building a high value integrated business … business capability conference 2014 hollywood, fl...

Building Business Capability Conference 2014

Hollywood, FL

Presented By Linda Hebert and Tammy Talley, Veterans Health Administration Wednesday, November 5, 2014 at 8:00am

BUILDING A HIGH VALUE INTEGRATED BUSINESS CAPABILITY TEAM

Purpose

Equip new or exis.ng business analysis managers with ideas and approaches that combine insight into Business Analysis, Business Architecture, and Business Process

Expand the value of enterprise analysis to the business organiza.on through topics covering how to build an integrated business capability team

Enable development and refinement of business models, informa.on models and business requirements resul.ng in delivery of a business package of high value to the Business Owner through a flexible process

Guide the Business Owner to con.nuously review and refine the product backlog of func.onality that has not yet been delivered, to deliver business value and reduce work effort risks

Deliver a business package that defines the work effort from a business and/or func.onal viewpoint through a combina.on of agile/lean requirements development prac.ces, directly derived from business process led modeling efforts, and framed by informa.on modeling techniques.

2

Learning Objectives

1.  Explain how to implement an effective requirements elaboration process within your organization

2.  Define the building blocks to form the foundation of a business requirements and architecture team of excellence

3.  Plan and program business efforts through the development and management of business architecture and requirements

4.  Write agile/lean development business requirements traced to business process models, business information models and business reference model

5.  Describe an iterative elicitation, analysis and validation approach to model and requirements development that accurately express the needs of the stakeholder

6.  Explain how to deliver business value and reduce work effort risk through iterative processes

3

Organization of the Department of Veterans Affairs

4

VA Budget Apportionment

5

Six (6) P

rogram

Areas

Medical Care Program

Construc.on

Informa.on Technology

Na.onal Cemetery Administra.on

General Opera.ng Expenses

Benefits Program

Medical Care Program

6

Benefits Program

7

National Cemetery Administration

8

Information Technology

9

VA’s IT Budget

10

% of IT Budget

Mandatory Sustainment & Informa.on Security

Staffing & Administra.on

Development

Office of Informatics and Analytics Organization Chart

11

VHA OFFICE OF THE ASSISTANT DEPUTY UNDER SECRETARY FOR HEALTH (ADUSH) FOR INFORMATICS AND ANALYTICS (10P2)

Assistant Deputy Under Secretary for Health (ADUSH) for Informatics and Analytics Office (10P2)

Health Informatics (10P2A)

Analytics and Business

Intelligence (10P2B)

Connected Health (10P2D)

Health Information Governance (10P2C)

Strategic Investment Management (10P2E)

Program Support Operations (10P2F)

Business Architecture

Requirements Development &

Management

Common Services and Investment

Management

Open Source Management

Business Architecture

(BA)

Business Architecture and Requirements

12

Business Process Business Information

B ridge & C omm unic at e

fr om N eeds into S olutions

Identify Solutions

Chosen IT Solution I mplement the S olutions

S trategic D irections Drivers for Change

I mpacted F unctions of the B usiness

F igur e O ut I mplic ations

H ealth C ar e I deas to Solutions

Business Requirements Requirements Development & Management

(RDM)

Office of InformaPon and Technology (OI&T)

Business Reference Architecture

13

VHA Business Reference Model

Roles: • Provides func.onal framework/context for categorizing, planning and aligning business processes, informa.on models and business requirements

• Supports sound IT decision making by developing and maintaining the Business Architecture Repository (BAR) and its reports

• Supports Service Oriented Architecture development

Key Products: • VHA Business Func.on Framework (Business Reference Model)

14

VHA Business Process Model

Clinic Provider

+

Enter InpatientInfusion Order

+

Enter InpatientMedication Order -

Complex Dose

+

Enter InpatientMedication Order -

Simple Dose

+

Enter OutpatientMedication Order -

Complex Dose

+

Enter OutpatientMedication Order -

Simple DoseDetermine ifMedication Order is

for Clozapine

Select AppropriateItem Under Wr ite

Orders List[CPRS]

Select Order Tab

[CPRS]

CPRS performs preliminary order checksfor the patient depending on the order typeselected. These preliminary order checks

include Estimated CrCl, Polypharmacy,Dangerous Meds for Pt > 64, Renal Function

for Patients over age 65 and No AllergyAssessmentPerform Preliminary

Order Checks

[CPRS]

CPRS now prevents the user from renewingoutpatient and inpatient Clozapine orders. The

guidelines and procedures for prescribing Clozapineto a VA patient are detai led in the VHA Handbook 1160.02

Write a ClozapinePrescription

[CPRS]

Acknowledge OrderChecks

[CPRS]

When a user enters a high clinical dangerlevel override reason, the reason for overrideis sent with the orders to ancillary packages

so that the information is available to their users

Enter OverrideComments

[CPRS]

Requestfor

MedicationOrder

PatientProfile

OrderCheckResults

PatientProfile

OrderCheckResults

MedicationOrder Type?

Order forClozapine?

ClozapineCriteria Met?

With the Food and Drug Administration requiredchanges for adminis tering Clozapine, the following

criteria must be met for a provider to order Clozapine:the patient is part of the treatment program; The patient

has proper WBC (White Blood Count) and ANC(Absolute Neutrophil Count) lab tests within the

past 7 days; the ordering provider has theYSCL AUTHORIZED key; the ordering

provider has a valid Drug Enforcement Agencynumber or Veterans Administration number (DEA/VA#)

Does an OrderCheck Apply?

Crit ical OrderChecks?

Provider Decides to Cancel Order

Medication is requested

Contact ClozapineSpecialist

Inpatient Infusion Order

Inpatient Medicat ionOrder - Complex Dose

Inpatient Medicat ionOrder - Simple Dose

Outpatient MedicationOrder - Complex Dose

Outpatient MedicationOrder - Simple Dose

Yes

No

NoNo

Yes

Yes

Yes

No

Enter Medication Order Business Process Model

Roles: •  Establishes and oversees Business Process Modeling as a core business prac.ce

•  U.lizes industry standard Business Process Modeling Nota.on (BPMN 2.0)

•  Captures and communicates current and future business processes, as well as process improvement opportuni.es

•  Provides Business Process Reengineering (BPR) exper.se

•  Develops components of the full business package necessary for technical understanding and solu.on

•  Provides consulta.on services •  Implements agile methodologies based upon project need

Key Products: •  Process Model Summary Reports (PMSR)

Business Process Architecture

Business Information Model

15

Roles: • U.lizes industry standard format, Unified Modeling Language (UML) to develop models that provide orderly view of how informa.on should be structured – harmonizing informa.on modeling guidelines with the Federal Health Informa.on Model and Standards (FHIMS)

• Establishes informa.on domains that provide framework for categorizing VHA informa.on

• Develops components of the full business package that ar.culate current and future state informa.on requirements

Key Products: •  Informa.on Model Summary Report (IMSR)

Business Information Architecture

Roles: • Elicits, documents and validates requirements in order to:

• Support funding and project approval • Begin project planning

• Facilitate mee.ngs with the requestor, business owner, subject ma_er experts, external partners, por`olio managers, and technical resources

• Promotes agile methodologies and establishing collabora.ve teaming with Business Architecture, Por`olio Management and OI&T Key Products: • Business Requirements Documents (BRD) • Requirements Elabora.on Documents (RED)

• Requirements Traceability Matrix (RTM)

16

VHA Requirements Traceability Matrix

Business Requirements Analysis and Elaboration

Business Process Model Alignment

Business Requirements

The system SHALL provide the ability for the Pharmacy user to define a customizable view of the Patient’s detailed health record data (e.g., diagnosis, allergies)

The system SHALL transmit documented reasons for overriding a drug alert to the pharmacy to enable communication between the clinician and the pharmacist.

The system SHALL identify contraindications between a drug and patient conditions at time of the med ordering.

Information Model 17

BFF Number BFF Name BFF DescripPon

4.7.6.2 Support Medica.on Orders

Support Medica.on Orders includes orders for medica.ons, and immuniza.ons.

Business Process Model

Business Function Framework

Data Objects in Process Models are supported by

associated Information Models

Information Models Process Models

Health Care Ideas to Solutions

18

Identify Solutions

Chosen IT Solution I mplement the S olutions

S trategic D irections Drivers for Change

F igur e O ut I mplic ations

Data Objects in Process Models are supported by associated Information Models

B ridge & C omm unic at e

fr om N eeds into S olutions

Business Architecture and Requirements Alignment to the Business Architecture Framework

19

Manage Public Health

Provide Medical Services

Provide Ancillary Services

Provide Care Management

Provide Dentistry

Health Care Segment

Provide Outpatient Pharmacy Services

Provide Inpatient Pharmacy Services

Manage the National Formulary

Line of Business (Level 1)

Business Function (Level 2)

Business Function (Level 3)

Business Function (level 4)

Business Processes

Segment (Level 0)

Business Process Models

Provide Radiology Services

Provide General Laboratory Services

Provide Geriatrics and Extended Care

Provide Pharmacy Services

Provide Health Care Administration Deliver Health Care

Clinical Care Delivery Support System

Manage Inpatient Medication Enter Medication Order

Maintain Pharmacy Inventory

Provide Nursing

VA Strategic Goals

Increase Veteran client satisfaction with health, education, training, counseling, financial, and burial benefits and services

VA Strategic Goals

Enhancing the Veteran Experience in Access to Healthcare

Major VA Initiatives

Make it easier for Veterans and their families to receive the right benefits, meeting their expectations for quality, timeliness, and responsiveness

Educate and empower Veterans and their families through proactive outreach and effective advocacy

VA Integrated Objectives

Stra

tegy

Health Care Efficiency: Creating Organizational Value by Reducing Cost While Maintaining Quality

Improve the quality and accessibility of health care, benefits, and memorial services while optimizing value

Health Information Model

Person Identity Management Pharmacy Encounters

Health Information Model Information Domains

VHA Strategies & Initiatives

Become the national benchmark for quality, safety, and transparency of health care, particularly in those health

issues associated with military service

Provide timely and appropriate access to health care and eliminate

service disparities

Information Models Inpatient Pharmacy Outpatient Pharmacy Nuclear Medicine

Bus

ines

s In

form

atio

n

Pharmacy Services Business Needs NEED 249 – Pre Capabili.es that ... NEED 250 – The Record Pharmacy… NEED 251 – Recorded orders are… NEED 252 – Ac.vated orders are… NEED 253 – Arrival of the medic… … …

Business Needs


Business Requirements and Architecture Management Plan

(BRAMP)

•  Provides guidance regarding the development and management of business architecture and requirements to facilitate Veterans Health Administra.on (VHA) business efforts

•  Uses agile principles and lean processes •  Describes the procedures and guidelines to be used for the collec.on and management of business requirements and architecture

•  Includes a Joint Requirements Model between business and technical teams

What is BRAMP?

21

VHA

• Medical Center staff

VA

• Health Informa.cs Management Systems

• ePMO

• Architecture Strategy and Design

• Security

• Product Development

• Analy.cs • Standards & Terminology

22

• Pa.ent Safety

• Por`olio Managers

• Usability

• 508

• Informa.cists • Service Delivery and Engineering

BRAMP Collaboration

BRAMP

• Service Reliability

• Privacy

ExecuPve: This includes the Business Owner, who provides clinical input and helps define the current and future clinical/ business/workflow processes, requirements, and informa.on

Work Effort Integrated Business Team

23

Business Analyst Team: Responsible for developing the requirements and architectural ar.facts . Business Analyst Team members include: •  Coordinator •  Requirements Analyst •  Business Process Architect •  Business Informa.on Architect

SMEs: Func.onal SMEs provide subject ma_er exper.se as requirements and architecture are developed. Technical SMEs provides technical and feasibility input

Business Analyst Team

SMEs

Execu.ve

BRAMP Process

Analysis Phase Itera.ve

Elabora.on Phase

Goal: Gather & analyze high level requirements

Goal: Define detailed requirements

Activities: 1.  Conduct interview with

requestor to identify additional information

2.  Present request to AIM for discussion and identification of funding potential

Deliverables: draft high level business needs and determination to move into analysis

Business Team Planning, Prepara.on, Coordina.on

Activities: 1.  Conduct workgroup sessions,

interviews, and site visits 2.  Document themes, epics, user

narratives, and high level process models

3.  Stakeholders and Business Owners provide feedback and approval

Deliverables: Analysis Requirements and Architecture Package (A-RAP)

Activities: 1.  Document business

requirements, process models and information model at a level sufficient for OI&T to develop and design an IT solution


Deliverables: Iterative Requirements and Architecture Packages (I-RAP)

*More than 1 iteration may be needed

Goal: Identify supporting information and high level business needs

Assessment Phase

26

Analysis Phase

Goal: Gather & analyze high-level requirements

Activities: 1.  Conduct workgroup sessions,

interviews, and site visits 2.  Document themes, epics, user

narratives, and high level process models


Deliverables: Analysis Requirements and Architecture Package (A-RAP)

Deliverables: A-RAP

27

A-‐RAP BRD RTM PMSR

Deliverables High-‐level

business needs and desired processes

Analysis Phase

Business Requirements Document (BRD)

Describes business needs and func.onal requirements used to determine the IT

solu.on

Requirements Traceability Matrix

(RTM) Captures mappings of

business requirements to business process models,

business informa.on models and the VHA Business

Func.on Framework (BFF)

Process Model Summary Report (PMSR)

Describes the process that led to the development of “To Be” Business Process

Models

28

Itera.ve Elabora.on

Phase

Goal: Define detailed requirements Activities: 1.  Document business

requirements, process models and information model at a level sufficient for OI&T to develop and design an IT solution


Deliverables: Iterative Requirements and Architecture Packages (I-RAP)

Deliverables: I-RAP

29

I-‐RAP RED

Deliverables Detailed business requirements,

informaPon, and process to support business needs

Elabora.on Phase

Requirements Traceability Matrix

(RTM) * Captures mappings of

user stories and detailed business requirements to business process models, business informa.on

models and the VHA BFF

Process Model Summary Report

(PMSR) Describes the process

that led to the development of “To Be” Business Process

Models

RTM PMSR IMSR

Requirements ElaboraPon

Document (RED) Captures user stories and detailed business requirements to a level that is sufficient to begin design and development

InformaPon Model Summary Report

(IMSR) Contains model-‐based

representa.on of “To Be” business requirements and

processes from the perspec.ve of informa.on

that may be created/transmi_ed/received/

maintained

*The RTM was originally created in the Analysis Phase and is further defined in the Elaboration Phase

Integrated Team Example: Model Led Requirements Approach

30

Understanding Model Led Requirements Development Approach







Develop process model to drive the elicitation and

documentation of information needs and high level and detailed business

requirements

Model Led Requirements Approach Benefits

Logical and visual progression

SMEs understand ac.vity context

Iden.fica.on of pain points, bo_le necks, out of scope requirements

32

Strawman Model Development

•  The strawman model is a draft process that is developed based on the business need, existing documentation and models, and basic understanding of the process.

•  The strawman model is used to begin process discussions with stakeholders.

How does your process begin? What happens a6er the Medica8on is received? Are there any other inputs or outputs for this ac8vity? Are there any decision points in this process?

Business Architect

SME

33

High-Level Process Model

•  The high-level process model is an overview of the process from beginning to end, that accomplishes the intended goal of the process.

•  Provides a roadmap of the process for which further details will be captured, not only for process, but also for requirements and information. The high-level process also defines the scope of the process.

•  As the high-level model is developed, stakeholders begin to discuss desired requirements about the process.

Let’s decompose the Validate Medica8on Order sub-‐process/ac8vity

Business Architect

SME

34

What information do you need to Perform the Medication Order Checks? What happens if there is an issue with the order checks?


The system SHALL provide the ability to capture and document The system SHALL identify contraindications between a drug and patient conditions at time of the medication ordering.

Requirements

Validate Medication Order Sub-Process

Business Analyst

SME

35

Business Analyst SME

Is viewing the Patient Health Record sufficient for performing order checks? Do you need to capture and document interventions for only inpatients?

The system SHALL provide the ability to capture and document interventions for both inpatient and outpatient during the pharmacy workflow.

Perform Pharmacy Medication Order Checks Sub-Process

36

The system SHALL provide the ability for the Pharmacy user to define a customizable view of the Patient’s detailed health record data (e.g, diagnosis, allergies)

Requirements

The system SHALL provide the ability for the authorized pharmacy user to view the patient’s customizable electronic health record data within the pharmacy workflow.

When viewing the Patient Health Record what are you looking for?

Business Analyst

SME

Product Alignment






BFF Number BFF Name BFF DescripPon

4.7.6.2 Support Medica.on Orders

Support Medica.on Orders includes orders for medica.ons, and immuniza.ons.


Business Function Framework

38 10/20/14

Backup Slides

39

40

The VHA Business Function Framework is aligned to a wide range of VA and partner agency architectures and key products

VA CapabiliPes

Model

A4.5 Provide Health Information and Decision Support Management A.4 Provide Clinical Decision Support

A6.2 Coordinate Rehabilitation Research and Development Programming A2.4 Establish Effective Communication and Workflow Facilitation A6.3 Coordinate and Develop Medical Research Service Programs

A3.6 Administer Patient Care Administrative Services A6.1 Health Services Research and Development (HSR&D)

A3.7 Monitor Business Management Activities A1.5 Manage Beneficiary Encounter A5.4 Manage Clinical Information and Documentation A.3 Manage Health Care Administration

A4.9 Provide Automated Support for Care and Treatment Plans A1.7 Establish Access to Care Performance Measures A1.4 Manage Beneficiary Continuum of Health Services

A3.9 Perform Medical Situation Awareness A2.2 Develop Population Health Management Practices A7.3 Provide Adequate Supply of Health Personnel A4.3 Create/Manage Clinical Documents A3.3 Manage Human Resources

A4.10 Utilize Acceptable Health Care Messaging Standards

A2.1 Define / Assess Population A2.3 Support Proactive Health Activities

A5.6 Perform Operations Management and Communication A2.6 Perform Medical Surveillance

A4.11 Provide Technology Assessment A4.7 Provide for Communications with Civilian Providers

DoD Organization Specific A2.5 Evaluate Population Health Management

A1.1 Determine Beneficiary Care Eligibility Status A6.4 Administer Cooperative Studies Program (CSP)

VHA Organization Specific A7.2 Manage Graduate Medical Education

A5.5 Ensure Quality of Health Services A4.6 Provide Inter- Agency Interoperability

A4.8 Provide Immunization and Medication Alerts

A.5 Manage Health Care Delivery Common Health Care Business Activity A5.3 Manage Healthcare Services

A1.8 Support Community Outreach A1.6 Support Beneficiary Services A1.3 Schedule Beneficiary Care Services A1.2 Perform Assessment and Plan for Care A.7 Provide Health Care Education A.6 Provide Health Care Research A.2 Manage Population Health A.1 Provide Access to Care A.0 Provide Healthcare No DoD References Available

A3.2 Manage Finances A4.4 Provide Communications Support A4.1 Manage the Targeted Population Database

A3.4 Develop and Implement Policies A3.10 Identity Management

A4.2 Provide Access to Information Resources A5.1 Assess Beneficiary Health Status A3.8 Support Managed Care Contracts

A7.1 Manage Allied Health Education A3.1 Provide Logistics Management A3.5 Perform Medical Management

A5.2 Plan Health Services

Integrated Business Reference Model

(iBRM)

Health Care Focused VA Major IniPaPves

Health Por`olio New Models

of Care (NMOC) Research &

Development (R&D)

Health Care Efficiency (HCE)

Enhancing the Veteran

Experience & Access to Healthcare (EVEAH)

Health Informa.cs Ini.a.ve (hi 2 )

Improving Veterans Mental Health (IVMH)

VHA Business Process Models and InformaPon Models

VHA Business Requirements

VA Health Care IT ApplicaPons

Request ID Request Name VHA

IDs Need Description Need Tag Arch/BFF Category 20100701 Breast Cancer Clinical Case

Registry and Tracking of Abnormal Results 689, 774 Allow RT/NRT querying of the system to track

all diagnostic test results (abnormal or normal) and provide notification to providers of abnormal test results. VHBAO:NEED233 Monitor and Follow-up on

Patients Health Status and Outcomes 7 - New Models of Care (NMOC) -

Women ’s Health (WH) 20100701 Breast Cancer Clinical Case

Registry and Tracking of Abnormal Results 689, 774 Establish a registry to ultimately improve

detection, diagnosis, and treatment of breast cancer. VHBAO:NEED234 Monitor and Follow-up on


Women ’s Health (WH) 20100701 Breast Cancer Clinical Case

Registry and Tracking of Abnormal Results 689, 774 Provide breast cancer patients the ability to

directly interact with the care team and to provide key input into their preventative and curative care. VHBAO:NEED235 Monitor and Follow-up on


Women ’s Health (WH)

ApplicaPon System Acronym ApplicaPon System DescripPon Pharm: Bar Code Medica.on Administra.on (BCMA) BCMA Bar Code Medica.on Administra.on (BCMA) sonware provides a real-‐.me, point-‐

of-‐care solu.on for valida.ng the administra.on of Unit Dose (UD) and Intravenous (IV) medica.ons to inpa.ents in Veterans Administra.on Medical Centers (VAMCs). BCMA uses a Graphical User Interface (GUI), MS Windows-‐based Client/Server architecture, designed to improve the accuracy of the medica.on administra.on process, and to increase the efficiency of the administra.on documenta.on process. The end result is enhanced pa.ent safety and pa.ent care at VAMCs.

Pharm: Benefits Management (PBM) PBM The sonware extracts medica.on dispensing data elements from the Outpa.ent

Pharmacy, Inpa.ent Medica.ons IV and Unit Dose, Automa.c Replenishment/Ward Stock, and Controlled Substance modules; Procurement informa.on from Drug Accountability, Integrated Funds Control, Accoun.ng and Procurement (IFCAP); and a limited amount of Laboratory data on a monthly basis. The sonware makes data extrac.on reports available at Department of Veterans Affairs Medical Centers (VAMCs) and allows local management to use the data to project local drug usage and iden.fy poten.al drug accountability problem areas.

Pharm: Na.onal Drug File (NDF) NDF The Na.onal Drug File (NDF) package provides standardiza.on of the local drug

files in all VA medical facili.es. Standardiza.on includes the adop.on of new drug nomenclature and drug classifica.on, as well as linking the local drug file entries to data in the Na.onal Drug files. For drugs approved by the Food and Drug Administra.on (FDA), NDF provides VA medical facili.es with the ability to access informa.on concerning dosage form, strength and unit, package size and type, manufacturer’s trade name, and Na.onal Drug Code (NDC) informa.on. The NDF sonware also lays the founda.on for sharing prescrip.on informa.on among medical facili.es.

Health Care Segment

Conduct Health Care

Research Deliver Health Care Provide

Health Care

AdministraPon Manage Public Health Provide

Access to Health Care Provide

Health Care

EducaPon Manage Business Enabling Services

VHA Business FuncPon Framework

Line of Business

Segment

VA / VHA Strategic Drivers

Integrated Electronic Health Record (iEHR)

CapabiliPes

VHA IT Projects

FEA Business Reference Model

Health (110)

Health Care Research & PracPPoner

EducaPon (249) Health Care Delivery Services

(248) Health Care AdministraPon

(247) PopulaPon Health Mgmt. & Consumer Safety (246) Access to Care

(217) Provide Health

Care (0)

Provide Health Care Research

(5) Manage Health Care Delivery

(4) Manage Health Care AdministraPon

(3) Manage Public Health

(2) Provide Access to Health Care

(1) Provide Health Care EducaPon

(6) Manage Business Enabling Services

(7)

Federal Enterprise Architecture (FEA) Health Business Reference Model (BRM) VHA Business Architecture Business Func.on Framework Line of Business Sub -‐ Func.on Line of Business Func.on

OneVA Enterprise Architecture

VA has identified linkages between Legacy System Applications and the VHA Business Function Framework and has leveraged the Integrated Business Reference Model (iBRM) Architecture Alignment Model

VHA IT Project Analysis Business Architecture Alignment Model

41 DRAFT

FEA Business Reference Model

Health(110)

Health Care Research & Practitioner

Education (249)

Health Care Delivery Services

(248)

Health Care Administration

(247)

Population Health Mgmt. & Consumer

Safety (246)Access to Care

(217)

Provide Health Care (0)

Provide Health Care Research

(5)

Manage Health Care Delivery

(4)

Manage Health Care Administration

(3)


(2)

Provide Access to Health Care

(1)

Provide Health Care Education

(6)

Manage Business Enabling Services

(7)

Federal Enterprise Architecture (FEA)Health Business Reference Model (BRM)

VHA Business ArchitectureBusiness Function Framework

Line of Business

Sub-‐Function

Line of Business

Function

A4.5 ProvideHealth

Information andDecisionSupport

Management

A.4 Provide ClinicalDecision Support

A6.2 CoordinateRehabilitationResearch andDevelopmentProgramming

A2.4 EstablishEffective

Communicationand Workflow

Facilitation

A6.3 Coordinateand Develop

Medical ResearchService Programs

A3.6 AdministerPatient Care

AdministrativeServices

A6.1 HealthServices

Research andDevelopment

(HSR&D)

A3.7 MonitorBusiness

ManagementActivities

A1.5 ManageBeneficiaryEncounter

A5.4 ManageClinical

Informationand

Documentation

A.3 ManageHealth Care

Administration

A4.9 ProvideAutomatedSupport for

Care andTreatment

Plans

A1.7 EstablishAccess to CarePerformance

Measures

A1.4 ManageBeneficiary

Continuum ofHealth Services

A3.9Perform Medical

SituationAwareness

A2.2Develop

PopulationHealth

ManagementPractices A7.3 Provide

AdequateSupply of

HealthPersonnel

A4.3Create/Manage

ClinicalDocuments

A3.3ManageHuman

Resources

A4.10 UtilizeAcceptable HealthCare Messaging

Standards

A2.1Define /Assess

Population

A2.3 SupportProactive

HealthActivities

A5.6 PerformOperations

Managementand

Communication

A2.6PerformMedical

Surveillance

A4.11 ProvideTechnologyAssessment

A4.7 Provide forCommunications

with CivilianProviders

DoDOrganization

Specific

A2.5Evaluate

PopulationHealth

Management

A1.1 DetermineBeneficiary

Care EligibilityStatus

A6.4 AdministerCooperative

Studies Program(CSP)

VHAOrganization

Specific

A7.2 ManageGraduateMedical

Education

A5.5Ensure Quality

of HealthServices

A4.6 Provide Inter-Agency

Interoperability

A4.8 ProvideImmunization

andMedication

Alerts

A.5Manage

Health CareDelivery

CommonHealth Care

BusinessActivity

A5.3Manage

HealthcareServices

A1.8Support

CommunityOutreach

A1.6Support

BeneficiaryServices

A1.3Schedule

BeneficiaryCare Services

A1.2 PerformAssessment and

Plan for Care

A.7 ProvideHealth CareEducation

A.6 ProvideHealth CareResearch

A.2 ManagePopulation

Health

A.1 ProvideAccess to

Care

A.0 ProvideHealthcare

NoDoD

ReferencesAvailable

A3.2Manage

Finances

A4.4 ProvideCommunications

Support

A4.1 Managethe TargetedPopulationDatabase

A3.4 Developand

ImplementPolicies

A3.10 IdentityManagement

A4.2 ProvideAccess to

InformationResources

A5.1Assess

BeneficiaryHealth Status

A3.8 SupportManaged Care

Contracts

A7.1 ManageAllied Health

Education

A3.1 ProvideLogistics

Management

A3.5 PerformMedical

Management

A5.2Plan Health

Services

Integrated Business Reference Model (iBRM)

Integrated Program Level Requirements

Request IDRequest Name

VHA IDs Need Description Need Tag Arch/BFF Category

20100701

B reast C ancer C linical C ase R egis try and Tracking of Abnormal R esults

689, 774 A llow R T/NRT querying of the system to track all diagnostic test results (abnormal or normal) and provide notification to providers of abnormal test results .

VHBAO:NEED233 Monitor and Follow-‐up on P atients Health S tatus and Outcomes

7 -‐ New Models of C are (NMOC ) -‐ Women�s Health (WH)

20100701


689, 774 Establish a regis try to ultimately improve detection, diagnos is , and treatment of breast cancer.



20100701


689, 774 P rovide breast cancer patients the ability to directly interact with the care team and to provide key input into their preventative and curative care.



Integrated Electronic Health Record (iEHR) Capabilities

Health Care Segment

ConductHealth Care

Research

DeliverHealth Care

Provide Health Care

Administration


Provide Access to Health Care

Provide Health Care

Education

Manage Business Enabling Services

VHA Business Function Framework

Line of Business

Segment

VHA Business Function Framework

A.2 Provision of Health Services

A.2.1 Assess Beneficiary Health

Status

A.2.3 Deliver Health Services

A2.3.1 Conduct Beneficiary and

Family Education

A.2.3.2 Coach Beneficiary in Self Management and

Compliance

A: 2.3.3 Initiate Care Plan and

Perform Intervention or

Service

A2.3.3.X Provide Pharmacy Services

A2.4 Manage Information

Documentation

A.2.6 Ensure Quality of Health

Services

MHS Operational Activity Model (OV-‐5)

Joint VA / DoD Strategic Drivers

HL7 EHR System Functional Model (EHR-‐S FM)

Integrated End-‐to-‐End Business Process Models

iBRM Architecture Alignment Model VA Health Care IT

ApplicaPons

Application System Acronym Application System Description

Pharm: Bar Code Medication Administration (BCMA)

BCMA Bar Code Medication Administration (BCMA) software provides a real-‐time, point-‐of-‐care solution for validating the administration of Unit Dose (UD) and Intravenous (IV) medications to inpatients in Veterans Administration Medical Centers (VAMCs). BCMA uses a Graphical User Interface (GUI), MS Windows-‐based Client/Server architecture, designed to improve the accuracy of the medication administration process, and to increase the efficiency of the administration documentation process. The end result is enhanced patient safety and patient care at VAMCs.

Pharm: Benefits Management (PBM)

PBM The software extracts medication dispensing data elements from the Outpatient Pharmacy, Inpatient Medications IV and Unit Dose, Automatic Replenishment/Ward Stock, and Controlled Substance modules; Procurement information from Drug Accountability, Integrated Funds Control, Accounting and Procurement (IFCAP); and a limited amount of Laboratory data on a monthly basis. The software makes data extraction reports available at Department of Veterans Affairs Medical Centers (VAMCs) and allows local management to use the data to project local drug usage and identify potential drug accountability problem areas.

Pharm: National Drug File (NDF)

NDF The National Drug File (NDF) package provides standardization of the local drug files in all VA medical facilities. Standardization includes the adoption of new drug nomenclature and drug classification, as well as linking the local drug file entries to data in the National Drug files. For drugs approved by the Food and Drug Administration (FDA), NDF provides VA medical facilities with the ability to access information concerning dosage form, strength and unit, package size and type, manufacturer’s trade name, and National Drug Code (NDC) information. The NDF software also lays the foundation for sharing prescription information among medical facilities.