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2012 Pharmacy Informatics Virtual Conference Tana Defa, VHA Initiative Lead. Health Informatics Initiative ( hi 2 ). Transforming Health Care Delivery through Health Informatics (Health Informatics Initiative) VA Major Initiative launched on October 1, 2010

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Health Informatics Initiative (hi2)

Transforming Health Care Delivery through Health Informatics (Health Informatics Initiative)

  • VA Major Initiative launched on October 1, 2010
  • Promotes and fosters open, transparent communication between health care providers and software development teams through shared responsibility and accountability

Why was the Initiative Established?

  • Assist with VHA’s transition from a medical model of care to a patient-centered model of care through development of clinical software solutions
  • Build a sustainable collaborative between the Veterans Health Administration (VHA) and the VA Office of Information and Technology (OIT)
  • Cultivate and Invest in VA’s workforce


  • Adopt a Health/IT Collaborative supports rapid product development and delivery.  Restructures the relationship between VHA and OIT and provides an organizational foundation for reengineering existing processes and piloting VHA clinical software prototypes in a rapid, agile and iterative fashion.
  • Build a Health Management Platform to Transform Patient Care integrates informatics and health information technology (IT) in the delivery of health care. Provides a succession plan to transition the Computerized Patient Record System (CPRS) to the next generation of browser-based Electronic Health Record (EHR). 
  • Create Health Informatics Capacities develops the Health Informatics workforce and enhances organizational informatics literacy through competency, career and community development.
  • Deliver Communication and Change develops communication and change strategies to establish an Initiative-wide strategy, methods, tools, products to support achievement of Initiative milestones and deliverables.

What is Health Management Platform?

The Health Management Platform (HMP) is hi2’s component that builds IT products:

  • Transitions the healthcare team experienceto a patient-centered model (Team-facing)
  • Increases patient engagement and satisfactionat the point of care (Patient-facing)
  • Addresses population-based and healthcare systemaspects of care (System/Population-facing)

Supporting the Health Management Platform is a modern, web-based, tiered and open architectural framework based upon industry standards and best practices. The HMP enables incremental transition from old technology to new technology while both would co-exist harmoniously. The Health Management Platform provides a pathway for modernization of VA’s Computerized Patient Record System (CPRS.) For the near term, CPRS and HMP will co-exist.


What the HMP Accomplishes

The three components of the HMP are:

  • Healthcare Team-Facing
    • Browser-based, healthcare team user-interface modules
    • Workflow driven, role-based activity systems
    • Knowledge-driven, context-based decision support
    • Team-based, multi-patient care environment
  • Patient-Facing
    • Meaningful patient use, population reach and impact
    • Engage patients in their care

3. System/Population-Facing

  • Feedback to clinicians for panel management
  • Population and epidemiology-like studies
  • Measure how the “system” is performing – real-time visibility

WS A: Adopt a Health-IT Collaborative

  • Lead: Marcia Pickard
  • Restructures the working relationship between VHA and OIT
  • Pioneers development of clinical software prototypes in a rapid, agile and iterative fashion
  • Promotes strong relationships between development teams and end users
  • Pilots new agile methodologies for requirements identification and elaboration

WS A FY11 Accomplishments

  • WSA completed all FY11 deliverables:
    • hi2 Strategic Plan
    • Governance Document
    • Business and Technical Architecture Principles
    • hi2 Product Development Lifecycle Baseline Deliverable
    • Development Partnerships Baseline Deliverable
    • Knowledge Management Plan
    • Policy Reconciliation Documentation Process
    • Patient Outcomes Report
  • Collaborative efforts included:
    • Assisted hi2 Leadership with development of governance documents
    • Identified areas for potential collaboration with Indian Health Service
    • Developed relationships and identified opportunities for collaboration with OIT in the planning for and development of the Business and Technical Architecture Methodologies and Integration Points deliverable
    • Knowledge Management Workgroup established contact with several other efforts underway in VHA to implement KM strategies, including OHI Product Effectiveness and Veterans Relationship Management (VRM)
    • As part of cross Workstream collaboration efforts, the Product Development Lifecycle (PDLC) Workgroup worked closely with the Implementation Planning team to align PDLC with relationships and process change efforts being implemented with SDE

WS A FY11 Accomplishments (con’t.)

  • WSA Recent Achievements:
    • Completed first deliverable associated with the CART development partnership in collaboration with the CART and HMP Development Teams
    • In coordination with Workstream D, completed initial development of an online PDLC communications portal
    • Completed first draft of hi2 Knowledge Management Handbook and initiated planning for internal hi2 dissemination efforts
    • In coordination with Workstream B and Clinical Leads, continued efforts to identify project(s) for FY13 Patient Outcomes deliverable(s)
    • Drafted documentation of hi2 currently utilized requirement collection and elaboration practices
    • Developed draft Development Request Management process that will be used to manage requests external to the HMP Development Team

WS A FY11 Accomplishments (con’t.)

  • Near-Term Goals:
    • Build on the initial development of the online PDLC communications portal
    • Continue to facilitate development partnership with CART and Health Management Platform Developer Team
    • Develop dissemination plan for the hi2 Knowledge Management Handbook to initiate Knowledge Management within hi2
    • Continue to support System-Facing team efforts concerning antibiotic stewardship and the FY12 Patient Outcomes deliverable
    • Continue to develop plan and timeline for managing the collection, evaluation and allocation of functionality requests
    • Formally test and implement Development Request Management process

Open Source Electronic Health Record Agent

  • OSEHRA is a non-profit organization that serves as custodial agent for open source development
  • Founded in 2011, includes over 900 developers, programmers and researchers to date
  • Board of Directors:
    • Chairman - James B. Peake, MD, Lt. Gen., USA (Ret)
    • John D. Halamka, MD, Prof. of Medicine Harvard Med. School,CIO Beth Israel Deaconess Med Center, co-chair national HITStandards Committee
    • Michael O’Neill, Senior Advisor to Director, Veterans Affairs Innovation Initiative (VAi2)
    • Charles B. Green, MD, Lt. Gen. USAF, Surgeon General US Air Force

OSEHRA (con’t)

  • Source KIDS (SKIDS) – Source code repository for VistA code.
    • Represents VistA code in a source tree suitable for use with modern version control
    • Provides web based code review, visual cross reference
    • Currently contains the FOIA version of VistA as of 12/6/2011 and CPRS V28
  • Refactoring efforts
    • Coding changes to make VistA more modular
    • Develop open standard interfaces to support modern service oriented architecture
    • First effort will be Problem List

OSEHRA (con’t)

  • Relationship between hi2 and OSEHRA
    • Presentation on Health Management Platform architecture was provided to the OSEHRA Architecture workgroup
    • Next Steps:
      • Meeting with OSEHRA representatives in Washington, D.C. June 12-13, 2012 to determine OSEHRA readiness/plans to accommodate full modern architecture
      • Provide documentation on the Virtual Patient Record (VPR)
      • Consider putting VPR 1.0 or VPR 1.1 out in OSEHRA
        • VPR 1.0 is Class 1 software, read-only extracts from VistA, supports C32 document structure for data exchange

WS B .hmpAccomplishments in FY11

IT infrastructure modules to support transforming VA’s health IT system into a modern, web-based Health Management Platform (HMP)

Migration plan for evolving from CPRS to the Health Management Platform

Collaborative development environment and tools to enable the HMP development team to work interactively with informaticists, SMEs, development partners and pilot sites

Virtual Patient Record (VPR) as a robust data layer that promotes interoperability and data exchange through industry standards and accessible data schemas

Selecting and engaging VA San Diego Healthcare System as the firstHMP Pilot Site

Gap analyses of Team, Patient and System-facing components


WS B .hmp Accomplishments in FY12

  • Completion of the third and fourth HMP modules:
    • Patient Lists
    • User-defined presentation views
  • Established IT development teams for Patient andSystem-Facing components:
    • Mobile app for patient-entered Non-VA medications
    • Antibiotic Stewardship support
  • Initiated first HMP development partner collaboration with CART-CL:
    • Acquisition of an HMP Authority to Operate (ATO) allowing progression to Production testing and release
  • Demonstration of the HMP to leadership
    • VHA
    • VA OIT
    • DoD
    • Indian Health Service

Competency Development Accomplishments

  • Drafted Informatics and Analytics Training Plans
    • 31courses on TMS now
    • 10 more in development (one more release)
    • six specialty groups accreditation
    • 2175 courses completed
    • 936 of students enrolled
  • Developed an AMIA Partnership for a VA 10x10 certificate program
    • Based on AMIA Core Curriculum for Clinical Informatics White Paper (2009)
    • VA is one of the 13 approved AMIA 10x10 partners in the world
      • Purpose: To develop a cadre of leaders who can who can envision, configure, implement and support informatics solutions to improve the quality, safety and timeliness of patient care
      • Launched on June 1, 2012
      • Diverse team of Faculty Moderators
  • Planning for New Opportunities
    • Obtained a License for Moodle training platform
    • Pharmacy Informatics specialty module in development

Community Development Achievements

  • Drafted definition for Health Informatics- vetted with communities of practice
  • Drafted a “Methodology for Collaboration” White Paper
    • Leveraged an acquisition in process for a VA Enterprise-wide collaborative toolset – Jive!
    • Pilot testing now with three distinct use cases
  • Launched a Health Informatics Workforce Survey
    • Over 1700 participants
    • Plan to share results with external partners (Publish!)
  • Coordinated Nursing Informatics Workshops
  • Collaboration with Bellevue College for HIT training
    • 730 Graduates of an eight week online college course
    • All of the content from this course (and more!) has been gifted to the VA
  • Informatics tract planned for VeHU
    • First session presentation on Health Informatics in the VA –Past, Present and Future- 400 viewers
    • Main conference will be held this August

Career Development Achievements

  • Identified key informatics functions and tasks
  • Created a standardized Health Informatics Specialist (formerly known as CACs) PD classified as a Health Systems Specialist, Informatics 671 GS12
    • OHRM assigned a unique HR Title Code- enables tracking!
  • Established HIS career ladder (GS5-13)
  • Drafted a HIS recruitment and retention plan
  • Drafted a Job Series proposal to create a new HIT job family in HR systems
  • Drafted a standardized AdPAC PD
  • Evaluated the feasibility of Hybridizing the HIS role- White Paper
  • Drafted a White Paper to strengthen the EDM and make recommendations for Chief Health Informatics Officer role
  • Obtained AMIA Corporate Membership for 150 new members
  • Entered into a collaboration with Department of Labor to establish a federally registered apprenticeship

What Does This Mean For Me?

  • Be Inspired
    • Enroll for the Health Informatics Lecture Series (301) --TMS
    • Attend the Virtual VeHU Health Informatics sessions via MyVeHU Campus
  • Get Connected
    • Join a professional health informatics organization
    • Join the Movement – on the hi2 portal

Overview – Masoud Rabie, hi2 Communications Officer


Introduction of the hi2 Brand

Who We Are and Where We've Been

Engage, Educate, Empower

Where We Are Going

Looking Ahead

The Future




hi2 Brand Strategy – From Concept to Concrete

Proposed in May 2010 as “T16”. Following Initiative launch in October of the same year, communication strategy was formally implemented. In February of 2011, brand strategy transformed “T16” to “hi2” (“Health Informatics Initiative”).

WS D Built Strategy To Deliver On the Following Objectives:

  • Deliver and maintain a consistent, strategic application of enhanced and unified brand and messaging roadmap: Branding and Launching the Brand (hi2)
  • Deliver action-oriented approach to effectively position Initiative value within all key target audience groups: Branding the Platform/Technology (.hmp)
  • Deliver a change management approach and engagement to key stakeholders and hi2 change agents: Branding Collaboration (Task Force DELTA)

WS D: Marketing and Communications Strategy

Branding the Initiative

  • The Health Informatics Initiative promotes and fosters open, transparent communication between health care providers and software development teams through shared responsibility and accountability – innovation through collaboration. The hi2 brand has successfully elevated and positioned the Initiative to maximize stakeholder engagement and momentum.

The Initiative


WS D: Marketing and Communications Strategy

Branding the Platform

The development of the new Health Management Platform is more than just another version of CPRS (i.e. AViVA). It is truly transformational technology based on industry standards and best practices, that provides a pathway for modernization. We took this opportunity to truly brand the platform in a highly dynamic way, where .hmp is more than just a logo execution, it is a new vernacular that defines the interaction of our products with our platform.

The Platform


WS D: Marketing and Communications Strategy

The .hmp Approach:

.hmpis the solution that defines the interaction of our products with our platform.

.hmpis the vernacular of the new technology.

.hmpis a new suffix, and URL extension.


WS D: Marketing and Communications Strategy

Branding the People(Coming Late Summer 2012)

Whether you are in a VA Leadership Role, OIT Developer, Project Manager, Strategist, Informaticist, Educator, Care Team Member, or VA Patient, the development and implementation of the new Health Management Platform is comprised of teams of “People” making a difference. “Delta” means “change” – and Task Force DELTA represents the change management component and collaboration of all those involved making health care transformation possible.

The People



The Brand Components

  • Our strategic approach to branding encompasses all aspects of the Health Informatics Initiative and its work areas. An upcoming Brand Style Guide will provide the framework for brand continuity across all communications and marketing efforts.

[ The People ]

[ The Technology ]

[ The Initiative ]