2014 Defense Health Information Technology Symposium
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1 LTC Rich Wilson 2014 Defense Health Information Technology Symposium Current and Future Delivery of Enterprise Tools Medically Ready Force Ready Medical Force 1
2 DHA Vision A joint, integrated, premier system of health, supporting those who serve in the defense of our country. Medically Ready Force Ready Medical Force 2
3 Learning Objectives Describe the current state of enterprise tools and solutions Describe the Solutions Delivery Division of DHA Health Information Technology (HIT) Directorate Program Management User Integration Process Integration System Integration Understand the future state of enterprise tool delivery and integration Medically Ready Force Ready Medical Force 3
4 Agenda Overview User Integration Process Integration Systems Integration Solutions Branch EHR Modernization (DHMSM) Medically Ready Force Ready Medical Force 4
5 Solution Objectives & Challenges Budget & DBC Culture Environment Challenges Interoperability Priorities Objectives Provides user tools to support and improve outcomes Timely, Efficient & Reliable Error free Contracting Medically Ready Force Ready Medical Force 5
6 Current State Medically Ready Force Ready Medical Force 6
7 Current State Medically Ready Force Ready Medical Force 7
8 Current State Who is managing the portfolio? DHSS DHCS SDD Regions Services MTF Logistics Medically Ready Force Ready Medical Force 8
9 Solutions Delivery Programmatics Technical Architecture Process Integration System Integration User Integration Medically Ready Force Ready Medical Force 9
10 HIT Directorate Acting Leadership Organizational Chart CAPT Margaret Beaubien Deputy Director Mr. David Bowen Director Innovation & Advanced Technology Development Mr. Division Mark Goodge CDR James Ellzy Portfolio Management & Customer Relations Division Col Richard Chip Terry Ms. Sharon Larson Infrastructure & Operations Division CDR Tony Thornton Dr. Peter Marks Solution Delivery Division LTC Rich Wilson Mr. Dan Magee Information Delivery Division Col Al Bonnema Vacant Cyber Security Division Mr. Frank Rowland Lt Col Michael Stone Defense Health Services Systems (DHSS) Dr. Dan Magee Mr. Chris Harrington Defense Health Clinical Systems (DHCS) Ms. Paula Friedman Ms. Lydia Mitchell Strategy/Planni ng Branch Enterprise Architecture Branch Support Services Branch Systems Integration Branch Data Architecture Branch Policy Branch Mr. Jake Jacobs Steven McAdams Maj G. Delaney Ms. J. Pereira Lt Col Kevin Seeley LTC Dan Bridon Mr. A. Anderson Ms. C. Reberkenny Mr. Servio Medina Execution Branch CDR Art Anthony = Acting Deputy Director = Acting Chief of Operations = Acting Branch Chief = Acting Branch Chief of Operations External Relations & Performance Management Branch Ms. Lois Kellett Investment Management Branch Ms. Tricia Cantu Vacant Security Operations Center Branch LtCol Jay Ludescher Mr. F. Echon Engineering, Design and Deployment Branch Mr. W. Spencer Mr. Albert Dickson Operations and Sustainment Branch Process Integration Branch Lt Col Kevin Kaps User Integration Branch Dr. Brian Jones Solutions Branch Mr. Mark Beckner Maj(P) R. Sennie Knowledge Management Branch TBD CEI Branch Lt Col D. Carnahan Informatics Branch CAPT Joel Parker Certification and Accreditation Branch Ms. Joan Luke Mr. Jeff Eyink Continuous Monitoring Branch LCDR D. McCullough Mr. W. Arrington = Program Executive Officer = Deputy Program Executive Officer Mr. Wayne Speaks Mr. Bill Novak
11 HIT Solution Delivery Division Solution Delivery Division LTC Rich Wilson Mr. Dan Magee Systems Integration Branch Process Integration Branch User Integration Branch Solutions Branch LTC Dan Bridon Lt Col Kevin Kaps Dr. Brian Jones Mr. Mark Beckner Maj(P) Reginald Sennie Enterprise Integrated Master Scheduling (EIMS) Section Business Process Management (BPM)Section End User Training Support Section Project Management Service Section (Business) Ms. Nora Crossan Ms. Kim Heermann-Do Ms. Arlene Ophof Mr. Brian Schafer Enterprise Integrated Systems Management (EISM) Section Organizational Change Management Section Operational & Integration Testing Section Project Management Service Section (Clinical) Mr. Chris Nichols LCDR Heather Ray TBD Mr. James Hickey = Acting Deputy Director = Acting Chief of Operations = Acting Branch Chief = Acting Branch Chief of Operations = Acting Section Chief Medically Ready Force Ready Medical Force 11
12 Current Functional Mapping Solutions Delivery Division SDD Business Portfolio SDD Clinical Portfolio DHCS Clinical Systems DHSS Business Systems SDD Branches User Integration Process Integration System Integration Other HIT Divisions I/O Security Medically Ready Force Ready Medical Force 12
13 Agenda Overview User Integration Process Integration Systems Integration Solutions Branch EHR Modernization (DHMSM) Medically Ready Force Ready Medical Force 13
14 Organization DHA Healthcare Ops R&D Health IT Ed & Training Business Support NCR Medical Solutions Delivery User Integration End-User Training Operational and Integration Testing Medically Ready Force Ready Medical Force 14
15 End-User Training Section Health Information Technology (HIT) Training Program Policy, Planning and Analysis Conducts Analysis, Designs and Manages training standards and policies Product Curriculum Lifecycle Development- System Workflow and Training (SWAT) Packages for all systems in the HIT Portfolio Provides comprehensive HIT training implementation and sustainment Conducts workflow training on clinical and business solutions EHR Workflow and Training Backbone Medically Ready Force Ready Medical Force 15
16 Clinical System Training & Workflow Metrics Service Cost (millions) CSU CST/CWA CST/CWA:CSU Army Navy Air Force Total $27.4 ($24 GS Over-hire, $3.4 Contract) $7.6 (Contract) $4.5 (Contract) $39.1 ($24 GS, $15.1 contract) ~49, :168 ~31, :632 ~25, :455 ~105, :265 CSU Clinical System User (Active) CST Clinical System Trainer CWA Clinical Workflow Analyst Tri-Service Workflow Contract $9M 22 Training and Workflow FTW Medically Ready Force Ready Medical Force 16
17 Operational & Integration Testing Section Define Operational testing requirements and expectations for functional, role-based use Develop performance and User Acceptance metrics for success and continued monitoring for all SWAT packages Maintain testing methods and standards Conducts and manages testing, minimizes impact on mission Medically Ready Force Ready Medical Force 17
18 Potential Future State COA 1 (DHA Tactical Mission) DHA HIT Solution Delivery Division creates and delivers a standardized Training & Workflow Implementation package to the individual end user by migrating current service capabilities into the DHA HIT SDD COA 2 (DHA Strategic Mission) DHA HIT Solution Delivery Division creates and delivers a standardized Training & Workflow Implementation package to the Services. Services will be required to maintain infrastructure to meet DHA implementation requirements COA 3 (DHA Hybrid Mission) DHA HIT Solution Delivery Division creates and delivers a standardized Training & Workflow Implementation package to the Services. DHA SDD capabilities will augment existing Service training and workflow implementation capabilities during deployments. Medically Ready Force Ready Medical Force 18
19 Agenda Overview User Integration Process Integration Systems Integration Solutions Branch EHR Modernization (DHMSM) Medically Ready Force Ready Medical Force 19
20 Process Integration Branch Subdivisions of Process Integration Business Process Management (BPM) Operational Change Management (OCM) Tri-Service Workflow Team (TSWF) Aligned to address the typical barriers to efficiency Non-standardization Poor adoption Difficulty identifying barriers and avoidance of them during implementation Medically Ready Force Ready Medical Force 20
21 Process Integration Tools/Products BPM AS Is and To Be Workflows for a unified approach UCD (Use Case Descriptions) to capture stakeholder s requirements OCM Review and Refine Project Manager s OCM plan Identifying measures and assistance with plan revision taking into consideration the results of those measures TSWF Identify/develop clinical workflow Develop TSWF AIM form for standardized documentation with CPG s embedded when available and clinical decision support Create training materials and deploy across the MHS Medically Ready Force Ready Medical Force 21
22 Clinical Outcomes When AIM Form used for Diabetics, it increased prescribing of medications that decrease morbidity/mortality Depression Screening Potential savings of $2.7M when applied across the enterprise Low Back Pain CPG AIM Form 41.2% to 97.8% in documentation of Red Flags Increased screening using a validated tool in Primary Care 29% to 89% Medically Ready Force Ready Medical Force $300K savings at a single MTF in 1 st quarter by unnecessary MRIs and subspecialty consult orders 22
23 Agenda Overview User Integration Process Integration Systems Integration Solutions Branch EHR Modernization (DHMSM) Medically Ready Force Ready Medical Force 23
24 Systems Integration Integrate MTF/HIT schedules, coordination and planning Enterprise-wide Scheduling Common Operating Picture Conceptual Tool Enterprise Scheduling Platform (ESP) Integrate HIT portfolio systems Domain management - OP, IP, Ancillary, Med Devices, Network Infrastructure, Data Center, Business, and Theater/Operational Provides enterprise application and system integration analysis and recommendations Work closely with EA, PMOs, Capability Mgrs, I&O etc. Broad view of all systems in domain; cross-pollination between domain mgrs Integrate systems into MTFs Execution support for deployment/decommissioning processes for HIT systems Centralize deployment operations Medically Ready Force Ready Medical Force 24
25 Enterprise Scheduling Platform Problem Statement No Common Operating Picture (COP) for the development, deployment, and sustainment of IM/IT Infrastructure and Information Systems No central repository of information No standardized view of the MTF environment Not customer-facing or globally accessible Manpower intensive Medically Ready Force Ready Medical Force 25
26 Current Scheduling Environment Currently, mixed media for scheduling exists throughout the enterprise that do not communicate with one another DHCS Master Schedule Excel Spreadsheet DHSS Currently has no IMS DHMSM Currently working to create an IMS in MS Project IA (DIACAP, IV&V, and ATO) - SharePoint/Excel Spreadsheets Lifecycle Management- SharePoint/Excel Spreadsheets MILCON - SharePoint/Excel Spreadsheets Medically Ready Force Ready Medical Force 26
27 Current Army Medicine Strategic Synchronization Matrix (AM2M) Medically Ready Force Ready Medical Force 27
28 Mature Environment Deployments Upgrades Decommissioning's Major Exercises Inspections Governance IA (DIACAP, IV&V, and ATO status) MILCON Projects Training Schedules Facility Updates (ex: Paging System) Lifecycle Events (ex: refresh, OS upgrades) Reports (trend analysis, etc.) ADHOCS Schedule by System/Program Schedule by Facility Schedule by Service Schedule by Region Schedule by Capability Medically Ready Force Ready Medical Force 28
29 Tool Mock-up Medically Ready Force Ready Medical Force 29
30 Tool Mock-up Customized View Eglin Regional Hospital 96 th Medical Group Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec HSI AHLTA Update MILCON Renovation Information Services Facility 50% Schedule - 34% Actual BOD: 1 Mar 14 FOD: 30 Apr 14 EBMS Deploys CHCS Update ATO Expires NIPR 2 nd ATO Site Scheduled: 6/4/2014 Exp: 8/4/2014 ORI DBSS Decommission EHR Deploys Medically Ready Force Ready Medical Force 30
31 Agenda Overview User Integration Process Integration Systems Integration Solutions Branch EHR Modernization (DHMSM) Medically Ready Force Ready Medical Force 31
32 Solutions Branch Vision To assure healthcare providers have the Information Technology tools and information required to deliver high quality healthcare by providing superior Project Management services to the Defense Health Agency and its customers in a transparent, scalable, flexible, efficient and effective manner. Mission The Solutions Branch enables excellence in the area of Program Management in the Defense Health Agency and its customers by providing Program Management services of varying sizes and shapes allowing the customer to choose the services to best meet their need. All services will be conducted leveraging standardized processes, templates and industry best practices all tailored to meet our unique environment as it undergoes significant change in an evolutionary manner with both organizational structure and technical approach. Medically Ready Force Ready Medical Force 32
33 Branch Structure Solutions Branch Functions as PMO Business Function Program Office Sections Clinical Business Program Management Service (Business) Business Function Program Office Business Function Program Office Offices Offices have functional alignment Contains Service applications from all Services Structure aligns to rationalizing duplicative applications or management teams Solutions Delivery Division Solutions Branch Systems Integration Process Integration User Integration Program Management Service (Clinical) Business Function Program Office Cliincal Function Program Office Clinical Function Program Office Clinical Function Program Office Clinical Function Program Office Medically Ready Force Ready Medical Force 33
34 Assess the As-Is Organizational Process NAVMISSA AFMOA DHCS USAMITIC DHSS Medically Ready Force Ready Medical Force 34
35 Identify Expected Portfolio Navy Medicine e-library ESAMS MEDRUMPMIS EAS IV BUMIS II EEDRS CBIS NMO WMSNi ICIB S3 AFIFHTC ANAM VSSM VSISM NSQIP IMED Consent TRDVS FTDTL AudioCare MedWeb OPADS OMAS ARMD MiCare MEDBOLTS MEBITT SRTS CDA/CDS ITS AMSPi MODS TAMMIS ACS-ECG AWCTS BHDP Medically Ready Force Ready Medical Force 35
36 Define the To-Be Organizational Processes Medically Ready Force Ready Medical Force 36
37 Agenda Overview User Integration Process Integration Systems Integration Solutions Branch EHR Modernization (DHMSM) Medically Ready Force Ready Medical Force 37
38 SDD & EHR Modernization SDD Branches Solutions Delivery Division User Integration Process Integration System Integration SDD Business Portfolio SDD Clinical Portfolio DHCS Clinical Systems DHSS Business Systems DHMSM Sustainment Medically Ready Force Ready Medical Force 38
39 Evaluations Please complete your evaluations Medically Ready Force Ready Medical Force 39
40 Contact Information LTC Rich Wilson Deputy CIO, Solutions Delivery, HIT, DHA Medically Ready Force Ready Medical Force 40
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