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VHA OI Emerging Health Technologies Sampler


Intend to assess VHA interest in and viability of this technology ... Receive general innovation news. Access resource libraries ... – PowerPoint PPT presentation

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Title: VHA OI Emerging Health Technologies Sampler

VHA OI Emerging Health Technologies Sampler
Presented to VA Information Resource Center
(VIReC) November 17, 2008
Jim Demetriades Nancy Wilck Emerging Health
Presentation Outline
  • Emerging Health Technologies Overview
  • Clinical Wiki Pilot
  • Point of Care Device Technology Assessments
  • Collaborative Innovation
  • Electronic Health Record System Visioning

Emerging Health Technologies Overview
  • Organization VHA Office of Information start-up
    chartered in October 2006
  • Purpose to sense and extend VHAs information
    technology horizon through the application and
    introduction of technologies and practices
  • Approach to provide evidence of healthcare
    technology value via high-level studies, proofs
    of concept, pilots to help inform both strategic
    and tactical planning
  • Focus 3-5 year future window

Presentation Outline
  • Emerging Health Technologies Overview
  • Clinical Wiki Pilot
  • Point of Care Device Technology Assessments
  • Collaborative Innovation
  • Electronic Health Record System Visioning

Clinical Wiki Pilot
  • Working with Office of Information and Technology
    (OIT) to establish a formal clinical wiki pilot
    inside VA
  • Intend to assess VHA interest in and viability of
    this technology
  • Premise is clinicians and allied health
    professionals will utilize wiki technology to
    freely share clinical knowledge with colleagues
  • Contributes to larger goal of assessing Web 2.0
    social networking

Anticipated Wiki Benefits
  • Will encourage collective creation of knowledge
    within VHA and ensure its availability to
    interested persons
  • Viewed as credible information source and provide
    immediate relevance to VHA clinicians
  • Attract wide range of clinical users including
    nurses, researchers, residents, medical and
    allied health students

Clinical Wiki Pilot (cont)
  • Initial wiki environment will use same feature
    set as found in the open source technology
    powering Wikipedia.com
  • Will support both general and specialized
    communities (portals) and availability of
    discussion areas, news and event postings
  • Will require contributor authentication and
  • Expect pilot to be available early next quarter

Presentation Outline
  • Emerging Health Technologies Overview
  • Clinical Wiki Pilot
  • Point of Care Device Technology Assessments
  • Collaborative Innovation
  • Electronic Health Record System Visioning

Point of Care (POC) Device Assessment Program
  • Purpose Examine the use of information
    technology products for use by VHA clinicians at
    the point of care
  • POC device definition Information technology
    (IT) products with user interfaces (e.g. hand
    held, mobile, wireless, laptop, thin/thick client
    devices) that can access VAs VistA computer
    system and / or other information sources
  • What is excluded diagnostic and therapeutic
    biomedical devices

POC Device Assessment Approach
  • Approach
  • Define POC device reference model (framework)
  • For a particular setting (e.g. clinic, ward, long
    term care) and role (primary care doc, nurse,
    specialist) identify and prioritize devices of
    high interest
  • Engage clinicians in conducting assessments
    (tablet PCs will be first examined)
  • Provide opportunity for diverse collaboration
    with other teams (e.g. security, patient safety,

POC Device Assessment Program (cont)
  • Publish a series of on-line Consumer Reports
    like articles.
  • Program will serve as information resource for
    sites looking at devices
  • Focus is on technology and not products
  • Acquisition recommendations are out of scope.
  • Timeframe Contract award to develop methodology
    and framework expected in Dec. 2008

Presentation Outline
  • Emerging Health Technologies Overview
  • Clinical Wiki Pilot
  • Point of Care Device Technology Assessments
  • Collaborative Innovation
  • Electronic Health Record System Visioning

Collaborative Innovation Definition
  • Collaborative Innovation
  • Self-organizing groups of highly motivated
    individuals working together towards a common
    goal .
  • Peter A. Gloor, Carey Heckman, Fillia Makedon

Our Focus The Intersection
Collaborative Innovation happens here
Innovation Sandbox Description
  • The Innovation Sandbox is much more than a
    software development environment. It is also a
    virtual space for people to collaborate,
    innovate, and develop ideas and requirements
  • The Sandbox is a geographically limitless
    solution to the historic challenge of locally
    bound development efforts
  • The Sandbox is intended for anyone wishing to
    contribute ideas to VistA development

Collaborative Innovation Initial Accomplishments
  • VHA Informatics and Data Management Committee
    (IDMC) charge
  • Early 2007
  • Propose a way to preserve innovation, minimizing
    IT re-organization challenges
  • Cross organizational workgroup
  • Chartered May 2007
  • Stakeholders from field, OIT and OI
  • Innovation Concept of Operations (CONOPS)
  • Presented and approved for pilot by IDMC Sept
  • Industry review and comment Gartner, Perot
    Systems, EDS, Microsoft, IBM

Collaborative Innovation Goals
  • Perpetuate local innovation in support of mission
  • Strengthen early idea sharing
  • Encourage communities of interest
  • Increase collaboration
  • Eliminate redundancy
  • Rapidly deploy innovative software which adheres
    to national development standards

Collaborative Innovation Principles
  • Access is easy and open to all
  • The Sandbox is structured to allow ideas and work
    products to be freely shared
  • There is a well-defined path for mainstreaming
    innovative creations into production
  • Failures are expected and accepted as a cost of
    being innovative
  • Sandbox governance promotes process consistency,
    simplicity, and reuse

User Experience
  • Receive general innovation news
  • Access resource libraries
  • Discover or create birds of a feather
  • Contribute ideas and collaborate in shaping
    business requirements
  • The more technically inclined can initiate
    software projects
  • Innovation ideas or requirements may be submitted
    to the New Service Request (NSR) process
  • Applications that meet high-bar exit criteria
    for national business value, OIT programming
    standards and infrastructure capacity may be
    fast-tracked within the NSR process

Market Survey
  • Contract awarded to survey market for toolset
  • final recommendations received in March 2008 and
    refreshed in August 2008
  • The market is clearly emerging and volatile
  • No single solution meets our wants
  • Current thinking bridge two commercial products
  • one strong in idea and community management
  • a second to provide a solid development

Collaborative Innovation Current and Future Plans
  • In progress now
  • Bench validation of candidate products
  • Development of functional requirements for
    Sandbox environment
  • In the queue
  • Pilot approach decision
  • Acquisition/installation
  • Initial live testing (pilot)
  • Transition planning

Presentation Outline
  • Emerging Health Technologies Overview
  • Clinical Wiki Pilot
  • Point of Care Device Technology Assessments
  • Collaborative Innovation
  • Electronic Health Record System Visioning

Definition of EHR-S
  • EHR-S includes all clinically related systems or
    applications such Computerized Patient Record
    Systems (CPRS) and radiology, lab, scheduling,
    and pharmacy packages
  • Medical devices and national data bases such as
    Decision Support System (DSS) and the
    Administrative Data Repository (ADR) are not part
    of the EHR-S although the need to interface with
    them will be a key characteristic of it

EHR-S Visioning Objective
  • Want to define shared vision for next
    generation EHR-S
  • Called shared because products of meetings
    become basis for vision document that will be
    available for broad community review and
  • Will seek to make shared vision an authoritative
  • Will serve as roadmap for VHA as it defines
    capabilities and priorities for future
    development efforts

EHR-S Visioning Approach
  • Facilitating a series of meetings with key EHR-S
  • Final meeting will begin tomorrow with allied
    health, research, education, and academic
  • VHA stakeholders (e.g., Veteran Service
    Organizations (VSO) and healthcare partners
    (e.g., DoD and IHS) will be briefed
  • Vision document will be iterated and available
    for contributions from larger VHA community
  • Look for draft vision in January

EHR-S Visioning How You Can Contribute
  • Participate in development of the shared vision
  • Contact the VIReC Help Desk at virec_at_va.gov for
    the VA Intranet address
  • Propose additional guiding principles if needed
  • Propose capabilities the EHR-S must provide to
    support your line of business (remembering that
    it is first and foremost a clinical tool)
  • Encourage your co-workers and colleagues to
    contribute to the shared vision

Contacts for Additional Information
  • Jim Demetriades
  • Jim.Demetriades_at_va.gov
  • 518-449-0627
  • Nancy Wilck
  • Nancy.Wilck_at_va.gov
  • 703-927-8880

Supplemental Material
  • This material supplements the formal briefing.
    Feel free to contact us if you have questions on
    any of it.

EHR-S Guiding Principles
  • Participants in the visioning meetings developed
    the following EHR-S Guiding Principles statement
  • In building the EHR-S of the future
  • VHA will define its content, functionality and
    performance requirements.
  • Clinicians will lead and collaborate with other
    stakeholders in the continuous evolution of the
  • The EHR-S of the future will support and enable
    VHAs missions, with specific focus on patient
    safety and quality of care, by
  • Being patient-centric
  • Facilitating knowledge discovery, accommodating
    innovation and changes in health care practice
    and information needs
  • Providing a framework to identify and promote use
    of best practices and innovation, in both patient
    care and informatics
  • Reducing undesirable variation through support
    for consistent approaches to common tasks
  • Supporting standardization at the core and
    diversity at the periphery
  • Enhancing communication internal and external to
    VHA, among clinicians and with patients, across
    organizations and the continuum of care and
  • Promoting the efficiency and effectiveness of
    clinical staff.

EHR-S Capabilities
  • Participants in the visioning meetings determined
    that the EHR-S must have the following
  • Be flexible, modular, and integrated
  • Promote data standardization, data quality,
    information and data reuse capture the data once
    and use it many times
  • Support context-driven views, giving the right
    information at the right time
  • Provide access to data for all users, including
    people with disabilities (e.g., access from
    numerous places with numerous devices)
  • Manage the patient's composite record including
    longitudinal patient views (internal source,
    format, location, identity)
  • Be context, role, and event aware
  • Be instrumented to support user efficiencies
  • Promote the wellness of the veteran population

EHR-S Capabilities (cont)
  • Provide both prescriptive and assistive real-time
    clinical decision support
  • Be configurable with standard defaults
  • Enable support care team collaboration (any
  • Support data input from multiple sources
    (devices) and locations
  • Be easy to navigate and comprehend
  • Provide multiple information horizons, arranged
    by cognitively significant context, and provide
    multiple-level views and abstractions.
  • Incorporate transportable tools, templates,
    lists, orders, and pathways
  • Provide ability to manage workflow
  • Must ensure complete, computationally correct,
    dynamic records.
  • Facilitate a user interface in which provision of
    care is compatible with care eligibility

Profile of Attendees at EHR-S Visioning Sessions
To Date
  • Medical Doctors (24)
  • Registered Nurses (8)
  • Clinical Pharmacists (2)
  • Psychologist (1)
  • PhD. (2)
  • Clinical Applications Coordinator (1)
  • Experts in
  • Clinical Decision Support (1)
  • Cognitive Engineering (1)
  • Data Quality (3)
  • Enterprise Portfolio Management (2)
  • Health Eligibility (1)
  • Health Information Management (1)
  • Information Management (2)
  • National Data Systems (1)
  • Privacy (1)
  • Section 508 (1)
  • Security (2)
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