180 likes | 745 Views
2. Agenda CHCS II: The Military Electronic Health Record (EHR). CHCS II in 2003 : The Year in ReviewCHCS II in 2004: Block 1 Worldwide DeploymentA look at the application's features and its futureCritical Service InvolvementTri-Service Collaboration ForumsCHCS II Implementation Strategy CHCS II Deployment ProcessQ and A .
E N D
1. Colonel Victor Eilenfield, MS, USA
Program Manager, CITPO
2. 2 AgendaCHCS II: The Military Electronic Health Record (EHR) CHCS II in 2003 : The Year in Review
CHCS II in 2004: Block 1 Worldwide Deployment
A look at the applications features and its future
Critical Service Involvement
Tri-Service Collaboration Forums
CHCS II Implementation Strategy
CHCS II Deployment Process
Q and A
3. 3 CHCS II in 2003: The Year in Review Since the last TRICARE Conference
A limited deployment of CHCS II has been completed and analysis performed
Approval granted for worldwide deployment of CHCS II Block 1
4. 4 Overview: Limited Deployment Limited Deployment occurred between February December 03 at seven Army, Navy, and Air Force facilities
Limited Deployment strategy was developed with the Service Medical Departments
Focus
Refinement of implementation and training processes
Included creating efficiencies in facility preparation, customizing training, and providing the most effective deployment support
Resolution of any functional or technical issues previously identified at the test sites
Assessment of productivity and workflow issues
In 2003, DoD completed its EHR limited deployment phase. We took CHCS II to seven MHS hospitals. The limited deployment included Army, Navy, and Air Force sites and a variety of medical specialties to ensure that the feedback would reflect the wide variety of care settings and any Service-specific differences.
This limited deployment provided a rich opportunity to refine the processes for implementation and training and allowed us to take another look at any functional or technical issues and ensure that they had been fully addressed. It also gave us significant opportunity to look at provider productivity and workflow. Remember, one of our EHR Essentials is that the tool must support our providers workflow and must not be obtrusive to patient care.
The amount of data and the increases in our understanding of how to create efficiencies in our implementation and training processes from this effort is astounding. After all, the providers in these hospitals and clinics were performing more than 65,000 patient encounters each month using the EHR.
In 2003, DoD completed its EHR limited deployment phase. We took CHCS II to seven MHS hospitals. The limited deployment included Army, Navy, and Air Force sites and a variety of medical specialties to ensure that the feedback would reflect the wide variety of care settings and any Service-specific differences.
This limited deployment provided a rich opportunity to refine the processes for implementation and training and allowed us to take another look at any functional or technical issues and ensure that they had been fully addressed. It also gave us significant opportunity to look at provider productivity and workflow. Remember, one of our EHR Essentials is that the tool must support our providers workflow and must not be obtrusive to patient care.
The amount of data and the increases in our understanding of how to create efficiencies in our implementation and training processes from this effort is astounding. After all, the providers in these hospitals and clinics were performing more than 65,000 patient encounters each month using the EHR.
5. 5 Block 1 Limited Deployment Sites Tinker Air Force Base, Oklahoma (Completed May 03)
Fort Eustis, Virginia (Completed Jun 03)
Fort Story and Fort Monroe
Goodfellow Air Force Base, Texas (Completed Jun 03)
Naval Medical Center Portsmouth, Virginia
Cherette [Selected Clinics] (Completed May 03)
Naval Station Sewells Point (Completed Aug 03)
Naval Air Base Little Creek, Boone Clinic (Completed Aug 03)
Naval Air Station Oceana (Completed Aug 03)
Fort Bliss, El Paso, Texas (Completed Aug 03)
White Sands Missile Range
Seymour Johnson Air Force Base, North Carolina (Complete Oct 03)
Langley Air Force Base, Virginia (Completed Dec 03)
There is a good chance that a military medical facility near you has been using CHCS II. The limited deployment took the EHR to military hospitals and clinics in four states: Oklahoma, Virginia, Texas, and North Carolina.
McDonald Army Community Hospital at Fort Eustis, Virginia was the first to begin the limited deployment and William Beaumont Army Medical Center, Fort Bliss, Texas was the first tertiary care facility to complete limited deployment.
Portions of Naval Medical Center Portsmouth, Virginia and ambulatory care facilities in the Tidewater area have implemented CHCS II.
The Air Forces aggressive stance resulted in completing deployments at four hospitals, including the 1st Medical Group at Langley Air Force Base, Virginia; the 4th Medical Group at Seymour Johnson Air Force Base, North Carolina; the 72nd Medical Group at Tinker Air Force Base, Oklahoma; and the 17th Medical Group at Goodfellow Air Force Base, Texas.
There is a good chance that a military medical facility near you has been using CHCS II. The limited deployment took the EHR to military hospitals and clinics in four states: Oklahoma, Virginia, Texas, and North Carolina.
McDonald Army Community Hospital at Fort Eustis, Virginia was the first to begin the limited deployment and William Beaumont Army Medical Center, Fort Bliss, Texas was the first tertiary care facility to complete limited deployment.
Portions of Naval Medical Center Portsmouth, Virginia and ambulatory care facilities in the Tidewater area have implemented CHCS II.
The Air Forces aggressive stance resulted in completing deployments at four hospitals, including the 1st Medical Group at Langley Air Force Base, Virginia; the 4th Medical Group at Seymour Johnson Air Force Base, North Carolina; the 72nd Medical Group at Tinker Air Force Base, Oklahoma; and the 17th Medical Group at Goodfellow Air Force Base, Texas.
6. 6 CHCS II in 2003: The Year in Review On 6 November 2003, CHCS II Block 1 deployment was approved by the Senior Military Medical Advisory Committee (SMMAC)
SMMAC membership: ASD (Health Affairs), DASDs, and the Surgeons General
On 17 November 2003, based on the favorable results of a limited deployment of CHCS II, an ADM was issued by the OASD, NII authorizing worldwide deployment of CHCS II Block 1
The ADM states that the OASD, NII expects full Block 1 implementation by 30 June 2006
7. 7 CHCS II in 2004: Block 1 Worldwide Deployment Underway 30-month rollout beginning January 2004
Fields a longitudinal EHR that is
Legible and accessible 24x7
Supports population health and disease management activities
To be used in MHS facilities and in deployed settings
Train as we fight
Future blocks will build on Block 1
8. 8 Global Access
9. 9 Block 1 Clinical Capabilities Patient Demographics1
Patient Alerts1
New Results
Cosign Orders/Encounters
New Telephone Consult
Appointment List1
Telephone Consult List
Unscheduled Visit Creation
Consult Tracking
Questionnaires (e.g., HEAR)
Problem Knowledge Couplers
Standard Reports
10. 10 Block 2 Clinical Capabilities Dental Charting and Documentation
Dental Notes for general dentistry
Emergency Triage
Periodic Exam
Multiple Data views
Full Mouth Diagnostic & immediate treatment views
Individual Tooth Charting
Specialist Diagnosis & Treatment
Dental Radiology Orders
Spectacle Request Transmission System II
Prescription Eyewear Order Tracking
Automated Clinical Practice Guidelines
Ad Hoc Reporting
Common Access Card Patient Identification
11. 11 Block 3 Clinical Capabilities Replacement/enhancement of Legacy CHCS Ancillary Functionality
(Includes Order Entry, Results Retrieval, and Alerts)
Laboratory
Anatomic Pathology
Pharmacy
Radiology
Enhanced Dental Functionality Begin replacement of legacy system Begin replacement of legacy system
12. 12 Documentation
13. 13 HPIHPI
14. 14 ROSROS
15. 15 PEPE
16. 16
17. 17 Disposition and CodingDisposition and Coding
18. 18 Population Health
19. 19
20. 20
21. 21
22. 22
23. 23 Copy Forward
24. 24
25. 25
26. 26
27. 27
28. 28
29. 29
30. 30 Flow Sheet
31. 31
32. 32 Practice Guideline Support
33. 33
34. 34
35. 35 A/P, Wellness, and CPG Protocol Mockup
A/P, Wellness, and CPG Protocol MockupA/P, Wellness, and CPG Protocol Mockup
A/P, Wellness, and CPG Protocol Mockup
36. 36 Standard Software & Components
37. 37 Forensics
38. 38 DoD Forensic Work Flow
39. 39
40. 40
41. 41
42. 42
43. 43
44. 44
45. 45
46. 46
47. 47
48. 48
49. 49 Mobile Technology Use of handheld technology and capture of data from medical devices may be supported by CHCS II
Use of handheld technology for inpatient care has been programmed
System built to be capable of interfacing with myriad input devices:
Electrocardiogram
Ultrasound
Blood Pressure Cuffs
Joint Biological Agent Identification and Diagnostic Systems
Handheld Devices
Tablet PCs
50. 50 CHCS II: The Military EHR Creates a true longitudinal EHR that will span the entire Service members (and other beneficiaries) experience with the MHS
Provides a comprehensive, patient-centric health record
Integrates the record across locations and medical specialties
Increases record availability to over 99 %
Improves patient safety and record accuracy
Supports the team approach to health care
Automates much of the writing and coding of health records
Supports preventive health care services delivery and disease management
Addresses information assurance issues in depth
Enables a train as we fight approach to health care
51. 51 By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care.
-President George W. Bush
State of the Union Address
20 Jan 2004
52. 52 CHCS II (Block 1) Worldwide Deployment
53. 53 FY04 Deployment Sites NMC PORTSMOUTH - WW
KENNER AHC-FT. LEE
43RD MEDICAL GROUP-POPE
EISENHOWER AMC-FT. GORDON
375th MED GRP-SCOTT
NH BREMERTON
NH CAMP LEJEUNE
62nd MED GRP-MCCHORD
WINN ACH-FT. STEWART
92nd MED GRP-FAIRCHILD
7th MED GRP-DYESS
NH OAK HARBOR
NH CHERRY POINT
DARNALL ACH-FT. HOOD
NMC SAN DIEGO
BLANCHFIELD ACH-FT. CAMPBELL
NH CORPUS CHRISTI
2nd MED GRP-BARKSDALE
MARTIN ACH-FT. BENNING
314th MED GRP-LITTLE ROCK NH CAMP PENDLETON
47th MED GRP-LAUGHLIN
NH TWENTYNINE PALMS
NACC PORT HUENEME
71st MED GRP-VANCE
NH LEMOORE
97th MED GRP-ALTUS
WOMACK AMC-FT. BRAGG
59th MED WING-LACKLAND
82nd MED GRP-SHEPPARD
311TH MED SQUAD-BROOKS
12th MED GRP-RANDOLPH
LYSTER ACH-FT. RUCKER
FOX AHC-REDSTONE ARSENAL
LANDSTUHL REGIONAL MEDCEN (Test Clinic)
NH CHARLESTON
95th MED GRP-EDWARDS
30th MED GRP-VANDENBERG
61st MED SQUAD-LOS ANGELES
54. 54 Tri-Service Collaboration Forums
Working Groups and Communication Process support the level of coordination and communication necessary
55. 55 Tri-Service Collaboration ForumsWorking Groups
56. 56 Tri-Service Collaboration ForumsCommunication Process
57. 57 Implementation StrategyRefined Based on Limited Deployment Define Roles and Responsibilities
Use Standard Deployment Process
Pre-Implementation Conferences
Surveys
Deployment Support
Training Model Adapted to Meet Specific Service Needs
Identification of Challenges and Lessons Learned
58. 58 Roles and ResponsibilitiesCITPO and TIMPO CITPO CHCS II Program Office Responsibilities
Contract management of CHCS II Program
Design, Development, Testing
Tier III support
Implement and Train CHCS II
59. 59 Roles and ResponsibilitiesCITPO and TIMPO TIMPO Responsibilities
Design, Implement, and Maintain Infrastructure
Procure, Install, Integrate, Test, and Maintain Hardware/ Software
Performance Monitoring and Management
Direct DISA activities on Communications and Computing Infrastructure
Manage End User Device Program
MHS Help Desk
60. 60 Roles and Responsibilities Key MTF Players Commander
CHCS II Project Officer
Clinical Champion(s)
Information Management
Facility Training Coordinator
PAS Scheduler
Public Affairs Officer
Data Quality Manager
CHCS I System Administrator
Base DOIM Representative
61. 61 Roles and Responsibilities MTF Responsibilities Perform Business Process Reengineering
Establish Local CHCS II Project Team
Participate in Pre-Implementation Meetings
Coordinate Local Approvals, e.g. Site Access
Prepare for and Monitor Installation Activities
Accept Equipment/System
Coordinate Training Schedules and Clinic Activation Sequence
Report Problems with System
Provide Sustainment Training
62. 62 CHCS II Deployment Process*
63. 63 Deployment Operations Center Manages, coordinates, and integrates all activities required to deploy EHR to DoD health care facilities
Brings together key players in one centralized location
Provides central clearinghouse for deployment support to facilities
Ensures prompt resolution of deployment issues
Database used to capture and follow issues through resolution
Leads all day-to-day implementation support meetings The CITPO, which serves as the project office for CHCS II, established the Deployment Operations Center to provide a central point of contact to assist Service Medical Chief Information Officers (CIOs) and treatment facilities with deployment, training, and activation issues. It is the mission of the Deployment Operations Center to support each site throughout this implementation. The Deployment Operations Center staffs a toll-free line (866-837-1924) with automated directory assistance to ensure that any facility with a question or issue can obtain help quickly and easily.
The Deployment Operations Center published an Implementation Guide along with additional guidance documents and templates for use in developing customized, site-specific plans will be provided to each facility and its local implementation team members. The Deployment Operations Center maintains an electronic library of all implementation-related documents.
The CITPO, which serves as the project office for CHCS II, established the Deployment Operations Center to provide a central point of contact to assist Service Medical Chief Information Officers (CIOs) and treatment facilities with deployment, training, and activation issues. It is the mission of the Deployment Operations Center to support each site throughout this implementation. The Deployment Operations Center staffs a toll-free line (866-837-1924) with automated directory assistance to ensure that any facility with a question or issue can obtain help quickly and easily.
The Deployment Operations Center published an Implementation Guide along with additional guidance documents and templates for use in developing customized, site-specific plans will be provided to each facility and its local implementation team members. The Deployment Operations Center maintains an electronic library of all implementation-related documents.
64. 64 Training Model Components Service-Approved Training Models Combine:
Classroom Training
Structured-On-The-Job Training (SOJT)
Computer-Based Training (CBT)
Implementation Assistance (IA)
Validated During Limited Deployment
Adapted by Each Service
Continuing Medical Education Credits Issued by Uniformed Services University of the Health Sciences (USUHS)
65. 65 Challenges Locking In and Optimizing Training Schedule
Communicating Schedule to All End-Users
Limiting No-Shows
Filling Classes to Capacity
Scheduling Classes Consecutively: Little or no down time between classes
Training Reserve: There are limited additional resources when scheduling students for classes
Only 10% of students can be rescheduled for classes
66. 66 Challenges Completing Structured On-The-Job Training (SOJT)
Supporting Change Management from CHCS I to CHCS II
Completing Coding in CHCS II
Always Using CHCS II for Unscheduled Visits
Staying Within Budget (Dont Use Next MTFs Resources)
67. 67 Where to Learn More Visit the CITPO Booth
#2000 - 2001
Talk with Project Officers
See Demonstrations It is highly likely that there will be more questions than there is time for Q&A. Please come visit us at the CITPO booth if we are unable to answer your question during the time allotted. Thank you. It is highly likely that there will be more questions than there is time for Q&A. Please come visit us at the CITPO booth if we are unable to answer your question during the time allotted. Thank you.
68. 68 Q & A Period