Title: VHA OI Emerging Health Technologies Sampler
1VHA OI Emerging Health Technologies Sampler
Presented to VA Information Resource Center
(VIReC) November 17, 2008
Jim Demetriades Nancy Wilck Emerging Health
Technologies
2Presentation Outline
- Emerging Health Technologies Overview
- Clinical Wiki Pilot
- Point of Care Device Technology Assessments
- Collaborative Innovation
- Electronic Health Record System Visioning
3Emerging Health Technologies Overview
- Organization VHA Office of Information start-up
chartered in October 2006 - Purpose to sense and extend VHAs information
technology horizon through the application and
introduction of technologies and practices - Approach to provide evidence of healthcare
technology value via high-level studies, proofs
of concept, pilots to help inform both strategic
and tactical planning - Focus 3-5 year future window
4Presentation Outline
- Emerging Health Technologies Overview
- Clinical Wiki Pilot
- Point of Care Device Technology Assessments
- Collaborative Innovation
- Electronic Health Record System Visioning
5Clinical Wiki Pilot
- Working with Office of Information and Technology
(OIT) to establish a formal clinical wiki pilot
inside VA - Intend to assess VHA interest in and viability of
this technology - Premise is clinicians and allied health
professionals will utilize wiki technology to
freely share clinical knowledge with colleagues - Contributes to larger goal of assessing Web 2.0
social networking
6Anticipated Wiki Benefits
- Will encourage collective creation of knowledge
within VHA and ensure its availability to
interested persons - Viewed as credible information source and provide
immediate relevance to VHA clinicians - Attract wide range of clinical users including
nurses, researchers, residents, medical and
allied health students
7Clinical Wiki Pilot (cont)
- Initial wiki environment will use same feature
set as found in the open source technology
powering Wikipedia.com - Will support both general and specialized
communities (portals) and availability of
discussion areas, news and event postings - Will require contributor authentication and
attribution - Expect pilot to be available early next quarter
8Presentation Outline
- Emerging Health Technologies Overview
- Clinical Wiki Pilot
- Point of Care Device Technology Assessments
- Collaborative Innovation
- Electronic Health Record System Visioning
9Point of Care (POC) Device Assessment Program
- Purpose Examine the use of information
technology products for use by VHA clinicians at
the point of care - POC device definition Information technology
(IT) products with user interfaces (e.g. hand
held, mobile, wireless, laptop, thin/thick client
devices) that can access VAs VistA computer
system and / or other information sources - What is excluded diagnostic and therapeutic
biomedical devices
10POC Device Assessment Approach
- Approach
- Define POC device reference model (framework)
- For a particular setting (e.g. clinic, ward, long
term care) and role (primary care doc, nurse,
specialist) identify and prioritize devices of
high interest - Engage clinicians in conducting assessments
(tablet PCs will be first examined) - Provide opportunity for diverse collaboration
with other teams (e.g. security, patient safety,
etc.)
11POC Device Assessment Program (cont)
- Publish a series of on-line Consumer Reports
like articles. - Program will serve as information resource for
sites looking at devices - Focus is on technology and not products
- Acquisition recommendations are out of scope.
- Timeframe Contract award to develop methodology
and framework expected in Dec. 2008
12Presentation Outline
- Emerging Health Technologies Overview
- Clinical Wiki Pilot
- Point of Care Device Technology Assessments
- Collaborative Innovation
- Electronic Health Record System Visioning
13Collaborative Innovation Definition
- Collaborative Innovation
- Self-organizing groups of highly motivated
individuals working together towards a common
goal . - Peter A. Gloor, Carey Heckman, Fillia Makedon
14Our Focus The Intersection
Collaborative Innovation happens here
15Innovation Sandbox Description
- The Innovation Sandbox is much more than a
software development environment. It is also a
virtual space for people to collaborate,
innovate, and develop ideas and requirements - The Sandbox is a geographically limitless
solution to the historic challenge of locally
bound development efforts - The Sandbox is intended for anyone wishing to
contribute ideas to VistA development
16Collaborative Innovation Initial Accomplishments
- VHA Informatics and Data Management Committee
(IDMC) charge - Early 2007
- Propose a way to preserve innovation, minimizing
IT re-organization challenges - Cross organizational workgroup
- Chartered May 2007
- Stakeholders from field, OIT and OI
- Innovation Concept of Operations (CONOPS)
- Presented and approved for pilot by IDMC Sept
2007 - Industry review and comment Gartner, Perot
Systems, EDS, Microsoft, IBM
17Collaborative Innovation Goals
- Perpetuate local innovation in support of mission
needs - Strengthen early idea sharing
- Encourage communities of interest
- Increase collaboration
- Eliminate redundancy
- Rapidly deploy innovative software which adheres
to national development standards
18Collaborative Innovation Principles
- Access is easy and open to all
- The Sandbox is structured to allow ideas and work
products to be freely shared - There is a well-defined path for mainstreaming
innovative creations into production - Failures are expected and accepted as a cost of
being innovative - Sandbox governance promotes process consistency,
simplicity, and reuse
19User Experience
- Receive general innovation news
- Access resource libraries
- Discover or create birds of a feather
communities - Contribute ideas and collaborate in shaping
business requirements - The more technically inclined can initiate
software projects - Innovation ideas or requirements may be submitted
to the New Service Request (NSR) process - Applications that meet high-bar exit criteria
for national business value, OIT programming
standards and infrastructure capacity may be
fast-tracked within the NSR process
20Market Survey
- Contract awarded to survey market for toolset
- final recommendations received in March 2008 and
refreshed in August 2008 - The market is clearly emerging and volatile
- No single solution meets our wants
- Current thinking bridge two commercial products
- one strong in idea and community management
- a second to provide a solid development
environment
21Collaborative Innovation Current and Future Plans
- In progress now
- Bench validation of candidate products
- Development of functional requirements for
Sandbox environment - In the queue
- Pilot approach decision
- Acquisition/installation
- Initial live testing (pilot)
- Transition planning
22Presentation Outline
- Emerging Health Technologies Overview
- Clinical Wiki Pilot
- Point of Care Device Technology Assessments
- Collaborative Innovation
- Electronic Health Record System Visioning
23Definition of EHR-S
- EHR-S includes all clinically related systems or
applications such Computerized Patient Record
Systems (CPRS) and radiology, lab, scheduling,
and pharmacy packages - Medical devices and national data bases such as
Decision Support System (DSS) and the
Administrative Data Repository (ADR) are not part
of the EHR-S although the need to interface with
them will be a key characteristic of it
24EHR-S Visioning Objective
- Want to define shared vision for next
generation EHR-S - Called shared because products of meetings
become basis for vision document that will be
available for broad community review and
contribution - Will seek to make shared vision an authoritative
document - Will serve as roadmap for VHA as it defines
capabilities and priorities for future
development efforts
25EHR-S Visioning Approach
- Facilitating a series of meetings with key EHR-S
stakeholders - Final meeting will begin tomorrow with allied
health, research, education, and academic
affiliations - VHA stakeholders (e.g., Veteran Service
Organizations (VSO) and healthcare partners
(e.g., DoD and IHS) will be briefed - Vision document will be iterated and available
for contributions from larger VHA community - Look for draft vision in January
26EHR-S Visioning How You Can Contribute
- Participate in development of the shared vision
- Contact the VIReC Help Desk at virec_at_va.gov for
the VA Intranet address - Propose additional guiding principles if needed
- Propose capabilities the EHR-S must provide to
support your line of business (remembering that
it is first and foremost a clinical tool) - Encourage your co-workers and colleagues to
contribute to the shared vision
27Contacts for Additional Information
- Jim Demetriades
- Jim.Demetriades_at_va.gov
- 518-449-0627
- Nancy Wilck
- Nancy.Wilck_at_va.gov
- 703-927-8880
28Discussion
29Supplemental Material
- This material supplements the formal briefing.
Feel free to contact us if you have questions on
any of it.
30EHR-S Guiding Principles
- Participants in the visioning meetings developed
the following EHR-S Guiding Principles statement
- In building the EHR-S of the future
- VHA will define its content, functionality and
performance requirements. - Clinicians will lead and collaborate with other
stakeholders in the continuous evolution of the
system. - The EHR-S of the future will support and enable
VHAs missions, with specific focus on patient
safety and quality of care, by - Being patient-centric
- Facilitating knowledge discovery, accommodating
innovation and changes in health care practice
and information needs - Providing a framework to identify and promote use
of best practices and innovation, in both patient
care and informatics - Reducing undesirable variation through support
for consistent approaches to common tasks - Supporting standardization at the core and
diversity at the periphery - Enhancing communication internal and external to
VHA, among clinicians and with patients, across
organizations and the continuum of care and - Promoting the efficiency and effectiveness of
clinical staff.
31EHR-S Capabilities
- Participants in the visioning meetings determined
that the EHR-S must have the following
characteristics - Be flexible, modular, and integrated
- Promote data standardization, data quality,
information and data reuse capture the data once
and use it many times - Support context-driven views, giving the right
information at the right time - Provide access to data for all users, including
people with disabilities (e.g., access from
numerous places with numerous devices) - Manage the patient's composite record including
longitudinal patient views (internal source,
format, location, identity) - Be context, role, and event aware
- Be instrumented to support user efficiencies
- Promote the wellness of the veteran population
32EHR-S Capabilities (cont)
- Provide both prescriptive and assistive real-time
clinical decision support - Be configurable with standard defaults
- Enable support care team collaboration (any
handoffsinternal/external) - Support data input from multiple sources
(devices) and locations - Be easy to navigate and comprehend
- Provide multiple information horizons, arranged
by cognitively significant context, and provide
multiple-level views and abstractions. - Incorporate transportable tools, templates,
lists, orders, and pathways - Provide ability to manage workflow
- Must ensure complete, computationally correct,
dynamic records. - Facilitate a user interface in which provision of
care is compatible with care eligibility
33Profile of Attendees at EHR-S Visioning Sessions
To Date
- Medical Doctors (24)
- Registered Nurses (8)
- Clinical Pharmacists (2)
- Psychologist (1)
- PhD. (2)
- Clinical Applications Coordinator (1)
- Experts in
- Clinical Decision Support (1)
- Cognitive Engineering (1)
- Data Quality (3)
- Enterprise Portfolio Management (2)
- Health Eligibility (1)
- Health Information Management (1)
- Information Management (2)
- National Data Systems (1)
- Privacy (1)
- Section 508 (1)
- Security (2)