Deputy Assistant Director, Information Operations (DAD IO/J-6) Health Information Technology 8 November 2018 Ensuring the right information is accessible to the right customers at the right time and in the right way

Deputy Assistant Director, Information Operations Speaker Introduction COL Rich Wilson Deputy Assistant Director, Information Operations (DAD IO/J-6) Chief, Solution Delivery Division COL Rich Wilson serves as the Division Chief for the Solution Delivery Division (SDD). SDD is responsible for the portfolio of enterprise applications, data solutions and clinical training and integration activities. He is a clinical informaticist with 24+ years of military service and was recently named as one of Computerworld's Premier 100 Technology Leaders. 2

DAD IO/J6 Focus DAD IO/J6 Focus

Deputy Assistant Director, Information Operations Directorate-at-a-Glance Vision: A premier system of health information technology, enabling integrated health care delivery for those who serve in the defense of our country, retirees, and their families Transitional Intermediate Management Organization Administers/Supports transitioning MTFs Architecture, Advanced Concepts & Engineering Engineers, designs, and supports the deployment of all MHS operational platform IT services, and underpinning technologies required by users and administrators in two major functions - Application Engineering and Platforms & Infrastructure Evaluates, scopes, and tests emerging IT-enabled health technologies Solution Delivery Clinical & Business solutions snapshot: AHLTA – Outpatient EHR Essentris® – Inpatient EHR CHCS – appointing and ancillary TOL Patient Portal HAIMS – artifacts and imagery EBMS – blood product management DMHRSi – medical human resources DMLSS – medical logistics ESSENCE – syndromic medical surveillance JCCQAS – credentialing PSR – patient safety Provides web and mobile solutions Data and analytics solutions Cyber Security Defends and secures the network Oversees accreditation and compliance plans at all stages of the IT lifecycle Infrastructure & Operations Sustains the wide area network backbone providing connectivity across the MHS organization Installs and maintains network protection suites Portfolio & Resource Management Supports planning, programming, budgeting, financial execution and contract tracking 4

Deputy Assistant Director, Information Operations DHA Strategy Integration DHA Strategy Map DAD IO Assessment We are an organization in transition … and we have a lot more to do … We have to get better at the basics: Personnel, financial, and contract management We must manage risk to ensure the safety of our patients and effectiveness of each dollar spent DAD IO Priorities Get better at the basics … we must become “cost warriors” Anticipate and respond to customer priorities Desktop To Datacenter (D2D) / Med-COI Support to MHS GENESIS Formalize Missions, Functions, Organization, and processes to better enable “702” IT Reform Implement a Cyber Operations Center Make Risk Management Framework (RMF) more “counsel than judgement” Master data management 5

Environmental Context MHS IT Reform NDAA Modernization NATIONAL DEFENSE AUTHORIZATION ACT 2017 Congress mandates the DHA assume Management and Administration of Military Treatment Facilities (MTFs) HAPPENING NOW Procedural Instructions related to obtaining and sustaining DHA Enterprise IT Core Services are being developed (and will continue to be) for distribution SINCE 1 OCTOBER 2018 MTFs and Defense Health Units will obtain DHA Enterprise Core IT Services (e.g., Global Service Center, Active Directory Services, Enterprise E-mail) SUSTAIN A MODEL IN 2019 Adherence to an operating model that builds better partnerships with local staffs and commanders to enable “act local, think Enterprise-wide” 6

Deputy Assistant Director, Information Operations Health IT Reform Reform Objective Optimize IT costs by reducing duplicative IT services and systems, reducing the IT manpower footprint across the Military Health System (MHS) enterprise, standardizing IT business processes and workflows to maintain and enhance quality of patient care Six Core Functions Systems: Provide and sustain assigned enterprise systems being used across the MHS Network: Provide and sustain the medical enterprise network upon which all the systems communicate (“Medical Community Of Interest” or Med-COI) Budget & Portfolio Management: Portfolio management of assigned systems Cyber: Defend and secure the network Innovation / Reform: Design and implement solutions leading to efficiencies to enable cost reductions of IT manpower, infrastructure, and applications Customer Support: Provide enterprise help desk in support of the systems and network Downrange Three lines of effort will reduce duplicative IT services and systems, reduce the IT manpower footprint, effectively manage risk, and standardize IT business processes and workflows Central Services Regional Services Military Treatment and Other Facilities 7

Deputy Assistant Director, Information Operations Centralized Services As NDAA 2017 takes shape, the DAD IO / J6, with Services and MTFs’ facilitation, will be at the center of several concurrent activities including: Cloud Adoption EHR Modernization (MHS GENESIS) Data Consolidation Helpdesk Restructuring Desktop to Datacenter (D2D) Rebaseline D2D Core Capabilities Implementation Strategy These activities are meant to: Reduce duplicative IT services and systems Reduce the IT manpower footprint Standardize IT business processes and workflows Assuage some of the impacts of MHS IT Reform 8

Deputy Assistant Director, Information Operations Regional Services 9

Deputy Assistant Director, Information Operations Military Treatment and Other Facilities An extensible manning framework for Medical Centers, large, medium and small medical facilities will utilize standard missions, functions, and organization and incorporate enterprise plans for modernization (D2D, Med-COI, MHS GENESIS, etc.) Common to all … 10

Solution Sets: Today & Tomorrow

Solution Delivery Division (SDD) Overview Mission: To deliver IT solutions to the Military Health System through expert acquisition program management, process reengineering, information translation and sharing, training and integration activities in order to support and advance the delivery of health care to our patients. Program Offices (6) Enterprise applications (73) Business Solutions DMHRSi – medical human resources DMLSS – medical logistics ESSENCE – syndromic medical surveillance JCCQAS – credentialing iMEDCONSENT – patient consent S3 – surgical scheduling PSR – patient safety EIRB – research support CCE – medical coding assistance Clinical Solutions AHLTA – Outpatient EHR Essentris® – Inpatient EHR CHCS – appointing and ancillary TOL Patient Portal EHR Sustainment – Transition to new modernized EHR HAIMS – artifacts and imagery EBMS – blood product management PASTOR – pain management Data & Analytics Solutions CarePoint– information portal HSDW – health services data warehouse MDR – MHS Data Repository Registries – patient cohorts Data science tools and services Web & Mobile Solutions Enterprise Collaboration – SharePoint Websites - Health.mil, tricare.mil, armymedicine.com, etc. Mobile Apps – Breathe2Relax, Opioid Safety, Navy Leader’s Guide, etc. Integrators Clinical Informatics & Training Stakeholder engagement Acquisition support Solution Architects

Solution Delivery Division Generating Value: Rationalization Rationalization = Modernization + Consolidation + Efficiencies + Requirement Reductions Not all IT in J-6 Requirements ↑ / Budget ↓ MHS GENESIS Schedule Considerations ↑ Systems Required Post-MHS GENESIS Rationalization Requires Investment RATIONALIZATION = KEY POINTS

Solution Delivery Division Modernization Initiatives [4] 1 Modernization 96 High Decommissioning 2 Consolidation “MHS Information Portal” Current State plus Legacy Data Repository (LDR) and HealtheIntent 3 Rationalization Decommission 111 LPNI Rationalization Hosting Consol. Cloud Assessment Sustain 34 LPI Cloud 4 Cloud Assessments 2017 2018 2019 2020 2021 2022 2023 ENABLERS: Tool Consolidation, Contracting, LDR, & Investment RISKS: Dependent Projects & Schedules, Governance & Funding

Solution Delivery Division Capacity Services Model Effort launched in 2014 to migrate 16 systems from customer-owned hardware to the DISA Capacity Services environment. 15

Solution Delivery Division Managed Services Model MHS is moving to the cloud, with resources that enable the organization to deliver everything from simple cloud-based apps to sophisticated, cloud-enabled enterprise applications. MANAGED SERVICES TIMELINE Authorized Use Only

Solution Delivery Division Data Modernization MHS Information Platform Data Use MHS GENESIS Millennium Rhapsody HealtheIntent* Dentrix HIE HL7 Feed ACS DAL Social Determinant Data Wearables Data Application Data Warehouse Bio-Medical Data * Legacy System Interfaces will be removed; Legacy Data will be ingested Potential Warehouse Examples: Army Analytics Group (AAG), Financial Data etc… Potential Application Examples: DHMRSi, Essence etc… * EIDS provides Population Health tools and Corporate Measures/Metrics for MTF management; GOAL: Provide these from HealtheIntent at FOC or before depending on maturity of tool CONSIDERATIONS: User provisioning, training, data ingest, analytics tool availability Consolidation through Master Data Management of warehouses (e.g. HSDW, MDR, DMSS, etc)

Solution Delivery Division Data to Information Visualization | Logic & Tools | Data

Solution Delivery Division Legacy Data Repository The Legacy Data Repository (LDR) solution will assume data and capability management for legacy Clinical and Business data for systems as they are decommissioned. As the LDR assumes Legacy data, it must be retained within a flexible, scalable, and cost effective platform, but must also maintain the discipline of existing MHS data governance , management standards and regulatory requirements. 19

Solution Delivery Division Generating Value Record Users ↓Time to market Highest Availability Unprecedented Data & Analytics UX Agile DevOps Managed Services Talent Management

Questions/Discussion