Air Force Health Information Technology Transformation

Transcription

1 San Antonio AFCEA Chapter Luncheon Air Force Health Information Technology Transformation May 19, 2015 Lt Col Kevin Seeley Chief Technology Officer Office of the Surgeon General

2 Agenda Air Force Medical Service Air Force Health IT (HIT) Digital Health Trends Defense Health Agency (DHA) DHA HIT Transition Electronic Health Record Acquisition Summary 2

3 CSAF s Charge Each Airman has a compelling story that needs to be told. Tell your story. Let your fellow Americans know that their Air Force provides Global Vigilance, Global Reach, and Global Power to defend our great Nation. - General Welsh Fly, Fight & Win In Air, Space & Cyberspace I n t e g r i t y - S e r v i c e - E x c e l l e n c e 3

4 US Air Force Medicine AF MISSION The Mission of the United States Air Force is To Fly, Fight and Win in Air, Space and Cyberspace AFMS MISSION Enable Medically Fit Forces, Provide Expeditionary Medics, and Improve the Health of All We Serve to Meet Our Nation s Needs AFMS VISION Our Supported Population is the Healthiest & Highest Performing Segment of the U.S. by 2025 Trusted Care Anywhere 4 I n t e g r i t y - S e r v i c e - E x c e l l e n c e

5 Air Force Medical Service Mission: Enable Medically Fit Forces, Provide Expeditionary Medics, and Improve the Health of All We Serve to Meet Our Nation s Needs Total Force Personnel Deployed 32,661 Active Duty >102K patients moved out of 7,439 Civilians CENTCOM since 11 Sep 01 4,056 Contractors 1,289 medics deployed to 19 16,318 AF Reserve/Guard countries in 38 locations FY14 Budget/Infrastructure $6.5B (all programs) 75 Medical Facilities 61 CONUS 14 OCONUS Homestation 2.6M eligible beneficiaries (AF) 10.3M ambulatory visits/year 34K inpatient admissions/year 59K Prescriptions/day Air Force Medicine Delivering Trusted Care, Anywhere! I n t e g r i t y - S e r v i c e - E x c e l l e n c e 5

6 International Total Force Engagement AFRC ANG AFRICOM CENTCOM I n t e g r i t y - S e r v i c e - E x c e l l e n c e PACOM SOUTHCOM EUCOM 6

7 SM5 SM5 Lighter, Leaner, and Faster Medical Response TM60 Log/BMET Pharm Joint Tactical Radio System (JTRS) Admin BEE TM60 PHO Lab Xray OB/GYN TM60 PED PCM Enhanced Logistics Package OR TM60 ICU Dental TM60 ER EMEDS HRT 40 Medics / 1 C-17 Pt Care in < 15 Mins ER/OR/ICU < 6 hours EMEDS HRT (4 holding beds) Medical Command HSS Admin Medical Logistics Field Surgery Dental Prev Med (Pub Health, BEE, IDMT) Primary Care or Flt Med Critical Care Pharmacy Radiology PAM Augmentation* Specialty Care Aug International Health Specialist (IHS)* EMEDS+10 (10 beds total) Complex Med/Surg Svc Enhanced Critical Care Enhanced Med Log Laboratory Support PAM Augmentation 6 Additional Beds All EMEDS HRT Capability * Mission Dependent EMEDS+25 (25 beds total) Physical Therapy Enhanced Dietary Services Exp C2, Admin, Log Exp Ancillary Services Exp Med/Surg Services Dental Augmentation Surgical Augmentation 15 Additional Beds All EMEDS+10 Capability All EMEDS HRT Capability Rapid Capability to Stabilize and Evacuate I n t e g r i t y - S e r v i c e - E x c e l l e n c e 7

8 Create a Patient Staging Continuum Advance Care in the Air Capabilities Continue to Decrease Combat Mortality Closing the Gap in the En Route Care Continuum Patient Staging CCATT TCCET Transition System to Enroute Patient Staging System (ERPSS) Modular/Flexible for any Contingency or DSCA Single/Integrated Training Platform Critical Care Air Transport Team Modernizing Equipment Specialty Capabilities In-Flight EHR 187K Patients Moved Since October 2001 (> 8K CCATT Pts) Tactical Critical Care Evacuation Team Increasing Number of Teams in AOR Initiated Point of Injury Mvt 292 patients to date > 1,135 Critical Patients Moved Evidence Based Refinement of En Route Care 8 I n t e g r i t y - S e r v i c e - E x c e l l e n c e

9 Building Our Capabilities Goals Department of Defense Increase Capacity and Currency of Staffs Build Win-Win Partnerships in Training, Research and Development CIVILIAN HOSPITALS Trained Current Deployable ACADEMIA Recapture Care Effects Improves Quality of Care More Patient Choices VETERANS AFFAIRS Retains Providers Reduces Cost Saves Lives Coordinated Care to Deliver Expertise and Value I n t e g r i t y - S e r v i c e - E x c e l l e n c e 9

10 Air Force Medics Owning the Mission Wing/CCs Own Their Medics and Medics Own Their Wing Mission 10 I n t e g r i t y - S e r v i c e - E x c e l l e n c e

11 AFMS HIT Role AF AFMS HIT CIO/SG6 MHS Core Services & Non- Medical IT Requirements DHP $ & Enterprise Medical Systems 11

12 HIT Functional Mission - Leverage tech & data to drive high reliability / accountable care - Navigate hype vs. value to patient outcomes - Bridge all stakeholders across enterprise - Support standardization to conserve resources, reduce one-offs - Critical to provision of patient care, services, mission assurance 12

13 Critical Mission Enabler Analytics & Informatics Insight & Action (Change Agent) Knowledge Mgmt (Right person/place/time) Information Management (The right data is available) Information Assurance (Data from a system is reliable) Information Security (Data is protected and recoverable) Information Technology (Phones work, networks work, PCs work reliably)

14 We operate a Full Spectrum of: Health Systems, Infrastructure, Devices & Data MiCare ASIMS/PIMR MRDSS Ultra CarePoint CHAS KX S3 ARMD Innovian ICDB Dragon RMS PACs AIDC-RTLS Wireless LAN SDC CEMM AHLTA CHCS HAIMS Essentris TMIP DMLSS DHMRSi MEPRS TOL BHDP BHIE/FHIE PDTS TPC CCE ICD10 DBLS 14

15 We keep this working 15

16 Manage the Hype Cycle 16

17 Digital Health Trends Activity Trackers Smart Watches Smart Clothing Patches/Tattoos Ingestibles Implantables 17

18 What is AFMOA? AFMOA will provide direct reach-back capability related to clinical processes and administrative management in support of 75 MTFs and 11 MAJCOM activities Realigned mission based upon HQ AF Directive in January (7 yrs ago) Air Force Medical Support Agency (AFMSA) is policy arm of the AFMS; AFMOA is execution and operations 18

19 AFMOA HIT Capabilities MTF Reachback 1 st stop for IM/IT answers/field guidance Medical ESD/GSD Centralized helpdesk Tier 1 Network Ops Interface w/ AF network/firewalls/net security Deployment Ops Clinical systems deployments/sustainment MSIM LAN/WLAN Infrastructure/cable plants/switches/phones Info Ops Knowledge X-change/SharePoint/Web/Media Portals EUD Refresh Desktops/Laptops/Tablets PMOs Program offices/responsible/accountable system owners Cyber Ops AFSPC Medical Liaisons/Fellowships 19

20 So why the DHA? 20

21 Opportunities for efficiency 21

22 We must 22

23 From Task Force to Transition 23

24 Outcome - 10 DHA Shared Services 1 Facility Planning 6 Pharmacy Programs 2 Medical Logistics 7 Contracting 3 Health Information Technology 8 Budget & Resource Management 4 TRICARE Health Plan 9 Medical Education & Training 5 Public Health 10 Medical Research & Development 24

25 DHA Joint Leadership

26 DHA HIT All In Shared Service Health Information Technology (HIT) shared services aims to create an integrated HIT environment in support of an integrated Military Health System To support this vision, HIT will fully consolidate operations to be all-in under the management of the Defense Health Agency (DHA) A DHA Chief Information Officers (CIO), Service Chief Medical Information Officers (CMIO), management functions, and operational services were put in place first at IOC (1 Oct 2013) 26

27 DHA HIT Mission Implement, manage, and sustain an integrated and protected medical information enterprise that delivers the right information to the right customers at the right time Vision A premier health information technology environment enabling integrated care delivery for our nation s defenders, retirees, and their families 27

28 Organizations Forming DHA HIT, 1 Oct

29 DHA HIT AF HIT Assimilation Director Defense Health Agency Deputy Director, HIT (Deputy CIO) Director HIT (CIO) 182 MEDICAL FACILITIES WORLDWIDE Innovation & Advanced Technology Development Portfolio Management and Customer Relations Infrastructure & Operations Solution Delivery Information Delivery Cyber Security Strategy/Planning Branch Innovation and SOA Realization Section Innovation and SOA Transition and Program Mgmt Section Execution Branch Research and Development (R&D) Section Alliance, Coordination, and Execution (ACE) Section Enterprise Architecture Branch Communications & Customer Relationship Branch Information Reachback Investment Management Branch Strategy & Process Management Branch HIT Operations Support Branch Business Operations Branch Strategic Investment Process (SIP) Security Operations Center Branch Engineering, Design and Deployment Branch Medical Systems Infrastructure Modernization (MSIM) Operations and Sustainment Branch inosc/network Svcs MESD IT Refresh Solutions Integration, Implementation, and Sustainment Branch Deployment Ops Modernization Branch Requirements Liaison Section Project Liaison Section Informatics Branch Intelligence & Analytics Section Knowledge Management Section Operations Branch Data Governance & Management Section Platform & Apps Section Cyber Security Policy, Coordination and Compliance Branch Privacy Office & Policy Collaboration - HIPAA Security Branch Information Assurance Branch Cyber Security Operations Branch 29

30 Textbook Challenges: Forming, Storming, Norming Copyright 2014 TeamQuest Corporation The concept of IT service optimization is often associated with increased efficiency and reduced risk, two forces that will drive valuable improvements. But without a full understanding of the business objectives and how IT needs to be aligned with those, full optimization is not possible. 30

31 For Official Use Only Concept for Joint Capability and Requirements Development Business Process 1 Business Owner Business Process 2. Business Process N A N AF A N AF A N AF Horizontal & Vertical Communication Business Owner (MDAG) Determines operating model for the business the targeted level of business/clinical process standardization and integration. Accountable for overall cost and performance of business. Reviews, prioritizes, and approves business cases and investment proposals. Accountable for driving change needed to realize benefits from improvement projects throughout acquisition lifecycle. Business Process Owners (Capability Manager/Functional Proponent) Accountable for the total cost and performance for a given area of the business (e.g., primary care, pharmacy, referral management). Has responsibility and authority to drive standardization and reengineering of business processes needed to improve performance. Prioritizes improvement projects and requirements for business area. Represents respective organization in the development of joint capabilities and requirements throughout acquisition lifecycle. Function stays in Services to ensure the alignment with Service customers and to drive the necessary business changes within organization. Joint Capability Joint Capability. Joint Capability Joint Requirements Standard Business Processes & Data Timely development and validation of joint requirements and standard business processes is key to the success of HIT. Joint Capability & Requirements Developers (Information Manager) Facilitates and coordinates: Joint capability and full spectrum requirements development Development of standard business processes/data Development of standard measures of performance Prioritization, consolidation, and rationalization of portfolio Functional input throughout acquisition lifecycle Supports the joint governance process Function resides in Defense Health Agency to ensure enterprise focus and to drive the level of process standardization and integration specified by MDAG. *** Shared Service *** (Proposed Name: Joint Capability and Requirements Development )

32 What we have to do: Portfolio Rationalization Decisions Business/Clinical Value 32

33 Develop and Execute For Official Use Only Example of Product Line Consolidation: Help Desk To realize its projected cost savings, HIT will conduct portfolio rationalization and business process reengineering (BPR) for all product lines. As it consolidates and reengineers each product line, HIT will gain approval from leadership at preestablished decision points, allowing Service leadership to approve plan development, review and accept estimates of costs and savings, and sign off on technology acquisition and implementation plans before each phase begins. Below is an illustration of how the consolidation of one product line, Help Desk, might proceed within DHA HIT. Conceptual Design End to End Process Design Implement Decision Point: Planning Decision Point: Design and Development Decision Point: Implementation Air Force Help Desk Navy Help Desk DHA Help Desk Army Help Desk Current State Assessment Process Inventory Funding, Cost and Savings Figures Functional Requirements Personnel/Headcount Transition Plans End-to-End Processes Measures/KPIs Technical Requirements Help Desk Platform Analysis Vendor Selections Acquisition Plan Consolidation Plan Reports Development System Rollout Help Desk Decommissioning Plan Personnel Transition Funding Realignment = Governance Decision Point

34 DHA HIT To-Be at Maturity Consolidate & Standardize: Datacenter to Desktop (D2D) One Forest identity & enterprise mgmt, active directory One Network consolidate multiple networks One everyone on same system One Datacenter single datacenter hosting strategy One Web single web hosting solution One Desktop a single desktop configuration and strategy One Help Desk a single help desk capability One AV/Comm a single AV/communications strategy One e-learning a single shared platform One EHR single integrated EHR platform One Analytics Platform everyone using common data service 34

35 HIT Infrastructure Plan in Place IT SERVICE CAPABILITY BUSINESS IMPACT Network Security Management Service (NSMS) Directory Services (DS)/ Enterprise Management (EM) Seamless integrated Wide, Local, and Wireless Network Capabilities include a Single Security Architecture and centralized Designated Accrediting Authority (DAA), standardized monitoring/ management, and improved provider mobility Centralized and secure access and authentication capability to network resources Leverages ability to centrally manage DS infrastructure throughout the enterprise Systems and applications will be accessible across the entire DoD health care environment allowing complete access to all patient information regardless of health care location. Health care providers and staff will be able to move from hospital to hospital and be able to authenticate to all IT services without needing new accounts. Desktop as a Service (DaaS) Compute and Storage Management Service (CSMS) Global Service Center (GSC) Desktop design standardization service across the application, desktop and server environments Includes standardized desktop configuration and application virtualization capabilities across physical and virtual desktops Centrally managed, integrated, and robust computing: infrastructure Geographically-distributed infrastructure designed to deliver low-latency services close to the point of care or point of need Consolidated MHS enterprise IT service desk All desktops will be standardized so providers and staff will be able to move within the medical facility and have access to their information resources. Provides a standard method to host applications and the ability for the DoD health care system to use single applications to support all care encounters. Provides a single point of contact for all customers to obtain support for all systems regardless of physical location. 35

36 Need for Consolidated Medical Network 36

37 DHA Standard Desktop 37

38 Med-COI Network Transition 38

39 Medical Cyber Enterprise 39

40 Shared Services Culture vs. Technology 40

41 Buying a New EHR 41

42 New Electronic Health Record (EHR) Acquisition Mandate 21 May 13: SECDEF completed 30 day review of the DoD/VA integrated EHR Pursue full, open competition for EHR modernization led by USD Acquisition, Technology & Logistics (AT&L) 21 Jun 13: USD (AT&L) authorized a DoD EHR acquisition to buy Established new program office: Defense Health Management Systems Modernization (DHMSM) 25 Aug 14 Final EHR RFP released for bid Projected contract award 30 Jun 15 Goal: Begin replacing MHS legacy medical systems by January

43 Defense Healthcare Management Systems Modernization (DHMSM): Next 24 months 43