Military Health System Joint Medical Information Systems

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Military Health SystemJoint Medical Information
Systems

• Mark A Lyford, COL, MS, USA
• Program Executive Officer

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Military Health SystemJoint Medical Information
SystemsSupport Across the Operational Continuum
Health Information Infrastructure
Operational Continuum
Clinical
Medical Resources
Medical Logistics
Theater
Executive Information
Deployed Forces
Sustaining Base
DISN
Nonmedical Applications
(Personnel, Finance, Logistics . . .)
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Military Health SystemJoint Medical Information
SystemsStrategic Objectives

• Support for the Warfighter
• Customer-Focused Mission-Based Requirements
  (Link to MHS Balanced Scorecard)
• Robust Enterprise Architecture
• Strong Information Assurance
• DoD-Wide Interoperability (C4ISR, GIG, JTA)
• Disciplined IT Investment Process
• Lead DoD in Implementing Software Acquisition
  Process Improvement
• Standardization of Health Information/Data
• DoD/VA/Federal Health Sector Collaboration
• DoD/Industry Partnership

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Military Health SystemJoint Medical Information
SystemsAcquisition Programs

• ACAT I Programs
• Composite Health Care System II (CHCS II)
• Theater Medical Information Program (TMIP)
• Defense Medical Logistics Standard Support
  (DMLSS)
• ACAT III Programs
• TRICARE Online (TOL)
• Enterprise-Wide SchedulingRegistration (EWSR)
• Defense Medical Human Resources System internet
  (DMHRSi)
• Central Credentials Quality Assurance System
  (CCQAS)
• Defense Occupational and Environmental Health
  Readiness System (DOEHRS)
• Medical Surveillance (MS)
• Patient Accounting System (PAS)
• Enterprise Workload Forecasting (EWF)
• Global Business Data Warehouse (GBDW)
• Clinical Data Warehouse (CDW)

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Military Health SystemJoint Medical Information
SystemsPrograms in Sustainment

• Clinical
• Composite Health Care System (CHCS)
• Defense Blood Standard System (DBSS)
• Clinical Information System (CIS)
• Special Needs Program Management Information
  System (SNPMIS)
• Nutrition Management Information System (NMIS)
• Veterinary Service Information Management System
  (VSIMS)
• Encoder Grouper
• Medical Resources
• Defense Medical Human Resources System (DMHRS)
• Expense Assignment System (EAS)
• Workload Management System for Nursing (WMSN)
• Third-Party Outpatient Collection System (TPOCS)

• Executive Information
• MHS Management Analysis Reporting Tool (M2)
• MHS Data Repository (MDR)
• Purchased Care Reporting Tools (TMA-RT)
• Population Health Operational Tracking
  Optimization (PHOTO)
• Managed Care Forecasting Analysis System
  (MCFAS)
• Theater
• TRANSCOM Regulating and Command Control Evac.
  System (TRAC2ES)
• Medical Analysis Tool (MAT)
• Logistics
• Joint Medical Asset Repository (JMAR)

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Military Health SystemJoint Medical Information
SystemsCommon Services

• Wide Area Network (WAN)
• Local Area Network (LAN) Upgrades
• End-User Device (EUD)
• MHS Help Desk
• Business-to-Business (B2B) Gateway
• Enterprise Licenses
• Information Security Accreditation/Information
  Assurance
• MHS Hub

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Military Health SystemJoint Medical Information
SystemsCommon Services B2B/WAN/LAN/EUD
High speed local area networks
Base/Post/Station
GigE
MHS Workstations
Network Protection Blocking unwanted users
GigE
MHS Workstations
Switch/ Router
Border Router
Firewall
VPN Data Encryption
Router
MTF LAN
External Intrusion Detection
Internal Intrusion Detection
Servers
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Computing Centers
VPN
i
I
MCSC
B2B Gateway
VPN
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Military Health SystemJoint Medical Information
SystemsCommon Services (contd)

• Help Desk
• Enterprise Licenses
• Microsoft, Oracle, Business Objects, KEA,
  Informix, Persona 5.0
• Security Accreditations for 3 ACAT I and 28 ACAT
  III programs
• MHS Hub
• TOL
• ICDB (30 Sites)
• P-GUI (20 Sites)
• CBIS (DINPACS, Dictaphone, ORMA, CIS, CHCS II
  Gateway)
• CCE
• EWRAS

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Military Health SystemJoint Medical Information
SystemsDMLSS Migration Plan
DMLSS High-Level Capabilities
Future Applications
Existing/Near-Term Systems
Customer Area Inventory Management Customer
Support on the Web Facility Management Integrated
Prime Vendor Interface System Services Contract
Services Stockroom Readiness Inventory
Management Assemblage Management Equipment
Management Equipment Maintenance
DMLSS 3.0
Customer Area Inventory Management Customer
Support on the Web Facility Management Stockroom
Readiness Inventory Management Assemblage
Management Equipment Management
JMAR
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Military Health SystemJoint Medical Information
SystemsCITPO Migration Plan
CITPO High Level Capabilities
Future Applications
Existing/Near-Term Systems
Electronic Health Record Clinical Data
Repository Structured Clinical Notes Problem
List Health History Alerts and Reminders Immunizat
ion Tracking Strong Patient Privacy
Protection Dental Optometry Ad Hoc
Query Laboratory (OE,RR) Pharmacy (OE,RR,
Alerts) Radiology (Results Reporting) Exposure
Data Health Risks Control Measures Risk-Based
Algorithm Enhance Environmental/Industrial
Hygiene Data Appointing Personal Health
Journal Medical References Referral
Authorization Web-Based Pharmacy
Refills Non-Availability Statement
CHCS II
Block 1 Electronic Health Record Clinical Data
Repository Structured Clinical Notes Strong Pt
Privacy Protection
Health History Alerts Reminders Immunization
Tracking Problem List
CHCS
Block 2 Dental Optometry Ad Hoc Query
Block 3 Laboratory (OE, RR) Pharmacy (OE, RR,
Alerts) Radiology
CHCS II Block 1
TOL
TOL NAS, EWRAS, Secure Provider Access to CHCS,
etc.
DOEHRS-IH Exposure Data Collection, Longitudinal
Exposure Records. Corporate Reporting
DOEHRS-IH
RITPO Projects EWS-R, EWF (Enterprise-Wide
Scheduling/Workload Forecasting), PAS (Patient
Accounting System)
CHCS
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Military Health SystemJoint Medical Information
SystemsRITPO Migration Plan
RITPO High Level Capabilities
Future Applications
Existing/Near-Term Systems
Patient accounting Third party billing Itemized
billing Coding Standard claims forms Compliance
checking Cost accounting Contract
management Operating Room management Scheduling Pa
tient Appointing Workload forecasting Staff
Scheduling Personnel management Medical special
pay Manpower Labor cost accounting Education and
training Readiness Provider registry Provider
profiling Provider panel management PCM by
Name Credentialing/Privileging Medical
malpractice Risk management Adverse
actions Patient Safety
TPOCS 3.0 CHCS (MAC, MSA)
Patient Accounting
CHCS II
CHCS/P-GUI
EAS IV EAS IV Repository MEQS III
EAS IV 3.0
CHCS Scheduling, Appointing, Registration
Enterprise Scheduling - Registration
DoD WMSN WMSN-A
Enterprise Workload Forecasting
EAS III (partial) SPMS II/ BUMIS MODS
(Partial) UCAPERS
Defense Medical Human Resources-Internet
CCQAS 2.6 2.7 CHCS (partial)
CCQAS 2.8
Patient Safety
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Military Health SystemJoint Medical Information
SystemsEI/DS Migration Plan
EI/DS High Level Capabilities
Future Applications
Existing/Near-Term Systems
Claims Processing Purch. Care Institutional
Claims Purch. Care Non-Inst. Claims Purch. Care
Provider Data Appointment Data Direct Care
Inpatient Data Direct Care Outpatient
Data Eligibility Data Enrollment Data Normative
Data Financial Data Pharmacy Data Customer Survey
Data Reference Data Eligibility
Forecasting Enrollment Forecasting Geo-mapping Bus
iness Intelligence Tools Reporting, Ad hoc
Predefined Health Promotion Metrics HEDIS
2003 Medical Surveillance
Clinical Data Warehouse Global Business Data
Warehouse Purchased Care Data Warehouse Patient
Encounter Processing Reporting (PEPR)
MHS Data Repository (MDR)
TMA Reporting Tools
MHS Management Analysis Reporting Tool (M2) v3
M2 v3
Managed Care Forecasting Analysis System
(MCFAS) v3.00
MCFAS v4.00/v5.00 Analysis Forecasting
PHOTO v4.01a
PHOTO v5.00
MHS Medical Surveillance System
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Military Health SystemJoint Medical Information
SystemsTMIP Migration Plan
TMIP High Level Capabilities
Future Applications
Existing/Near-Term Systems
Medical Command Control Medical logistics
assemblage management Blood management
Immunization tracking Medical record generation
(SF600) Structured text clinical encounter
Symptomology
Battle injuries, DNBI Sick call
physical exams Post deployment surveys Consult
generation (SF513) ICD-9 coding
scheme Occupational health/radiation exposure
Lab results Automated medical reference/library S
tatus reporting Interface with Electronic
Information Carrier (EIC) Occupational
Environmental Health Readiness Patient Movement
Regulating Inpatient ITV
CHCS II - T Inpatient
CHCS NT
CHCS II - T
CHCS II - T
SAMS
SAMS
TDBSS
DBSS 5.0
DMLSS AM
DCAM DMLSS 3.0
MSA
JMEWS
TRAC2ES
DOEHRS
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Military Health SystemJoint Medical Information
SystemsTo Be Architecture
DEERS
Provision of Care
Service Unique Apps
MHS HUB
Access to Care
Population Health
Manage The Business
CDR MDR CDW
Theater
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Military Health SystemJoint Medical Information
SystemsHighlights

• Reduction of Sustainment costs through
• Improved Processes through SA-CMM
• Legacy System Migration
• Analysis of On-site Support Requirements
• Development of Common interfaces through MHS Hub
• System Convergence
• Integrated Master Schedule
• Integrated Sequence Plan
• Integration and Migration IPT