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VISION INFORMATION TECHNOLOGY PR

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					               VIRGINIA DEPARTMENT OF HEALTH (VDH)

           AGENCY TECHNOLOGY PORTFOLIO RESPONSE
                         Version 1.0


                          Plan Date: 09/07/01



Approved by:        Health Commissioner, E. Anne Peterson, M.D., M.P.H.

Agency Contact:     Chief Information Officer, Ivy Cole
Phone:              804-786-1558
Fax:                804-692-0698
Email:              icole@vdh.state.va.us
Part Two - Agency IT Strategic Direction:

                          Summary of Current Agency IT Environment

The Virginia Department of Health seeks to achieve and maintain personal and community health
by emphasizing health promotion, disease prevention, and environmental protection. The
Virginia Department of Health administers the Commonwealth’s system of public health.

VDH operates through its central office regions, which includes 35 health districts that operate
119 local health departments. During fiscal year 2000, local health departments provided
services to approximately 760,000 different patients who accumulated over 1.2 million patient
visits. In addition to the patient visits, the local health departments administered over 670,000
immunizations and a large number of other regulatory and health protection activities.

VDH decided to rewrite the system into an internet-based application, which will result in the
new Web-VISION. Web-VISION will be a patient-level system that manages client registration,
patient visit documentation, immunizations, accounts receivable, community events, and
maternity statistics.

Historically, factors such as the high turnover in the Office of Information Management
leadership positions and inadequate funding have placed VDH information systems projects at
risk. Presently, VDH’s largest and most complex information technology issue is the Virginia
Information Systems – Integrated On-line Network (Web-VISION). VDH is tasked with
bringing together a heterogeneous collection of agency, program, district, and infrastructure IT
issues. Additionally, some new development is decentralized. VDH’s central planning process
coordinates these activities at the agency level.

The currently deployed VISION system is being designed to meet the following criteria as
outlined in the Information Technology Strategic Planning Guidelines, Section II:

       Focus on customer service
       Improve service delivery
       Improve quality of Information and Decision-making
       Accessibility anywhere, anyplace, anytime




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                     VDH INFORMATION TECHNOLOGY SUCCESSES


NETWORK - Establishment of high-speed network linking all local Health Department
throughout the Commonwealth.

SECURITY - Strict adherence to a comprehensive security policy has safeguarded VDH services
and data.

IT BEST PRACTICES - Reorganization of VDH IT structure into best practices model has made
a significant improvement in software development, user support and ultimately a positive impact
on client services.

       Configuration Management
       Quality Assurance
       Main Frame to Client Server

IT POLICY - Established comprehensive IT guidelines for agency standardization.

IT STRAGEGIC PLAN - Built prioritization of projects, that AIMAC has done for greater than 4
years into a IT strategic plan to insure IT actions are in line with core agency business activities.


DATA WAREHOUSE - Design and development of a data warehouse to analyze and
disseminate health related information.

VITAL RECORDS -

       Birth Record Database and Retrieval System
       Electronic Birth Reporting System
       Back file conversion of non-automated birth records

TELEMED - Establishment of three telemedicine sites linked to UVA and VCU.

VIDEO CONFERENCING - VDH has established video conferencing capabilities to all Health
Districts in the Commonwealth. This is being used for training, communications, grievance
hearings and bioterrorism networking. This Virginia wide capability has been demonstrated and
has the capability of being shared with other agencies.

WEB VISION - Application coding complete for phase I, positive feedback on design and
functionality from users. Scheduled to be released in 2002. This application will make VDH a
pioneer in the health care field by processing client transaction on-line in a web-based
environment.

ENVIRONMENTAL HEALTH - Purchase of software and support services for a statewide
environmental health system. Currently in the implementation phase, this system centralizes data
collection and facilitates reporting of statewide EH data. This system will be of great assistance to
local government and a true Governor legacy item.



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VDH WEB - Posting of all VDH forms needed by citizens. (Executive Order 51). Guidance
documents and interactive components are being added. The VDH web is core to serving
customers as an increasingly popular source for transforming health information. VDH is in the
process of Spanish translations for the main page and the Commissioner’s communications via
the web.

TCO - Agency Total Cost of Ownership study completed.

EVA - VDH pilot site for electronic purchasing.

HIPAA - Task Force established and incorporating requirements into IT activities where needed.




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                                         Current IT Focus


VDH’s current focus is the following four major projects and ongoing support as outlined below.

1. WebVISION

WebVision is the current focus of development in OIM. This is a replacement for the existing
client server VISION system that provides for patient billing, immunization tracking, and
maternity statistics in the local health departments. The replacement system uses three-tiered
architecture with an Oracle 8i database to replace the basic functionality of the existing system in
a more robust incarnation. Some enhancements are being added including a proven vaccine
predicative module and central pharmacy, but most of the effort is to provide an application that
reliably meets the business needs of the local health departments. This application includes:

       Client registration
       Encounter processing (recording the procedure details of each visit)
       Community events (batch processing of individuals in mass encounter settings such as a
        flu shot clinic)
       Account receivables (including patient bills, third party billing – both paper and
        electronic, and collections/debt setoff)
       Maternity statistics
       Immunization records
       An immunization predictive module that uses the patients current data and an
        immunization algorithm to suggest immunizations for that patient
       A central pharmacy system to manage vaccine inventory

This application is scheduled to be completed and deployed in each district by 2002.

2. WICNet

This project is being developed by the Office of Chronic Disease and Nutrition in the Office of
Family Health Services and is funded by the US Department of Agriculture. This client server
application will replace a manual check issuing system and an automated tracking system with an
integrated system allowing on-site check printing and much better compliance with USDA
requirements. It is estimated that this application will be deployed in the spring of 2002, but the
project is undergoing a major review and that date is approximate. Best practices as employed in
the development of Web-Vision are being integrated into the development of WICNet.

3. Environmental Health

This application was part of the original concept for VISION, but was removed form the
development protocol during Y2K efforts. Several districts had created their own systems to track
environmental efforts, but no system emerged that met statewide needs. After gathering
functional requirements and performing a make vs. buy analysis, and the RFP process was used
to select Health Space as the vendor for this turnkey solution. Their existing application has a
very good fit with our needs and this application is scheduled for rollout in late 2001. It will run
in client-server mode using Lotus notes as the underlying system.




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4. Trauma Registry

This three-tiered system using an Oracle 8i database was developed in the spring of 2000, but
production security upgrade difficulties securing hardware resources and completing user testing
have delayed its deployment. This application will replace an existing system with a web-
enabled solution that will allow participating hospitals to report data on trauma patients. EMS
will own the system and Rehabilitation Services will use a subset of data.

                                         Ongoing support

VDH’s objective is to ensure the smooth and uninterrupted functioning of existing applications.

Currently deployed and supported applications:

1) VISION
2) Environmental Health (a limited number of districts)
3) CDC
4) CPAMS
5) Chronic Disease Prevention Program
6) F&A
      [Modules]
    - Financial Services
    - Purchasing and General Services
    - Central Services
    - Pharmacy Services
    - Quality Improvement & Human Services
    - Internal Audit
    - Budget Services
7) F&A (an instance of F&F used by Tobacco Settlement)
8) Oimops

Additional enhancement support focus includes:

       Work with the user groups to understand, evaluate and implement changes and
        enhancements to the existing applications.

       Upgrade technical platforms to keep pace with the technology.

       Maintain compliance with State, Federal or industry guidelines and standards for
        information systems.

       Ensure that the best practices and processes are being followed for all areas of operation
        relating to Production Support.




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                                         Agency IT Vision

Mission Statement for OIM:

Saving lives, improving health, and decreasing disability through the rational business-oriented
application of information technologies

The Commissioner has given the following guidance to AIMAC in setting Agency IT priorities:

       VDH should provide good public health data to enhance health-related action, education,
        and change. We are not just interested in providing numbers, but in packaging data to
        guide policy, to understand health trends and associations. Our goal is to make that
        information known, understood and acted upon by the people of Virginia. Data should be
        broadly interpreted to include vital events, educational programs, outcome data, program-
        specific data, district/locality-specific data, analysis, etc.

       VDH should pursue efforts to enhance the functioning of VDH through improved
        processes, business efficiencies, and enhanced linkages both within the agency and with
        others.

       VDH should provide full support to EO 51 and egov.


Given the direction from the Commissioner, AIMAC, EO 51 and egov the future agency IT
environment will be Web enabled applications supported by a central office back office
infrastructure that will allow Web-based accessibility to information for the citizens of Virginia.

Our new application WebVision will provide:

       Web based access
       Information for Citizens
       Data for staff
       Better and more accurate data collection and reporting
       Enhanced data security
       Better and more accurate financial reporting
       Improve invoicing and collections.


Implementation of best practices will provide:

       QA Process
       User Groups
       Documentation & Training
       Enhance Help Desk support
       Lower cost and improve productivity
                                                          VDH -Short and Long Term IT Issue List


Issue Id   Issue and Overall Impact.          IT       IT Strategy                                    Base      Additional   Measure's) of Success
Number                                        Impact                                                  Funding   Funding
ST01       WebVision –rewrite of the main     Y        Long term Multi year project in process.       Y         N            End user satisfaction survey and deployment by
           agency application                          Complete the project by June 2002.                                    June 2002

ST02       WICNET - no current system to      Y        Long term Multi year project in process.       Y         N            End user satisfaction survey and deployment by
           accomplish required reporting               Complete the project by June 2002.                                    June 2002
           and tracking

ST03       EMS / Trauma registry - no         Y        Long term Multi year project in process.       Y         N            End user satisfaction survey and deployment by
           current system to accomplish                Complete the project by June 2002.                                    June 2002
           required reporting and tracking

ST04       Environmental Health – no          Y        Long term Multi year project in process.       Y         N            End user satisfaction survey and deployment by
           current system to accomplish                Complete the project by June 2002.                                    June 2002
           required reporting and tracking

ST05       WebVision scope creep – as         Y        Development of project control methodologies   Y         N            Containment of project within approved project
           new requirements and                        to include a defined scope and out of scope                           timelines and budgets.
           functionality are requested, the            contract with clients.
           implementation date is revised

LT01       Critical positions vacant –        Y        Expand our recruitment area and utilize the new N        Y- $300K Critical positions are filled in a timely manner.
           projects are at risk without                compensation system to attract qualified
           adequate staffing                           employees
LT01.1     *   Agency Security officer
LT01.2     *   OIM Site security office
LT01.3     *   OIM Data base Administrators
LT01.4     *   Configuration manager
                                              VDH -Short and Long Term IT Issue List


LT02   General funds funding scheme       N   Continue to seek general funding for the IT     N    Y - $2.3m General funding achieved for VDH IT
       for IT- Governor supported IT          backbone of VDH                                                infrastructure
       issue

LT03   Staffing model dependent upon      Y   Develop a staffing transition plan to return OIM N   Y-        When the staffing model reflects
       body shop personnel                    to a staffing model of core knowledge resident       $400K     the change, our cost are lowered
                                              in state FTE's with the ability to utilize                     and shifted to a project cost basis.
                                              contracts to temporarily flex up to meet funded
                                              project requirements. Would require a
                                              temporary increase in expense to achieve a
                                              long-term reduction.

LT04   HIPAA compliance requirements Y        Adherence to Federal Guidelines                 N    Y-        Successful audit review
                                                                                                   $100K

LT05   Infrastructure enhancements for    Y   Development of capacity plan and                N    Y-        Capacity plan approved by commissioner and
       increased bandwidth                    reexamination of a partnership with DIT.             $500K     resources successfully obtained and allocated.
       * Increased use for Video
       conferences
       * Voice over IP

LT06   Email and Web- internal &          Y   Development of a long term                      N    Y-        Communications plan approved by
       external communications vital to       communications plan                                  $250K     commissioner and resources successfully
       the core business of VDH                                                                              obtained and allocated.




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