9
10 Health Data Sharing Today Legacy EHR Systems DoD Medical Information Exchange 1.7M+ Legacy Unique Terms 15+ Data Standards Used by DoD Modernized EHR System Patients 9.5M+ eligible beneficiaries 218K weekly Blue Button views Private Sector 60% of care 11+ HIE connections Federal Partners 7.4M unique patient records shared with VA Claims adjudication with Social Security 10
11 DMIX Journey Four Major Software Deliveries in Less Than 24 Months 11
12 Leading the Industry JLV may knock about a minute off the time to complete a teledermatology consultation. When I'm doing 50 or 60 a day, that's a BIG deal. -Dermatologist, VA Puget Sound HCS, Seattle I use JLV quite regularly for missing records cases find all the electronically available progress notes and radiology notes in one view in JLV, without hunting through every category under the DoD records tab in CAPRI. -Military Records Specialist, Alaska VA HCS & Regional Office 1.5M Data Elements Exchanged Daily JLV is a great help with rating. It has saved me from having to order exams and/or clarifications multiple times. -Rating Veterans Service Representative, Salt Lake City VA Regional Office 12
13 Why Modernize? 13
14 Our EHR Modernization Journey 14
15 Lessons Learned So Far Have multi-disciplinary team with mix of functional, technical, and acquisition experts Develop clear organizational roles and responsibilities Get requirements right functional and technical Establish well-defined and realistic objectives Make timely decisions honor commitments and schedule Aggressively communicate and engage stakeholders inside and outside DoD Embrace fiscal responsibility and stewardship of American taxpayer dollars Stay focused on outcomes, not bureaucracy Technology is just a tool. -Bill Gates 15
16 DHMSM IOC Execution Timeline 16
17 EHR Modernization Potholes Governance Unstable resources Unclear program scope Insufficient change management Inadequate technical skills Schedule driven Consensus decision making Lack of communications Insufficient training Underestimating culture Leadership stability 17
18 Pothole Irony 18
19 Technical Challenges Data management Integration of devices Clinical decision support Genetics and genomics Analytics Continual workflow improvement Private sector health data sharing 19
20 Pace of Innovation Years Until a Third of U.S. Population Used Radio 31 TV 26 PC 16 Cell Phones 13 Internet 7 Business processes have less and less time to adapt to new solutions 20
21 DoD Acquisition Multiple gates Multiple stakeholders Multiple layers of oversight High amount of documentation Extensive testing Zero tolerance for failure 21
22 Our EHR Modernization Journey Distribution D: Distribution authorized to the DoD Distribution and U.S. DoD A: Approved contractors for only. Public Other Release requests for this document shall be referred to. 22
23 Responses Industry: Everyone helps keep it moving forward and on track Government: Get out, take everything, and burn the bus 23
24 Our EHR Modernization Journey Requirements informed by cost, schedule, and technical risks Reduce overwhelming bureaucracy Reform legislation from Congress Streamline/minimize documentation Limit multiple layers of briefings to stakeholders Develop leadership culture willing to fail Drives innovation Key to learning Program Managers given real authority, not just responsibility Rapid hiring authority Resource flexibility Provide budget stability 24
25 Our EHR Modernization Journey Tie your shoes, pack a good lunch, and remember that we re all in this together. 25
26 Contact Us Defense Healthcare Management Systems 26
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