1. VA eHMP Agile RFI Community Response Thursday, February 11, 2016 3:00 PM EST Request Summation and Topic Discussion

2. 1.VA and OSEHRA Perspectives 2.RFI Overview 3.Root Cause Analysis 4.Solution Considerations 5.Community Recommendations Contents

3. VA and OSEHRA Perspectives

4. eHMP is the right thing to do How to do it is the issue Challenges –How best to transition from waterfall to Agile development model –How best to engage the community for optimal collaboration –How to minimize financial and performance risks for VA VA’s Perspective

5. OSEHRA is a community facilitator, not a solution provider Appropriate models of software development management –Leadership –Expertise –Team building –Value exchange How do we respond as a community? OSEHRA’s Perspective

6. Brief Overview of RFI Topics

7. Achieve full and seamless VA-DoD interoperability Implement a stakeholder-centric information model Build on a future-facing architecture Objectives of VistA Evolution

8. Cooperation between OI&T and VHA Transition from PMAS to VIP Length of time to develop CPRS replacement –Establishing and maintaining solution provider relationships within current models Acquisition Software management Building an appropriate SDK Strategic Challenges in eHMP Development

9. Root Cause Analysis

10. Historical rigidity of PMAS model –Values documentation over product Lack of model implementations? Poor communication between CPRS and eHMP team Poor identification and ramp-up of eHMP resources –Internal –External (with VistA experience) –External (without VistA experience) Sources of the Current Challenges

11. Gaps and overlaps –Technical (product & expertise) Perceived shortage of expertise Perceived difficulty of creating standard development environment / SDK –Management / contracting Not enough VA direction / visibility? –Access to clinical SMEs / testers? Sources of the Current Challenges

12. Incompletely specified / provided infrastructural requirements Coarse taxonomy of requirements –Strategic –Infrastructural –Application –Workflow –Communication & documentation Sources of the Current Challenges

13. Agile conditions for success –Skilled Agile development team –Suitable project –Sound practice (don’t skip ceremonies) Challenges for Agile in the Federal workspace –Resistance to the culture of scrutiny –Procurement practice and progress assessment –Lack of required skills Sources of the Current Challenges

14. Solution Considerations

15. Acquisition and development are separate, successive project phases –How does Agile methodology best serve each one? Move away from blanket firm-fixed- price (FFP) acquisition? Field testing and implementation –Proper identification of model implementation needs to be clinically driven What Is Being Managed?

16. Where would it make sense to replace a SOW (statement of work) to an SOO (statement of objectives)? –SOO allows agile decision-making –SOO allows distinction between FFP and time-and- materials (T&M) T&M risk: ability of government to manage Decision to request FFP vs. T&M: better made by program manager than by TAC? More granularity of timespan, deliverables, contract options? Long-term contracting vs. relatively short-term acquisitions? Can Acquisition Be Improved?

17. An appropriately granular taxonomy of requirements is needed –Strategic –Infrastructural –Application –Workflow Where does waterfall make better sense than Agile? –Infrastructure-focused tasks –Application-focused tasks –Workflow-focused tasks Do Requirements Drive Methodology?

18. Proper characterization and achievement of needed competencies Committed core team with well- identified resources (internal and external) A “Chief Agile Officer” to guide and monitor the use (and misuse) of Agile methodologies? Finding and Building Expertise

19. Recommendations

20. What areas do we target? Suggestions: –Strategy for Agile –Community engagement within the context of Agile How do / should we refine the solution considerations stated in previous slides? What haven’t we thought of? Recommendations

21. Thank You! Mike Henderson hendersonm@osehra.org Guy Esten guy.esten@apexdatasolutions.net