HT0012-RFI-_0008_-_Medical_Electronic_DoD_Integrated_Core_System_(MEDICS)_-_Attachment_1_(Anticipated_EHRS_Objectives).pdf

REQUEST FOR INFORMATION

Title: Medical Electronic DoD Integrated Core System (MEDICS)

RFI #: HT0012-RFI-0008

Attachment (1) – Anticipated Electronic Health Record System (EHRS) Objectives

The following paragraphs provide a list of anticipated objectives to be met by the DoD EHRS.

1. General Objectives

The general objectives include the following:

1) Replace the current DoD systems with an EHRS that is at least a Generation 3 EHRS, or later generation, as defined in Gartner's “Criteria for the Enterprise CPR”, Published: 29

June 2007

2) Provide better performance than existing DoD EHRs

3) Provide longitudinal medical record for each beneficiary that is globally available across all time zones (24/7/365) and full range of military operations

4) Improve electronic exchange of medical and patient data between the DoD and their external partners

2. Clinical Objectives

The clinical objectives include the following:

1) Provide ability to view legacy and external data

2) Provide a configurable user interface to enable tailoring of the clinician workflow

3) Provide patient facing view of record, supporting data entry and secure messaging

4) Provide team management tools to improve efficiency and collaboration

5) Provide the clinician workforce with innovative and advanced tools, i.e., clinical decision support, highly integrated orders services, and cognitive analytic capabilities

6) Provide capability to implement automated clinical practice guidelines (condition based reminders and suggested formatting behaviors) that can be configured to Military Health

System (MHS) standards and adapt to changing healthcare environments

7) Provide clinician and commander workforce with the ability to control access to segmented, privileged, very important person (VIP) and sensitive / masked data

8) Provide a capability that operates with autonomous, self-contained medical devices

9) Provide standards-based data export to an auxiliary data warehouse / analytics-like capability to enable data mining for identification of trends and support for medical research

10) Provide patient safety through delivery of current, complete, and appropriate patient information and evidence-based decision support to providers to make quality decisions

11) Improve patient safety through use of analysis and monitoring of data for early detection, identification, and investigation of hazards

12) Provide a reporting functionality for visibility and transparency of safety events throughout the system for improved patient outcomes

13) Provide / identify ancillary care processes that contribute to patient safety

14) Provide historical patient safety information to consumers / patients to build trust through a transparent system

15) Provide the capture of structured and unstructured data in a way that enables easy customization, consistent with usability standards, of ad hoc reports and generation of template reports

16) Support Patient Centered Medical Home

3. Business Objectives

The business objectives include the following:

1) Support 70,000 total clinicians and a maximum of 20,000 concurrent clinicians

2) Dramatically reduce overall costs incurred by the DoD healthcare environment

3) Provide an upgrade strategy with minimal cost and disruption to user community

4) Provide capabilities for aggregate analysis to include export of standard data elements for use by peripheral business systems

5) Provide predictable costs and performance measures such that the DoD can analyze the cost of treatment to evaluate existing and future costs of operations

4. Program Management Objectives

The program management objectives include the following:

1) Ensure the program has a well-defined risk management approach

2) Plan and execute a user acceptance and adoption strategy that mitigates identified adoption risks and is responsive to the changing needs of DoD’s clinician workforce

3) Provide a transition strategy that minimizes disruption to operations

4) Provide and eventually move all inter-related components of the EHRS to the appropriate

DoD sustainment activity

5) Provide a program approach that utilizes the Agile Scrum methodology to include product configuration, development, integration, and clinical, technical, and management engagements

5. Technical Objectives

The technical objectives include the following:

1) Configure the EHRS to interface with medical devices and respective data

2) Deploy an EHRS that has the ability to exchange data in non-proprietary formats, using federally approved health data exchange standards

3) Deploy an EHRS that uses an open and standards-based information / data model

4) Deploy an EHRS that has standardized and open Application Program Interfaces (APIs)

5) Deploy an EHRS whose underlying and supporting technologies are designed to support extensibility, and supports interoperability with separately developed capabilities

6) Deploy an EHRS that supports a federated data architecture and includes federation with

VA data sources and other external data sources

7) Deploy an EHRS that maintains, and supports enhancements to, ongoing data exchange between DoD and VA, and all external partners

8) Deploy an EHRS which is end-user platform independent, and supports use by credentialed users (clinicians and patients) independent of location and device (e.g., mobile devices)

9) Deploy an EHRS that maintains patient context across all user-facing components

10) Deploy an EHRS that enables 100% compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and with the Privacy Act of 1974 as amended

11) Deploy an EHRS that securely controls data at rest and during transmission

12) Deploy an EHRS with attribute-based access controls and an authorization mechanism to differentially protect data (e.g., by type or level of sensitivity)

13) Deploy an EHRS with the ability to customize and manage workflow and associated business rules

14) Deploy an EHRS that utilizes a Government-operated Identity Management service

15) Deploy an EHRS with a Single Sign-On approach using a DoD Common Access Card

(CAC)

16) Deploy an EHRS that meets DoD Information Assurance requirements to include obtaining Authorization to Operate (ATO) and Authority to Connect (ATC)

17) Deploy an EHRS that allows continued operations with no data loss when disconnected from the network or in low or no bandwidth environments and allows for efficient disaster recovery

18) Deploy an EHRS that utilizes industry best practice for configuration management, system updates, and deployment change management on an enterprise scale

19) Deploy an EHRS designed to operate in a multi-network environment (e.g., .mil, .gov)

20) Deploy an EHRS that supports data exchange with systems to be identified (e.g., Defense

Medical Logistics Standard Support (DMLSS), Blood Donor Management System

(BDMS), Healthcare Artifact and Image Management Solution (HAIMS), Coding and

Compliance Editor (CCE), and Theatre Medical Data Store (TMDS))

21) Deploy an EHRS using a regional data center approach to deliver capability to medical facilities and end users

22) Deploy an EHRS using a scalable, regional hub construct and infrastructure that allow the

EHRS to meet non-functional performance requirements (e.g., user experience, system availability, disaster recovery, data read / write response time, etc.)

23) Employ a repeatable, scalable change management and training approach to deliver technical and functional end-user training while continuously optimizing user experience

24) Deploy an instance of the system (including all integration efforts) as a “Training

Environment” that supports users in pre-deployment training, future new, and refresher training enabling end-users to practice in a non-production environment

25) Deploy an EHRS that includes a support and sustainment strategy to address maintenance and updates for the system

26) Ensure that the proposed regional hub design for EHRS is consistent with the Medical

Community of Interest (Med-COI) strategy

27) Deploy an EHRS that supports remote system performance monitoring and modern techniques for preemptive failure prediction and adjudication