OSEHRA Product Management Perspectives

1. OSEHRAProduct Management Perspectives OSEHRA Product Management Work Group 28th VistA Community Meeting Friday, January 17, 2014

2. Presenters • 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.

3. Topics • What is OSEHRA VistA? • How Fileman 22.2 Can Boost the VA Healthcare Enterprise (And Yours) • A Community Implementer’s Perspective on Product Management

4. What is OSEHRA VistA?

5. 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

6. Visualizing 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?

7. End User Audience • 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

8. Developer 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

9. Visualization Demo

10. Fileman 22.2: Improving VistA Quality and Safety

11. Fileman22.2 • 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

12. Fileman22.2 • Data Analysis Tools • Indexing to any key field length • Orphan pointer checks into a given file • Automatic auditing of DD changes • Meta Data Dictionary

13. Fileman22.2 • 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

14. Fileman22.2 • 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

15. Fileman22.2 • Documentation • Navigable online documentation • Convenient section grouping and access • Includes glossary, index, suggestions for best practices

16. Fileman22.2 • Safety • Word processing fields can be audited • Word processing fields can be made uneditable • Changes can be filtered by user

17. Fileman22.2 • 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

18. OSEHRA Impact On End Users: A Community Implementer’s Perspective on Product Management Denise LeFevre Chief Information Officer Oroville Hospital

19. Why Electronic Health Records? • Personal reasons • Health issues • Participation in H.I.E. • Meaningful Use funds

20. Code Convergence 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

21. Enough to Go Around 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

22. Problem Identification and Resolution Gather at the Ice Cream Shoppe Discuss/identify/resolve common but specific issues Vulnerability problem prime example

23. Pull Together • February 2014 • HIMSS 2014, Orlando, Fla. • September 2014 • OSEHRA Summit, Bethesda, Md. • October 2014 • VistA Expo & Symposium, Seattle, Wash.

24. Tracking the RegulatoryTimelines

25. Tracking the Regulatory 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)

26. OSEHRA and Community Roles • 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

27. Questions?

28. Thanks for attending! • Denise LeFevre • mailto:dlefevre@orohosp.com • tel:+1-530-532-8565 • Christopher Edwards • mailto:Christopher.Edwards@krminc.com • tel:+1-304-876-6600 • Mike Henderson • mailto:hendersonm@osehra.org • tel:+1-571-858-3383