Post on 22-Aug-2020
Air Force Health Information TechnologyTransformation
May 19, 2015
Lt Col Kevin SeeleyChief Technology Officer
Office of the Surgeon General
San Antonio AFCEA Chapter Luncheon
Air Force Medical Service
Air Force Health IT (HIT)
Digital Health Trends
Defense Health Agency (DHA)
DHA HIT Transition
Electronic Health Record Acquisition
Summary
Agenda
2“Medically Ready Force…Ready Medical Force”
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
CSAF’s Charge
“Each Airman has a
compelling story that
needs to be told. Tell your
story. Let your fellow
Americans know that their
Air Force provides Global
Vigilance, Global Reach,
and Global Power to
defend our great Nation.”
- General Welsh
Fly, Fight & Win … In Air, Space & Cyberspace
3
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
US Air Force Medicine
Enable Medically Fit Forces,
Provide Expeditionary Medics,
and Improve the Health of All
We Serve to Meet Our
Nation’s Needs
The Mission of the
United States Air Force is
To Fly, Fight and Win…in Air,
Space and Cyberspace
AF MISSION
AFMS VISION
AFMS MISSION
Trusted Care Anywhere 4
Our Supported Population is the
Healthiest & Highest Performing
Segment of the U.S. by 2025
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Air Force Medical Service
Mission: Enable Medically Fit Forces, Provide Expeditionary Medics, and
Improve the Health of All We Serve to Meet Our Nation’s Needs
Total Force Personnel
32,661 Active Duty
7,439 Civilians
4,056 Contractors
16,318 AF Reserve/Guard
FY14 Budget/Infrastructure
$6.5B (all programs)
75 Medical Facilities
61 CONUS
14 OCONUS
Deployed
>102K patients moved out of
CENTCOM since 11 Sep 01
1,289 medics deployed to 19
countries in 38 locations
Homestation
2.6M eligible beneficiaries (AF)
10.3M ambulatory visits/year
34K inpatient admissions/year
59K Prescriptions/day
Air Force Medicine…Delivering “Trusted Care, Anywhere!”
5
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
CENTCOM
AFRC
SOUTHCOM
EUCOM
PACOMANG
AFRICOM
International Total Force
Engagement
6
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Lighter, Leaner, and Faster
Medical Response
Joint Tactical
Radio System (JTRS)
TM60
TM60
TM60
TM60 TM60
SM5 SM5
ER
OB/GYN
ORAdmin
Log/BMET
ICU
Pharm
Lab
BEE
PHO
Xray
PED
PCM
Dental
EMEDS
HRT
40 Medics / 1 C-17
Pt Care in < 15 Mins
ER/OR/ICU < 6 hours
Rapid Capability to Stabilize and Evacuate
Enhanced
Logistics
Package
Physical Therapy
Enhanced Dietary Services
Exp C2, Admin, Log
Exp Ancillary Services
Exp Med/Surg Services
Dental Augmentation
Surgical Augmentation
15 Additional Beds
Complex Med/Surg Svc
All EMEDS+10 Capability
Enhanced Critical Care
Enhanced Med Log
Laboratory Support
PAM Augmentation
6 Additional Beds
Medical Command
All EMEDS HRT Capability All EMEDS HRT Capability
HSS Admin
Medical Logistics
Field Surgery
Dental
Prev Med
(Pub Health, BEE, IDMT)
Primary Care or Flt Med
Critical Care
Pharmacy
Radiology
PAM Augmentation*
Specialty Care Aug
International Health
Specialist (IHS)*
EMEDS HRT
(4 holding beds)
EMEDS+10
(10 beds total)
EMEDS+25
(25 beds total)
* Mission Dependent
7
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Closing the Gap in the
En Route Care Continuum Create a Patient Staging Continuum
Advance “Care in the Air” Capabilities
Continue to Decrease Combat Mortality
Transition System to
Enroute Patient Staging
System (ERPSS)
Single/Integrated
Training Platform
Patient StagingTCCET
Tactical Critical Care Evacuation Team
Increasing Number of Teams in
AOR
Initiated Point of Injury Mvt
292 patients to date
> 1,135 Critical Patients Moved
Modular/Flexible for any
Contingency or DSCA
CCATT
In-Flight EHR
Modernizing Equipment
Critical Care Air Transport Team
187K Patients Moved Since
October 2001
(> 8K CCATT Pts)
Specialty Capabilities
Evidence Based Refinement of En Route Care8
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Building Our Capabilities
Coordinated Care to Deliver Expertise and Value
Trained
Current
Deployable
Department
of
Defense
CIVILIAN
HOSPITALSACADEMIA
VETERANS
AFFAIRS
Goals
Increase Capacity and
Currency of Staffs
Build “Win-Win”
Partnerships in Training,
Research and Development
Recapture Care
Effects
Improves Quality of Care
More Patient Choices
Retains Providers
Reduces Cost
Saves Lives
9
I n t e g r i t y - S e r v i c e - E x c e l l e n c e
Air Force Medics…Owning the Mission
Wing/CCs Own Their Medics and Medics Own Their Wing Mission 10
AFMS HIT Role
Core Services & Non-Medical IT Requirements
DHP $ & Enterprise Medical Systems
AF MHSAFMS HIT
CIO/SG6
11“Medically Ready Force…Ready Medical Force”
- Leverage tech & data to drive high reliability / accountable care- Navigate hype vs. value to patient outcomes- Bridge all stakeholders across enterprise- Support standardization to conserve resources, reduce one-offs- Critical to provision of patient care, services, mission assurance
12“Medically Ready Force…Ready Medical Force”
HIT Functional Mission
Critical “Mission Enabler”
Information Security(Data is protected and recoverable)
Information Technology(Phones work, networks work, PCs work…reliably)
Information Assurance(Data from a system is reliable)
Information Management(The right data is available)
Knowledge Mgmt(Right person/place/time)
Insight& Action
(Change Agent)
Analytics &Informatics
We operate a Full Spectrum of:Health Systems, Infrastructure, Devices & Data
14“Medically Ready Force…Ready Medical Force”
• MiCare• ASIMS/PIMR• MRDSS Ultra• CarePoint• CHAS• KX• S3• ARMD – Innovian• ICDB• Dragon• RMS• PACs• AIDC-RTLS• Wireless LAN• SDC• CEMM
• AHLTA• CHCS• HAIMS• Essentris• TMIP• DMLSS• DHMRSi• MEPRS• TOL• BHDP• BHIE/FHIE• PDTS• TPC• CCE• ICD10• DBLS
15“Medically Ready Force…Ready Medical Force”
We keep this working
Manage the Hype Cycle
16“Medically Ready Force…Ready Medical Force”
17“Medically Ready Force…Ready Medical Force”
Digital Health Trends
• Activity Trackers
• Smart Watches
• Ingestibles
• Implantables
• Smart Clothing
• Patches/Tattoos
18“Medically Ready Force…Ready Medical Force”
What is AFMOA?
AFMOA will provide direct reach-back
capability related to clinical processes
and administrative management in
support of 75 MTFs and 11 MAJCOM
activities
Realigned mission based upon HQ AF
Directive in January 2008. (7 yrs ago)
Air Force Medical Support Agency
(AFMSA) is policy arm of the AFMS;
AFMOA is execution and operations
MTF Reachback – 1st stop for IM/IT answers/field guidance
Medical ESD/GSD – Centralized helpdesk – Tier 1
Network Ops – Interface w/ AF network/firewalls/net security
Deployment Ops – Clinical systems deployments/sustainment
MSIM – LAN/WLAN Infrastructure/cable plants/switches/phones
Info Ops – Knowledge X-change/SharePoint/Web/Media Portals
EUD Refresh – Desktops/Laptops/Tablets
PMOs – Program offices/responsible/accountable system owners
Cyber Ops – AFSPC Medical Liaisons/Fellowships
AFMOA HIT Capabilities
19“Medically Ready Force…Ready Medical Force”
20“Medically Ready Force…Ready Medical Force”
So why the DHA?
21“Medically Ready Force…Ready Medical Force”
Opportunities for efficiency
We must …
“Medically Ready Force…Ready Medical Force” 22
23“Medically Ready Force…Ready Medical Force”
From Task Force to Transition
Outcome - 10 DHA Shared Services
1
TRICARE Health Plan
2
Pharmacy Programs
3
Medical Education & Training4
Medical Research & Development5
Health Information Technology
Facility Planning
Public Health
Medical Logistics Contracting
Budget & Resource Management
6
7
8
9
10
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“Medically Ready Force…Ready Medical Force”
DHA Joint Leadership
Health Information Technology (HIT) shared services aims to create an integrated HIT environment in support of an integrated Military Health System
To support this vision, HIT will fully consolidate operations to be “all-in” under the management of the Defense Health Agency (DHA)
A DHA Chief Information Officers (CIO), Service Chief Medical Information Officers (CMIO), management functions, and operational services were put in place first at IOC (1 Oct 2013)
DHA HIT “All In” Shared Service
26“Medically Ready Force…Ready Medical Force”
DHA HIT
MissionImplement, manage, and sustain an integrated and protected
medical information enterprise that delivers the right
information to the right customers at the right time
VisionA premier health information technology environment
enabling integrated care delivery for our nation’s defenders,
retirees, and their families
“Medically Ready Force…Ready Medical Force” 27
Organizations Forming DHA HIT, 1 Oct 2013
28“Medically Ready Force…Ready Medical Force”
Deputy Director, HIT (Deputy CIO)
Portfolio Management and Customer Relations
Enterprise Architecture Branch
Communications & Customer Relationship Branch
• Information Reachback
Investment Management Branch
Strategy & Process Management Branch
HIT Operations Support Branch
Infrastructure & Operations
Business Operations Branch
• Strategic Investment Process (SIP)
Security Operations Center Branch
Engineering, Design and Deployment Branch
• Medical Systems Infrastructure Modernization (MSIM)
Operations and Sustainment Branch
• iNOSC/Network Svcs• MESD• IT Refresh
Solution Delivery
Solutions Integration, Implementation, and Sustainment Branch
• Deployment Ops
Director Defense Health Agency
DHA HIT – AF HIT Assimilation
Cyber Security
Cyber Security Policy, Coordination and Compliance Branch
Privacy Office & Policy Collaboration - HIPAA Security Branch
Information Assurance Branch
Cyber Security Operations Branch
Innovation & Advanced
Technology Development
Strategy/Planning Branch• Innovation and SOA
Realization Section• Innovation and SOA
Transition and Program Mgmt Section
Execution Branch• Research and
Development (R&D) Section
• Alliance, Coordination, and Execution (ACE) Section
Modernization Branch• Requirements Liaison
Section• Project Liaison Section
Informatics Branch• Intelligence & Analytics
Section• Knowledge Management
Section
Operations Branch• Data Governance &
Management Section• Platform & Apps Section
Information Delivery
Director HIT (CIO)
182 MEDICAL FACILITIES WORLDWIDE
29“Medically Ready Force…Ready Medical Force”
Textbook Challenges:Forming, Storming, Norming…
“Medically Ready Force…Ready Medical Force” 30
Copyright ©2014 TeamQuest Corporation
“The concept of IT service optimization is often associated with increased efficiency and reduced risk, two forces that will drive valuable improvements. But without a full understanding of the business objectivesand how IT needs to be aligned with those, full optimization is not possible.”
- 31 -
For Official Use Only
*** Shared Service ***(Proposed Name: “Joint Capability and Requirements Development”)
Business Process Owners (Capability Manager/Functional Proponent)
• Accountable for the total cost and performance for a given area of the business
(e.g., primary care, pharmacy, referral management).
• Has responsibility and authority to drive standardization and reengineering of
business processes needed to improve performance.
• Prioritizes improvement projects and requirements for business area.
• Represents respective organization in the development of joint capabilities and
requirements throughout acquisition lifecycle.
Function stays in Services to ensure the alignment with Service customers and
to drive the necessary business changes within organization.
Business Owner (MDAG)
• Determines “operating model” for the business – the targeted level of
business/clinical process standardization and integration.
• Accountable for overall cost and performance of business.
• Reviews, prioritizes, and approves business cases and investment proposals.
• Accountable for driving change needed to realize benefits from improvement
projects throughout acquisition lifecycle.
Joint Capability & Requirements Developers (Information Manager)
• Facilitates and coordinates:
• Joint capability and full spectrum requirements development
• Development of standard business processes/data
• Development of standard measures of performance
• Prioritization, consolidation, and rationalization of portfolio
• Functional input throughout acquisition lifecycle
• Supports the joint governance process
Function resides in Defense Health Agency to ensure enterprise focus and to
drive the level of process standardization and integration specified by MDAG.
Concept for Joint Capability and Requirements Development
Business
Owner
Business
Process 1
Business
Process 2
Joint Requirements
Standard Business Processes & Data
Business
Process N
A N AF A N AF A N AF
….
….Joint
Capability
Joint
Capability
Joint
Capability
Timely development and validation of joint
requirements and standard business processes is
key to the success of HIT.
Horizontal & Vertical
Communication
32
What we have to do:Portfolio Rationalization Decisions
Business/Clinical Value
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For Official Use Only
Conceptual Design End to End Process Design Implement
Deve
lop
an
d E
xe
cu
te • Current State Assessment
• Process Inventory
• Funding, Cost and Savings Figures
• Functional Requirements
• Personnel/Headcount
• Transition Plans
• End-to-End Processes
• Measures/KPIs
• Technical Requirements
• Help Desk Platform Analysis
• Vendor Selections
• Acquisition Plan
• Consolidation Plan
• Reports Development
• System Rollout
• Help Desk Decommissioning Plan
• Personnel Transition
• Funding Realignment
Example of Product Line Consolidation: Help Desk
= Governance Decision Point
To realize its projected cost savings, HIT will conduct portfolio rationalization and business process reengineering (BPR)
for all product lines. As it consolidates and reengineers each product line, HIT will gain approval from leadership at pre-
established decision points, allowing Service leadership to approve plan development, review and accept estimates of
costs and savings, and sign off on technology acquisition and implementation plans before each phase begins. Below is
an illustration of how the consolidation of one product line, Help Desk, might proceed within DHA HIT.
Air Force Help Desk
Army Help Desk
Navy Help Desk
Decision Point:
Design and Development
Decision Point:
Planning
DHA Help Desk
Decision Point:
Implementation
DHA HIT “To-Be” at Maturity
34“Medically Ready Force…Ready Medical Force”
Consolidate & Standardize: Datacenter to Desktop (D2D) “One Forest” – identity & enterprise mgmt, active directory
“One Network” – consolidate multiple networks
“One Email” – everyone on same email system
“One Datacenter” – single datacenter hosting strategy
“One Web” – single web hosting solution
“One Desktop” – a single desktop configuration and strategy
“One Help Desk” – a single help desk capability
“One AV/Comm” – a single AV/communications strategy
“One e-Learning” – a single shared platform
“One EHR” – single integrated EHR platform
“One Analytics Platform” – everyone using common data service
HIT Infrastructure Plan in Place
IT SERVICE CAPABILITY BUSINESS IMPACT
Network Security Management Service (NSMS)
Seamless integrated Wide, Local, and Wireless NetworkCapabilities include a Single Security Architecture and centralized Designated Accrediting Authority (DAA), standardized monitoring/ management, and improved provider mobility
Systems and applications will be accessible across the entire DoD health care environment allowing complete access to all patient information regardless of health care location.
Directory Services (DS)/ Enterprise Management (EM)
Centralized and secure access and authentication capability to network resourcesLeverages ability to centrally manage DS infrastructure throughout the enterprise
Health care providers and staff will be able to move from hospital to hospital and be able to authenticate to all IT services without needing new accounts.
Desktop as a Service (DaaS)
Desktop design standardization service across the application, desktop and server environments Includes standardized desktop configuration and application virtualization capabilities across physical and virtual desktops
All desktops will be standardized so providers and staff will be able to move within the medical facility and have access to their information resources.
Compute and Storage Management Service (CSMS)
Centrally managed, integrated, and robust computing: infrastructureGeographically-distributed infrastructure designed todeliver low-latency services close to the point of careor point of need
Provides a standard method to host applications and the ability for the DoD health care system to use single applications to support all care encounters.
Global ServiceCenter (GSC)
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Consolidated MHS enterprise IT service desk Provides a single point of contact for all customers to obtain support for all systems regardless of physical location.
36“Medically Ready Force…Ready Medical Force”
Need for ConsolidatedMedical Network
DHA Standard Desktop
37“Medically Ready Force…Ready Medical Force”
38
Med-COI Network Transition
Medical Cyber Enterprise
39“Medically Ready Force…Ready Medical Force”
Shared ServicesCulture vs. Technology
40“Medically Ready Force…Ready Medical Force”
Buying a New EHR
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New Electronic Health Record (EHR)Acquisition Mandate
21 May 13: SECDEF completed 30 day review of the DoD/VA integrated EHR
Pursue full, open competition for EHR modernization led by USD Acquisition, Technology & Logistics (AT&L)
21 Jun 13: USD (AT&L) authorized a DoD EHR acquisition to “buy”
Established new program office: Defense Health Management Systems Modernization (DHMSM)
25 Aug 14 – Final EHR RFP released for bid
Projected contract award 30 Jun 15
Goal: Begin replacing MHS legacy medical systems by January 2017
42“Medically Ready Force…Ready Medical Force”
Defense Healthcare Management Systems Modernization (DHMSM): Next 24 months…
43“Medically Ready Force…Ready Medical Force”
EHR Modernization Guiding Principles
44“Medically Ready Force…Ready Medical Force”
Initial Operating Capability (IOC)Wave Zero
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Are we making progress?
46“Medically Ready Force…Ready Medical Force”
Transformation Journey
47“Medically Ready Force…Ready Medical Force”
Summary
Contact Info
“Medically Ready Force…Ready Medical Force”
Lt Col Kevin Seeley
Chief Technology Officer
Office of the Air Force Surgeon General
Kevin.seeley@us.af.mil
DSN: 969-9871 COMM: 210-395-9871
“Medically Ready Force…Ready Medical Force”
You Have Questions.- Captain Obvious, Hotels.com