My HealtheVet VA-DoD Collaboration Session 172 by ust13620

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									My HealtheVet: VA-DoD Collaboration
           Session 172


                   Theresa Hancock
Acting Director, My HealtheVet Strategic Program Office

               Major Michael Whitaker
     Information Manager, TRICARE Mgt Activity,
             U.S. Military Health System
                           Agenda


•   Background
•   Key Goals
•   Methodology
•   Common Portal Audience
•   JIF Collaboration Plan & Strategy
•   Results- Education Sub Group
    – Demonstration
• Lessons Learned
• Next Steps
                          VA/DoD Background

•The VA portal, My HealtheVet (MHV) and the DoD portal,
TriCare Online (TOL), were both initiated around 2000.
•Focused in different directions
   –MHV was created as a Proof of Concept to demonstrate that veterans
   and delegates could be provided with copies of key portions of their
   health record.
   –TOL concentrated on providing electronic services to beneficiaries
   and providers.
•Six years later
   –Both organizations are coming to the point in their development life
   cycle where they are ready to provide all the functionality of a robust
   portal. They want to move to a model where they can align
   architectures and jointly develop Standards and Requirements, Patient
   Education Objects, and shared portlets.
                  Key Goals

Position TOL And MHV To Collaborate

                   Define business requirements &
                    architectural direction
                   Establish policy and standards
                   Identify areas that will result in
                    shared projects producing
                    economies of scale and cost
                    avoidance to both agencies in the
                    future
                      Common Portal Audience

Primary MHV And TOL User Groups Overlap


                                                           Medical Support
               VA Employee                                   Personnel

                                VA            TOL
                               Patient      Beneficiary                    TOL
     Veteran                                                         External Support
                                                                        Contractor
                                  VA            TOL
        Veteran Advocate/     Health Care    Health Care
        Family Member/         Provider       Provider
        Friend
                                                                 TOL
                                                                Manager
                      Other
  Methodology



 Document the “AS IS” state
  for TOL and MHV

 Perform a gap analysis
  between the two portals

 Provide recommendations
                                   JIF Project Collaboration Plan &
                                               Strategy
                                  Goals
           •Leverage Economies of Scale
           •Reduce Costs

                                                                                   Ensure Unified And
                                                                                   Sustainable
                                                                                   Communication
         Personal Health Record         Usability & Accessibility                  Between VA And DOD
               Subgroup                        Subgroup
                                                                                   Regarding Business
                                                                                   And Technical Aspects
                                                                                   Of The MHV And TOL
  Business Needs &
Requirements Subgroup
                           Technical Subgroup           Training & Communication
                                                                Subgroup
                                                                                   Portals



                    Recommendations
                                                                      Roles

                                                                            • MHV & TOL
        MHV                                               TOL                 Management
   Management Team                                  Management Team
                                                                              Teams
                                                                            • Contract Team
         Personal Health Record
               Subgroup
                                        Usability & Accessibility
                                               Subgroup
                                                                            • Subgroup
                                                                              Committees with
                                                                              Representatives
  Business Needs &         Technical Subgroup    Training & Communication
Requirements Subgroup                                    Subgroup             from TOL/DoD and
                                                                              MHV/VA


                            Contract Team
Subgroup Committees


        Training & Communication
        Subgroup
        Committee
           •   Educational Objects
           •   Training
           •   Communication
           •   Change Management
Subgroup Committees



   Personal Health Record Subgroup
   Committee
      • Personal Health Record
Subgroup Committees


  Business Needs & Requirements
     • Functional Requirements
     • Business Requirements
     • Performance Measures
Subgroup Committees



    Usability & Accessibility
       •   Section 508
       •   Usability
       •   Style Guide
       •   Accessibility
       •   Testing
Subgroup Committees



    Technical
       • Architecture
       • Security
       • Portal Site Map
            Training & Communication Sub
                    Group Results
1. Defined collaborative process to share joint
   educational object content approval
2. Developed (3) shared joint pilot educational
   objects on PTSD
     Managing Stress, Triggers and Work
3. Identified the existing programs which can be
   readily shared
4. Developing Joint User Focus Groups for
   “reality check”
             Initial 3 Topics on PTSD


• Managing your Stress (link to Demo)

• Managing your Triggers

• Managing at Work
            Current Opportunities for Sharing
                 Educational Programs

MHV                          DoD/TOL
The five centers available   Self Paced Training
  now are:
• Diabetes                   • Asthma Action Plan
• Coronary Heart             • Diabetes
• Disease                    • Hypertension Monitoring
• Heart Failure                High Blood Pressure
• Hypertension
• Stroke                     • Virtual Coach
                               Understanding A1C
Future MHV Educational Centers
    ….which can be shared




           • Spirituality
           • Hepatitis C
           • HIV/AIDS
Benefits of Shared Program
       Development

    • Decreases duplication
       – Time and Human resources
    • Reduces Costs
    • Increases Efficiency
    • Increases number of programs in
      portfolio
    • Increases content quality with
      breadth of SME expertise
      available
                User Review (focus group)
                        Timeline

• August 2007
  – Develop single script for use with both active and
    veteran soldiers
• September 2007
  – Identify representatives from around the country
    including acute and non acute care settings and all
    VISNS.
• October 2007
  – Hold focus groups and get feedback
               User Review (focus group)
                       Timeline


• November 2007-
  – Revise content per feedback


• December 2007 -
  – Stress, Triggers and Work PTSD programs on line for
    use by soldiers, vets, providers.
              Highlights from other Subcommittee
                             Efforts

• Performance Evaluation forum for TRICARE and My
  HealtheVet was held, resulting in DoD participation in
  VA’s performance measurement subcommitee.
• TRICARE has adopted Healthwise for its Health
  content.
• Group is exploring Joint E-Forum structure for the vetting
  of health content requests, to reduce redundancy and
  maximize resources.
• DoD has briefed My HealtheVet on their approach to
  Secure Messaging, in an effort to collaborate and share
  technical strategies.
                       Lessons Learned

• Statements of Understanding (which are specific outlines
  of the approach, information to be captured, as well as
  activities to be performed) are necessary to baseline
  expectations for deliverables in a transient environment

• Staffing of subgroups needs to be reviewed regularly, as
  organizational changes (contract turnover, staff changes)
  impact subgroup membership and participation.

• In a collaborative environment where the focus is
  discovery, project schedule needs to be agile enough to
  take advantage of opportunities as they are discovered.
                      Lessons Learned
                              (Continued)

• Projects across multiple agencies require a considerable
  amount of time to coordinate and meet with subject
  matter experts and stakeholders in each organization.
  This, coupled with the organization structure differences
  can pose significant challenges for time, resources, and
  delivery within short timeframes.
                            Next Steps

• Documenting Sustainable and Repeatable
  Communication Processes
• Identifying and documenting timelines and
  strategies for leveraging resources and
  opportunities for sharing
• Focus Groups Launched
  – Inclusion of Users for testing satisfaction with content
    and usability
  – Explore identifying existing data on returning active
    duty and soon to leave active duty for usability
    criteria.
• Feedback and Revisions
               TRICARE Online (TOL)




        Major Michael Whitaker

Information Manager, TRICARE Mgt Activity,
        U.S. Military Health System
                      Agenda



• eHealth Overview
• Implementation Challenges / Lessons
  Learned
• What’s New
• Summary
                       eHealth - TRICARE Online


• TRICARE Online (TOL), as a Product of TRICARE,
  Provides a Comprehensive Suite of Capabilities to Support
  Consumer Empowerment for MHS Beneficiaries
   – Empowers beneficiaries to become more involved in their own
     healthcare

• Provides Secure, Role-Based Access to Customized
  Services and Information that Automate and Supplement
  Key MHS Business Processes

• TOL Met and Continues to Meet Identified
  MHS Needs
   – MHS Strategic and Optimization Plans
                     Overview of MHS eHealth

Log-on to www.TRICARE.mil (TOL), the MHS HIPAA-
            compliant secure portal….




     TRICARE


               TOL
                   Overview of MHS eHealth

          which provides role-based access for
Beneficiaries, Providers, Support Staff, and Contractors…



                       Beneficiaries

       TRICARE
                         Providers


                 TOL
                        Support
                         Staff



                       Contractors
                      Overview of MHS eHealth

to eHealth applications and services, that automate and
      supplement key MHS business processes.
                                         Capabilities

                                        Appts Tools MTF  Health
                                                   Pages Content
                        Beneficiaries

      TRICARE
                                                               Med
                          Providers     SPAC DRMROL NAS     Resources


                TOL
                         Support
                          Staff
                                        DRMROL NAS SPAC

                        Contractors

                                        SPAC
                Overview of MHS eHealth…
                                    Upcoming

The capabilities in blue are functionality coming later
                       this year

                                                                   December 2007
                                                        Health          Rx
                                       Appts Tools MTF                 Refill   PHR   BWE
                                                  Pages Content
                    Beneficiaries

   TRICARE
                                                              Med
                      Providers        SPAC DRMROL NAS     Resources


             TOL
                     Support
                      Staff
                                      DRMROL NAS SPAC

                    Contractors

                                      SPAC
                Implementation Challenges
                            MHS




• Culture Change

• Power Balance – Patient and
  Provider Relationship

• Territorialism –
  Home-Grown Programs
                Implementation Challenges
                             Patient




• Internet Proficiency and
  Access

• Distrust of Electronic Avenue

• Loss of Personal Connection

• Security and Privacy
                        Lessons Learned
                   Patient and Provider Concerns




• Enable Timely Program Customization

• Usability

• Understand Existing Business Processes Before
  Web-Enabling Them

• System Availability
                      Lessons Learned
                    Navigating Culture Changes




Patient Empowerment

  • Patients as partners: more responsible and
    involved in their own healthcare

  • Patients as consumers
                   Lessons Learned
                  Navigating Culture Changes




Territorialism

  • Loss of autonomy – homegrown programs

  • Mandates and regulations

  • Communications with stakeholders
                     Lessons Learned
                          Marketing




• Need Support from Top Down

• Spokesperson or Advocate is Helpful

• Communicate Potential of eHealth Programs

• Expect Slow and Steady Progress

• Counter Negative Word-of-Mouth
    Definitions

• Electronic Health Record
  (EHR)
 Electronic repository of health information
 retained on behalf of beneficiary – provider-
 entered data only

• Personal Health
  Record (PHR)
  Set of electronic tools that enables
  beneficiaries to access and manage
  their health information, to obtain
  personalized health education and risk
  assessments, and to co-manage their
  medical conditions along with the
  healthcare care team
                                        PHR Functionality Overview

                                                DISA SATX                                          Phase I
                                                    TOL Central
                   TOL Registered Beneficiary            Appointing                                            DISA Montgomery


                                                      MHS Med Profile               Medication Profile

                                                       VA Med Profile              VA Medication Profile
                         PHR Secure Access
MHS SSO Authentication                                                                                                CDR
                                                       Allergy Profile                Allergy Profile

                                                    Demographic Profile           Demographics Profile

                                                   Personal Health Journal




                             Existing                             PHR application and data              (self-entered info) Future
PHR Functionality




  • Components of PHR Phase I
  – Read-only access to Beneficiary EHR
    data
    Demographics
    Allergies
    Pharmacy
     (DoD, VA, TRICARE Mail Order
     Pharmacy, & Civilian Prescriptions)
                              PHR Functionality
• Personal Health Manager
                                        Printable Report
  – Self-entered Health History

• Personal Health Summary
                     Additional Capabilities
                               2007



• Web-Based Pharmacy Refill
• Web-Based Health
  Assessments
• Beneficiary Web Enrollment
                 Future PHR Functionality
                       Under Consideration




• Remainder of EHR data not Included in Phase 1
  (Other Data Elements)
• Hematology, Chemistry, Lab Reports (VA
  Collaboration)
• Beneficiary Data Interactive with Health Content
  (Based upon Problem List)
• Beneficiary Data Incorporated into EHR
• Third-Party Access
                             Summary


• TRICARE Online, as a Product of TRICARE,
  Empowers Beneficiaries to Become More Involved in
  Their Own Healthcare
• TOL Met and Continues to Meet Identified MHS Needs
• Human Process – Needs Patience and Understanding
• Lessons Learned – Communicate, Educate,
  Demonstrate … Then Market
• eHealth has to Prove Itself Everyday
  to Everyone
Questions?
Q&A
   Thank Your
     for Your
Time and Attention!

								
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