Toward Ideal Health

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• Toward Ideal Health
• Health Information Systems
• Gary A. Christopherson
  
• Chief Information Officer, VHA
  October 2001 

HealthePeople
HealtheVet
VistA
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How will the future health/ information nexus be
different?

•   Privacy, security, portability are essential
•   Information technology support what users
  need
•   Genetic code held by beneficiary
•   Whole health record, across time providers,
  held by beneficiary
•   Full information available entered during
  care across providers
•   Beneficiary has as much diagnostic/treatment
  information as most sophisticated provider
•   Beneficiary empowerment through information

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What should be health drivers?

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

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Why ideal health info systems?

• Care
• Ensure high quality, highly satisfying care given
  achieving optimal health outcomes
• Supporting
• Effective management and analysis
• Productive research
• Effective billing and payment
• Safety during health care
• Secure information maintain privacy
• Efficient use of provider administrative staff

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VistA
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How information improves quality?

• Greater Patient Involvement / Support (Patient
  Activation)
• Consistent Patient Resources, including Internet
  (Health eVET)
• Better Provider Support
• More Accessible Clinical Decision Support,
  Guidelines, Internet resources
• Evidence-Based Framework
• Benchmarking (VHA, HP2010, HEDIS, etc.)
• Better Managerial Support for Better Care Value
• More robust, timely performance data
• New tools for assessing improving service to
  Veterans

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Why change? Not lose what we have

• VISTA was a success
• Built by fire of VHA collaboration
• Was state of the art some parts still are
• VISTA has growing weakness
• Fragile systems
• Hard to upgrade
• Aging M (MUMPS) foundation
• Facility focused
• Costly to maintain

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HealtheVet
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maximize veterans health/satisfaction

• HealtheVet - ideal info system
• veteran-focused
• high performance
• secure, private
• future-oriented, adaptive
• exceeds standards

OneVA/VHA enterprise information architecture
to be
resourcing (appropriate)
Capital Investment Board in process
Enterprise Architecture review in process
VHA Nat Policy Bd unanimous 3/21/01
VA CIO Council unanimous 3/2/01
enterprise information architecture
eternal vigilance
VHA Nat Leadership Bd unanimous 2/22/01
VHA CIO Council unanimous 1/25/01
living, evergreening
VHA IT Advs Com unanimous 1/18/01
collaboration - OneVA
collaboration VHA HQ
consultation DoD, HHS, GAO, Congress, IG
VHA enterprise information architecture
collaboration VHA field
baselining
home
history
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VA ideal health information system
HealtheVet
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HealtheVet (Veterans Health Information System)
OneVA
Veteran Input Output
Information Education System (e
communications/transactions)
Health Provider System (input/output)
Registration, Enrollment Eligibility System
(input/output)
Registration, Enrollment, Eligibility Database
OneVA/Health
Health Data Repository Health
Non-VA Health Information Environment
Health Data System (input/output)
Security Architecture Data Quality
Financial Database OneVA/Health
Management Financial System (input/output)
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HealtheVet (Veterans Health Information System)
National
Veteran
Home/Work
Registration/ Eligibility/ Enrollment System
Local/VISN
Data Repository
Hospital
Health Data System
Data Repository
Com-munity Based Outpa-tient Clinic
Nur-sing Home
Health Provider Systems
Data Repository
Management/ Financial Systems
Data Repository
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Drive toward the ideal
Longer Term achieve ideal health information
system
Mid Term- develop new interim systems in
context of ideal
Near Term carry out current development efforts
of concern in context of ideal
Ongoing - deliver high performance operations
2001 2002 2003
2004 2005 2006
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maximize veterans health/satisfaction

• HealtheVet - ideal information systems
• veteran-focused
• high performance
• supports OneVA enterprise architecture
• secure, private
• future-oriented, adaptive
• exceeds standards

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HealthePeople
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Shared, similar, standards-based systems
HealthePeople
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HealthePeople Partnership Options

• Collaborative, open-source, open-systems with
  many partners publicly owned.
• Collaborative partnership of VA private sector
  company VA owns for VA IHS company owns for
  commercial use. May or may not include DoD.
• VA system using combination of in-house build
  commercial-off-the-shelf products VA owns for VA
  IHS VA owns in-house build COTS owned by
  companies. May or may not include DoD.
• Note DoD may be involved in the above options
  partners may include consumer groups, health care
  organizations, private companies, other
  government agencies, etc.

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HealthePeople - The System
HealthePeople virtual health record
Persons Input Output
Registration, Enrollment Eligibility System
(input/output)
Information Education System (e
communications/ transactions)
Health Provider System (input/output)
Registration, Enrollment, Eligibility Database
Health Data Repository
Security Architecture Data Quality
Infrastructure
Public/Private Health Information Environment
Health Data System (input/output)
Financial Database
Management Financial System (input/output)
Support resources for person
Decision/learning support for provider
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HealthePeople - The System
HealthePeople web site, virtual health record,
trusted information, self-reported information,
link to other health providers
Outside health organizations, etc.
e communications/ transactions
Management Financial System (input/output)
Health Provider Data System (input/output)
Registration, Enrollment Eligibility System
(input/output)
Database
Database
Database
Provider Payment System
Clinical Interface System
Billing System
Pharmacy System
Laboratory System
Radiology System
Enrollment System
Scheduling System
Blood System
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maximize peoples health/satisfaction

• HealthePeople - ideal information system
• person-focused
• high performance
• supports health enterprise architecture
• secure, private
• future-oriented, adaptive
• exceeds standards

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Back-up slides
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Achieve the ideal HealtheVet