VistA Legacy to VistA Health e Vet Transition Plan  Office of Information and Technology Office of Enterprise Development ...
<ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model  </...
<ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model  </...
VA Health IT: Setting the Benchmark “ How VA hospitals became the best”  Time magazine,  8/27/06 “ The best medical care i...
<ul><li>Documents  (Progress Notes, Discharge Summaries, Reports) </li></ul><ul><ul><li>906,000,000 ……..  +640,000 each wo...
VHA Objectives for Health Care <ul><li>Current VistA – World Class System : </li></ul><ul><li>Delivers a complete hospital...
Challenges in Transition to VistA HeV <ul><li>H e V Concept Solid, Past Efforts at Implementing Ran into Challenges </li><...
<ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model  </...
Reason for Using Enterprise Architecture <ul><li>Provides a Model for Managing Transition </li></ul><ul><ul><li>EA Provide...
Federal Enterprise Architecture Framework Technical Standards, Departmental Standards, etc Technical Reference Model Visio...
Health Segment Responsibilities by Layer <ul><li>Lead for Each Layer Responsible for Developing Artifacts </li></ul>OI&T: ...
<ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model  </...
VistA’s Current Development Strategy <ul><li>For VistA Legacy </li></ul><ul><ul><li>Annual, fixed investment that will be ...
<ul><li>In Building HeV Plan, Common Question Arose:  When is a Capability Completely Transitioned? </li></ul><ul><li>Prop...
HeV Transition Phase I <ul><li>Primary Capability in Development </li></ul><ul><ul><li>Build Common Services and Testing C...
HeV Transition Phase II <ul><li>Primary Capability in Development </li></ul><ul><ul><li>Continue Building Out Common Servi...
SECURITY MAILMAN MANAGER MENU  MANAGER RPC BROKER TASK MANAGER VA  FILEMAN INTEGRATED DATABASE KERNEL VISTA SOFTWARE PACKA...
VistA HeV Architecture DoD Systems Other Federal Systems Private Systems Personal Computers Medical Devices PDAs Web Porta...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Secu...
Phase II: Integrated Schedule Scheduling (RSA) Alpha Beta National Laboratory Pharmacy Beta National Prototype Alpha Natio...
<ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model  </...
Core Elements of HealtheVet SECURITY MAILMAN MANAGER MENU  MANAGER RPC BROKER TASK MANAGER VA  FILEMAN INTEGRATED DATABASE...
Security Archive Service Organization Service Audit Service Deployment Toolkit Common Services HEALTHeVET PORTFOLIO Social...
QUESTIONS
BACKUP
Health EA: Strategy Layer <ul><li>VA Strategic Plan is Primary Guide for Transitioning Health Care </li></ul><ul><li>Other...
Health EA: Business Layer <ul><li>For Patient-Centric Care, Five Areas Selected for Business Process Improvement </li></ul...
Health EA: Information & Data Layer <ul><li>Implement Single Logical View of Patient </li></ul><ul><ul><li>Accessible from...
Health EA: Application and Services Layer <ul><li>Employ a Service Oriented Architecture </li></ul><ul><li>Iterative Devel...
Health EA: Application and Services Layer <ul><li>Open Systems </li></ul><ul><ul><li>Interfaces between Applications and M...
Health EA: Application and Services Layer <ul><li>VistA H e V Applications Must Meet the Following Minimum Requirements fo...
Health EA: Technology Infrastructure Layer <ul><li>Technologies </li></ul><ul><ul><li>VA Enterprise Architect Defines Tech...
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  • Two primary Health e Vet Program Goals are: (1) to provide affordable “world class” support capability to our veterans, and (2) to ensure that the basic system infrastructure can support current and future system requirements. The challenge will be to continue to deliver expected “World Class” service while seamlessly transferring to the new systems. The benefits and rewards for program success, however, are immense. The direct benefits of creating a more nimble, cost-effective IT environment will be an increase in the proportion of allocated funds available for direct patient care and/or a significant increase in the number of veterans that can be covered by the VA health care system. Additionally, the enhanced system will give VA greater flexibility in meeting legislative requirements and Congressional mandates, responding to national emergencies, and implementing new health care models and veterans services. Finally, an estimated 40% of veterans treated at VA each year also receive care from non-VA physicians. Health e Vet will foster greater interaction with our health care partners by: Establishing interoperability with the DOD and private-sector health systems, promoting continuity of care as service members transition from active-duty to veteran status, and increasing opportunities for sharing health information and clinical resources (e.g., pharmacies, co-located clinics); Supporting VA’s participation in the creation of a National Health Information Network (NHIN), as directed by the President, to exchange health data privately and securely; Supporting bio-surveillance activities and population health reporting to federal (e.g., NIH, CDC), state, and local health partners, and Reinforcing VA’s on-going involvement in collaborative standards activities with private- and public-sector partners (e.g., as a founding partner of Consolidated Health Informatics (CHI)) and in leadership roles in Standards Development Organizations (SDOs)).
  • Strategy and Business Layer Artifacts/Guiding Documents VA Strategic Plan VA EA Executive Perspective VHA Strategic Plan Clinical Info Systems in VHA: Vision for the Future Information and Data/Applications and Services Artifacts Sequencing Plan Transition Plan Technical Reference Model All VHIT architecture documents available on VHIT website for review
  • Under development tools – a single development environment or do you mean a single configuration – there are development systems at each of the OIFO are you proposing to merge them all and have development done on a single system? – or is this for the rational stuff
  • 200_VEHU.ppt

    1. 1. VistA Legacy to VistA Health e Vet Transition Plan Office of Information and Technology Office of Enterprise Development Program Executive Office for Veteran Health IT Jackie Gill August 21, 2007
    2. 2. <ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model </li></ul><ul><li>The Product VistA Health e Vet Transition Plan </li></ul><ul><li>Next Steps </li></ul>Topics
    3. 3. <ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model </li></ul><ul><li>The Product VistA Health e Vet Transition Plan </li></ul><ul><li>Next Steps </li></ul>Topics
    4. 4. VA Health IT: Setting the Benchmark “ How VA hospitals became the best” Time magazine, 8/27/06 “ The best medical care in the U.S.” Business Week, 7/17/06 “ Technology has transformed the VA” Fortune Magazine, 5/11/06 “ Model for health care nationwide.” NBC Nightly News, 3/15/06 <ul><ul><li>“ Top-notch health care” </li></ul></ul><ul><ul><li>U.S. News and World Report, 7/10/05 </li></ul></ul>They've adopted a culture of patient safety and quality that is pervasive. The centerpiece of that culture is VistA , the VA's much praised electronic medical-records system.” Business Week July 17, 2006
    5. 5. <ul><li>Documents (Progress Notes, Discharge Summaries, Reports) </li></ul><ul><ul><li>906,000,000 …….. +640,000 each workday </li></ul></ul><ul><li>Orders </li></ul><ul><ul><li>1.7 Billion …….... +960,000 each workday </li></ul></ul><ul><li>Images </li></ul><ul><ul><li>641,700,000 ……… +913,000 each workday </li></ul></ul><ul><li>Medications Administered with the Bar Code Medication Administration (BCMA) system </li></ul><ul><ul><li>885,000,000 ……… +620,000 each workday </li></ul></ul>VA Health IT: Setting the Benchmark <ul><ul><ul><li>Statistics as of March 2007 </li></ul></ul></ul>
    6. 6. VHA Objectives for Health Care <ul><li>Current VistA – World Class System : </li></ul><ul><li>Delivers a complete hospital information system to include </li></ul><ul><li>the EHR, Imaging, Bar Code Medication Administration… </li></ul><ul><li>It’s fast, extensible & has most of the functionality users currently want. </li></ul><ul><li>But… </li></ul><ul><li>Includes 100+ applications in 128 systems at 113 sites </li></ul><ul><li>Decentralized: application and data bases are hospital-centric </li></ul><ul><li>Does not easily accommodate mandated changes - HIPAA, etc, </li></ul><ul><li>Does not provide a national EHR for today’s mobile population, and </li></ul><ul><li>Is built on dated architecture with minimal documentation; hard to </li></ul><ul><li>modify, expensive to maintain and knowledgeable Mumps programmers are dwindling. </li></ul>… <ul><li>VistA-HealtheVet Health Care Environment : </li></ul><ul><li>Patient-centered / Directed </li></ul><ul><li>Complete medical record available anywhere </li></ul><ul><li>Accurate, fast health information </li></ul><ul><li>Interdisciplinary clinical care </li></ul><ul><li>Clinical, patient decision support </li></ul><ul><li>Open / robust systems architecture </li></ul><ul><li>Pre-emptive care for veterans; Virtual patient </li></ul><ul><li>Support for comprehensive “outcomes research” </li></ul><ul><li>Integrating web-based capability where feasible </li></ul><ul><li>Reduced Infrastructure Cost </li></ul>… 2005 2012 …
    7. 7. Challenges in Transition to VistA HeV <ul><li>H e V Concept Solid, Past Efforts at Implementing Ran into Challenges </li></ul><ul><ul><li>In 2005, VHA Requested CMU SEI Assessment </li></ul></ul><ul><ul><li>Following Recommendations Were Made </li></ul></ul><ul><ul><ul><li>Define the H e V Vision and the Transition Path </li></ul></ul></ul><ul><ul><ul><li>Constitute Proper Integrated HeV Program Governance </li></ul></ul></ul><ul><ul><ul><li>Institute Effective, Standard Practices </li></ul></ul></ul><ul><ul><ul><li>Manage to Realistic, Changing Program/Technical Options and Risks </li></ul></ul></ul><ul><ul><ul><li>Develop a Framework to Meet H e V Program Lifecycle Needs </li></ul></ul></ul><ul><li>Severe Budget Reductions in FY06/FY07 Forced Restructure </li></ul><ul><ul><li>Content Removed </li></ul></ul><ul><ul><li>Schedule Milestones Pushed Out </li></ul></ul><ul><ul><li>Entire Development Plan Revamped </li></ul></ul>VistA-H e V FY06 Development Budget
    8. 8. <ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model </li></ul><ul><li>The Product VistA Health e Vet Transition Plan </li></ul><ul><li>Next Steps </li></ul>Topics
    9. 9. Reason for Using Enterprise Architecture <ul><li>Provides a Model for Managing Transition </li></ul><ul><ul><li>EA Provides a Big Picture View Across the Organization </li></ul></ul><ul><ul><li>Captures the Mission, Supporting Information, and Technologies to Perform the Mission </li></ul></ul><ul><ul><li>Links Technology Investments to the Overall Mission and Objectives </li></ul></ul><ul><ul><li>Includes As-Is Architecture, To-Be Architecture, and Transition Plan </li></ul></ul><ul><ul><li>Addresses New Technologies and Changing Mission Needs </li></ul></ul><ul><li>Provides Method for Implementing Two of the SEI Recommendations </li></ul><ul><ul><li>Define the H e V Vision and the Transition Path </li></ul></ul><ul><ul><li>Develop a Framework to Meet HeV Program Lifecycle Needs </li></ul></ul><ul><li>It’s Required by OMB </li></ul><ul><ul><li>Agencies are expected to architect first, and then use the architecture to guide and inform information technology (IT) investment planning and implementation </li></ul></ul><ul><ul><ul><li>Federal Enterprise Architecture Practice Guide </li></ul></ul></ul>
    10. 10. Federal Enterprise Architecture Framework Technical Standards, Departmental Standards, etc Technical Reference Model Vision, Mission, Objectives, Goals Performance Measures Business Lines, Business Services, Functions, Processes Business Reference Model Semantic Models, Logical Data Models, Physical Data models Data Reference Model Software Applications, Web Services, Messaging Service Service Reference Model Strategy Business PRM BRM Applications & Services Technology Infrastructure SRM TRM Information Information & Data DRM Security and Other Cross Cutting Capabilities
    11. 11. Health Segment Responsibilities by Layer <ul><li>Lead for Each Layer Responsible for Developing Artifacts </li></ul>OI&T: O&I VHA OI&T: OED Strategy Business PRM BRM Applications & Services Technology Infrastructure SRM TRM Information & Data DRM 5 th PILLAR 4 th PILLAR
    12. 12. <ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model </li></ul><ul><li>The Product VistA Health e Vet Transition Plan </li></ul><ul><li>Next Steps </li></ul>Topics
    13. 13. VistA’s Current Development Strategy <ul><li>For VistA Legacy </li></ul><ul><ul><li>Annual, fixed investment that will be prioritized yearly </li></ul></ul><ul><ul><li>Used to address critical capabilities and patient safety Issues </li></ul></ul><ul><li>For VistA-Health e Vet </li></ul><ul><ul><li>Phased transition in-line with budget and program executability / risk </li></ul></ul><ul><ul><li>First phases target development of software infrastructure </li></ul></ul><ul><ul><ul><li>Common software services such as security, identity management, alerts and audits </li></ul></ul></ul><ul><ul><ul><li>Design data stores; implementation of regional data processing centers </li></ul></ul></ul><ul><ul><ul><li>Hardware and networking required to run Health e Vet </li></ul></ul></ul><ul><ul><ul><li>Robust capability for testing </li></ul></ul></ul><ul><ul><li>Subsequent phases target the implementation of clinical and administrative capabilities </li></ul></ul>
    14. 14. <ul><li>In Building HeV Plan, Common Question Arose: When is a Capability Completely Transitioned? </li></ul><ul><li>Propose Adopting Use of Terms Initial Operating Capability (IOC) and Full Operating Capability (FOC) </li></ul><ul><li>Initial Operating Capability </li></ul><ul><ul><li>Replicates All Necessary Functions from VistA Legacy </li></ul></ul><ul><ul><li>Meets Some, But not All, HeV Architectural Requirements </li></ul></ul><ul><ul><li>Deployed to at Least One Field Site </li></ul></ul><ul><li>Full Operating Capability </li></ul><ul><ul><li>Meets All Requirements Identified at Beginning of Transition (i.e. Requirements Identified When Program Completed Milestone I) </li></ul></ul><ul><ul><li>Meets All HeV Architectural Requirements </li></ul></ul><ul><ul><li>Deployed to All Field Sites </li></ul></ul>Initial vs. Full Operating Capability
    15. 15. HeV Transition Phase I <ul><li>Primary Capability in Development </li></ul><ul><ul><li>Build Common Services and Testing Capabilities </li></ul></ul><ul><ul><ul><li>Health and Administrative Data Repositories (HDR/ADR) </li></ul></ul></ul><ul><ul><ul><li>Identity Management </li></ul></ul></ul><ul><ul><ul><li>Security </li></ul></ul></ul><ul><ul><ul><li>Messaging & Interface Services </li></ul></ul></ul><ul><ul><ul><li>Standards & Terminology Services </li></ul></ul></ul><ul><ul><li>Transition Application Modules </li></ul></ul><ul><ul><ul><li>Enrollment </li></ul></ul></ul><ul><ul><ul><li>Scheduling </li></ul></ul></ul><ul><li>Major Milestones* </li></ul><ul><ul><li>FY07: IOC </li></ul></ul><ul><ul><li>FY07: Enrollment Beta & National Release; Scheduling Alpha Release </li></ul></ul><ul><ul><li>FY08: Scheduling Beta & National Release </li></ul></ul><ul><ul><li>FY12: FOC </li></ul></ul>*: Milestone dates assume consistent levels of funding
    16. 16. HeV Transition Phase II <ul><li>Primary Capability in Development </li></ul><ul><ul><li>Continue Building Out Common Services </li></ul></ul><ul><ul><li>Transition Application Modules </li></ul></ul><ul><ul><ul><li>Laboratory </li></ul></ul></ul><ul><ul><ul><li>Pharmacy </li></ul></ul></ul><ul><ul><ul><li>CCDSS (CPRS Re-Engineering) </li></ul></ul></ul><ul><li>Major Milestones* </li></ul><ul><ul><li>FY08: IOC </li></ul></ul><ul><ul><li>FY08: Deploy Pharmacy Drug Dosage Checking (PEPS .5) </li></ul></ul><ul><ul><li>FY09: Deploy Pharmacy Drug Dosage Checking (PEPS 1.0) </li></ul></ul><ul><ul><li>FY10: Begin National Fielding of Laboratory </li></ul></ul><ul><ul><li>FY11: Begin National Fielding Re-Engineered Pharmacy for HeV </li></ul></ul><ul><ul><li>FY15: FOC </li></ul></ul>*: Milestone dates assume consistent levels of funding
    17. 17. SECURITY MAILMAN MANAGER MENU MANAGER RPC BROKER TASK MANAGER VA FILEMAN INTEGRATED DATABASE KERNEL VISTA SOFTWARE PACKAGES REHAB MEDICINE ACCOUNTS RECEIVABLE LIBRARY NURSING RADIOLOGY BLOOD BANK SOCIAL WORK MENTAL HEALTH ENGINEERING ONCOLOGY DIETETICS INPATIENT PHARMACY OUTPATIENT PHARMACY MEDICAL CARE COST RECOVERY SCHEDULING WOMEN’S HEALTH MEDICINE BAR CODE MEDICATION ADMINISTRATION SURGERY DENTAL LABORATORY PATIENT FUNDS ADMISSION DISCHARGE TRANSFER MEDICAL RECORDS TRAINING VOLUNTARY SERVICE INTEGRATED FUNDS CONTROL ACCOUNTING & PROCUREMENT ENROLLMENT PROBLEM LIST HEALTH SUMMARY CLINICAL REMINDERS CONSULT / RESULT TRACKING AUTHORIZATION SUBSCRIPTION UTILITY (ASU) TEXT INTEGRATION UTILITIES (TIU) COMPUTERIZED PATIENT RECORD SYSTEM (CPRS GUI) VistA IMAGING WARDS DRUGS PERSONS INVENTORY PRESCRIPTIONS IMAGES LAB RESULTS PATIENTS BLIND REHAB SPINAL CORD INJURY EMERGING TECHNOLOGY My Health e Vet Home Telehealth Health IT Sharing In HeV by 2015 In HeV after 2015 Legend
    18. 18. VistA HeV Architecture DoD Systems Other Federal Systems Private Systems Personal Computers Medical Devices PDAs Web Portals Other Interfaces SERVICES BUS Pharmacy Bar Coding Laboratory CPRS Radiology Surgery Mental Health Prosthetics Blind Rehab Spinal Cord Other Capabilities HEALTH PROVIDER Enrollment CAPRI Financial Mgmt Patient Mgmt Scheduling Logistics Mgmt Other Capabilities HEALTH ADMINISTRATOR My Health e Vet Home TeleHealth Vet ID Cards VHA Learning Other Capabilities VETERAN VistA H e V Common Services Person Services Organization Services Security Messaging Exception Logging Archive Services Alerts Electronic Signature Other Services One VA Common Services Under Development National/Regional Database Stores Health Data Repository Admin Data Repository
    19. 19. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test
    20. 20. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT PERSON SERVICES IDENTITY MANAGEMENT Enumerates and maintain person identities of both patients and non-patients. Implements business service components to provide for retrieval, validation, entry, and editing of person demographic data elements and re-engineers functionality to support HeV standards and technology modernization. FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test
    21. 21. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT ORGANIZATION SERVICES Provide administrative application to support capture and maintenance of VHA Organizations (VAMCs, CBOCs, CMOPs, and Outpatient Pharmacies) to be enumerated with National Provider Identifier values. FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test
    22. 22. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT SECURITY: FatKAAT Provide authentication, authorization and audit of HealtheVet Applications using Fat-Client Kernel Authentication/Authorization Tool (FatKAAT). FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test
    23. 23. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test MESSAGING AND INTERFACE SERVICES Messaging is the backbone of HealtheVet and provides a “one stop shop” for message service.  Mechanism for allowing one application/service to communicate with another through a common interface.  Provides message routing, delivery and translation.
    24. 24. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test HEALTH DATA REPOSITORY Repository of clinical information; resides on a national platform and several regional data processing centers (RDPCs) to support longitudinal clinical patient-centric care. Data Warehouse storing all clinical data for use by non-patient care giving applications, systems, and individuals.
    25. 25. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test TESTING SERVICES Provides comprehensive functional, performance, and environments & operations testing for scheduling.
    26. 26. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test <ul><ul><li>ENROLLMENT </li></ul></ul><ul><ul><li>Compiles benefits, eligibility, enrollment and income verification information from multiple sources using a HealtheVet-compatible architecture. </li></ul></ul><ul><ul><li>Rehosts and reengineers the centralized M-based legacy application to a centralized, web based system. </li></ul></ul><ul><ul><li>Program highlights include: supports enrollment and eligibility determinations, means test processing, and will facilitate sharing of demographical, clinical and military data used in determination of VA benefits. </li></ul></ul>
    27. 27. Phase I: Integrated Schedule Scheduling (RSA) Alpha Beta National Beta National Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Release w/RSA RSA Testing National Development Test National Pre Production Phase I Release w/ESR HDR-IMS National HDR-LAB HDR-CDS HDR II National FATKAAT FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test <ul><ul><li>SCHEDULING </li></ul></ul><ul><ul><li>Robust enterprise-level scheduling and a re-engineered GUI for appointment management as well as inter-facility scheduling. </li></ul></ul><ul><ul><li>Will support patient appointment preferences and linked appointment sets (i.e., attaching radiology, EKG, and lab to appointments). </li></ul></ul><ul><ul><li>Replaces VistA legacy appointment module. </li></ul></ul>
    28. 28. Phase II: Integrated Schedule Scheduling (RSA) Alpha Beta National Laboratory Pharmacy Beta National Prototype Alpha National Beta CPRS/CCDSS IVV Beta National Dose Checking Re-Engineering Person Services Organization Services Security Messaging HDR Testing Services Enrollment (ESR) Project Deferred Alpha National Beta Release w/RSA RSA National 09/2012 Testing National Development Test National Pre Production Phase I Pre Production Phase II & Integration Release w/ESR National HDR-IMS National HDR-LAB HDR-CDS HDR II National Final Pre Production HDR and CDS Local Deployed Active Directory EOL FATKAAT Development Env RSA Beta Testing FY06 FY07 FY08 FY09 FY10 FY11 Deployment Development Test
    29. 29. <ul><li>The Vision VHA’s Objectives for Health Care </li></ul><ul><li>The Process Use of Enterprise Architecture Model </li></ul><ul><li>The Product VistA Health e Vet Transition Plan </li></ul><ul><li>Next Steps </li></ul>Topics
    30. 30. Core Elements of HealtheVet SECURITY MAILMAN MANAGER MENU MANAGER RPC BROKER TASK MANAGER VA FILEMAN INTEGRATED DATABASE KERNEL VISTA SOFTWARE PACKAGES REHAB MEDICINE ACCOUNTS RECEIVABLE LIBRARY NURSING RADIOLOGY BLOOD BANK SOCIAL WORK MENTAL HEALTH ENGINEERING ONCOLOGY DIETETICS INPATIENT PHARMACY OUTPATIENT PHARMACY MEDICAL CARE COST RECOVERY SCHEDULING WOMEN’S HEALTH MEDICINE BAR CODE MEDICATION ADMINISTRATION SURGERY DENTAL LABORATORY PATIENT FUNDS ADMISSION DISCHARGE TRANSFER MEDICAL RECORDS TRAINING VOLUNTARY SERVICE INTEGRATED FUNDS CONTROL ACCOUNTING & PROCUREMENT ENROLLMENT PROBLEM LIST HEALTH SUMMARY CLINICAL REMINDERS CONSULT / RESULT TRACKING AUTHORIZATION SUBSCRIPTION UTILITY (ASU) TEXT INTEGRATION UTILITIES (TIU) COMPUTERIZED PATIENT RECORD SYSTEM (CPRS GUI) VistA IMAGING WARDS DRUGS PERSONS INVENTORY PRESCRIPTIONS IMAGES LAB RESULTS PATIENTS BLIND REHAB SPINAL CORD INJURY EMERGING TECHNOLOGY My Health e Vet Home Telehealth Health IT Sharing In HeV by 2015 In HeV after 2015 Legend
    31. 31. Security Archive Service Organization Service Audit Service Deployment Toolkit Common Services HEALTHeVET PORTFOLIO Social Work Primary Care Management Module Voluntary Service System Imaging System Surgery Spinal Cord Dysfunction Release of Information (DSSI) Radiology/Nuclear Medicine Prosthetics Police & Security Oncology Nutrition And Food Service Nursing Service Mental Health Library Veterans Personal Finance System (VPFS) Incident Reporting Home Based Primary Care Dental Record Manager Fee Basis CAPRI (AMIE) Blind Rehabilitation ASISTS Credentials Tracking VetPro HeV Desktop Messaging/ Enterprise Service Bus Administrative Data Repository Enrollment Application System Laboratory Pharmacy PIMS Scheduling Workload Management Ophthalmology QUASAR Audiology & Speech Analysis Adverse Reaction Tracking Authorization/ Subscription Utility Automated Info Collection System Bar Code Expansion Project Care Management Clinical Case Registries Clinical Decision Support Clinical Device Connectivity Clinical Procedures Clinical Reminders Consult/Request Tracking Discharge Summary Emergency Room Employee Health Record Health Summary Healthcare Acquired Infection & Influenza Surveillance Implant Management Intake/Output Standardization And Terminology Services Order Check Expert Order Entry/ Results Reporting Outpatient Clinical Care Problem List Progress Notes Remote Order Entry System Text Integration Utilities Vitals/Measurements Women’s Health Operations & Management Application Monitoring Device Manager System Monitoring DoD Systems Bed Contingency Interfaces to AHLTA Emerging Technologies Home Telehealth Health IT Sharing eGov DFAS FLITE HR Shared Services Center National/Regional Database Stores RISE Health Data Repository COMPUTERIZED CARE DELIVERY SUPPORT SYSTEM Patient Advocate Tracking System (PATS) Beneficiary Travel Incomplete Record Tracking LEGEND Phase 1 Phase 2 Phase 3 Phase 5 Phase 4 Phase 6 Business Rules Engine Workflow Engine Clinical Data Warehouse Report Writer Person Service Enhanced VA/DoD Seamless Care Joint Inpatient Electronic Health Record My Health e Vet
    32. 32. QUESTIONS
    33. 33. BACKUP
    34. 34. Health EA: Strategy Layer <ul><li>VA Strategic Plan is Primary Guide for Transitioning Health Care </li></ul><ul><li>Other Source Documents </li></ul><ul><ul><li>VA CIO Priorities, Especially in Areas of Security </li></ul></ul><ul><ul><li>VA/DoD Joint Electronic Health Plan Interoperability (JEHRI) Plan </li></ul></ul><ul><ul><li>Health Standards Groups such as Healthcare Information Technology Standards Panel (HITSP) </li></ul></ul>Strategy Business Applications & Services Technology Infrastructure Information & Data VA Strategic Plan VA Publications VA EA Executive Perspective Clinical Information Systems in VHA: Vision for the Future VHA Strategic Plan
    35. 35. Health EA: Business Layer <ul><li>For Patient-Centric Care, Five Areas Selected for Business Process Improvement </li></ul><ul><ul><li>Veteran Enrollment </li></ul></ul><ul><ul><li>Appointing </li></ul></ul><ul><ul><li>Laboratory Analysis </li></ul></ul><ul><ul><li>Drug Prescription Management </li></ul></ul><ul><ul><li>Clinician Care Delivery </li></ul></ul><ul><li>Implementing New Business Processes Drove Changes in IT Systems, Resulted in First Phase of Transition to VistA H e V </li></ul><ul><ul><li>ESR: Enrollment System Re-Engineering </li></ul></ul><ul><ul><li>RSA: Re-Engineered Scheduling Application </li></ul></ul><ul><ul><li>LSRP: Laboratory System Re-Engineering Project </li></ul></ul><ul><ul><li>PRE: Pharmacy Re-Engineering </li></ul></ul><ul><ul><li>CPRS: Clinical Patient Record System </li></ul></ul><ul><li>Actual Investment in Transition is Determined by Annual Prioritization of Requirements </li></ul><ul><ul><li>Based on Metrics from Strategic Plan </li></ul></ul><ul><ul><li>VHA Seeks Balanced Investment Between Critical Upgrades to Legacy and Investment in Future Capabilities of VistA H e V </li></ul></ul>Strategy Business Applications & Services Technology Infrastructure Information & Data
    36. 36. Health EA: Information & Data Layer <ul><li>Implement Single Logical View of Patient </li></ul><ul><ul><li>Accessible from Any VA Medical Facility </li></ul></ul><ul><ul><li>For Veteran, Accessible via Internet </li></ul></ul><ul><ul><li>Use HL7 as Standard for Messaging, Extend as Necessary for Internal VA Use </li></ul></ul><ul><li>Use Data Standardization to Implement Interoperability </li></ul><ul><ul><li>Supports Seamless Transition with DoD </li></ul></ul><ul><ul><li>Supports Eventual Sharing of Data Across Entire Health Care Community </li></ul></ul><ul><li>Use Iterative Development, Incremental Delivery </li></ul><ul><ul><li>Avoids Risks of “Big Bang” Approach </li></ul></ul><ul><ul><li>Delivers Some Capability Now, Not All Capability Later </li></ul></ul><ul><ul><li>Gradual Transition from Facility-Centric to Patient-Centric Access </li></ul></ul>Strategy Business Applications & Services Technology Infrastructure Information & Data
    37. 37. Health EA: Application and Services Layer <ul><li>Employ a Service Oriented Architecture </li></ul><ul><li>Iterative Development, Incremental Delivery </li></ul><ul><ul><li>Goal is to Develop and Release Capabilities in Six Month Intervals </li></ul></ul><ul><ul><li>Avoids Risks of “Big Bang” Approach </li></ul></ul><ul><ul><li>Delivers Some Capability Now, Not All Capability Later </li></ul></ul><ul><ul><li>Gradual Transition from Facilities-Centric to Patient-Centric </li></ul></ul><ul><li>Employ Multiple Techniques for Transitioning Modules </li></ul><ul><ul><li>Wrap: Interface to Legacy Code, Re-Use as a Service in VistA H e V </li></ul></ul><ul><ul><li>Re-Host: Rewrite Modules Using Legacy Business Logic </li></ul></ul><ul><ul><li>Re-Engineer: Rewrite Modules in Response to New Business Processes </li></ul></ul><ul><li>Make/Buy Decisions Based on Best Value to VA </li></ul><ul><ul><li>Decision on Whether to Use in House Development or Contract for a Module Will be Based on Business Case Analysis </li></ul></ul><ul><ul><li>Factors for Consideration in Analysis are Performance, Cost, Schedule, Risk, Contribution to Health Community </li></ul></ul>Strategy Business Applications & Services Technology Infrastructure Information & Data
    38. 38. Health EA: Application and Services Layer <ul><li>Open Systems </li></ul><ul><ul><li>Interfaces between Applications and Modules will be Controlled via ICDs </li></ul></ul><ul><li>Open Source Code </li></ul><ul><ul><li>Government Developed Source Code will be Made Available to the Public Domain </li></ul></ul><ul><li>Security </li></ul><ul><ul><li>Begin with User Authentication, Incrementally Improve Security to Include Role-based Access, Auditable Transactions, Etc. </li></ul></ul><ul><li>Device Independence </li></ul><ul><ul><li>Device Independence will be Implemented in Phases Throughout the Transition </li></ul></ul><ul><li>VA Enterprise Architecture </li></ul><ul><ul><li>As Part of IT Re-Alignment, VA Reviewing Its Approach to One VA Services </li></ul></ul><ul><ul><li>VistA will Move to One VA Services as They Become Available </li></ul></ul><ul><ul><li>In Interim, VistA H e V will Continue Use of Services Developed for Health IT </li></ul></ul>Strategy Business Applications & Services Technology Infrastructure Information & Data
    39. 39. Health EA: Application and Services Layer <ul><li>VistA H e V Applications Must Meet the Following Minimum Requirements for National Release </li></ul><ul><ul><li>Functionality: Replicate All the Functionality of the VistA Legacy Application </li></ul></ul><ul><ul><li>Service Oriented Architecture </li></ul></ul><ul><ul><ul><li>Provide Services via Enterprise Messaging </li></ul></ul></ul><ul><ul><ul><li>Utilize Common Services Available in VistA H e V Environment </li></ul></ul></ul><ul><ul><li>508: Compliance by National Release </li></ul></ul><ul><ul><li>Security: Support User Authentication </li></ul></ul><ul><ul><li>Device Independence: Browser/Client Platform Independence </li></ul></ul><ul><ul><li>Multilingual Support: </li></ul></ul><ul><ul><ul><li>English is Only Language Required to Support Clinicians and Administrators </li></ul></ul></ul><ul><ul><ul><li>Multi-Lingual Required for Patient Instructions </li></ul></ul></ul><ul><ul><ul><li>Services Accessed Directly by Veterans (e.g. My HealtheVet) Must Support Multi-Lingual </li></ul></ul></ul><ul><ul><ul><li>Common GUI: All Services will be Available from a Single User Interface </li></ul></ul></ul><ul><li>Threshold Requirements Can Only be Waived with Approval of VHA and VA CIO </li></ul>Strategy Business Applications & Services Technology Infrastructure Information & Data
    40. 40. Health EA: Technology Infrastructure Layer <ul><li>Technologies </li></ul><ul><ul><li>VA Enterprise Architect Defines Technical Standards for Department </li></ul></ul><ul><ul><ul><li>Maintained in Technical Reference Model (TRM) </li></ul></ul></ul><ul><ul><ul><li>Provides Department Policy </li></ul></ul></ul><ul><ul><ul><li>Provides List of Allowed Hardware and Software Technologies </li></ul></ul></ul><ul><ul><li>For Health, A Segment TRM Will be Maintained </li></ul></ul><ul><ul><ul><li>Derived from VA TRM </li></ul></ul></ul><ul><ul><ul><li>Restricted to Technologies Approved by Department TRM </li></ul></ul></ul><ul><ul><ul><li>Provides Phased Implementation </li></ul></ul></ul><ul><li>Development Tools </li></ul><ul><ul><li>Single Development Environment will be Used </li></ul></ul><ul><ul><li>Specified in the Health Segment TRM </li></ul></ul><ul><li>Hardware and Networking </li></ul><ul><ul><li>VA Pursuing Long Term Strategy of Locating Servers at Regional Data Processing Centers </li></ul></ul><ul><ul><li>VistA Working Towards Centralized System with Regional Replications </li></ul></ul>Strategy Business Applications & Services Technology Infrastructure Information & Data
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