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    Feb_10_monthly_report_Stat_Rep Feb_10_monthly_report_Stat_Rep Document Transcript

    • SG6 Office of the CIO (Previously SGRH AF MHS DEPLOYMENTS DIVISION) RCO 0046 3618-300 Monthly Progress Report February 2010 Finalized: Mar 2010 Submitted: Mar 2010 Prepared for: HQ AF/OCIO Document Created by: Planned Systems International, Inc. 5201 Leesburg Pike, Suite 1100 Falls Church, VA 22041 OCIO CLINICAL INFORMATION SERVICES Project, RCO #46 2010 Monthly Progress Report TABLE OF CONTENTS 1. Project Status and Accomplishments 3 1.1. Project Research and Development Support 3 2. Project Scope Management 5 2.1. Change Requests 5 2.2. Contract Modifications 5 3. Status of Deliverables or Work Products 5
    • 3.1. Project Management and Oversight 5 4. Project Problems and Corrective Action 5 4.1. Issues or Problems Experienced 5 4.2. Actions 5 OCIO CLINICAL INFORMATION SERVICES Project, RCO #46 2010 Monthly Progress Report Project Status and Accomplishments Project Research and Development Support Key accomplishments in February: Ø Workflow Integration & Business Process Reengineering (Dr. Timothy Corcoran) o Brought COMPASS Workflow to the Little Rock AFB § Participated in training providers and technician staff in COMPASS Workflow. Their clinics continue to be challenged by ‘hybrid’ AHLTA installs on their workstations- began troubleshooting process with our office but no clear resolution by time of departure o Did explore options with System Flight of how this situation could be mitigated (ghost image of ‘pristine’ install, uninstall & reinstall, etc.) § Presented Workflow to Family Practice, Flight Medicine, GYN NP, and Peds § Discussed possible workflow scenarios with PHA clinic as well o Brought COMPASS Workflow to the Charleston AFB § Demonstrated and trained Family Practice, Flight Medicine, and Pediatrics providers & Techs on COMPASS Workflow § Provided accolades to Systems Flight as every workstation visited by our Team was configured correctly despite having AHLTA installed o This was a first at an AF site § Explored with Sr. Systems Manager (Sean Lawrence) a trial of virtual installation of AHLTA utilizing VMWare (1 priority) and Sun st VirtualBox (2 priority) nd o To date, Citrix has been the most common platform for virtualization of AHLTA in the AF
    • o Citrix has fallen short of being the ‘panacea’ that was hoped for in simplifying the distribution & updates involving AHLTA o VMWare & Sun VirtualBox should be simpler to install and much less expensive as c/w Citrix § Will closely monitor progress of this virtual installation which should be concluded by end of Mar 2010 o Identified six major impediments to the proper deployment & use of Dragon Medical dictation software across the AF. Working closely with Nuance on mitigation of each of the six impediments to the proper use of Dragon Medical. These are listed beneath each entry below. This will permit a resumption of workflow integration of Dragon with Flight Medicine & Primary Care within the AF § There are 4 categories of Dragon licenses for a given AF MTF (the original 1080 SG purchase which has been upgraded to 10.1, 515 newly purchased SG Dragon 10.1 licenses, licenses individually purchased by AF MTFs that were never upgraded to 10.1, and licenses purchased by individual MTFs that are 10.1). There is no central accounting for these different categories of licenses and therefore no true accountability for licenses in use o Spreadsheet is being co-developed with AF POCs and Nuance that lists all known license #’s and types for each AF MTF § License for Dragon use is not understood by receiving AF MTF because it is not included with the software. This has resulted in a suboptimal installation of the software at receiving MTFs o Nuance has clarified license and drafted separate letter that explains what constitutes proper use of license. This has been added as an attachment to AF customized instructions for installation & maintenance § Distribution of software is broken. Present method is to send a copy of a DVD with Dragon on it to different POCs at each MTF. Upon scrutiny of the most recent mailing list, we discovered a mixture of POC authorities (some sent to SGH, some to Systems, some to AHLTA trainer, etc.) and a number sent to people no longer assigned to the MTF. This caused great problems at the receiving end and resulted in the latest release of Dragon never getting to the end-user's workstation o Working with AFCEDS to post Dragon Medical software on their secure site. All Systems Flights within the AF have access to this secure site. This will enable an efficient distribution of all future versions of Dragon § No directions for proper installation & maintenance are included with Dragon DVD so this has resulted in an incorrect configuration & maintenance at AF MTFs
    • o Have co-developed with Nuance step-by-step directions for AF Systems to properly install & maintain Dragon Medical § There is no provision for providing consistent training for Dragon. The typical scenario goes like this: After a suboptimal installation of an old version of Dragon is installed on a provider's workstation, the provider is told to "go through the tutorial" built into Dragon. This amounts to voice training which is not intended by Nuance to substitute for training. Subsequently, there are very few Dragon users in the AF that understand the capabilities of the program o Exploring the use of AHLTA Trainers to provide teaching Dragon Medical to MTF staff. The Army had Nuance professionally instruct a cadre of trainers hired by the Army who then went out and trained the Army installations. Our trainers are embedded within each AF facility and could provide the ongoing training needed to become proficient § There is no central POC for AF or Nuance that could easily process an individual AF MTF pre-negotiated upgrade or newly acquired 10.1 licenses for Dragon. This further complicates the task of individual MTFs obtaining software and makes central tracking of licenses impossible. As individuals 'maintaining' the licenses in the MTFs subsequently separate, PCS, deploy, etc. the knowledge of the licenses goes with them o Working with AFMOA South and Nuance to designate respective POCs that would process orders from MTFs so central accounting of licenses are maintained o Continued to Critique & Provide Feedback to AIM Form Developer on the new COMPASS Core AIM Form (“COMPASS Core 2.0”) § Developed an approach to removing multiple prior versions of COMPASS AIM forms from the Enterprise o This method of removal will permit an orderly transition over to the new COMPASS Core 2.0 AIM form § Further development will be on the expected six month release of COMPASS Core 3.0 o Gave Presentation to AHLTA Trainers on New COMPASS Core AIM § Provided via Teleconference o Continue to Provide Support to the ANG/Reserves Training POC as it Relates to AHLTA o Assisted AFMOA’s Care Coordination Program Manager in understanding how ‘V’ codes for BMI were calculated by AHLTA. This undocumented behavior gave the erroneous impression that these V codes could not be altered o Worked with the POC for a widely used Excel macro Asthma Action Plan. Explained to the developer the need for being able to clearly read the Asthma Action Plan once copied into the Add Note section of AHLTA. Nurses at various
    • MTFs are called by patients when they have lost their Action Plan and would like to know what the Plan was. The only record of this plain available in AHLTA was in the Add Note section which could not be read due to the very small size. The POC agreed for the need to have a copy that could be read in AHLTA o Ø Ø Department of Defense/Veterans Affairs (DOD/VA) Share Projects (PA Robin Abbott) o Air Force (AF) Point of Contact for matters related to DOD/VA Sharing Initiatives. Briefed Senior Air Force Medical Service (AFMS) leadership on progress, issues, and challenges related to projects. Provided weekly updates on activities to AF Chief Information Officer (CIO). Provided support to the AF Chief Medical Information Officer (CMIO) on matters related to DOD/VA sharing and AHLTA. o Supported service representation to meetings related to the various DOD/VA initiatives: § Health Executive Council (HEC) IM/IT WG § DHIMS Share Updates for Leadership § MAJCOM Joint Venture Meetings § Interagency Clinical Informatics Board (ICIB) § Interagency Program Office (IPO) § Virtual Lifetime Electronic Record (VLER) § James A. Lovell Federal Health Care Center IM/IT Update § DHIMS Service Representative Meeting o HEC Pre-Brief for AF Deputy Surgeon General § The HEC oversees the cooperative efforts of each agency’s health care organizations and all councils or workgroups designated by the co- chairs. § Briefed Maj Gen Hepburn on status of North Chicago Project § Prepared facers for AF CMIO to brief on the ICIB 2010 interoperability objectives and VLER update o Defense Business Systems Management Committee (DBSMC) § Facilitated AF inputs regarding VLER to be presented by the AF representative to the DBSMC o VLER § Corresponded with individual sites to answer individual questions related to this initiative
    • o Government Audit Office (GAO) § Attended an exit conference for the GAO review of the “Fully Interoperable Personal Health Care Information for the VA and the DoD”, code 310945 o Community of Interest Board (COIB) § Provided update to CIO so that action item related to request for joint incentive funding for VLER could be closed o Submitted slides related to BHIE, VLER, and NHIN to be incorporated into presentation for Eglin MTF’s Leadership Conference: Systems of the Future Ø Congressional Hearing Slides for Issues Binder o Developed slides to be submitted into the 2010 Issues Binger for Congress o Slides submitted on behalf of the Surgeon General to update IM/IT projects for VA/DOD Sharing, EHR Way Ahead, AHLTA, and COMPASS Ø Site Visit to Charleston Clinic, Charleston SC o Augmented Tiger Team sent to site in response to complaints regarding AHLTA’s speed and performance o Worked with clinicians and the Systems Department to report issues experienced in the clinic and results of trouble shooting o Worked with clinicians to optimize their workflow, computer and application settings Ø Electronic Health Record Way Ahead (EHRWA) o Attended 2010 MHS Conference Sharing Knowledge: Achieving Breakthrough Performance o Attended Single Sign On and Context Management Software Requirements Specification Review § Developed a CIO approved comprehensive list of applications that the AF requested to have included in the project Ø System Change Request (SCR) AF Submission Process o Continued to evolve process for tracking AF submissions § Attended the Outpatient System Integrated Project Team (OSIPT) o Supported functional community to review and prioritize all submissions from the services Ø AHLTA Known Issues Tracking Sheet o Continued to update spreadsheet with new finding Ø SG3 Policy Meeting with Deployment Operations o Facilitated monthly meeting to support creation and updates of policies related to medical IM/IT issues
    • Ø MedOps Panel o Participated in monthly panel to answer questions about AHLTA Ø Air Force Knowledge Exchange (Kx) Sites o Continued maintenance of the AHLTA, COMPASS, Essentris and AHLTA Dental Pages Ø AHLTA Dental o Participated in the VA Dental Record Manager System Demonstration Expected progress next month (Feb): Ø Support of Deployment Ø Bring COMPASS Workflow to Little Rock AFB, prototype Flight Medicine workflow and prototype proper installation & deployment of Dragon Naturally Speaking voice dictation software at Andrews AFB Ø Liaison with USU for preliminary research on impact of bringing COMPASS Workflow to medical students in training Ø Continued support of DOD/VA Sharing Initiatives Ø Develop project management plan for the BHIE Share Deployment at AF inpatient facilities Expected progress next 90 days (Feb-Apr) Ø Continue to help stabilizing AHTLA at AF sites that request help Ø Aid in deployment of AHLTA once ‘pause’ is lifted Ø Bring COMPASS Workflow Little Rock, Charleston, Offutt, and Eglin AFBs Ø Present at USAFP AF Breakout on Workflow & Simplified Coding Ø Produce additional COMPASS training videos Ø Coordinating future site visits to deploy COMPASS Initiative 1.2 Monthly travel in support of task Name Destination Arrival Date Depart Date COMPASS Little Rock AFB, AK 02/01/2010 02/05/2010 Workflow COMPASS Charleston AFB, SC 02/22/2010 02/26/2010 Workflow Project Scope Management Change Requests Ø No change requests are pending.
    • Contract Modifications Ø No contract modifications are pending. Status of Deliverables or Work Products Project Management and Oversight Monthly Status Rpt Submitted Project Problems and Corrective Action Issues or Problems Experienced Ø N/A Actions Ø N/A