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New IT Service Requests and New Commercial Technology Requests: A How-To Guide for VHA researchers May 16, 2006

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New IT Service Requests and New Commercial Technology Requests: A How-To Guide for VHA researchers May 16, 2006 David M. Douglas MD Geriatric Psychiatrist Associate Director for Information Member IDMC Screening Committee Portland VAMC Mike Davey MD PhD ACOS Research & Innovation AGENDA

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New IT Service Requests and New Commercial Technology Requests: A How-To Guide for VHA researchersMay 16, 2006

slide2
David M. Douglas MD

Geriatric Psychiatrist

Associate Director for Information

Member IDMC Screening Committee

portland vamc

Portland VAMC

Mike Davey MD PhD

ACOS Research & Innovation

agenda
AGENDA
  • What is the role of the Informatics and Data Management Committee (IDMC)?
  • What are New IT Service Requests (NSR) and New Commercial Technology (NCT) requests?
  • What does a researcher need to do to place a request?
  • How can Research help OI?
defining the request nsr vs nct
Defining the Request:NSR vs. NCT
  • New IT Service RequestNew IT Service Requests are requests for products, product enhancements and changes to information systems maintained by OI.
  • New Commercial TechnologiesCommercial Technologies can be described as developmental software and/or information devices and systems written by VA employees, by vendors, contractors, or development partners. The evaluation process applies to 1) Devices displaying VistA data in a different format, and/or 2) Any device, external system, or vendor or locally developed software writing to VistA other than Diagnostic, Imaging, or Clinical Procedures equipment using nationally supported HL7 or DICOM protocols.
  • IDMC Screening Committee evaluates both requests.
idmc sc charter
IDMC SC Charter
  • SC established to work cooperatively with OI
  • Perform analyses on all IT requests to ensure alignment with VHA priorities
  • Provide guidance on prioritization of IT initiatives
idmc screening committee
IDMC Screening Committee
  • Informatics & Data Management Committee (IDMC) is the advisory group to the USH through the NLB on IT resources, policies, and issues.
  • The following committees report to IDMC
    • IDMC Screening Committee (IDMC SC or SC)
    • OI Health Information Systems Executive Boards
    • VHA Data Consortium
vha key organizations relationships current
VHA Key Organizations & Relationships - Current

VA

VSSC Oversight Board

Patient Care Services Data Workgroup

I & T (CIO)

Data Management Board

IT Enterprise

Architecture

NLB

VHA

EIB

Strat Plan C

IDMC

DUS Ops & Mgmt

Health System C

Policy, Portfolio

Oversight & Exec

Screening Subcommittee

Finance C

VHA Chief Architect

OI

Data Consortium

DUSH O&M

21 VISN

Comm C

Data Archi-tecture Working Group

Info Tech

Operations

Dep CIO VHA

VHIM Stake-holder Council

Dir ServNet (E, C, W)

Facilities

VISN CIO Council

HRC

Architecture Planning Workgroup

Cyber &

Info Sec

Major Organizations

IT

Business

Permanent Organizations

Boards, Committees, Working Groups

Coordination

Direction

P/D

CHIO

Auto-mation Center

Health Data & Informatics

Domain Prioritization Workgroup

HSD&D

Data Standard-ization Oversight Board

ESMs

HPMO

Domain Action Teams

Collaborative Health Information Partners (CHIP)

HISEB

idmc sc membership
IDMC SC Membership

Renee Oshinski (Chair) Deputy Network Director, VISN 12

William H. Beer, MD CIO, San Antonio VAMC

Cynthia Breyfogle Chief Business Officer, VISN 23

Kathryn Corrigan, MD Interim ACOS Amb Care Tampa VAMC

David Douglas, MD Assoc Dir Information Portland VAMC

Brian Heckert Director, VAMC Columbia

Peter Henry Director, Black Hills VAMC

James Laub Chief Information Officer (CIO), VISN 18

Michael Simberkoff, MD COS, NY Harbor Health VAMC

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NLB’s Informatics & Data Management Committee

IDMC

Screening Committee

  • Initial Assessment & Briefings (IABs) prepared by
  • Office of Information’s
    • Health Systems Design & Development - Planning & Analysis
  • With input from Office of Information’s
  • Enterprise Systems Management HISEBs (Executive Boards)

HISEB

Health Data Systems

HISEB

Veterans Programs

HISEB

Health Provider Systems

HISEB

Management & Financial Systems

HISEB

Infrastructure

HISEB

Common Services

executive board input to idmc sc
Executive Board input to IDMC SC

Health Provider Systems (HPS)

  • Supports health care providers in the care of veterans. Key HPS systems include BCMA, CPRS, Lab, Nursing, Pharmacy, and VistA Imaging.
  • Primary Stakeholders: Clinical Providers

Health Data Systems (HDS)

  • The storage and use of dataand related efforts for interoperability and standardization of information. Key HDS systems include data standardization, information sharing, clinical data repositories, warehouses, and data marts.
  • Primary Stakeholders: Groups who use clinical data, external users. (Patient care, research, epidemiology, biostatistics, patient safety, decision support, quality/ performance improvement, clinical and administrative management)

Management, Enrollment & Financial Systems (MEFS)

  • Management, financial, and business aspects of VHA.   Includes financial systems, logistics systems, pay, enrollment and eligibility, scheduling and billing.
  • Primary Stakeholders: Chief Business Officer, Chief Logistics Officer, Chief Financial Officer
executive board input to idmc sc12
Executive Board input to IDMC SC

Veteran Programs (Under discussion, may leave with HPS)

  • Systems used directly by veterans, their families, veteran advocates, and designated VA and non-VA health providers. Included are MyHealtheVet (MHV) and Home Telehealth.
  • Primary Stakeholders: Veteran Representatives

Systems for External Information Exchange (Under discussion)

  • An outward looking portfolio for information exchange with users outside VA/VHA, to include CDC, IHS, DOD, RHIO’s.
  • Primary Stakeholders: External Users

Infrastructure, Common Services, Foundations (may be renamed)

  • Common requirements of the primary programs, such as hardware, platforms, and software infrastructure.
  • Primary Stakeholders: Internal to OI
new service requests nsr
New Service Requests (NSR)
  • NSR process initiated via Planning and Analysis Service (PAS) Webpage
  • NSRs must be authorized by an approving authority
  • Submit Request
  • View Request
  • Guidance Policy
authorized approving authorities
Approved List of Endorsers

Secretary of Veterans Affairs

Deputy Secretary for Veterans Affairs

Under Secretary for Veterans Benefits

Veterans Benefits Administration CIO

Director, C&P Service

Associate Deputy Under Secretary for Programs & Policy (VBA)

Under Secretary for National Cemetery

National Cemetery Administration CIO

Director, Office of Financial Management

Deputy Assistant Secretary, Acquisition and Materiel Management

Assistant Secretary, Human Resources and Administration

Assistant Secretary, Information and Technology

Assistant Secretary, Public and Intergovernmental Affairs

Assistant Secretary, Congressional and Legislative Affairs

Assistant Secretary, Policy and Planning

Assistant Secretary, Management

a. VHA Board of Directors

Under Secretary for Health

Principal Deputy Under Secretary for Health

Chief of Staff (USH)

Chief Compliance & Business Integrity Officer

Chief Management Support Officer

Deputy USH for Operations & Management

Deputy USH for Health Policy Coordination

Medical Inspector

Chief Quality and Performance Officer

Director, Office of Research Oversight

Chief Patient Safety Officer

Assistant Deputy USH for Policy & Planning

Director, Strategic Initiatives Office

Chief Communications Officer

Director, National Center for Ethics in Health Care

Chief Prosthetics and Clinical Logistics Officer

Chief Patient Care Services Officer

Chief Research and Development Officer

Chief Public Health and Environmental Hazards Officer

Chief Academic Affiliations Officer

Chief Readjustment Counseling Officer

Chief Business Officer

Chief Financial Officer

Chief Facilities Management Officer

Chief Information Officer

Chief Health Informatics Officer

Chief Employee Education System Officer

Director, Veterans Canteen Service

Chief Nursing Officer

b. All VISN Directors

c. All VISN Chief Information Officers

d. Office of the Chief Information Officer

Director, Health Enterprise Strategy

Director, Enterprise Systems Management

Enterprise System Managers

Director, Health System Implementation, Training and Enterprise Support

Director, Health Systems Design & Development

Director, Health Data and Informatics

Authorized Approving Authorities
nct requests
NCT Requests
  • NCT requests require two key endorsers: VISN Chief Information Officer (CIO) and Medical Facility Chief of Staff (COS)/Director.
  • NCT requests require that the product must be entered in the Commercial Products Registry
  • NCT requests require a Vendor Product Evaluation Packet
what are the steps in the process
What are the steps in the Process?
  • Once the request is submitted, Planning and Analysis (P&A) team members will begin the analysis process. 
  • The initial steps include: assigning of a functional and business analyst, contacting the appropriate development team(s), verifying endorsement and contacting the requestor. 
  • P&A determine whether the request will need to be submitted to the Screening Committee for approval. If so, the functional analyst and business analyst will contact the requestor and subject matter experts to gather information to support the request. The development teams are also asked for impact information.
  • Once the necessary information is gathered, the completed packet is submitted up for approval.  
how do new service or new technology requests get screened
How do New Service or New Technology Requests get screened?
  • After requests have been submitted to the website, P&A staff create a document which serves as the basis for screening by the committee. The document comes to the IDMC SC in 2 forms
    • Intent to Proceed
    • Initial Assessment and Briefing
itp intent to proceed
ITP: Intent to Proceed
  • Projects with legal, political, or financial implications so compelling that they come to the SC basically as a fait accompli
  • SC asked to provide input but not asked to approve or prioritize
iab initial assessment and briefing
Decision Support Memo to SC

Overview

Description of Request

Background

Description of Project

Legacy Vista Changes

HeV Vista Enhancements

High Level Impacts

Resources Needed

Project Schedule

Considerations/ Recommendations

AS-IS vs. TO-BE flowcharts

IAB: Initial Assessment and Briefing

SC reviews IAB and then recommends disposition to IDMC

sc meeting agenda
SC Meeting Agenda
  • VANTS call 4th Thurs 2-4PM Eastern
    • ITP review
    • IAB review/discussion/disposition
    • Weekly summary of new IT service requests (is Fast Track warranted?)
    • Quarterly Review of Parking Lot Items
disposition
Disposition
  • IDMC reviews/approves SC recommendations
  • “Approved” projects may be parked or put on hold and might be subject to lengthy delays due to competing projects/ scarce resources
  • SC/IDMC Approved Projects
  • Decision memos sent to requestors via Outlook
  • Decisions can be appealed
parking lot items aka parked projects
Parking Lot items AKA Parked Projects
  • These projects have been approved but are parked awaiting funding or are dependent on another application under development before work can start.
  • Parked projects are reviewed quarterly to determine the need for re-prioritization, deletion, or acceleration based on current VHA strategic initiatives, performance goals, and/or business drivers
common reasons for disapproval
Common Reasons for Disapproval
  • Insufficient business case
  • Enhancements to legacy Vista would not be complete until after anticipated release of HeV
  • Project would cause unacceptable delays in other high priority projects
  • Limited national applicability (one facility or only one VISN affected)
recent enhancements to nsr nct process
Recent Enhancements to NSR/NCT Process
  • SC to ask for IDMC review/approval of items in the Parking Lot
  • SC to develop a Fast Track Process
  • SC to revisit/propose process for evaluation of New Commercial Technologies
  • Promote/Improve input from HISEBs
  • Publicize the NSR and Fast Track Processes
fast track
Fast Track
  • Process clarified and enhanced after August NLB meeting
    • SC and IDMC review items in the Parking Lot quarterly
    • Business Owners/Requestor and OI ESMs invited to directly participate in SC meetings
    • SC will review weekly summaries of NSRs to identify projects which should be Fast Tracked
fast track cont d
Fast Track, cont’d
  • HISEB input sought earlier in the process so as to be included in the IABs referred to the SC
  • HISEB review and response time shortened from 2 weeks to 1
  • Fast Track projects will have an expedited review
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VHA Fast Track IT Service Request

Patient Safety Initiative or a

Legislative/Strategic Initiative endorsed by USH/PDUSH

New IT Service Request

Must be endorsed by NLB Member (VISN Director or Program Officer)

http://vista.med.va.gov/pas/NewITRequestForm.asp

Endorsed by Facility/VISN Leadership

Development Teams and SME’s/User Groups

HSD&D Conducts Initial Planning & Analysis Functions

5 - 7 DAYS

3 - 4 MONTHS

Preparation of Intent to Proceed (ITP)

“Must Do Work”

Preparation of Initial Assessment and Briefing (IAB)

OI Leadership Review Period

HISEB Review Period

1-2 Weeks

Screening Committee Review ALL Feedback is forwarded for review process.

Multidisciplinary SC Membership

IDMC

Review of Screening Committee’s Recommendations

Multidisciplinary IDMC Membership

Notification sent to Requestor

Indicating IDMC Decision

APPROVED

Entered OI Technical Service Project Repository

DISAPPROVED

Requestor may re-submit request or ask for appeal through IDMC Manager

Notification Sent to Appropriate HISEB

scenario 1 nsr for a change to a vista package to roll data up nationally
Scenario 1: NSR for a change to a VistA package to roll data up nationally
  • Researcher submits NSR after obtaining endorsement
  • NSR indicates national rollup of data is needed
  • Planning and Analysis staff assist in solidifying requirements which includes setting up Kick-Off Call
  • Packet workup then begins to assemble the documentation to support further discussion and decision making
  • IAB (or ITP) sent to HISEBs for comment
  • IAB AND HISEB feedback sent to IDMC SC members prior to monthly call where requestor will participate
  • IDMC SC makes recommendation to IDMC
  • IDMC approves, disapproves, requests further analysis
  • Requestor notified
scenario 2 nct for a clinical decision support system
Scenario 2: NCT for a clinical decision support system
  • Researcher enters product into registry, completes paperwork, obtains endorsement and submits NCT
  • Planning and Analysis staff request security and architecture review
  • Packet workup then begins to assemble the documentation to serve as the basis for discussion and decision making
  • IAB sent to HISEBs for comment
  • IAB and HISEB feedback sent to IDMC SC members prior to monthly call where requestor will participate in the discussion
  • IDMC SC makes recommendation to IDMC
  • IDMC approves, disapproves, requests further analysis
  • Requestor notified
new commercial technology process will be re engineered
New Commercial Technology Process will be re-engineered

5 aspects of NCT process reviewed at special February meeting of SC

1) Governance

2) Funding to Maintain Innovation

3) NCT Review Process Timelines

4) Procurement for Testing Products

5) Market Analysis

summary and forecast
NSR Process Clarified

Insufficient resources and competing projects mean that many worthwhile projects will be delayed

Centralization, IT Reorg and Budget cuts cast further uncertainty on the process

HISEB and field input essential but not well operationalized

NCT process will be re-engineered later this year

Summary and Forecast
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