VA eHMPAgile RFI Community Response

Thursday, February 11, 20163:00 PM EST

Request Summation andTopic Discussion

1. VA and OSEHRA Perspectives2. RFI Overview3. Root Cause Analysis4. Solution Considerations5. Community Recommendations

Contents

VA and OSEHRA Perspectives

• eHMP is the right thing to do• How to do it is the issue• Challenges

– How best to transition from waterfall to Agile development model

– How best to engage the community for optimal collaboration

– How to minimize financial and performance risks for VA

VA’s Perspective

• OSEHRA is a community facilitator, not a solution provider

• Appropriate models of software development management– Leadership– Expertise– Team building– Value exchange

• How do we respond as a community?

OSEHRA’s Perspective

Brief Overview of RFI Topics

• Achieve full and seamless VA-DoD interoperability

• Implement a stakeholder-centric information model

• Build on a future-facing architecture

Objectives of VistA Evolution

• Cooperation between OI&T and VHA• Transition from PMAS to VIP• Length of time to develop CPRS

replacement– Establishing and maintaining solution provider

relationships within current models• Acquisition• Software management

• Building an appropriate SDK

Strategic Challenges in eHMP Development

Root Cause Analysis

• Historical rigidity of PMAS model– Values documentation over product

• Lack of model implementations?• Poor communication between CPRS and

eHMP team• Poor identification and ramp-up of eHMP

resources– Internal– External (with VistA experience)– External (without VistA experience)

Sources of the Current Challenges

• Gaps and overlaps– Technical (product & expertise)

• Perceived shortage of expertise• Perceived difficulty of creating standard

development environment / SDK– Management / contracting

• Not enough VA direction / visibility?– Access to clinical SMEs / testers?

Sources of the Current Challenges

• Incompletely specified / provided infrastructural requirements

• Coarse taxonomy of requirements– Strategic– Infrastructural– Application– Workflow– Communication & documentation

Sources of the Current Challenges

• Agile conditions for success– Skilled Agile development team– Suitable project– Sound practice (don’t skip ceremonies)

• Challenges for Agile in the Federal workspace– Resistance to the culture of scrutiny– Procurement practice and progress assessment– Lack of required skills

Sources of the Current Challenges

Solution Considerations

• Acquisition and development are separate, successive project phases– How does Agile methodology best serve each

one?• Move away from blanket firm-fixed-price

(FFP) acquisition?• Field testing and implementation

– Proper identification of model implementation needs to be clinically driven

What Is Being Managed?

• Where would it make sense to replace a SOW (statement of work) to an SOO (statement of objectives)?– SOO allows agile decision-making– SOO allows distinction between FFP and time-and-

materials (T&M)• T&M risk: ability of government to manage• Decision to request FFP vs. T&M: better made by program

manager than by TAC?• More granularity of timespan, deliverables, contract options?

• Long-term contracting vs. relatively short-term acquisitions?

Can Acquisition Be Improved?

• An appropriately granular taxonomy of requirements is needed– Strategic– Infrastructural– Application– Workflow

• Where does waterfall make better sense than Agile?– Infrastructure-focused tasks– Application-focused tasks– Workflow-focused tasks

Do Requirements Drive Methodology?

• Proper characterization and achievement of needed competencies

• Committed core team with well-identified resources (internal and external)

• A “Chief Agile Officer” to guide and monitor the use (and misuse) of Agile methodologies?

Finding and Building Expertise

Recommendations

• What areas do we target? Suggestions:– Strategy for Agile– Community engagement within the context of

Agile• How do / should we refine the solution

considerations stated in previous slides?

• What haven’t we thought of?

Recommendations

Thank You!

Mike Hendersonhendersonm@osehra.org

Guy Estenguy.esten@apexdatasolutions.net