eHealth in VHA ez access for veterans

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eHealth in VHAe-z access for veterans

• Panel Discussion
• VA CIO Conference
• February 2002
• Robert Kolodner ACIO, Enterprise
  Strategy, Office of Information
• William Beer Clinical Information
  Officer, VISN 17
• Anita Weeks CIO, VISN 16
• David Wood CIO, VISN 2 Director, Bath
  VAMC

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Overview

• The Vision
• Background
• Internet Policy Task Force
• eHealth Task Force
• Veteran enablers
• Veteran Perspective
• Veteran Focused Internet Redesign
• National Perspective Scheduling Replacement
• VISN 16 / 17 OI Partnership
• VISN Perspective VISN 2
• Personal health record - My HealtheVet
• Telehealth

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The Vision

• A world where VHA provides current, accurate,
  robust content, and user-friendly
  e-communications / transactions for
• veterans,
• their families,
• employees,
• and other customers
• anytime, anywhere

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VA Internet Policy Task Force

• Formed August 2000
• Completed January 2001
• Task Force report signed by Secretary March 2001
• Recommendations
• Establish the Electronic VA Committee to oversee
  e-communications and transactions policy and
  process.
• Improve the quality and quantity of
  data/information and transactions provided via
  the Internet, Intranet, and other
  e-communications and transactions.
• Enhance and fund Web searching and content
  management capabilities.
• Developed a number of principles for content and
  transactions.

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eHealth Task Force

• IPTF recommended that VA follow the principle
  that the ownership of data and information will
  stay with Administrations, Staff Offices, and
  business lines.
• USH established the eHealth Task Force in October
  2001
• Co-chairs
• VHA Chief Information Officer (CIO)
• VHA Chief Quality and Performance Officer
• Director, VISN 15
• Membership to include senior managers in Central
  Office and the field.

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enablers for

• Employees
• Business partners
• Veterans
• Focus today e-z access for veterans to health
  information and services

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Veteran enablers

• Veteran Focused Internet Redesign Project
• OneVA effort
• August 1999 reiterated in follow-up survey in
  October 2000
• Veteran focus groups identified top priorities
  in doing business with the VA
• Scheduling
• Rx Refills
• On-line access to VBA
• For more information, including the focus groups
  comprehensive list of wishes, go to
  vaww.va.gov/VFIRP

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Veteran enablers

• At the national level, VHA is pursuing a
  replacement for the scheduling package.
• At the VISN level, many VISNs are putting
  together aggressive eHealth strategies.
• At the national level, pilot project underwayfor
  a Personal Health Record and related services
• At many levels, Telehealth activities underway

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Panel presentations

• William Beer
• Anita Weeks
• National Scheduling Replacement Project
• Dave Wood
• VISN 2 eHealth strategy
• Rob Kolodner
• My HealtheVet
• Telehealth

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Scheduling Replacement Project
Veteran enablers

• A VISN 16/17
• and
• Office of Information
• Partnership

Dr. William Beer Clinical Information
Officer VISN 17
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Tasks
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Task 1 Develop enterprise-wide work flow
  process and information flow models.
• Task 2 Develop information system
  specifications, to include a broad range of input
  from across VHA enterprise including OI.
• Task 3 Evaluate and select information system
  vendor

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Tasks
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Task 4 Conduct Laboratory testing
• Task 5 Conduct VISN-level testing at 1 or
  2 sites
• Task 6 Implement redesigned business processes
  and information technology capabilities in two
  VISNs
• Task 7 Implement redesigned business processes
  and information technology capabilities VHA-wide

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Accomplishments
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Two Successful Stakeholder Workshops Held
• Current Business Process Model Delivered
• Future Business Process Model Delivered
• Received Board of Directors Approval
• System Specifications Delivered (functional
  requirements)
• Trade Study Completed
• Capital Investment Plan approved for Funding

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Current Status
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Trade Study results are under review by the VHA
  Architects as a final checkpoint.
• Recommendation to Board for selection of a COTS
  product for testing will occur March 02
• DoD partnership formed to share information.
  VISN has representative on DoDs Integrated
  Project Team to assist them with requirements
  gathering.

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Current Model High-Level Diagram
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership
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Future Model High-Level Diagram
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership
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OVERARCHING ISSUES
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Provide Sufficient Flexibility to Support
  Individual Business Process Implementation
  Variations
• Flexible Schedule, Resource Definition, and
  Control
• Assume a Balanced Approach to Performance
  Measurement
• Ensure Data Collection Supports Production of
  Performance Measures that Tell the Complete Story
  
• Recognize that a Scheduling System Alone Cannot
  Sustain Wait Time Reductions in a Capacity
  Constrained Environment
• Collect Workload Information at the Appropriate
  Place/Time
• As Part of the Encounter Documentation, After the
  Fact

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OVERARCHING ISSUES
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Flexibility Does Have Limits
• Standards Must Be Established For
• Compliance with Statutory Requirements
• e.g., Eligibility, Means Tests, etc.
• Conformance with Performance Measurement
  (e.g., Wait Time Data) Collection Requirements
• Particularly Important Standardize Workload Data
  Capture
• Process Standards Could Be Established, Once
  Determined, For Best Practices Within Like
  Services and Environments

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OVERARCHING ISSUES
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Workload Data Capture White Paper
  summary for Board
• Recommendation Identify Standard for Workload
  Capture apart from Appointment Scheduling
• Issues Will Be Identified as Part of Architecture
  Development and Integration Effort
• Benefits
• Improved Ability to Identify Capacity vs.
  Efficiency Issues (i.e., to Identify the
  True Causes of Waiting)
• Standardization Provides Basis for More
  Meaningful Comparison (i.e., Nationally and/or
  with Commercial Sector)
• Cleaner Segregation of Functionality
• Everything will be OK

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Upcoming Events
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• May 02 Architecture Model for integrating COTS
  and VistA will be finalized.
• May 02 Process Improvement Framework (VHA
  Business Rules) will be finalized
• Overall the Project is in Good Health

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Need more information?
Veteran enablers
National Scheduling Replacement VISN 16 17 / OI
Partnership

• Go to http//10.4.229.70/website/
• SCHEDULING REPLACEMENT
  OFFICE OF INFORMATION
  Systems Design and Development
• Publications delivered and approved
• Minutes
• Project status
• Points of contact

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The VISN Perspective
Veteran enablers

• February, 2002

David Wood Network 2 CIO, Bath VAMC Director
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eHealth is a Journey
eHealth in Network 2

• VISN 2 Website
• Virtual Help Desk serves 1300
• Quickcard
• Patient Education
• Access to Services
• Internet Access Project
• HR Job Bank
• PKI Project for Patient/Provider Communication

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Why?
eHealth in Network 2

• Improving access to services
• Maintaining competitive advantage
• Empowering consumers
• Cost savings
• Supplement traditional health care
• Extending the patient/provider interaction
• Quality

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Soliciting User Feedback
eHealth in Network 2

• Ask!
• Virtual Help Desk
• Current usage patterns
• Survey results
• Usability Testing
• Benchmarking

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User Identified Priorities
eHealth in Network 2

• Pharmacy Refills
• Patient Education
• Patient/Provider Communication
• Appointment Scheduling
• Communities

The best prescription is knowledge C. Everett
Koop
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Areas of Focus
eHealth in Network 2

• Pharmacy Refills
• High user demand
• Potential cost savings
• Convenience
• User satisfaction
• Common need for Networks
• User authentication and security needs

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Areas of Focus
eHealth in Network 2

• Patient Education
• Rich interface
• Customization
• Convenience
• User satisfaction
• Empowering consumers
• Saving Provider time
• Content

Knowledgeable consumers are better able to make
informed healthcare choices
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Areas of Focus
eHealth in Network 2

• Patient/Provider Communication
• High user demand
• Enhance patient access
• Convenience
• User satisfaction
• Extend interaction
• Workload credit for email consultations
• Explore appropriate scope

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Areas of Focus
eHealth in Network 2

• Communities of Care
• Disease Management Model
• One Stop Access to information, tools, resources,
  patient education
• Customized information
• Patient/provider Peer support
• Self-care
• MVAC Prototype

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Areas of Focus
eHealth in Network 2

• Website-User Focused Redesign
• Increased page widths
• Enhanced navigation
• Focused content
• Redesign Medical Center Homepages
• Redesign Internet Homepage
• Marketing

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Creating an eHealth Culture
eHealth in Network 2

• Charter eHealth Task Force
• Identify Areas of Focus
• Develop Strategic Plan
• eHealth Summit
• Develop Marketing Strategy
• Enhance Access and Literacy
• Strengthen Existing Applications
• Solicit National Support
• Seeking My HealtheVet Pilot
• Evaluate and Renew

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Secure Email Follow up
Clinical Reminders
Discussion Forums
Pharmacy Refills
Computer Literacy Access
Quickcard
EMR
CPGs
Access to Services
John Smith
Office Visit
Virtual Help Desk
Patient Education
Health Risk Assessments
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Personal Health Records
Rob Kolodner ACIO Enterprise Strategy Office of
Information
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My HealtheVet
Veteran enablers

• OI is developing a prototype for an
  internet-based, secure Personal Health Space that
  will enable veterans to retain, view, and update
  their personal health data
• Health eVAult
• Copy of VistA health information
• Personalized health assessments
• Currently uses HealthGate (same as DoD)
• Veteran controls who they will share that
  information with
• 5 self-entered tracker metrics
• Blood Pressure
• Blood Sugar
• Cholesterol
• Weight
• Heart rate

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Telehealth
Veteran enablers

• VHA is a leader in telehealth
• 20 years experience
• Adam Darkins, MD, Chief Consultant, Strategic
  Healthcare Group

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eHealth Drivers
Veteran enablers

• Drive health abilities to the max
• Drive satisfaction to the max
• Drive affordability to the max
• Drive security privacy to the max
• Drive portability to the max
• Drive time inconvenience to zero
• Drive system defects to zero

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Questions?