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 has no financial interest to disclose. Commercial support was not received for this activity.
HIT Enterprise Transformation: EHR Rollout...It's Happening Now!
Mr. David Bowen, SES Director, Defense Health Agency (DHA) Health Information Technology Directorate Disclosures The presenter has no financial relationships to disclose.
This continuing education activity is managed and accredited by ProfessionalEducation Services Group in cooperation with AMSUS. Neither PESG, AMSUS, nor any accrediting organization support or endorseany product or service mentioned in this activity. PESG and AMSUS staff has no financial interest to disclose. Commercial support was not received for this activity. Learning Objectives: At the conclusion of this activity, the participant will be able to: Discuss the important changes, direction and benefits of the new EHRmodernization Discuss the strategic direction for the HIT Directorate and the concept ofShared Services Explain how a culture of change is needed for operational success Military Health System What We Currently Support
117 Naval Ships 6 Theater Hospitals 17 Submarines 57 Medical Centers 281 Dental Clinics 255 Veterinary Facilities 2 Hospital Ships 1,099 Locations in 16 countries 153,000 employees 364 Ambulatory Care Clinics This graphic reflects the spectrum of MHS support today with our legacy systems. This will change somewhat with the deployment of the new EHR as COL Kerkenbush will discuss later in this session HIT Transformation Modernizing MHS Management with an Enterprise Focus
Through DHA, we are -- Creating a more globally integrated health system Driving enterprise-wide services and standardized clinical and business processes that produce better health and better health care Implementing future oriented strategies and technologies to create a better, stronger, more relevant medical force Transition from TMA to DHA is part of an effort to modernize MHS managementincluding management of DHA HITwith an enterprise focus This is a once-in-a-generation opportunity to shape the future of military medicine.Readiness and quality of care will be enhanced and beneficiaries will receive the same level of care from a more efficient and effective organization Moving to a Shared Services Model
The Shared Services model organizes supportfunctions to optimize delivery of reliable,flexible and cost effective services tocustomers in accordance with performancetargets or service level agreements When the DHA reached Initial Operating Capability (IOC) on October 1, 2013, the HIT Directorate was one of the first shared services to begin operating Before the transition to DHA, HIT infrastructure and management were decentralized and managed within TMA and separately by the Services Over the two-year period from October 2013 to October 2015, the HIT Shared Service consolidated assets from the Army, Navy, and Air Force to centralize HIT management Services All In on HIT Shared Services from Day 1 Moving to a Shared Services Model October 2013 to October 2015
HIT Shared Service consolidates functions from the Army, Navy, and Air Force to centralize HIT management Service IT management functions transitioned into DHA DHA becomes single provider/coordinator of HIT services Focus is on customer service optimization To support the transition of the bulk of health IT functions to the DHAs HIT Shared Service, the services IT management functions were transitioned into the DHA Service CIOS havehave been actively involved in the planning for the DHAs HIT shared service Consolidation and reengineering of IT management services and infrastructure services is being performed with a focus on customer service optimization Ultimately, DHA becomes the single provider/coordinator of these services HIT Shared Services Business Case Savings Areas
Re-engineering of IT management functions and processes Consolidate management and management resources across the Services Infrastructure Consolidation Inventory and consolidation ofduplicative contracts Rationalize the MHS HIT application portfolio Identify duplicative applications Consolidate requirements, evaluate solutions Decide on a single solution, decommission the others Infrastructure Consolidation involves consolidation of Identity Management Engineering Services Testing and Evaluation Hosting Services Network Operations End User Support Communications and Messaging, and Information Assurance We are realizing significant cost avoidance from our efforts to consolidate hardware and software contracts.At least $10M in cost avoidance has been achieved. This is a DHA HIT good news story that demonstrates just how effective the reduction of duplication can be in reducing expenditures. Rationalizing the MHS HIT application portfolio involves Identifying duplicative applications Consolidating requirements, evaluate solutions Deciding on a single solution Adopting the selected solution and decommissioning the others Consolidation of hardware and software contracts alone has yielded at least 10M in cost avoidance HIT Shared Services Business Case Cost Savings for the DoD AND Improved, Simplified IT Support for the MHS Consolidate and standardize IT infrastructure One Forest:Active Directory and Enterprise Management One Network: consolidate multiple networks One put everyone on the samesystem One Datacenter: a single datacenter hosting strategy One Web: a single web hosting solution One Desktop: a single desktop configuration and strategy One Help Desk: a single help desk capability One AV/Comm: a single AV/communications strategy What does the consolidation of IT services under the HIT Shared Services business case mean for clinicians? IT means we can successfully address two of your key pain points with HIT system downtime and who to contact when you have an IT issue. In addition to the consolidation and simplification achievements listed here, we are also working with DoD CIO to get you some relief from Common Access Card related challenges DHA HIT is framing a set of use cases where utilization of a Common Access Card with the new EHR system may present significant challenges.These include non-DoD personnel working in our healthcare system; unmonitored computers such as ER tracking boards and central fetal monitors in a nursing station or provider on call room; infection or contaminant control scenarios in lab settings; and terminals routinely used by multiple staff members or beneficiariesin short time frames like those used for bedside charting or kiosks used for patient check in. Potential means of addressing these situations under discussion include temporary token assignment, single sign-on with context roaming sessions: and proximity capability (radio frequency communication between the card and a reader). We will be seeking a waiver from the DoD CIO to facilitate the implementation of solutions for some of these challenging scenarios to help our clinical community get their jobs done efficiently and securely. Consolidated Infrastructure Services Objectives
Improve the quality of health care by implementing a single IT infrastructure from Desktop to Datacenter (D2D) Eliminate IT redundancies across the enterprise to maximize effectiveness and achieve financial efficiencies Increase IT responsiveness through a centrally managed and maintained technical architecture to support the military medical community Support the requirements of the new EHR implementing first in the Pacific Northwest (PNW) to achieve Initial Operating Capability (IOC) Our objectives for consolidated infrastructure services include Improving the quality of health care by implementing a single IT infrastructure from Desktop to Datacenter Reforming the management of the IT infrastructure will, over time, give us the ability to managehealth IT delivery all the way to the desktop (D2D concept) The end result will be an enterprise-wide, integrated IT environment with standardized infrastructure and applications that are accessible through the devices used by MHS end users Eliminating IT redundancies across the enterprise to maximize effectiveness and achieve financial efficiencies Increasing IT responsiveness and agility through a centrally managed and maintained technical architecture to support the military medical community AND Supporting the requirements of the new EHR implementing first in the Pacific Northwest (PNW) to achieve Initial Operating Capability (IOC) and then continue deploying enterprise-wide, leveraging lessons learned achieving IOC Infrastructure Services Key Milestones for FY 16
Network DHA Single Wide Area Network (Med-COI), as well as, Local Area and Wireless Network transition by end of Q2 FY16 Network Desktop Desktop DHA manages standard Desktop by end of Q3 FY16 Enterprise Management DHA Single Enterprise Management by end of Q2 FY16 IT Support DHA manages the IT support model by end of Q3 FY16 Infrastructure Services Supporting the EHR Modernization
BUSINESS IMPACT Network Security Management Service Seamless integrated Wide, Local, and Wireless Network ManagementSingle Security Architecture and centralized Designated Accrediting Authority, standardized monitoring and management resulting in Lower Costs and Improved Uptime Directory Services/ Enterprise Management Centralized and secure access and authentication capability to network resources A Provider will be recognized on the network anywhere within the MHS! Desktop as a Service Desktop design standardization service across the application, desktop and server environments Standardized desktop configuration and application virtualization capabilities across physical and virtual desktops for lower acquisition and management costs and improved problem resolution Global Service Center Consolidated MHS enterprise IT service desk One number to call for help from anywhere!Lower operating cost, 24 X 7 operation. IOC Infrastructure End State Increased Bandwidth, Route Diversity and Backup Capability
DISA NH Oak Harbor NH Bremerton Fairchild AFB M