SDD Supports Successful Deployment of MHS GENESIS at Fairchild Air Force Base

On Feb. 16 the successful deployment of MHS GENESIS at Fairchild Air Force Base (AFB) was announced. A single integrated inpatient and outpatient electronic health record (EHR), MHS GENESIS transforms the delivery of healthcare for the Department of Defense (DoD) and the Military Health System (MHS). This cutting edge technology supplies MHS providers throughout the continuum of care, as well as private sector healthcare partners, with the necessary data to collaborate and make the best possible healthcare decisions.

Ms. Stacy Cummings, program executive officer, Program Executive Office Defense Healthcare Management Systems stated,

“We have a responsibility to provide the best possible user experience to our beneficiaries and healthcare providers from day one. Today we delivered on that responsibility. MHS GENESIS will transform the delivery of healthcare and advance data sharing through a modernized electronic health record for service members, veterans, and their families.”

As the owner of the legacy EHR and its many support systems, the Solution Delivery Divi-sion (SDD) plays a vital role in the transition

to MHS GENESIS. SDD’s EHR Moderniza-tion Program Management Office (PMO) is at the forefront of this effort acting as the liaison between the Defense Health Agency and DoD Healthcare Management System Modernization (DHMSM) PMO to provide transition application planning, portfolio rationalization and eventually manage the sustainment of the new EHR. Ms. Deborah

“Kim” Zirnfus, EHR Modernization, Program Manager explains, “Our interface work is critical to the deployment of MHS GENESIS. Daily meetings were conducted with our partners to ensure all interface issues were resolved prior to the launch at Fairchild AFB. Expanding the coordination between the legacy and DHMSM teams, to include joint engineering resources, will be the focus as we continue the roll out.”

The Customer Deployment Support Branch functioned as the link to our customer during the deployment, utilizing tri-service working groups to aid in the successful integration of health information technologies. “The real-time coordination of MHS GENESIS activities enabled the enterprise command center to provide the highest level of support to our customers,” said Dr. Brian Jones, Customer Deployment Support, Branch Chief.

Clinical Support applications have been redesigned to ease the transition to the MHS GENESIS Portal and our EHR Core and Care and Benefits Integrated Systems PMOs started the arduous task of decommissioning legacy applications. The support provided by each PMO and Branch is different but the priority remains the same, SDD is dedicated to improving the delivery of healthcare to our service members and their families worldwide. Additional MHS GENESIS information is located at www.health.mil/MHSGENESIS.

MHS GENESIS Go-Live Recognition, Red Morgan Center, Fairchild Air Force Base (from left):CMSgt Willard Armagost, Col Margaret M. Carey, VADM Raquel Bono and Lt Gen (Dr.) Mark A. Ediger

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IN THIS ISSUESDD Supports Successful Deployment of MHS GENESIS at Fairchild Air Force Base ...............1

SDD At-A-Glance ........................... 2

Leadership Message ..................... 2

Joint Patient Safety Reporting Prevents Patient Harm .................3

Award Programs Recognize SDD Personnel ......................................3

SDD User Integration Branch: ‘The Voice of the Customer’ ........4

EIRB Releases Two New Versions ........................................4

Did You Know? ...............................4

Meeting the Standards ....................5

SDD Releases First MHS Opiate Use Registry ....................................5

THE NEWSLETTER OF THE SOLUTION DELIVERY DIVISION

BEATThe

If the first months are any indication, 2017 is shaping up to be one of the busiest and most productive years for the Solution Delivery Division (SDD) to date. I’m excited to share some of our recent accomplishments in this March edition of The BEAT. Most notably the 92nd Medical Group at Fairchild Air Force Base in Washington state went “live” with Military Health System (MHS) GENESIS, our next generation electronic health record. I am proud to share SDD contributions to support this monumental advancement in military health care.

Our feature story this quarter introduces the Joint Patient Safety Reporting application that provides a standardized and simple way to communicate safety-related incidents. Next check out the “PMO/Branch Spotlight” where our User Integration Branch’s contributions to the MHS GENESIS launch are highlighted. As you continue through the newsletter, direct your attention to the “Did You Know?” section where recent TRICARE® Online Patient Portal and Secure Messaging updates are summarized. Immediately following is

this quarter’s “Product Spotlight” featuring two enhancements to the Electronic Institutional Review Board, a web-based application used for submission, management, and regulatory oversight of research protocols, supporting documents and scholarly products.

Please take a moment to review our final article to get an inside

perspective on how standards get updated and deployed in the military health information technology environment and to learn how our MHS Opiate Use Registry provides a consolidated view into opiate prescribing patterns and other medications that increase the risk of adverse events for our patients.

Lastly, a quick shout out to our team members who have been acknowledged by the J6 - Health Information Technology Directorate for their superior service; Congratulations LTJG Fonseca, Maj Raps, and TSgt Stewart! I encourage our staff to continue to push themselves each day to do better than the last, always keeping in mind our mission to support and advance the delivery of health care to our patients.

Message from SDD Division Chief

COL Richard A. Wilson, Division Chief, SDD

Visit SDD News Subscriber page to register for topics of interest.

SDD Portfolio

• The SDD portfolio delivers the functional benefits of information technology to drive health care to health

• Global reach in all military treatment facilities (MTF)

- 63 hospitals, 5,519 beds - 413 medical clinics - 375 dental clinics

Direct Impact to MTF Operations

• 9.4M beneficiaries with clinical data• 95K+ active users, 125K+ end-user

devices• 150K+ new encounters daily• Process nearly 25K requisitions and

$13M+ in medical supplies and pharmaceuticals daily

• Near real-time global medical surveillance• Support patient safety, nutrition services,

blood programs, occupational health, and more

Clinical EHR Solutions

• AHLTA – outpatient EHR • Essentris® – inpatient EHR • CHCS – appointing and ancillary • TOL Patient Portal and Secure Messaging • EHR Sustainment – transition to new,

modernized EHR• HAIMS – artifacts and imagery• EBMS – blood product management

Business & Administrative Solutions

• DMHRSi – medical human resources• DMLSS – medical logistics • ESSENCE – syndromic medical

surveillance• JCCQAS – credentialing• iMEDCONSENT – patient consent• S3 – surgical scheduling• JPSR - patient safety• EIRB – research support• CCE – medical coding assistance

SDDAT-A-glance

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The BEAT | The Newsletter of the Solution Delivery Division - Delivering Solutions, Advancing Health Care

Volume III | Issue 1 | March 2017

Joint Patient Safety Reporting Prevents Patient Harm

Recent Solution Delivery Division award winners are summarized below to recognize their hardwork and dedication to the delivery of health care information technologies to our patients:Joint Patient Safety Reporting

(JPSR), introduced to the Veterans Health Administration (VHA) beginning December 2016, provides a standardized and simple way for a reporter to communicate safety-related incidents and issues, which increases the early detection and prevention of future patient harm, according to Department of Defense (DoD) and VHA officials.

“The goal is to improve the safety of patient care at every military hospital and clinic,” explained Mr. Chris Harrington, Program Manager, Clinical Support Program Management Office, Solution Delivery Division, a component of the Defense Health Agency J6 - Health Information Technology Directorate. “JPSR is a web-based application that integrates the DoD and VHA patient safety reporting organizations to create a joint global application. The joint application will improve the identification and documentation of patient safety related events for our military hospital and clinic staff, Active Duty and Veteran patients and their families.”

The joint patient safety effort was initiated in response to a 2001 Congressional mandate requiring the DoD and VHA to develop processes

for sharing information regarding error tracking as it relates to patient care. The centralized JPSR can be accessed by DoD/VHA staff and is Personal Identity Verification (PIV) card and/or Common Access Card (CAC) enabled. The application provides users the ability to capture patient safety information using an event submission form and the Patient Safety Manager the ability to track and trend data using an automated event management system and enhanced reporting features.

The new joint DoD and VHA capability will increase the frequency and consistency of reporting; improve the quality and granularity of reports; aid in the identification of trends, issues and lessons learned at a National and/or interagency level; and provide a common taxonomy for patient safety events, to study and learn from systems and process errors. The combined efforts of the DoD and VHA will also help to generate cost efficiencies by sharing software licenses and data centers, and reduce costs of system maintenance and help-desk training workload across the organizations. This partnership aligns with the future expansion of data sharing opportunities between DoD and VHA which seeks to identify common issues and solutions to create safer systems, safer care.

FY17 DHA & HIT Service Member of the 1st Quarter Winners

LTJG Paul Heyliger Fonseca, USAF (Company Grade Officer) - DHA & HIT

Maj Stephanie Raps, USAF (Field Grade Officer) - DHA & HIT

TSgt Michael Stewart, USAF (Junior Enlisted Officer) - HIT

OSD’s Award for Excellence

Ms. Sandra Attidore, EHR Core PMO, Project Manager

Best of milSuite Awards

EHR Modernization PMO Best User Group

Program Support Branch Best Team

Best Multiplatform Use Best DoD/Joint PSB

2017 FedHealthIT100 Award Winners

COL Rich Wilson, US Army, SDD, Division Chief

Maj Randall Shiflett, USAF, CBIS PMO, Product Manager

Ms. Brenda Stevens, CBIS PMO, Product Lead

Col David Carnahan, USAF, EIDS PMO, Acting Deputy Program Manager

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The BEAT | The Newsletter of the Solution Delivery Division - Delivering Solutions, Advancing Health Care

The Electronic Institutional Review Board (EIRB) is a web-based application used for submission, management, and regulatory oversight of research protocols, supporting documents and scholarly products.

On Dec. 31, the Institutional Animal Care and Use Committee (IACUC) Assistant module was configured to meet Department of Defense standards. IACUC templates were standardized for Protocol, Continuing Review and Amendments. This module enables researchers to submit animal studies electronically, manage their entire IACUC protocol

and help ensure compliance with regulatory standards for safe, efficient and ethical animal research.

On Jan. 23, the functionality of the Publication Clearance Board (PCB) was configured for the Dwight Eisenhower Army Medical Center. The PCB will provide users with the ability to process Publication Clearance Forms that are both associated and not associated with a human subject’s research protocol.

Sign up for EIRB news and events at https://public.govdelivery.com/accounts/USMHSDHSS/subscriber/new.

The Solution Delivery Division (SDD) User Integration Branch (UIB) focuses on deploying SDD programs that meet the real-world needs of our Military Health System customers. UIB recently supported MHS GENESIS’ successful launch by leading the Defects Review Board. The board, comprised of ten Subject Matter Experts (SMEs), including seven active duty members,

helped developers conduct more than 1,200 system tests covering the entire suite that comprises MHS GENESIS. The tests spanned more than 800 different scenarios determined by the Leidos Partnership for Defense Health and our Tri-Service Workflow Advisory Group SMEs. For example, one SME had testers walk through a hypothetical script for a service member who is injured in theater, tracking health information from point of injury to discharge to the Veterans Health Administration. This type of focused work gives a voice to our customers, ensuring the most effective and efficient delivery of health care to service members and their families.

PRODUCT SPOTLIGHT:

EIRB Releases Two New Versions

PMO / BRANCH SPOTLIGHT: SDD User Integration Branch: ‘The Voice of the Customer’ KNOW?

DIDYOUTOL Patient Portal Updates Are Available New outreach materials have been developed to educate users on TOL Patient Portal (TOLPP) capabilities. Access at:

• TOL Patient Portal, “Resources”: www.tricareonline.com

• TRICARE Publications, Search “TOL”: www.tricare.mil/publications

For assistance with TOLPP, please contact:

• “Contact Us”: www.tricareonline.com

• Toll Free Number: 1-800-600-9332

• OCONUS Telephone Numbers located at “Contact Us”

Our TOLPP Secure Messaging platform, provided by RelayHealth, released a new url and customer support contact information to make access easier for Department of Defense users. Access at:

• TOL Patient Portal Secure Messaging: https://mil.relayhealth.com

• Login to TOL Patient Portal, Click on “Secure Messaging”: www.tricareonline.com

New TOLPP Secure Messaging customer support contact information is available at:

• Toll Free Number: 1-866-309-4138

• Patient: federalsupport@relayhealth.com

• Care Team: t1federalsupport@relayhealth.com

SDD

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The BEAT | The Newsletter of the Solution Delivery Division - Delivering Solutions, Advancing Health Care

Volume III | Issue 1 | March 2017

KNOW?YOU

SDD Releases First MHS Opiate Use Registry On Dec. 16 the Solution Delivery Division (SDD) announced the release of the first Military Health System (MHS) Opiate Use Registry. The registry provides a consolidated view into opiate prescribing patterns along with other medications that increase the risk of adverse events for patients based on requirements developed by subject matter experts from the military, the Department of Veterans Affairs and the University of Texas Health Science Center at San Antonio. The pharmacy community plans to operationalize and guide further development to increase the value of the registry.

“This clinical registry is a shining example of how Information Management/Information Technology can promote the mission of becoming a Learning Health System,” said Col David Carnahan, Deputy Program Manager, Enterprise Intelligence and Data Systems, Program Management Office, SDD.

How do Code Sets get updated and deployed to MHS clinical and adminis-trative systems? What is a Code Set?

Under the Health Insurance Portability and Accountability Act (HIPAA), a “code set” is any set of codes used for encoding data elements, such as tables of terms, medical concepts, medical diagnosis codes, or medical procedure codes. Those transactions may also include MHS-specific code sets, such as DMIS IDs, appointment types or patient category codes. While there are code sets used in multiple aspects of health care, this article will focus on health administrative transactions.

What are some examples of Code Sets?

CHCS, AHLTA, CCE and ABACUS are instances of MHS systems that apply these code sets to MHS data. Code sets include International Classification of Disease v10 (ICD-10), Medical Severity Diagnosis Related Groups (MS-DRGs), Common Procedural Terminology v4 (CPT-4), Healthcare Common Procedure Coding System (HCPCS) and National Drug Codes (NDC) codes. These code sets are used extensively at the MHS and in the case of ICD, MHS appends specific codes to the code sets.

How are code sets updated and distributed throughout the MHS?

Key MHS workflow processes are coor-dinated to share data across multiple systems. The workflow processes are used to mitigate risks and gauge impact of code set release to both the direct care and purchased care systems.

MHS awards system preparation and maintenance contracts for some integral code sets (e.g. ICD-10, CPT/HCPCS, APC and MS-DRG), with release oversight

from the Reference Code and Table Synchronization Work Group; which consists of DHA Decision Support Division, Information Management, key functional and PM system representatives, contract support and SDD CACI. Figure 1 is a sample of a detailed Process Flow illustrating code release to source systems and feeder systems (e.g. CPT/HCPCS from CHCS to AHLTA and EAS-IV).

Figure 2 provides a historical representation of the start date and duration for each stage of the annual ICD-10 update. The Historical ICD-10 Graph; maintained by CACI; allows stakeholders to track the stage of the release cycle and is distributed monthly to the Reference Code and Table synchronization Work Group. Over 20 systems subscribe to the code set and table release updates.

For more information, contact Ms. Nancy Orvis at nancy.j.orvis.civ@mail.mil.

Figure 1: Partial Example of Highly Detailed Code Release Process Flow (click on diagram to enlarge)

Figure 2 Historical Days - Start to 98% Deployment (click on diagram to enlarge)

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The BEAT | The Newsletter of the Solution Delivery Division - Delivering Solutions, Advancing Health Care

Meeting The StandardsPromoting a Bridge to Worldwide Interoperability