OSEHRAProduct Management Perspectives

28th VistA Community MeetingFriday, January 17, 2014

OSEHRAProduct ManagementWork Group

• On behalf of OSEHRA Product Management Work Group– Mike Henderson (co-chair)

• Director, Open Source Product Management, OSEHRA

– Denise LeFevre (co-chair)• Chief Information Officer, Oroville Hospital

– Christopher Edwards• Technical Manager, KRM Associates, Inc.

Presenters

1. What is OSEHRA VistA?

2. How Fileman 22.2 Can Boost the VA Healthcare Enterprise (And Yours)

3. A Community Implementer’s Perspective on Product Management

Topics

What is OSEHRA VistA?

• The Product Definition Challenge– Distributions– Categories– Capabilities vs. Packages

• How to Look at OSEHRA VistA– The Capability View– The Package View

What is OSEHRA VistA?

• It is all about the audience– New & end user view

• Can VistA run my hospital/clinic?• Can VistA do x?

– Programmer view• Who depends on my code/API? OR• What does my code/API depend on?

Visualizing VistA

• Know the generics– Example: Does VistA have Laboratory

capabilities?

• No existing solution– We just point them to the firehose

• Build a new view based on functional categories and groupings– May/May not care how we solved the problem

technically

End User Audience

• Already knows where the package is (in most cases)

• Needs to have the details• Needs to be approachable by new and

knowledgeable programmers• Linked to by the End User view

– Allows new developers to explore– Can start from the developer view to get a

bird’s eye view of the code

Developer Audience

Visualization Demo

Fileman 22.2: Improving VistA Quality and Safety

• Improvements to Fileman functionality– Over 1,000 bug fixes– Screenman enhancements

• Still used by many clinicians...because it works!• A smoother path to Web UI

Fileman 22.2

• Data Analysis Tools– Indexing to any key field length– Orphan pointer checks into a given file– Automatic auditing of DD changes– Meta Data Dictionary

Fileman 22.2

• Path to future application package enhancements– Fileman development originally part of FLAP

• Can once again run on its own!– Other VistA packages need not be installed– Browser doesn’t require Kernel device file– Extends full Fileman dictionary capabilities

Fileman 22.2

• Path to convergence– Broad adoption mitigates the risk that early

and late implementers will be too far apart on the curve

– Provides a smoother solution path for intake of open-source vendor products built on current versions of Fileman

– Leverages skills and ecosystem knowledge of current open-source VistA community

Fileman 22.2

• Documentation– Navigable online documentation– Convenient section grouping and access– Includes glossary, index, suggestions for best

practices

Fileman 22.2

• Safety– Word processing fields can be audited– Word processing fields can be made

uneditable– Changes can be filtered by user

Fileman 22.2

• Quality– Distributes unit tests based on MUnit– Enables on-demand or continuous monitoring– Unit tests can be run in execution framework– The quality that is baked in, stays in

Fileman 22.2

OSEHRA ImpactOn End Users:A Community Implementer’s Perspective onProduct Management

Denise LeFevreChief Information OfficerOroville Hospital

• Personal reasons– Health issues– Participation in H.I.E.

• Meaningful Use funds

Why Electronic Health Records?

• Single stop shop – Marketplace for Code procurement – What a Ice Cream Shop!

• Pick YOUR flavor• Pick YOUR toppings• Don’t have to worry about extra non-value calories,

worry has been removed, these are proven products!• Adopt, make your own, and share:

Pumpkin Pecan Cheesecake?

Lays – Sriracha Chips – Tyler Raineri

Lake Zurich, IL

Chicken Waffle

Code Convergence

• Users have different levels of software need• Different levels of software support

expectation• Different levels of ability to support

hardware• Different levels of Implementation Needs

including setup and education• Different levels of funding – now and

ongoing

Enough to Go Around

• Gather at the Ice Cream Shoppe• Discuss/identify/resolve common but

specific issues• Vulnerability problem prime example

Problem Identification and Resolution

• February 2014– HIMSS 2014, Orlando, Fla.

• September 2014– OSEHRA Summit, Bethesda, Md.

• October 2014– VistA Expo & Symposium, Seattle, Wash.

Pull Together

Tracking theRegulatory Timelines

• ICD-10– Required for billing– Implementation deadline: 1 October 2014– Takes effect in CPRS 30– Partial code-in-flight submitted to OSEHRA

• Meaningful Use Stage 2– Required for Problem List (SNOMED)– Implementation “extended through 2016” (CMS/ONC)– MU2 attestation to begin in 2014 for MU Stage 1

accredited systems (see Halamka blog)

Tracking the Regulatory Timelines

• OSEHRA role– Custodian of VA, community submissions– Not driving schedule but facilitating availability

• Implementer alternatives– Roll your own VistA?– Use a commercial version?– Take advantage of community contributions?– Discussion through 2014-2015 in Product

Management weekly meetings

OSEHRA and Community Roles

Questions?

Thanks for attending!

Denise LeFevremailto:dlefevre@orohosp.comtel:+1-530-532-8565

Christopher Edwardsmailto:Christopher.Edwards@krminc.comtel:+1-304-876-6600

Mike Hendersonmailto:hendersonm@osehra.orgtel:+1-571-858-3383