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Information Technology Initiatives Health Information

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Title: Information Technology Initiatives Health Information


1
Information Technology Initiatives Health
Information Strategic Plan
  • Susan Lloyd and Jim McDearmon
  • Veterans Health Administration
  • Office of Health Information
  • Enterprise System Management (ESM)
  • August 11, 2010

2
Major Initiatives andHealth Information
Strategic PlanAgenda
  • Introduction and Objectives
  • Section One (Susan Lloyd)
  • Strategic Planning in Veterans Administration/Vete
    rans Health Administration (VA/VHA)
  • Transformational Initiatives
  • Operating Plans IT Components
  • FY2011 Planning
  • Section Two (Jim McDearmon)
  • Scope of Health IT Strategic Plan
  • Key Content of Health IT Strategic Plan Two
    Questions

3
Introduction/Objectives
  • Share information regarding VAs major
    initiatives and how they relate to strategic
    direction
  • Raise awareness of the effort underway by VHA
    Office of Health Information (OHI) to formally
    document a Health Information Strategy
  • Describe how the Health Information Strategic
    Plan (HISP) fits in the context with other
    strategic planning efforts
  • Discuss the strategic drivers, principles, goals,
    and objectives with potential impacts to the way
    VHA delivers healthcare leveraging IT

4
  • Strategic Planning in VA/VHA

4
5
Expectations of Healthcare Industry Changing
  • Moment of Truth Healthcare Value, Economic
    Realities, Outcomes
  • Patients participate as partners in their care
  • Care is convenient and local Walk in clinics,
    ZoomCare, Walmart, Employer Embedded PC
  • Alternative care (non-institutional, homelike,
    complementary)
  • Health care information is readily available
    (WebMD, etc.)
  • Preventive health (Health clubs, Nutrition,
    Well-being)
  • Chronic health issues (diabetes, obesity)
  • Expectation that function continues beyond age,
    injury.
  • Public awareness of war and veterans issues
  • Younger veterans often have families and jobs.
  • Younger veterans have grown up with different
    expectations for service and the ability to
    communicate via e-mail, text messaging and online
    tools.

6
Principles of Veteran Centered Care
  • Honor Veterans expectation of safe, high
    quality, accessible care
  • Enhance the quality of human interaction and
    therapeutic alliances
  • Solicit and respect the Veterans values,
    preferences, and needs
  • Systematize the coordination, continuity, and
    coordination of care
  • Empower patients and families through
    information and education
  • Incorporate the nutritional, cultural, and
    nurturing aspects of food
  • Provide for physical comfort and pain management
  • Ensure emotional and spiritual support
  • Encourage the involvement of family and friends
  • Apply architectural/ interior design conducive
    to health and healing
  • Introduce creative arts into the healing
    environment
  • Support and sustain a satisfied and engaged
    workforce

7
Key VA Planning Elements
VAs Department-wide strategic management process
includes 6 key elements
Areas of focus for this session
1
2
8
  • Major Initiatives and Operating Plans

9
VA Strategic Plans and Initiatives
  • VA Secretarys Guiding Principles are detailed in
    the VA Strategic Goals
  • VA Strategic Goals are further articulated in the
    VA Strategic Plan
  • VA Strategic Plan is being executed through the
    VA Major Initiatives
  • Major Initiatives are executed through a
    published Operating Plan (Op Plan)
  • Every Initiative has an Executive Sponsor and
    Lead

Strategy (VA Strategy/Health Information
Strategic Plan (HISP) and Planning (Major
Initiatives/Op Plans) are integrally linked
10
VA Strategic Plans and Initiatives
11
Initiatives and Operating (Op) Plans
  • What is the difference between an Initiative and
    Operating Plan (Op Plan)?
  • Initiative the What, Why, and Who. It
    outlines what new capability is needed, what the
    benefits will be, why it is important, and who
    will benefit from it.
  • Op Plan the When, Where and How. It is a
    detailed plan formulated by initiative leads to
    outline tactical objectives for executing larger
    strategic objectives and successfully
    implementing organizational initiatives. It
    provides details of when, where and how
    objectives are planned to be met.
  • Website to current and future Initiatives and Op
    Plans
  • http//vaww.teamshare.va.gov/opp/Initiatives/defau
    lt.aspx

12
VHA Initiatives for FY 2010
12
13
VHA Initiatives for FY 2010
14
Every Major Initiative Must Have
  • Op Plan with prescribed template.
  • Organization chart
  • Management structure
  • Overview and mission description
  • Performance measures
  • Identification of IT components
  • And more
  • Operational Management Reviews (OMRs)
  • Executive overview of VA Transformational
    Initiatives
  • Chaired by the Deputy Secretary of the VA (Scott
    Gould)

14
15
Overview and Mission Description
15
16
Overview and Mission Description
16
17
IT Projects Supporting the Initiative(if
Applicable)
17
18
IT Components
  • New Healthcare Model
  • MyHealtheVet
  • Secure Messaging
  • Appointment View/Request
  • View Medical Records Test Results
  • Health Risk Assessment
  • Veterans Benefit Handbook
  • National Utilization Management Integration
    (NUMI)
  • Integrated Medication Manager
  • Patient Care Management Module (PCMM)
    Transmission Enhancements
  • Home Telehealth Enhancements
  • Telemedicine Enhancements
  • Access to Care
  • Bed Management Solution (BMS)
  • Emergency Department Integration System (EDIS)
  • Patient Kiosks
  • Surgery Quality and Workflow Manager (SQWM)
  • Clinical Flowsheets Enhancements (CLiO)
  • Teleradiology
  • Rural Health
  • Computerized Patient Record System (CPRS) v28

19
IT Components (continued)
  • Eliminate Veteran Homelessness
  • Call Center
  • Homeless Registry
  • National Resource Directory
  • Virtual Lifetime Electronic Record (VLER)
  • Nation-wide Health Information Network (NHIN)
  • Veterans Tracking Application (VTA)
  • Apollo VistA Version A (AVIVA)
  • Veterans Health Information Systems and
    Technology Architecture (VistA) Web
  • Clinical Terminology Standardization
  • Federal Recovery Coordinators Long Term IT
    Solution
  • Improve Veterans Mental Health
  • Pain Assessment Instruments in Mental Health
    Assistant
  • Comprehensive Outcomes Monitoring System
  • High Risk National Reminder Flag
  • Identification of Principle Mental Health
    Provider
  • My Recovery Plan
  • Treatment Planning Tools
  • Research and Development
  • Genomic Information System for Integrative
    Science (GenISIS)
  • VA Informatics Computing Infrastructure (VINCI)
  • Research Administrative Management System (RAMS)

20
IT Components (continued)
  • GI Bill
  • Chapter 33
  • Veterans Relationship Management System (VRM)
  • Identity Management
  • Call Centers
  • Integrated Operating Model (IOM)
  • VistA Fee Invoice Acceptance Date Controls
  • Financial Logistics Integrated Technology
    Enterprise (FLITE)
  • Enterprise (Web) Content Management System (eCMS)
  • Human Capital
  • MyPay
  • Human Resource Information System (HRIS)
  • Web HR
  • Veterans Benefit Management System (VBMS)
  • VETSNET
  • Compensation and Pension Records Interchange
    (CAPRI)
  • Integrated Operating Center (IOC)
  • Personal Identity Verification (PIV)
  • Enterprise-Wide Cost Accountability
  • Decision Support Services (DSS) Extracts

21
Health Care Efficiency (Op Plan 15)
  • Teams
  • Consolidated procurement
  • Non-VA Care
  • Accreditation
  • Beneficiary Travel
  • Specific Purpose Funded Programs
  • Facility Automation
  • All teams co-lead by program office and field
    (end-user) staff

22
Transforming Health Care Delivery through Health
Informatics (Op Plan 16)
  • Establish a VHA/OIT collaborative supporting
    rapid product development and delivery
  • Create a Health Management Platform to Transform
    Patient Care
  • Provider-Facing  
  • Patient-Facing
  • Population-Health Manager Facing
  • Build Health Informatics Capabilities

23
Summary
  • Strategy, planning, and resultant IT initiatives,
    are integrally linked
  • Legislative, operational, and technological
    influences allow shaping the plan to adapt,
    transform and be ready on time
  • Major Initiatives drive VA/VHA forward

24
  • Health Information
  • Strategic Plan
  • (HISP)

25
What is the Health Information Strategic Plan
(HISP)?
  • The Health Information Strategic Plan (HISP) is
    designed to represent the strategic direction for
    Information Technology at the Veterans Health
    Administration
  • The HISP compliments the VA IT Strategic Plans,
    with a 5 year planning horizon
  • It aligns with VA strategies, informs and guides
    requirements, portfolio management, and health
    segment architecture efforts

26
Why create the HISP?
  • VA Strategic Planning Efforts
  • VA Strategic Plan (Department Level)
  • Veterans Health Administration (VHA), Veterans
    Benefits Administration (VBA), and National
    Cemetery System (NCS) (Administration Level)
  • VHA Program Offices and VISN Strategic Plans
  • VA IT Strategic Plan (OIT at Department Level)
  • VHA Office of Health Information recognized the
    need for a strategic plan that consolidates
    Health IT strategy into an authoritative source

27
Health Information Strategic Plan (HISP)
Strategic Alignment Line of Sight
28
Veteran Demographic Trends and Unique Needs
  • Approximately 70 of VAs enrolled Veterans
    receive all or part of their care outside of VA
  • 40 of Veterans live in rural communities
  • 50 of all enrolled Veterans will be age 65 or
    over by 2017
  • Women comprise approximately 14 of the active
    military

Source VHA, Office of the Assistant Deputy
Under Secretary for Health for Policy and Planning
29
Veteran Demographic Trends and Unique Needs
(continued)
  • Internet savvy Veterans and their dependents will
    expect quick, convenient and personalized access
    to services and information
  • Increasing female Veteran population will propel
    womens health issues to forefront
  • VHA will continue to experience movement away
    from the medical center toward community and home

Source VHA, Office of the Deputy Assistant
Under Secretary for Health for Policy and Planning
30
Health IT Major ThemesRobert Petzel, M.D.,
Under Secretary for Health
31
Health IT Drivers Tripod
Business and Operational
Legislative, Regulations, Mandates, Policies
Technology
32
Business and Operational Drivers
  • Healthcare Trends
  • Next Generation Medical Network leading to
    on-demand, interoperable and electronic record
    portability across Federal and private sector
    service providers
  • Privacy and Security Policies for authentication
    and authorization
  • VA/DoD Interoperability and Data Sharing
  • Virtual Lifetime Electronic Record (VLER)
  • Continued emphasis on seamless transition from
    DoD to VA
  • Seamless integration include establishment of
    Federal Health Care Centers (FHCC)
  • Joint procurement of drugs and joint use of mail
    order systems for prescriptions etc.

33
Business and Operational Drivers
  • Presidents Management Agenda
  • Open Government Directive 2009 e.g. Data.Gov
    initiatives
  • Publishing government data online
  • Deploying broad-band internet to every U.S. home
    spurring new internet based technologies in
    health care and education
  • Rural Health
  • Given demographic realities and access
    constraints, VHA will improve access to care for
    Veterans in rural areas
  • Chronic Disease Management
  • Instances of diabetes, cardiovascular disease and
    hypertension are increasing in Veteran population
    and management and Preventive Care Programs
    become paramount

34
Legislative, Regulations, Mandates and Policies
  • Implications on business processes and
    implementation of Health IT
  • International Classification of Diseases (ICD-10
    migration)
  • Guidelines from the Joint Commission
  • National Defense Authorization Act of 2008
  • Veterans Mental Health Act of 2008
  • American Recovery and Reinvestment Act (ARRA) of
    2009

35
Technology Trends
  • Robotics
  • Clinical workflow to handle medical supplies,
    Physical therapy, and surgery
  • Nanotechnology
  • Cancer, drug delivery, tissue repair, surgery,
    imaging and genetic testing
  • Social Networks
  • Blogging, Wiki tools, Voice over IP, podcasts
  • Genomics/Bioinformatics

36
Technology Trends (Continued)
  • Tele-health/Telemedicine
  • Home tele-health, tele-mental health,
    tele-radiology, improve access for rural health
    minimize trips to treating facilities, maximize
    access
  • Next Generation Wireless Broadband (4G)
  • Smart phones and iPod-like devices for secure
    remote monitoring of patients
  • Radio Frequency Identification (RFID)
  • Home health monitoring measure blood pressure,
    weight, glucose levels, monitor pacemaker
    implants

37
Standards and Informatics
  • Standards Development Organizations
  • Health Level 7 (HL7)
  • Digital Imaging and Communications in
    Medicine(DICOM)
  • Health Information Technology Standards
    Panel(HITSP)
  • Code Sets and Terminology Standards
  • International Classification of Diseases (ICD-10)
  • Logical Observation Identifier Names and Codes
    (LOINC)
  • Systematic Nomenclature of Medicine Clinical
    Terms (SNOMED-CT)

38
HISP Content
  • IT and IM Strategic Direction
  • Demographics, Population Trends, Community Based
    Outpatient Clinics (CBOCs), CARES, IT and IM
    Guiding Principles
  • VHA Business Function Framework Strategic
    Alignment
  • Reference model that identifies VHA business
    functions aligned with VHA strategy
  • Goals and Objectives
  • Establish VHA Strategy and IT alignment for
    investment planning
  • Enhance Interoperability, info sharing and
    exchange with partners
  • Support Healthcare Research and Policy Analysis
  • Ensure Health Care Delivery Operational
    Excellence
  • Achieve Enterprise Integration of OHI Processes
    and Practices
  • Support Health 2.0 IT Initiatives

39
Current Status and Next Steps
  • Establish Governance steering committee with
    membership from across VHA and including OIT
  • Provide Strategic Guidance and Oversight
  • Ratify and Prioritize Drivers
  • Provide insights about planning efforts in VA and
    VHA
  • Validate Health Information Strategic Plan (HISP)
    Goals and Objectives
  • Publish Version 1.0
  • Inform VA IT Strategic Plan
  • Socialize across VHA Program Offices

40
Resource Links
  • VHA Strategic Planning
  •  http//vaww4.va.gov/vhaopp/strathom.htm
  • VA Initiatives and Operating Plans
  • http//vaww.teamshare.va.gov/opp/Initiatives/defa
    ult.aspx

41
  • Questions

42
  • Backup Slides

43
Major Initiative Overviews
The Five Year Plan to End Homelessness Among
Veterans will assist every eligible homeless
Veteran to acquire safe housing needed treatment
services opportunities to return to employment
and benefits assistance.  
With the VBMS Initiative, VA will create a
paperless environment for Veteran claims
processing and benefits delivery across the five
VBA business lines Compensation and Pension
Education Loan Guaranty Insurance and
Vocational Rehabilitation and Employment.
The Post-9/11 GI Bill provides education benefits
for service members and their families. The
long-term implementation strategy will result in
a fully-automated claims processing IT system
that will be used as a model to migrate all VA
educational programs onto an integrated,
sustainable platform.
44
Initiative Overviews
VLER will create a secure exchange for
electronically sharing and proactively
identifying health and benefits entitlements for
service members, Veterans, and their eligible
dependents, from accession through final honors.
Ultimately, VLER will allow Veterans, their
dependants, beneficiaries, care givers,
clinicians, and benefit providers to view all
relevant in a single, secure, electronic record
The IVMH initiative will transform VA mental
health programs into a subsystem operating within
the larger VA health care system, which is
self-regulating, patient-centered, and offers
meaningful choices to Veterans (and families). 
The VRM initiative will provide on-demand access
to VA services and benefits through a
multi-channel customer relationship management
approach.  The initiative includes modernization
of voice telephony, unification of public contact
representative desktops, implementation of
Identity and Access Management (IAM), development
of cross VA knowledge management systems,
implementation of customer relationship
management systems (CRM), and integrating
self-service capabilities with multiple
communication channels. 
45
Initiative Overviews
The NHCM initiative will educate and empower
patients and their families and ensure a more
holistic, Veteran-centered system, greatly
improving access and coordination of care.
The ACCESS initiative focuses on eliminating
disparities in access to care wherever they exist
within the VA system. ACCESS includes outreach
efforts to proactively identify and communicate
with Veterans who may be eligible for services,
but may be unaware of VA benefits or do not know
how to enroll. 
The Office of Operations, Security, and
Preparedness (OSP) will design, construct and
maintain a single office responsible for
collecting, analyzing, and disseminating
information to VA leadership, and ensure VA can
fulfill its role to serve as a primary back up to
the DoD Military Health Care System during war or
national emergency, and to assist other federal
agencies in providing medical and other services
during natural disaster or terrorist attack.
46
Initiative Overviews
The Enterprise Wide Cost Accountability (EWCA)
initiative will develop a shared enterprise-wide
framework for assessing value, to which all parts
of the organization will contribute commonly
denominated metrics, and will ensure departmental
and organizational leaders have the information
they need to evaluate performance and allocate
resources, as well as develop an effective
Departmental cost accounting system supporting
managerial decision making.
The Integrated Operating Model (IOM) initiative
will develop an enhanced management
infrastructure and IOM to improve integration and
management within and across VAs five key
corporate management functions. 
47
Initiative Overviews
The HCIP initiative will focus on improving
recruiting, hiring, and retention investing in
people development (e.g., leadership training)
supporting and developing the capabilities of our
Senior Executive Service (SES) and striving to
build a broad set of Human Resources capabilities.
This RD initiative focuses on improving the
health and well-being of Veterans by emphasizing
genomic medicine, access to care, and deployment
health. The overall mission of VAs Office of
Research and Development is to discover
knowledge, develop VA researchers and health care
leaders, and create innovations that advance
health care for our Veterans and the Nation.
48
New Initiatives for FY 2011
The initiative focuses on coordinating and
accelerating the ongoing cost savings initiatives
with new initiatives to allow for VA to enhance
services to clients
49
Health IT Underlying Themes
50
(No Transcript)
51
Highly Rural Enrollees by County
52
VHA Strategic Goals 8 for Excellence
  • Become the national benchmark for quality,
    safety, and transparency of health care,
    particularly in those health issues associated
    with military service.
  • Provide timely and appropriate access to health
    care and eliminate service disparities.
  • Transform VHAs culture through patient-centered
    care to continuously improve Veteran and family
    satisfaction.
  • Ensure an engaged, collaborative, and
    high-performing workforce to meet the needs of
    Veterans and their families.

53
VHA Strategic Goals 8 for Excellence (Continued)
  • Create value by leveraging scale and skill
    economies to achieve consistency and excellence
    in business practices.
  • Excel in research and development of
    evidence-based clinical and delivery system
    improvements designed to enhance the health and
    well-being of Veterans.
  • Promote excellence in the education of the future
    workforce to drive health care innovation.
  • Promote health within the VA, in local
    communities, and across the nation, in
    collaboration with our academic affiliates, other
    government agencies and the private sector.
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