Charles De Sanno February 21, 2013

1. Charles De Sanno February 21, 2013

2. “Canvas Orchestration” • Need to bring together all the projects that we have in flight – Orchestration is everything! • Mobility • Virtualization • Open Source • iEHR - IPO • Major Initiatives • Data Center Consolidation • Cloud Computing • Legacy VistA • IT Infrastructure • Technology Innovation Program Office

4. IT Infrastructure Cloud Computing Visualization Major Initiatives Data Center Consolidation Legacy VistA iEHR - IPO Open Source Technology Innovation Program Office Mobility

5. IT Infrastructure Cloud Computing Visualization Major Initiatives Data Center Consolidation Legacy VistA iEHR - IPO Open Source Technology Innovation Program Office Mobility

7. Mobility • Integrate mobile strategy into all initiatives • Increased usage of mobile technologies to access enterprise applications and data • Align VA strategies with Federal CIO “Digital Strategy” released at the end of May • High level goals • Advance VA healthcare by developing solutions that use the latest technology. VA may have up to 100,000 mobile endpoints across the Department within two years, helping to support the delivery of evidence-based medicine • Provision a mobile version of VistA with complete encryption, which may enable VA staff to securely upload and view medical records from tablets and other mobile platform • Pursue a technical and policy solution for BYOD

8. Virtualization • Increased use of Virtualization on both servers and clients • Currently approaching FY 12 target of 50% server virtualization • “Virtualization First” Policy • Virtual Desktop Infrastructure • Provide flexible access to applications and data • Deliver resources (applications and data) to users instead of devices • Helps facilitate increased use of mobile technologies

9. Open Source VistA SDE ESE is actively participating and enabling the Open Source Electronic Health Record Agent (OSEHRA) project through project planning, environment, and testing support for a October 11, 2012 field deliverable. The mission of OSEHRA is to facilitate, through the use of the best practices in open source software development, the improvement and maintenance of Electronic Health Record (EHR) information systems. The goal of SDE ESE efforts is to ultimately make VistA available to the public domain promoting free distribution and access of product source code and design hence enabling cross-organizational and 3rd party development. As part of that goal a portion of the VistA baseline is targeted to become part of the OSEHRA Gold Disk in October 2012 then fielded. It is expected that in the future full infrastructure components in support of both production and non-production environments will be necessary. Additionally contract services for non-production engineering, and testing will be desirable in support of the initiative.

10. iEHR - Integrated Electronic Health Record • In March 2011, the Secretary of Veterans Affairs and the Secretary of Defense agreed to build an integrated electronic health record serving both the Department of Veterans Affairs and the Department of Defense. • The common medical applications were identified and the initial operating capability of Lab and Immunizations is scheduled for implementation in San Antonio, TX and Hampton Roads, VA in 2014. • In February 2013, the Secretary of Veterans Affairs and the Secretary of Defense changed the scope of the iEHR to focus more in interoperability with the current systems. • The key milestones in scope for the change in direction are: • Both departments will select core iEHR capabilities. VA will continue to use VISTA. DoD is in the process of an RFI to select their core. • Patients in both departments will be able to download their medical records utilizing the Blue Button initiative. • The departments will have a common authoritative source for health data • The Janus Joint Legacy Viewer will be deployed to 8 more sites in VA and DoD to include 5 VA polytrauma sites, Elmendorf Alaska, Walter Reed and San Diego Naval. • Health care data will be standardized and the graphical user interface will be upgraded, enabling the real-time exchange of data between the two departments.

11. Major Initiatives • The Secretary has identified a number of “Major Initiatives” that the organization has focused on. • MI00. Integrated Electronic Health Record (iEHR) • MI01. Eliminate Veteran Homelessness (EVH) • MI02. Veterans Benefits Management System (VBMS) • MI03. Automate GI Bill Benefits • MI04. Implement Virtual Lifetime Electronic Records (VLER) • MI05. Improve Veteran Mental Health (IVMH) • MI06. Build Veterans Relationship Management (VRM) • MI07. New Models of Care (NMOC) • MI08. Enhance the Veterans Experience and Access to Healthcare (EVEAH) • MI09. Ensure Preparedness • MI10. Develop Systems to Drive Performance and Outcomes (STDP) • MI11. Integrated Operating Model (IOM) • MI12. Human Capital Improvement Plan (HCIP) • MI13. Perform Research & Development (R&D) • MI14. Strategic Capital Investment Planning (SCIP) • MI15. Healthcare Efficiency (HCE) • MI16. Health Informatics (HI)

12. Data Center Consolidation • Original plan was the migration of Region 2 & Region 3 VistA & related systems into commercial leased data centers • In consideration of iEHR. Discussion begun with Defense Information Systems Agency (DISA) on hosting in Defense Enterprise Computing Centers (DECCs) • Initial proposal for COLO provided attractive pricing • Enhanced services quote including Defense Information Security Network (DISN) transport due June 10 • Discussion of remaining NDCP orders and re-use of purchased hardware awaits DISA proposal • If DISA agreement is reached all VA healthcare applications would be considered for consolidation to DECCs

13. Cloud Computing

14. Cloud Computing • Federal CIO 25 Point Plan & Cloud First Strategy • Existing VA Cloud Implementations • Chapter 33, VBMS, VRM, AIDE • All using IaaS • Cloud Implementations under evaluation • Email • Archival • MDM • Collaboration – document/calendar sharing • Plans for expansion of internal IaaS and PaaS offerings

15. Legacy VistA • Migration to Linux • Many VA facilities have received Linux servers for their VistA system. • Installation of Linux servers across Region 2 and Region 3 as front ends allowed for spare equipment to be relocated. • Linux operating system is Version 5 for commodity front end application servers at local facilities. • Red Hat Linux Version 6 to be released with full Linux platform environment in Region 2 and Region 3 data centers. • Full Linux platform migrations are planned for St. Louis and Warner Robbins data centers. • First full Linux platform will be migrated to St. Louis by end of September 2012

16. IT Infrastructure Lifecycle refresh of critical infrastructure components Increased use of Open Standards Wireless installations SATCOM WAN Acceleration AV/Malware/HIPS Full Disk Encryption

17. Technology Innovation Program Office • Strategic planning and engineering of new infrastructure technologies to mitigate the risk of technology stagnation • Continually drive innovation by identifying alternative approaches and products • Monitor market trends, collect internal requirements, determine enterprise product set and develop technology road map • Plan integration of alternative technologies to advance competition in VA’s IT environment • Potential acquisitions: • Enterprise Software Asset Management • Engineering resources for analysis of alternative technologies/products • Server Hosted Virtual Desktop Pilot

18. Vision for 2013/2014 Expansion of secure mobile access to VA applications and data Increased usage of Virtualization Increased usage of Cloud Computing Move toward delivery of applications to users rather than devices Continued move towards open standards/open source products and technologies

19. Other Proposed FY 13 Projects Wireless Installations Dev/Test Center Expansion Strong Authentication/2FA OSD Driver Management Enterprise PKI Certificate Solution Enterprise SharePoint Implementation

20. Questions or Comments? Charles.DeSanno@va.gov