1. Advanced Planning Brief to Industry Lorraine Landfried Deputy CIO OIT Product Development June 9, 2011

2. 2 Agenda Product Development Organizational Overview PMAS and ProPath Refreshers Major Initiatives EHR Health, Benefits, and Corporate Products ICD-10 Open Source Upcoming Acquisitions

3. Office of Information & Technology 3 Assistant Secretary, Office of Information & Technology ------------------------------ Principal Deputy Assistant Secretary Quality, Performance, and Oversight VLER EPMO Service Delivery & Engineering Product Development Architecture, Strategy, & Design IT Resource Management Information Security Customer Liaisons

4. Product Development 4 DCIO for Product Development Lorraine Landfried Chief of Staff Mickie Krause ADCIO for Project Management Keith Seaman ADCIO for Product Support Wil Berrios ADCIO for Development Management Dave Peters

5. Product Development Center REPORT DATE: 04/20/11 Where is Product Development? Albany Dallas Oakland Salt Lake City Birmingham Bay Pines Washington DC Tuscaloosa Austin Denver Philadelphia Quantico Silver Spring Hines Eatontown Dublin

6. Project Management 6 ADCIO for Project Management Keith Seaman Director, Major Initiatives Steve Schliesman Director, EHR Susan Perez Director, Health Products Larry Weldon Director, Benefits & Corporate Products Dan Pate

7. Project Management 7 ADCIO for Development Management Dave Peters Director, Planning & Analysis Competency Mark Warner Director, Application Development Competency Catherine Pfeil Director, Product Assessment Competency Julie Harvey

8. Project Management 8 ADCIO for Product Support Wil Berrios Director, Health Product Support Vanessa Davis Director, Benefits Product Support Ron Hawkins Director, Corporate Product Support Tammy Watson

9. Product Development Objective: PD manages all VA enterprise application development. Development consists of planning, developing or acquiring, integrating, and testing applications to meet business requirements. It provides day-to-day direction over all solutions developed by OIT for VA business units and is a trusted partner in how VA delivers its mission and achieves VA’s transformational goals. 9

10. 10 PD Overarching Goals and Priorities Product Support  Serve as experts on deployed application software base  Respond to application software maintenance, and proactively identify/avoid potential problems  Maintain engineering and business integrity of operational products to support VA’s mission  Retire/consolidate products to reduce cost and/or exploit new benefits Develop and deploy new mission critical systems  Major Initiatives, EHR  Heath, Benefits, Corporate products  Other funded system enhancements

11. Product Support Flat or declining budgets Determining strategies for consolidating and retiring products Work must be “self-funded” – small investments for large return 11

12. Development Management Competency segment of organization Includes functions where consistency is critical: – Project planners – Project management – Programming – Technical analysis – Implementation management Planning common competency acquisitions in coming years 12

13. Critical Management Information Project Management Accountability System (PMAS): All projects must be PMAS compliant. ProPath: PMAS mandates use of ProPath standardized processes. Contractor clearance: process & project timeframes more stringent, efficient and timely clearance of contractors critical. 13

14. Changes in PD: Management and Execution Building accountability for schedule and dollars — Continuing to improve customer delivery performance through schedule rigor – 1 minute late is LATE. — 72% on time to date this FY (71% for MI, 74% non-MI) — 100% of development budget tied to outcomes — Working to better define requirements through PMAS-mandated IPTs — Close collaboration earlier in development cycle with business owners, TAC, and all stakeholders Structuring the organization — Competency-based — Central PMO contract — Flexibility and efficiency for changing priorities — Acquisitions will be structured to match organization — T-4 14

15. Critical Development Information Agile development Common infrastructure: necessitates strong design abilities. Open Source: impacts yet to be fully understood. Technical Reference Model (TRM) – Databases: Oracle, SQL Server – Languages: Java, MUMPS, Delphi – Development Tools: IBM Rational brand line, Microsoft Project – Operating Systems: Windows, RH Linux, Solaris – Application Server: Oracle WebLogic – Web Server: IIS, Tuxedo, MOSS – New initiatives: mobile apps, Android, Apple iOS2 15

16. PMAS: A Refresher Requires all IT programs be appropriately resourced and use incremental product build techniques to focus on delivery of new functionality to customers at least every six months Stringent monitoring; projects may be stopped. At sign of trouble, projects may be paused and reevaluated. Contracts now being structured and written according to PMAS requirements. PMAS is mandatory for all OIT development work. The PMAS Guide is available in the Bidder’s Library. All development work will be reported in the PMAS database (MS Project 2010). 16

17. ProPath: A Refresher ProPath is a front-end tool to a Process Asset Library containing information regarding standard VA IT processes. It is a one-stop shop, providing critical links to the formal approved processes, artifacts, and templates to assist project teams in facilitating their PMAS-compliant work. Visual flow representation makes it easy to retrieve information and comprehend process. It is SDLC agnostic. It reflects processes mandated for use with Agile, Linear, and any other methodology. Just as with the PMAS Guide, using ProPath is mandatory and is directly implied by the information in the PMAS Guide. ProPath is available in the Bidder’s Library. 17

18. 18 Major Initiatives VA’s Major Initiatives Eliminate Veteran Homelessness (EVH)Preparedness Veteran Benefit Management System (VBMS) Systems to Drive Performance (STDP) Automate Post-9/11 GI BillIntegrated Operating Model (IOM) Virtual Lifetime Electronic Record (VLER)Human Capital Investment Plan (HCIP) Improve Veteran Mental Health (IVMH)Research and Development Veteran Relationship Management (VRM)Strategic Capital Investment Planning New Models of Care (NMOC)Health Care Efficiency Enhance the Veteran Experience and Access to Health Care (EVEAH) Transforming Healthcare Delivery through Informatics Director: Steve Schliesman

19. Electronic Health Record (EHR) Formal agreement and sponsorship on March 17, 2011. EHR will be national model for capturing, storing, and sharing electronic health information. – Functional and technical experts developing overall concept of operations to determine best approach. – Team structure transformed to best support proposed governance model. – June 23, 2011: estimated completion of governance model, cost analysis, technical assessment, architectural review, and knowledge sharing process recommendation. – July: estimated completion of common Graphical User Interface (GUI). Challenges – Disparate architecture: DoDAF & FEA/ProPath – Need for platform independence: anything that should be joint will be joint Recent VA/DoD sharing initiatives – Health information for almost 4M Veterans and Servicemembers available to clinicians – Self-access through “Blue Button” technology – Joint Federal Health Care Center – VLER: Phased approach to data sharing to broader audience (private clinicians, benefits adjudicators, family members, care coordinators, and other caregivers) with five pilot sites where health information is shared between VA, DoD, and private sector 19

20. Common Interface Standards Presentation (Common GUI) Common Data Centers Common Services Broker (includes Enterprise Service Bus (ESB) and Infrastructure Services) Common Information Interoperability Framework (CIIF) Common Information Model, Common Terminology Model, Information Exchange Specifications, Translation Service Common Data Standards: SNOMED CT and Extensions, LOINC and RxNorm Pharmacy Disability Evaluation Dental Care Personal Health Record Inpatient Orders Mgmt Consult & Referral Mgmt Immunization Laboratory Emergency Dept Care Nursing Home Rehabilitative Care Long Term Care Transient Outreach DoD Unique (16) VA Unique (6) Common (Joint) Applications & Services (30) Battlefield CarePediatrics Military Readiness Obstetrics Enroute CareVeterinary Operating Room Mgmt Blood Mgmt Document Mgmt Applications and Services Common DoD-VA Requirements: HL7 EHR-S Functional Model with DoD and VA vetted Extensions (SV-4) Common DoD-VA Integrated Health Business Reference Model (OV-5) Common DoD-VA “To Be” Process Flow Model (OV-6C) Common DoD-VA Measures of Effectiveness, Measures of Performance and Key Performance Parameters Occupational Health (VA) Pharmacy Mail Order

21. 21 Health Products Health Provider ProductsHealth Administration Products ImagingPatient Management Clinical ProductsInternational Classification of Diseases (ICD)-10 Conversion Computerized Patient Record SystemFinancial Products Legacy Clinical Systems5010/D.0 Pharmacy ReengineeringVHA Enrollment Laboratory ReengineeringHealth Data Products Revenue Improvements and System Enhancements (RISE) Repository Products Clinical Information Support System (CISS)Standards and Terminology Service Products James A. Lovell Federal Health Care Center (FHCC)*Registry Products Director: Larry Weldon

22. ICD-10 International standard diagnostic classification for many health management purposes Government mandate for compliance by October 1, 2013 Participation from VHA, Health Information Management (HIM), and several OIT teams Affects nearly all areas of the health organization, including clinical functions, claims and financial functions and Health Information Management Many core applications will require upgrade to accommodate new ICD-10 codes New codes have greater degree of specificity than current ICD-9-CM codes and will increase in number – Approximately 13,000 ICD-9 codes – Approximately 68,000 ICD-10-CM codes 22

23. 23 Benefits & Corporate Products Benefits Products Fast Track (Agent Orange) Vocational Rehabilitation and Employment (VR&E) Director: Dan Pate Corporate Products Corporate Systems Web Services Financial Products Strategic Asset Management

24. 24 Open Source Transition to an Open Source Model Proposed governance structure embodied in a Custodial Foundation VA and DoD likely the first members VA initially funds the foundation VA contributes the initial code as open source base Desired outcomes: – Greater innovation and breadth of function – Improved interoperability among VistA modules and between VistA and related systems – Stronger system and application security – Rapid customization (such as unique localization requirements) – Improvements in quality and reliability

25. 25 Upcoming Acquisitions $350M more to come in FY11 for MIs $100M+ to come on other PD work $600M in FY12 on MIs and EHR

26. Upcoming Acquisitions RequirementCostInitiative Secretary’s Initiative Directorate – Automate GI Bill Benefits Initiative $1-5M3. Automate GI Bill Benefits FY11-96 VRM SOA Software Purchase VRM-105$1-5M6. Build Veteran Relationship Management NMOC Leadership Office (LO) Support$1-5M7. Design New Models of Care Health Risk Assessment$1-5M7. Design New Models of Care Clinical Video Teleconferencing (CVT) Scheduling System Development $1-5M7. Design New Models of Care NMOC Project Support$1-5M7. Design New models of Care Vendor Databridge Interface to Clinical Information Systems $1-5M8. Expand Health Care Access Patient Advocacy Database (PAD)$1-5M8. Expand Health Care Access Surgery Quality and Workflow Manager$15M+8. Expand Health Care Access Project ARCH Automated Eligibility Determination (ARCH) $1-5M8. Expand Health Care Access 26 To Be Awarded 4 th Qtr FY11 through 1 st Qtr FY12

27. Upcoming Acquisitions 27 RequirementCostInitiative Veteran Transportation Services (VTS)$1-5M8. Expand Veteran Healthcare Access Project Management Accountability System (PMAS) Project Support $1-5M11. Establish Strong IOM SES Talent Management System w/Dashboard$1-5M12. Transform Human Capital Management HR Academy/KM Web Portal$1-5M12. Human Capital Improvement Plan HCP Pilot Interface$1-5M15. Health Care Efficiency PD MI 15 HCE Non-VA Care, Program Integrity Tools$5-15M15. Health Care Efficiency PD MI 15 HCE Beneficiary Travel Enhancements$1-5M15. Health Care Efficiency Independent Verification and Validation (IV&V) and Project Support for Captain James A Lovell FHCC $1-5M BusinessWare Engineering Services Support$5-15M Benefits Legacy Applications Support Service$1-5M SPD - Scope Action Plan (ISO-9001) - PRISM$1-5M To Be Awarded 4 th Qtr FY11 through 1 st Qtr FY12

28. Upcoming Acquisitions 28 RequirementCostInitiative Software Configuration Change Management Follow-On Contract $5-15M Tools Support Services Consolidation Contract$5-15M LSRP Implementation Team$1-5M PD Health Products PM Division: Laboratory Re- Engineering - LSRP Software Engineering $1-5M Vista Maintenance$5-15M Enterprise Applications Maintenance$1-5M IRIS$1-5M Development Research Analysis$1-5M Agent Orange Fast Track$1-5M CAPRI Maintenance and Tactical Enhancements$1-5M FY11-62 VetSuccess Redesign and Rehost$1-5M To Be Awarded 4 th Qtr FY11 through 1 st Qtr FY12