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    1. Innovative Thinkers Session 188 August 12, 2010 1:30 p.m. 2:59 p.m.

    2. 2 Introduction Chuck Brown Housekeeping Faculty for today Objectives Program overview Governing principles Program portfolios Looking forward

    3. 3 Introduction - Housekeeping Cell Phone Reminder Please turn off or change your cell phones to vibrate If you must answer a call or text message, please leave the room

    4. 4 Housekeeping (Cont.) Please, no questions during the presentation Questions can be written on a 3x5 card & will be answered at the conclusion of the presentation, time permitting All questions and answers will be posted on the Web including those not answered during class

    5. 5 Faculty for Todays Session Innovation Program Team Members: Chuck Brown, Director Innovation Program Jason Carley, Management Analyst Gail Johnson, MS, PMP (HPTi) William Cerniuk, Technology Director Joe Tastrom, Management Analyst

    6. 6 Objectives Introduce the Veterans Health Administration (VHA) Innovation Program Describe the various VHA Innovation portfolios Elaborate on collaboration tooling and the Sandbox development environment Discuss the VHA Office of Information and Technology (OI&T) Innovation Initiative Exchange knowledge and encourage networking among potential field Innovators

    7. 7 Innovation Program - Overview 2008: Collaboration initiated between the Veterans Health Administration (VHA), Office of Health Information (OHI) and the Department of Veterans Affairs (VA) Office of Information and Technology (OI&T) 2010: As part of the VA Secretarys transformation of VA to a 21st century organization, the VA Innovation Initiative (VAi2) was born Current: All VHA, Veterans Benefits Administration (VBA) and OI&T innovation efforts are now coordinated under VAi2 to promote collaboration and ensure consistency

    8. 8 Governing Principles Allows critical health care innovations reliant on Information Technology (IT) to: Emerge from the field Evolve based on constructive and collaborative review Solicit commercial/private sector knowledge and alternatives Be piloted in a safe harbor environment Business driven Build projects start to finish in a transparent environment

    9. 9 Governing Principles (Cont.) Low bar for Entry: Anyone can participate Invites innovative ideas from the field and from other sources such as vendors, open sources, and academic organizations High bar for Exit: Promotes standardization, ensures security and operating performance Mitigates risk to mission critical systems Encourages solutions to emerge close-to Class I

    10. 10 Innovation Program Portfolios Bottom up Top down Laboratory

    11. 11 Innovation Program Portfolios Bottom Up: Field innovators identify clinical and business opportunities, propose innovative solutions, and compete for resources to develop those solutions Top Down: Targeted VHA business opportunities needing solutions are identified by VA leadership; industry competition to develop enterprise solutions with input of field subject matter experts

    12. 12 Innovation Program Portfolios (Cont.)

    13. 13 Innovation - Looking Forward Workforce Development: Activities undertaken to build a culture of innovation and a knowledgeable workforce Innovation Diffusion: Evaluation of the quality of products and how products work in the health care delivery process

    14. 14 Bottom Up Innovation Jason Carley Portfolio Overview Greenfield Incubation VHA/OI&T Innovation Initiative Status

    15. 15 Bottom Up Innovation - Overview

    16. Bottom Up Innovation Greenfield

    17. 17 Bottom Up Innovation II Deleted VHA/OI&T due to spaceDeleted VHA/OI&T due to space

    18. 18 Bottom Up Innovation VHA/OI&T II

    19. 19 Bottom Up Innovation II (Cont.) Usage Statistics 2/5/10 2/28/10

    20. 20 Bottom Up Innovation II (Cont.) Usage Statistics 2/5/10 2/28/10

    21. 21 Bottom Up Innovation II (Cont.) Thousands of ideas to 100 full proposals Crowdsourcing results used to identify the 75 most popular ideas Ideas voted up, voted down or commented on Incentives offered for top participants Under Secretary for Health (USH) designees selected 25 additional gems that were not identified by the voting process Proposal invitations released on March 23rd Full proposals to funded ideas 67 full proposals were received by April 16th Proposals were randomly distributed among 6 panels Each panel consisted of a: Physician, Nurse, Administrator, Informaticists, and Distinguished Guest Deleted Down SelectionDeleted Down Selection

    22. 22 Bottom Up Innovation II (Cont.) 26 proposals approved for funding on May 14th 20 proposals in both the normalized and raw top 25 6 additional highly ranked proposals recommended by the panels for funding 17 (65%) crowd nominated, 9 (35%) executive picks ~$15M required for execution Had to split 22 into 2 slidesHad to split 22 into 2 slides

    23. 23 Bottom Up Innovation II (Cont.)

    24. 24 Bottom Up Innovation II (Cont.)

    25. 25 Bottom Up Innovation - Status Many exciting Bottom Up Innovations are moving forward and are in various stages of maturity We look forward to many successful Innovations and soliciting more innovative ideas in the future

    26. 26 Top Down Innovation Gail Johnson Definition Approaches Results Current status of projects

    27. 27 Top Down Innovation Definition Top Down Projects: Are problematic areas or improvements needed to advance VHA patient care efforts In need of innovative solution definition and development Tend to be larger in scope and cost than Bottom Up project Are intended to ultimately be enterprise-wide solutions Speak to the ideas coming from the executives or JC (Starts with user centered design workshops)Speak to the ideas coming from the executives or JC (Starts with user centered design workshops)

    28. 28 Top Down Innovation - Approaches Three different approaches Conduct field developed solutions bake-off of existing VHA innovations to address a VHA Strategic Goal Solicit ideas from VHA Leadership, e.g. VISN Directors and VHA Chief Officers Accelerated user-centered design requirements and agile development methodologies applied by the Innovation PMO in close collaboration with VHA clinical sponsor and field personnel Conduct an Industry Innovation Competition VA Leadership topics selected Release to private sector for solution proposals

    29. 29 Top Down Results: Approach 1 Bake Off Joint Commission National Patient Safety Goal for Standardized Anticoagulation Therapy Management chosen for focus Working group formed 10 field developed Class 3 software solutions reviewed by cross Network and VA medical center innovators Portland Veterans Affairs Medical Center solution chosen and approved by the National Leadership Board (NLB) in September 2008

    30. 30 Top Down Results: Approach 2 Leadership Solicitation January 2009 solicitation 49 submissions received 12 from Veterans Integrated Service Networks (VISNs), 5 Central Office programs 15 peer reviewers Mix of field and VHA Central Office staff, clinical, business and technical staff Blinded independent review which assessed each Innovation Criteria on a 1-5 scale Potential conflicts of interest addressed Group discussion and final scoring at face-to-face meeting in March 2009 (think about a pie graph with submissions by visn)(think about a pie graph with submissions by visn)

    31. 31 Top Down Results: Approach 2 (Cont.)

    32. 32 49 strategic submissions ranked Full descriptions of all submissions http://vaww.innovations.va.gov

    33. 33 Top 10 identified by review team in March 2009

    34. 34 Top Down Results: Approach 3 VAi2 Industry Innovation Competition Solicitation for private sector ideas for solutions released Broad Agency Announcement (BAA) on 6/07/10 from the Department of Veterans Affairs (VA) Secretary open through September 2010 Six key areas for substantial advancement selected Innovative Housing Technologies to Address Veteran Homelessness Telehealth New Models of Dialysis and Renal Disease Prevention Improvement of Polytrauma Care Reducing Adverse Drug Events Integrated Business Accelerator

    35. 35 Top Down Current Status Anticoagulation Management Project Sept. 2008: Portland product began upgrade to Class 1 Sept. 2008: Joint field developer, stakeholder, and Office of Enterprise Development (OED) project team formed Oct. 2008: Product underwent technical review and revisions analysis March 2010: Product released nationally; implementation paused until patch correcting production issues tested and released Current: Final production release pending changes Visit VHA Innovation Booth for a demonstration.

    36. 36 Top Down Current Status (Cont.) Chemotherapy Ordering Project Nov. 2009: First Chemotherapy Ordering Workshop (Analysis Phase) held and conducted by the Vanderbilt Center for Better Health (VCBH) Start of user requirements definition Feb. 2010: Second Chemotherapy Workshop (Design Phase) held with VCBH User requirements refined and screen shot developed July 2010: Innovator project team formed Aug. 2010: Agile methodologies software development contract awarded 1. Procure fast paced collaborative methodologies to accelerate scope/prototype definition 2. Form Subject Matter Teams (SME) Teams - 1 per Challenge 1. Procure fast paced collaborative methodologies to accelerate scope/prototype definition 2. Form Subject Matter Teams (SME) Teams - 1 per Challenge

    37. 37 Top Down Current Status (Cont.) Chemotherapy Ordering Project Since August 2010: Agile development and prototypes produced Shared with project team to refine solution Please visit VHA Innovation Booth to see the current prototype demonstration.

    38. 38 Top Down Current Status (Cont.) Point of Care Support of Clinical Decision Making Project Jan 2010: First Point of POC of CDM Workshop (Analysis Phase) held and conducted by the Vanderbilt Center for Better Health (VCBH) Start of user requirements definition June 2010: Second POC CDM Workshop (Design Phase) held with VCBH User requirements refined and screen shot developed July 2010: Innovator project team formed Aug 2010: Agile methodologies software development contract awarded

    39. 39 Top Down Current Status (Cont.) Point of Care Support of Clinical Decision Making Project Since August 2010: Agile development and prototypes produced Shared with Project Team to refine solution Please visit VHA Innovation Booth to see the current prototype demo!

    40. 40 Top Down Current Status (Cont.) Six Leadership Solicitation Projects Solicitations of private sector proposals for Innovative solutions Industry responses coming in now

    41. 41 Laboratory William Cerniuk Laboratory Components Collaboration Innovation Sandbox

    42. 42

    43. 43

    44. 44 collaboration \k?-'la-b?-'ra-sh?n\ noun 1 the action of working with someone to produce or create something. 2 traitorous cooperation with an enemy : he faces charges of collaboration. DERIVATIVES collaborationist |-nist| noun & adjective (sense 2). ORIGIN mid 19th cent.: from Latin collaboration(n-), from collaborare work together.

    45. 45

    46. 46

    47. 47 Goals: Foster a Social Network of Innovation Cultivate Communities of Interest Reduce unnecessary redundancy Accelerate the innovation process Inspire innovators Propagate lessons learned

    48. 48 On the Horizon Idea management collection, assessment, workflow, promotion Knowledge management search and browse innovation knowledge base Source code management configuration management, assignment tracking and bug reporting

    49. 49 Laboratory - Innovation Sandbox Joe Tastrom

    50. 50 Laboratory - Innovation Sandbox (Cont.) Principles of Operation Easy access Available to all innovators Transparent to the enterprise Share, share, share Light touch governance to promote consistency and simplicity

    51. 51 Laboratory - Innovation Sandbox (Cont.) Sandbox Overview Software development and systems engineering Virtual workspace with virtual workstations Available enterprise-wide Joint effort between the Office of Health Information (OHI) and the Office of Information and Technology (OI&T) Open to all code warriors

    52. 52 Laboratory - Innovation Sandbox (Cont.)

    53. 53 Laboratory - Innovation Sandbox (Cont.)

    54. 54 Laboratory - Innovation Sandbox (Cont.)

    55. 55 Laboratory - Innovation Sandbox (Cont.)

    56. 56 Laboratory - Innovation Sandbox (Cont.)

    57. 57 Laboratory - Innovation Sandbox (Cont.)

    58. 58 Laboratory - Innovation Sandbox (Cont.)

    59. 59 Laboratory - Innovation Sandbox (Cont.)

    60. 60 Closing Chuck Brown Culture of innovation Goals and objectives Innovation program vision

    61. 61 Culture of Innovation Ignite the spark of innovation in the VHA once again Those closest to the issues know best how to correct them Foster collaboration with field development and national developers Embrace unsuccessful prototypes for the lessons learned and knowledge gained, which ultimately improves the organization

    62. 62 Culture of Innovation (Cont.) Business Focus Group Results: How to Value Innovations Improve patient care (e.g., safety, quality, or access) Improve efficiency (e.g., clinical workflow, cost/benefit) Affect numerous Veterans, staff, or other stakeholders Address an unmet need rather than incrementally improve existing methods Help meet an organizational requirement (e.g. Joint Commission or congressional mandate)

    63. 63 Goals and Objectives Full Transparency: Make all work, lessons learned, and documentation readily accessible to any member of the organization Ensures consistent and ongoing coordination with customers and continuous assessments of potential innovative solutions Promote knowledge transfer from innovator to production systems development staff

    64. 64 Innovation Program Vision Transition the local VHA innovation environment of the past to a virtual innovation community of the future Establish innovation partnerships with OI&T, VBA, and private industry Foster innovation lifecycle from incubation to bedside Recognize innovation as a critical element of the workforce Create, connect, and empower innovators