VHA INFORMATICS PROJECTS: TERMINOLOGY STANDARDS SUPPORT
Terminology Standards Support IDIQ
J P Systems secured 41 task orders under our first $100M single award IDIQ from the Veterans Administration. These task orders directly support CIDMO’s Knowledge Based Systems (KBS) group and the VHIE program office. Our team guides VA software teams in implementing Health Informatics practices and terminology standards. We also establish a common framework that enables functional and semantic interoperability of reusable health information. Our work covers nursing informatics, Clinical Decision Support, and Patient Safety systems. The following project summaries outline the major work streams we lead.
VHIE Support
VHIE Transition:
Team JPSys leads the transition of VHIE from its legacy adapter to the Veterans Data Integration and Federal Enterprise Platform (VDIF-EP). We also manage the migration to the DoD/VA Joint Health Information Exchange (JHIE) platform. For JHIE, we monitor network traffic and identify bottlenecks that hinder data exchange.
Our team analyzes response times and flags performance issues that violate contract standards. We directly support the Veterans Health Information Exchange Program Office and its Community Care provider partners. VHA external providers actively exchange Veteran health data through a secure, standards-based approach.
We design rapid stakeholder engagement strategies to onboard hospitals and clinics into the JHIE network. Our team applies deep expertise in Health Informatics, HL7 FHIR, and the Direct Secure Email program. These capabilities consistently deliver measurable value to our government clients and their provider partners.
Veteran's Health Information Exchange Network System Performance and Traffic Analysis
System Performance:
J P Systems supports the VHIE office, the Joint DoD Health Information Exchange, and VA Community Care healthcare providers. VHA’s external healthcare partners actively exchange Veteran health data with VHA, DHA, and Cerner platforms. Our team analyzes Cerner data to evaluate query performance and measure patient data transmission speed and accuracy.
J P Systems identifies data exchange bottlenecks and delays, and we perform root cause analysis to boost system efficiency. Then we recommend targeted improvements to ensure response times comply with contractual requirements. Next we engage internal and external partners to quickly resolve data exchange issues. Finally we conduct User Acceptance Testing and verify the accuracy of reported transaction response times.
VHIE Data Quality Improvement
Data Quality:
Leading a five-year VHA VHIE effort to improve clinical data quality for interoperability and Clinical Decision Support. We conduct strategic planning, UAT, C-CDA requirements analysis, and data quality improvement for the Joint DoD–VA Health Information Exchange. Our team examines incoming and outgoing JHIE data for accuracy in delivery and interpretation. We ensure VHA, Cerner Millennium, DoD, and community partners exchange data correctly and consistently.
KBS Clinical Terminology Services
Clinical Terminology Standards:
We provide terminology services for Knowledge Based Systems, including matching, standardization, and JLV and CHDR terminology mapping. Our team maps various clinical domains in support of VHA. We support data harmonization, terminology planning, and modeling to enable accurate and computable clinical data exchange. Clinical experts match medication and allergy data to international standards like RxNORM, SNOMED-CT, and UMLS. J P Systems supplies subject matter experts who complete required mappings for Clinical Decision Support and interoperability.
Our J P Systems Clinical Terminology support team specializes in Clinical Terminology, data standardization, clinical data quality improvement, and enterprise architecture work needed to keep the many VHA electronic patient records systems and Joint VA and DoD Health Information Exchange (JHIE) systems functioning properly. We produce the drug terminology called MED-RT which is distributed all over the country and hosted at NIH.
We maintain the VA Extension to SNOMED CT, modeling new concepts using TermSpace and submitting them to SNOMED International for the international edition;. We also maintain mappings of terms between VA legacy systems and international terminology standards, between VA and DoD, and between legacy systems and the new Federal EHR. We performed this mapping and curation using various COTS Terminology packages including Health Language, DTS and TDE, and currently Clinical Architecture’s Symedical, as well as our own Protégé models (for VA to FHIR mappings). Some standalone terminologies used to keep the VA databases updated include: LOINC, MED-RT, ICD-10-CM, ICD-10, ICD-9-CM, SNOMED CT, RxNorm, UMLS.
Medication Reference Terminology MED-RT
Standardization of Drug Reference Files:
MED-RT, a Medication Reference Terminology, replaces NDF-RT and uses modern tools and international standards for classifications. J P Systems regularly updates MED-RT and builds new releases for the VHA. Many healthcare providers use this standardized terminology within their vocabularies. We created Hierarchical Established Pharmacological Classes (EPCs) in MED-RT in collaboration with VA and FDA. Our team identified EPCs needing reclassification and moved them under newly created hierarchical EPC 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. Additionally, 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.
Furthermore, 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. Also, 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. Specifically, 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 (HRO) 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. Additionally, we support 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.
Additionally, 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
J P Systems secured 41 task orders under our first $100M single award IDIQ from the Veterans Administration. These task orders directly support CIDMO’s Knowledge Based Systems (KBS) group and the VHIE program office. Our team guides VA software teams in implementing Health Informatics practices and terminology standards. We also establish a common framework that enables functional and semantic interoperability of reusable health information. Our work covers nursing informatics, Clinical Decision Support, and Patient Safety systems. The following project summaries outline the major work streams we lead.
VHIE Transition:
Team JPSys leads the transition of VHIE from its legacy adapter to the Veterans Data Integration and Federal Enterprise Platform (VDIF-EP). We also manage the migration to the DoD/VA Joint Health Information Exchange (JHIE) platform. For JHIE, we monitor network traffic and identify bottlenecks that hinder data exchange.
Our team analyzes response times and flags performance issues that violate contract standards. We directly support the Veterans Health Information Exchange Program Office and its Community Care provider partners. VHA external providers actively exchange Veteran health data through a secure, standards-based approach.
We design rapid stakeholder engagement strategies to onboard hospitals and clinics into the JHIE network. Our team applies deep expertise in Health Informatics, HL7 FHIR, and the Direct Secure Email program. These capabilities consistently deliver measurable value to our government clients and their provider partners.
System Performance:
J P Systems supports the VHIE office, the Joint DoD Health Information Exchange, and VA Community Care healthcare providers. VHA’s external healthcare partners actively exchange Veteran health data with VHA, DHA, and Cerner platforms. Our team analyzes Cerner data to evaluate query performance and measure patient data transmission speed and accuracy.
J P Systems identifies data exchange bottlenecks and delays, and we perform root cause analysis to boost system efficiency. Then we recommend targeted improvements to ensure response times comply with contractual requirements. Next we engage internal and external partners to quickly resolve data exchange issues. Finally we conduct User Acceptance Testing and verify the accuracy of reported transaction response times.
Data Quality:
Leading a five-year VHA VHIE effort to improve clinical data quality for interoperability and Clinical Decision Support. We conduct strategic planning, UAT, C-CDA requirements analysis, and data quality improvement for the Joint DoD–VA Health Information Exchange. Our team examines incoming and outgoing JHIE data for accuracy in delivery and interpretation. We ensure VHA, Cerner Millennium, DoD, and community partners exchange data correctly and consistently.
Clinical Terminology Standards:
We provide terminology services for Knowledge Based Systems, including matching, standardization, and JLV and CHDR terminology mapping. Our team maps various clinical domains in support of VHA. We support data harmonization, terminology planning, and modeling to enable accurate and computable clinical data exchange. Clinical experts match medication and allergy data to international standards like RxNORM, SNOMED-CT, and UMLS. J P Systems supplies subject matter experts who complete required mappings for Clinical Decision Support and interoperability.
Standardization of Drug Reference Files:
MED-RT, a Medication Reference Terminology, replaces NDF-RT and uses modern tools and international standards for classifications. J P Systems regularly updates MED-RT and builds new releases for the VHA. Many healthcare providers use this standardized terminology within their vocabularies. We created Hierarchical Established Pharmacological Classes (EPCs) in MED-RT in collaboration with VA and FDA. Our team identified EPCs needing reclassification and moved them under newly created hierarchical EPC 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. Additionally, 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.
Furthermore, 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. Also, 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. Specifically, 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 (HRO) 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. Additionally, we support 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.
Additionally, 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.