HIT Enterprise Transformation:EHR Rollout...It's Happening Now!

COL Nicole KerkenbushMilitary Deputy Program Executive Officer, Program Executive Office

Defense Healthcare Management Systems

Disclosures

• The presenter has no financial relationships to disclose.

• This continuing education activity is managed and accredited by Professional Education Services Group in cooperation with AMSUS.

• Neither PESG, AMSUS, nor any accrediting organization support or endorse any product or service mentioned in this activity.

• PESG and AMSUS staff have no financial interest to disclose.

• Commercial support was not received for this activity.

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PEO DHMS Mission

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To efficiently improve healthcare for the active duty military, veterans, and beneficiaries by:•Establishing seamless medical data sharing between DoD, the VA and the private sector

•Modernizing the Electronic Health Record (EHR) for the Military Health System

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PEO DHMS OrganizationWhere We Fit

Department of Veterans Affairs Secretary of Defense

USD for Acquisition, Technology, and Logistics

Program Executive Office DoD Healthcare

Management Systems (PEO DHMS)

USD for Personnel and Readiness

ASD, Health Affairs

DoD/VA Interagency Program Office (IPO)

Standards

Defense Medical Information Exchange

(DMIX)

Information Exchange

DoD Healthcare Management System

Modernization (DHMSM)

Modernized EHR Acquisition

Defense Health Agency (DHA)

Office of Information Technology

Joint Operational Medicine Information

Systems (JOMIS)

Deployment of EHR to operational forces

A Common Goal

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“I walk slowly, but I never walk backward.”- President Abraham Lincoln

2009EHR Way

Ahead

2010iEHR

2013DHMSM Kick-Off

2015Contract Award

2006AHLTA Fielding

Complete

Why Modernize?

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Collaborative Delivery of a Modernized EHR

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To deliver a modernized EHR to the military garrison and operational points of care, and transform how the military health system provides healthcare, the Services, DHA and Acquisition Teams will collaboratively work with the care locations to configure, test, train and deploy the new solution

Conclusion

AcquisitionDHMS

Solution Delivery & InfrastructureDHA

Site PreparationServices

Modernized EHRBusiness Processes

& RequirementsFunctional Champion

Deploy to 1,200+ Care

Locations

& 205,000+ Providers

Across the World

EHR Modernization Guiding Principles

Approved by the ASD (HA) and Surgeons General

July 2014

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Standardization of clinical and business processes across the Services and MHS

Design a patient-centric system focusing on quality, safety and patient outcomes that meet readiness objectives

Flexible and open, single enterprise solution that addresses both garrison and operational healthcare

Clinical business process reengineering, adoption, and implementation over technology

Configure not customize

Decisions shall be based on doing what is best for the MHS as a whole – not a single individual area

Decision-making and design will be driven by frontline care delivery professionals

Drive toward rapid decision making to keep the program on time and on budget

Provide timely and complete communication, training, and tools to ensure a successful deployment

Build collaborative partnerships outside the MHS to advance national interoperability

Enable full patient engagement in their health

Enterprise EHR

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EHR Modernization Guiding Principle: A flexible and open, single enterprise solution for both garrison and operational healthcare

55 Military Medical Centers & Inpatient Hospitals352 Health Clinics282 Dental Clinics

450+ Forward & Resuscitative Sites300+ Ships2 Hospital Ships6 Theater Hospitals3 Aeromedical Staging unitsO

per

atin

g En

viro

nm

ent

Competitively acquire, test, deliver, and successfully transition to a state-of-the-

market EHR

Deployment of the new EHR and new theater capabilities to expeditionary

locations

EHR60+

Capabilities

JROC CDDRequirements

Small & Distributed Form Factor

Service Tactical Infrastructure

MHS Approved Requirements

DHMSM JOMIS

+ =Medical Command and Control (Med C2)

Medical Logistics (Med LOG)

Health Care Delivery (HCD)

Patient Movement

Medical Situational Awareness (Med SA)

DHMSM Configured EHR

++ Theater

Capabilities(Low to No

Communications)

Consolidated Data Center

MED COI Infrastructure

Industry Experience

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• Objectives:• Support coordination, communication, and

recommendations of EHR related activities• Provide agile O-5/O-6 decision making and

subject matter expertise• Maintain synchronization across multiple

organizations

• Objective is not to:• Direct the contractor• Replace existing organizational missions

or structure

EHR Modernization Synchronization Workstream Steering Committees (WSCs)

Workstream Steering Committee Descriptions and Leads

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PEO DHMS Lead – COL Nicole Kerkenbush DHA HIT Lead – LTC(P) Rich Wilson

Workstream Mission Leads

Data • Data management activities Patti Lothrop (DHMS)Andy Anderson (DHA HIT)

Technical & Configuration Management

• Technical & Environmental Configuration Management• Medical & End User Device Integration• Security• Interfaces/Conversion

Jim Bates (DHMSM)Nick Saund (DHA HIT)

Infrastructure • Hardware• Network

Heather Burke (DHMS)Dr. Pete Marks (DHA HIT)

Product Configuration Reconciliation of MHS workflows with EHR vendor-provided workflows COL Jacob Aaronson (DHMSM)FAC Chair (Services)

Test & Evaluation (T&E)

• Technical• Cyber Security• Operational

Dr. Greg Guernsey (DHMSM)Giancarlo Osorio (DHA HIT)*SDD Test Manager TBD

Training Initial and ongoing (sustainment) user training LCDR Kent Bui (DHMSM)Michele McCormick (DHA HIT)

Strategic Communications

Provide public affairs guidance, communications support, and COL Nicole Kerkenbush (DHMS)Tanya Bradsher (DHA—MHS Communications)

Deployment / Activation

Technical preparations, support plans and resources, and practice trials before executing the deployment of a new EHR system

Len Cayer (DHMSM)Dr. Brian Jones (DHA HIT)

Why Standardize?

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Standardization Supports:

Effectiveness

Agility

Cost Efficiency

Quality

EHR Configuration Management

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• DHMSM EHR program requirements have been formally established

• Changes will be addressed by a formal Configuration Steering Board (CSB)• Co-Chaired by USD, AT&L and ASD, HA

• Prevent unnecessary changes that could have an adverse impact on cost or schedule

• Functional requirement modifications will be handled and addressed by the FCLG

Multi-Service Market

Leadership

Medical Operations

Group

Medical Business

Operations Group

Manpower and Personnel

Operations Group

Functional Advisory Council

Service Deputy Surgeons General

EHR Functional Champions Leadership

Group (FCLG)

FCLGDHA: RADM (Ret) RobertsArmy: BG PlaceNavy: CAPT ZinderAir Force: Maj Gen Allen

FACDHA: CAPT MeierArmy: Ann Wolford-ConnorsNavy: CAPT EllzyAir Force: Col Jeter

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DHMSM Initial Operational CapabilityTimeline

DHMSM Initial Operational CapabilitySites

Madigan AMC

Washington

92ND Medical Group & Aeromedical DEN

SQ/SGD

Naval Hospital Oak Harbor

NHCL Everett

Naval Hospital Bremerton

NBHC Sub-base Bangor

Puyallup Medical Home

Madigan AMC

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Contact Us

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health.mil/dhms

@DoD_EHR

Defense Healthcare Management Systems