Department of Veterans Affairs: Streamlining Mobile Development

1. Department of Veterans Affairs:Streamlining Mobile Development Shawn Hardenbrook, Director, Web and Mobile Solutions, Connected Health Office, Office of Informatics and Analytics, Veterans Health AdministrationBrent Dalton, Program Manager, Connected Health Office, Office of Informatics and Analytics, Veterans Health Administration MAY 15, 2014

2. VA Vital Statistics 8.93 Million VA Health Care System Enrollees*** 6.84 Million VA Supervised & Administered Life Insurance Policies* * 3.66 Million Veterans Receiving VA Disability Compensation* * 3.31 Million VA Maintained Gravesites* ** 1.87 Million Active VA Home Loan Participants* * 950,000 VA Education Beneficiaries* * 300,000 Veterans Receiving VA Pension* * 300,000 Veteran family members receiving care through VA health care programs*** 56 VBA Regional Offices 131 VA National Cemeteries 1,600+ VA Health Care Sites *As of FY 2012 **As of 6/30/13 ***As of FY 2013

3. Hospital System to Health System In 1996, VA began the creation of Veterans Integrated Service Networks (VISNs) to transform VA Health Care from a “Hospital System” to a “Health System.” VHA currently has 21 VISNs. • 151Medical Centers • 985 Outpatient Clinics 820 Community-Based 151 Hospital-Based8 Mobile6 Independent • 300Vet Centers • 70 Mobile Vet Centers • 103 Domiciliary Residential Rehabilitation Programs • 135Community Living Centers Source: FY 2012-2013 End-of-Year Pocket Card

4. FY 2013 End-of-Year Totals Enrollees………………………………………………………………......8.9 Million Unique Patients Treated…………………………………............6.5 Million Outpatient Visits………………………………………................86.4 Million Outpatient Surgeries…………………………………………………..….292,600 Inpatient Admissions…………………………………………….……….694,700 Lab Tests (Inpatient & Outpatient)………………………….…266 Million Prescriptions Dispensed (30-Day Equivalent)……......268.6 Million Prosthetics Services Performed……………………..………..15.9 Million Source: FY 2012-2013 End-of-Year Pocket Card

5. VA’s Health Care Expertise VA is one of the largest civilian employers in the federal government and one of the largest health care employers in the world. 288,000+ Total VHA Employees 88,000+ Veteran Employees 177,000+ Clinical Employees

6. VHA’s Current Priorities • Patient Aligned Care Teams (PACT) • Connected Health Care • Access • Homelessness • Mental Health Care • Standardization

7. 500 million Smartphone users will be using health apps by 2015 7

8. More Cell Phone Devices Than Any Other Computing or Consumer Electronics Device Globally Billions MORE THAN 3 BILLION MORE DEVICES 5.0 1.3 0.7 0.3 Cell Phone Users TV Households Desktop PC Users Mobile PC Users 8

9. Leverages wireless/mobile technologies to improve the health of Veterans • Expands care for Veterans beyond the traditional office visits • Helps Veterans, Caregivers and VA health care team securely coordinate all aspects of care • ProvidesVeterans and their Caregivers with tools to help lead healthier lives 9

10. The Potential of Mobile Health Technology Decision support tools Increased access Self reporting Range of media Tailored information Quality face-to-face visits 10

11. Dr. Robert A. PetzelVA Under Secretary forHealth

12. Origin November 2011 OIT VHA 12

13. VA Mobile Health: Expanding Care for Veterans • Expand Care for Veterans • Governance • Increase Patient Engagement Personalized, Convenient, Coordinated & Accessible 13

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17. Veteran-Facing Apps Summary of Care Mobile Blue Button VA Launchpad 17

18. New Patient-Facing Mobile Apps • Texting for Health • Patient Health Inventory • Caring for Women Veterans • Preconception/Prenatal • Maternity Tracking • Veteran Health Competition • Biosurveillance Reporting • Subscription Service for Biometric Monitoring 18

19. VA’s Mobile Health Pilots June 2013 April 2013 January 2012 19

20. Family Caregiver Pilot Apps Suite of 11 apps pre-loaded on iPads and distributed to 1,120 Family Caregivers and their post 9/11 seriously injured Veterans 20

22. VA Launchpad VA Launchpad

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24. Summary of Care

25. Secure Messaging App

26. Rx Refill App Rx Refill App

27. Journal App

28. Mobile Blue Button

29. Mobile Blue Button

30. Mobile Blue Button 30

31. Apps for Everyone! 31

32. Mobile Application Environment (MAE) 32

33. Who is Building Mobile Apps? 33

34. Agile Development MethodologyStrengths and Weaknesses 34

35. Mobile Development MS0 MS2 MS1 ORR/IOC Entry PLANNING CONCEPT DEFINITION Multiple Apps O&M Multiple Apps DEVELOPMENT IMPLEMENTATION IOC Exit 7.8 SQA 7.13 VA Branding 7.9 Enterprise Security 7.10 Data Security 7.11Privacy 7.12 Independent V&V MAGB 9 Release 8 Field Testing 7 Agile Development 1 Request New App 2 Approve Request 5 Assign/ Contract Agile Team 6 Concept Paper Scope 4 Fund Effort 3 BusinessRequirements Document (BRD) 10 Product Support WMS PM VA OI&T PM 7.4 508 7.3 Data & Terminology 7.5 Clinical Assessment 7.2 Enterprise Architecture 7.7 OAP/ Sustainment Plan 7.6 Patient Safety 7.1 Human Factors 35

36. Mobile Development MS0 MS2 MS1 ORR/IOC Entry PLANNING CONCEPT DEFINITION Multiple Apps O&M Multiple Apps DEVELOPMENT IMPLEMENTATION IOC Exit 7.8 SQA 7.13 VA Branding 7.9 Enterprise Security 7.10 Data Security 7.11Privacy 7.12 Independent V&V MAGB 9 Release 8 Field Testing 7 Agile Development 1 Request New App 2 Approve Request 5 Assign/ Contract Agile Team 6 Concept Paper Scope 4 Fund Effort 3 BusinessRequirements Document (BRD) 10 Product Support Prepare Request Approve WMS PM VA OI&T PM 7.4 508 7.3 Data & Terminology 7.5 Clinical Assessment 7.2 Enterprise Architecture 7.7 OAP/ Sustainment Plan 7.6 Patient Safety 7.1 Human Factors App Intake and Request Process

37. App Intake Process 1 Register with VA by completing the forms that are specific to your request 37

38. App Intake Process Forms • Have VA build an app • Certify an app you are building to carry the VA brand • Start building a VA-branded app for which you have funds and resources • Request a VA mobile app development environment (Tools setup) • Request server resources for your VA mobile app development project • Request a user account to participate in an existing VA mobile app development project 38

39. App Intake Process 2 • You will be contacted by Web and Mobile solutions to prepare request for Mobile Apps Governance Board (MAGB) • MAGB is responsible for reviewing and approving request 39

40. IMPORTANT!!! App Intake Process !!! • In order to obtain approval by the Governance Board the request must answer 3 questions: •   Meets the VA Mission • Has a Business Sponsor • Business Sponsor Commitment to Sustain 40

41. App Intake Process 3 • Once MAGB approves your request, if applicable a JIRA project will be created 41

42. VA requirements documentation • Very detailed • Created by New Service Request (NSR) or agile development team • Basic documentation • Less detail and greater focus on “user stories” • Created by agile development team Business Requirements Document (BRD) 42

43. Mobile Development Agile Methodology Sprint meeting every 1-3 weeks Review work completed and planned Business Owner attendance 43

44. Mobile App Compliance Certifying Bodies

45. VA Branding Key Certifying Body 45

46. Mobile Project Management Accountability System (PMAS) MHEDBase PMAS DocsCovers All Mobile Apps & Created Once • 32 Individual PMAS Documents 12 PMAS DocsCovers each App 46

47. PMAS Documents • Business Requirements Document • Concept Paper/Scope Statement • Requirements Specification Plan • Requirements Specification Addendum • Software Design Document 47

48. Mobile Development Tools 48

49. OI&T MHED Release Process 49

50. Step 1: Validation and Verification (V&V) Step 2: Final Compliance Review Step 3: Review of Operation Readiness Report (ORR) and Initial operating Capability