VHA INFORMATICS PROJECTS: TERMINOLOGY STANDARDS SUPPORT

 41 task orders were awarded on our 5-year $100M IDIQ for the Veteran’s Health Administration, specifically CIDMO's Knowledge Based Systems (KBS) group. These technical projects provide guidance to VA software project teams in Health Informatics and the use of terminology standards. 

We assist in establishing a common framework for the functional and semantic interoperability of intelligent, reusable health information for nursing informatics, Clinical Decision Support, and Patient Safety Systems.  The major work streams are described in these project summaries.

VHIE Transition: Team JPSys led the effort to transition VHIE from its legacy health information exchange adapter to the Veterans Data Integration and Federal Enterprise Platform (VDIF-EP) and the DoD/VA Joint Health Information Exchange (JHIE).

Services include support of efforts for the Joint  Information Network (JHIE) Health Informatics,  Healthcare IT Data Architecture,  HL7 FHIR standards implementation, vaccination reporting,  Direct Secure Email program.

We support the Veteran's Health Information Exchange office and their Community Care healthcare  providers. The VHA external provider partners send and receive Veteran health information from the VHA using a standards-based approach.

System Performance: We support the Veteran's Health Information Exchange office and their Community Care healthcare providers. The VHA external provider partners send and receive Veteran health information from the VHA, partners and Cerner.

Using data provided by Cerner, we examine the performance of the various types of data streams being sent, the accuracy of the transmission times, and identify bottlenecks,. We analyze data exchange problems, delays and perform a root cause analysis. Then we engage with external and internal data exchange partners to help rectify them. We perform User Acceptance Testing and verify the accuracy of the reporting of response times for transactions.

Data Quality:  A five year effort for the VHA VHIE office for Clinical Data Quality Improvement for interoperability  (Data Exchange) and Clinical Decision Support.  We perform strategic planning, UAT work,  C-CDA requirements analysis,  and clinical data quality analysis and improvement services for the Joint DoD - VA Health Information Exchange (JHIE) .  We examine incoming and outgoing data in JHIE to determine if data is being  delivered and interpreted accurately between the VHA,  Cerner Millennium, DoD, and community provider partners.

Clinical Terminology Standards: Terminology Services for Knowledge Based Systems includes terminology matching, code standardization,  JLV matching,  Clinical Health Data Repository (CHDR) Medication and Allergy mapping between the VHA and DoD, data harmonization efforts,  terminology planning,  and terminology modeling.  CHDR is a VA/DoD mechanism to share prescribed medications in a fashion sufficient to permit computation of drug-drug interactions in the receiving pharmacy systems.   CHDR requires clinical experts to match each agency’s medications and allergies maps (Allergy Reactants; Allergy Reactions; and Medications) to federally-approved standards (RxNORM, SNOMED-CT and UMLS) to enable cross-departmental Clinical Decision support (CDS). JPSys provides subject-matter experts to accomplish the required matchings to specified standards.

Standardization of Drugs Reference Files  MED-RT is a Medication Reference Terminology. As the successor to the NDF-RT, MED-RT leverages new Informatics and terminology tools and internationally standardized terminologies to assert pharmacological classifications and relationships. JPSYS periodically updates MED-RT and builds the new releases for the VHA.  This standardized reference terminology is used by many providers as part of their vocabularies.   We created and placed Hierarchical Established Pharmacological Classes (EPCs) in MED-RT, working alongside VA and FDA.  We identified EPCs that fell under newly created hierarchical EPCs and moved them to newly added concepts.

JPSys analyzed the VHA data acquisition process from Cerner and made recommendations on the use of existing tools (CDW, VistA, Rocky’s) to improve the transfer of data into a data ecosystem managed by VHA. The team wrote a substantial white paper on Data Management and Data Governance which explained how the principles and framework of data governance are essential to developing a data management approach. We analyzed the architecture of the legacy VA data governance framework, and gave guidance and recommendations that presented a more scalable solution as an enterprise asset that is accurate, usable and functional. Practical use cases and examples of applying the framework in a real-world setting were researched and provided. We made recommendations specifically applicable to VA by analyzing the landscape and interviewing top-level VA Subject Matter Experts to gain firsthand knowledge of current issues. The JPSys experts weighed the input received and delivered a solution on how to achieve operational access to the data.

Data Quality:  A five year effort for the VHA VHIE office for Clinical Data Quality Improvement for interoperability  (Data Exchange) and Clinical Decision Support.  We perform strategic planning, UAT work,  C-CDA requirements analysis,  and clinical data quality analysis and improvement services for the Joint DoD - VA Health Information Exchange (JHIE) .  We examine incoming and outgoing data in JHIE to determine if data is being  delivered and interpreted accurately between the VHA,  Cerner Millennium, DoD, and community provider partners.

High Reliability Organization Consulting JPSys assessed implementation effectiveness and provided project management and consultation support across 18 pilot VAMCs and advised VHA leaders on strategy for HRO implementation. We supported system-wide cultural transformation, delivered leadership training to 194 VISN and VAMC leaders and generated system wide leadership practices to empower and support front line teams. Trainings focused on leadership engagement, implementing a 'just culture' and development of frontline teams, to include field clinicians and informaticists working on standardization of VHA health factors and clinical reminders. We completed leadership training during the COVID-19 response, enabling the VHA to move forward with their implementation plan that was developed prior to the pandemic. JPSys advised on the Site-Specific Assessments and Planning portion of the HRO implementation, which is currently being piloted in three VISNs with the intention of being distributed across the enterprise. We developed outreach strategies and advised on the HRO communication strategy and campaigns that were tailored to the implementation during the transition to a virtual environment during the onslaught of COVID-19.

VHA INFORMATICS PROJECTS: TERMINOLOGY STANDARDS SUPPORT

 41 task orders were awarded on our 5-year $100M IDIQ for the Veteran’s Health Administration, specifically CIDMO's Knowledge Based Systems (KBS) group. These technical projects provide guidance to VA software project teams in Health Informatics and the use of terminology standards. 

We assist in establishing a common framework for the functional and semantic interoperability of intelligent, reusable health information for nursing informatics, Clinical Decision Support, and Patient Safety Systems.  The major work streams are described in these project summaries.

VHIE Transition: Team JPSys led the effort to transition VHIE from its legacy health information exchange adapter to the Veterans Data Integration and Federal Enterprise Platform (VDIF-EP) and the DoD/VA Joint Health Information Exchange (JHIE).

Services include support of efforts for the Joint  Information Network (JHIE) Health Informatics,  Healthcare IT Data Architecture,  HL7 FHIR standards implementation, vaccination reporting,  Direct Secure Email program.

We support the Veteran's Health Information Exchange office and their Community Care healthcare  providers. The VHA external provider partners send and receive Veteran health information from the VHA using a standards-based approach.

 41 task orders were awarded on our 5-year $100M IDIQ for the Veteran’s Health Administration, specifically CIDMO's Knowledge Based Systems (KBS) group. These technical projects provide guidance to VA software project teams in Health Informatics and the use of terminology standards. 

We assist in establishing a common framework for the functional and semantic interoperability of intelligent, reusable health information for nursing informatics, Clinical Decision Support, and Patient Safety Systems.  The major work streams are described in these project summaries.

Data Quality:  A five year effort for the VHA VHIE office for Clinical Data Quality Improvement for interoperability  (Data Exchange) and Clinical Decision Support.  We perform strategic planning, UAT work,  C-CDA requirements analysis,  and clinical data quality analysis and improvement services for the Joint DoD - VA Health Information Exchange (JHIE) .  We examine incoming and outgoing data in JHIE to determine if data is being  delivered and interpreted accurately between the VHA,  Cerner Millennium, DoD, and community provider partners.

Clinical Terminology Standards: Terminology Services for Knowledge Based Systems includes terminology matching, code standardization,  JLV matching,  Clinical Health Data Repository (CHDR) Medication and Allergy mapping between the VHA and DoD, data harmonization efforts,  terminology planning,  and terminology modeling.  CHDR is a VA/DoD mechanism to share prescribed medications in a fashion sufficient to permit computation of drug-drug interactions in the receiving pharmacy systems.   CHDR requires clinical experts to match each agency’s medications and allergies maps (Allergy Reactants; Allergy Reactions; and Medications) to federally-approved standards (RxNORM, SNOMED-CT and UMLS) to enable cross-departmental Clinical Decision support (CDS). JPSys provides subject-matter experts to accomplish the required matchings to specified standards.

Standardization of Drugs Reference Files  MED-RT is a Medication Reference Terminology. As the successor to the NDF-RT, MED-RT leverages new Informatics and terminology tools and internationally standardized terminologies to assert pharmacological classifications and relationships. JPSYS periodically updates MED-RT and builds the new releases for the VHA.  This standardized reference terminology is used by many providers as part of their vocabularies.   We created and placed Hierarchical Established Pharmacological Classes (EPCs) in MED-RT, working alongside VA and FDA.  We identified EPCs that fell under newly created hierarchical EPCs and moved them to newly added concepts.

JPSys analyzed the VHA data acquisition process from Cerner and made recommendations on the use of existing tools (CDW, VistA, Rocky’s) to improve the transfer of data into a data ecosystem managed by VHA. The team wrote a substantial white paper on Data Management and Data Governance which explained how the principles and framework of data governance are essential to developing a data management approach. We analyzed the architecture of the legacy VA data governance framework, and gave guidance and recommendations that presented a more scalable solution as an enterprise asset that is accurate, usable and functional. Practical use cases and examples of applying the framework in a real-world setting were researched and provided. We made recommendations specifically applicable to VA by analyzing the landscape and interviewing top-level VA Subject Matter Experts to gain firsthand knowledge of current issues. The JPSys experts weighed the input received and delivered a solution on how to achieve operational access to the data.

Data Quality:  A five year effort for the VHA VHIE office for Clinical Data Quality Improvement for interoperability  (Data Exchange) and Clinical Decision Support.  We perform strategic planning, UAT work,  C-CDA requirements analysis,  and clinical data quality analysis and improvement services for the Joint DoD - VA Health Information Exchange (JHIE) .  We examine incoming and outgoing data in JHIE to determine if data is being  delivered and interpreted accurately between the VHA,  Cerner Millennium, DoD, and community provider partners.

High Reliability Organization Consulting JPSys assessed implementation effectiveness and provided project management and consultation support across 18 pilot VAMCs and advised VHA leaders on strategy for HRO implementation. We supported system-wide cultural transformation, delivered leadership training to 194 VISN and VAMC leaders and generated system wide leadership practices to empower and support front line teams. Trainings focused on leadership engagement, implementing a 'just culture' and development of frontline teams, to include field clinicians and informaticists working on standardization of VHA health factors and clinical reminders. We completed leadership training during the COVID-19 response, enabling the VHA to move forward with their implementation plan that was developed prior to the pandemic. JPSys advised on the Site-Specific Assessments and Planning portion of the HRO implementation, which is currently being piloted in three VISNs with the intention of being distributed across the enterprise. We developed outreach strategies and advised on the HRO communication strategy and campaigns that were tailored to the implementation during the transition to a virtual environment during the onslaught of COVID-19.