VA118-17-R-2324-012.docx

VETERAN - FOCUSED INTEGRATION PROCESS (VIP)

Major COTS Program Deployment Guide for EHRM

1 Overview

The Department of Veteran’s Affairs (VA) Veteran-focused Integration Process (VIP) is a Lean-Agile framework that services the interests of Veterans through the efficient streamlining of activities that occur within the enterprise. Acknowledging that there is not a “one size fits all” solution, the VIP artifact requirements can be tailored to accommodate the unique needs of Major Programs[footnoteRef:2] in an effective manner. Major Programs with a commercial off-the-shelf (COTS) solution require execution on an accelerated timeline and the flexibility to incorporate artifacts provided by software vendors. For Major Programs where an internal (i.e., non-COTS) solution is deemed necessary, the regular VIP process should be applied. [2: https://www.va.gov/op3/Enterprise_Program_Management_Office.asp]

This VIP Major COTS Program Guide for Electronic Health Record Modernization (EHRM) outlines how the VA’s EHRM program will progress through the streamlined VIP lifecycle, requiring VA-approved documents from the COTS service provider Cerner Corporation to replace complete or portions of VIP mandatory artifacts.

2 Streamlined VIP Lifecycle

The streamlined VIP lifecycle for major programs is designed to adapt the pre-designed artifacts from vendors, allowing for valuable time and resources to be focused on the configuration of the solution to meet the quality and security standards of the VA. VA Leadership involvement may expedite the Intake of the request due to congressional mandate or administration priority. The Project Planning component of the Project Phase can be accelerated due to vendor support; it is anticipated that project management plans developed by the vendor have been validated through the vendor’s deployment experience and likely require relatively minor modifications to best fit the environment.

Build and development within the Product Phase can be significantly shortened as the products predominantly require configuration and interface testing (please reference VIP Major COTS Program Interface Development Guide). Release preparation will require much of the same rigor as applied to internally developed solutions to ensure the product meets VA’s high standards. The development of a user acceptance testing document and training guide is the responsibility of the vendor. The VA Program Manager will work with the vendor to ensure security standards and contingency plan requirements documented in the compliance epics/security requirements, and are met prior to release. Release and sustainment will align with the standard VIP reporting requirements to ensure data is gathered in a consistent manner for portfolio-level management.

Figure 1 VIP Lifecycle for Major COTS Programs

2.1 Alignment to CERNER Gateways

The VIP Major COTS Programs lifecycle process aligns with the Cerner Gateways process (see Appendix A: Cerner Gateways Overview), allowing VA to maximize efficiencies while working with Cerner for program implementation.

Figure 2 Cerner Gateways

The flexibility of VIP artifact requirements allows for major programs to reap the full benefit from the documentation provided by Cerner and focus resources towards the configuration needed for successful implementation. Table 1 VIP Artifacts for Major COTS Programs provides a quick reference for those artifacts that are required by VIP and/or VA Compliance Epics and those that will likely be provided by Cerner.

Table 1 VIP Artifacts for Major COTS Programs

2.2 Accelerated Project Planning

Figure 3 Accelerated Project Planning Project Initiation is the governance process through which Cerner absorbs the problem statement and starts to envision a solution.

Cerner Gateway Alignment Cerner defines the initial project planning stage as a four-month endeavor to work with their client’s organization to align goals, resources, and project plans. Project planning includes current-state assessments, leadership debriefs, individual site kick-offs, and a value workshop to establish how successful implementation will be measured.

2.3 Critical Decision 1 Event

Figure 3 Critical Decision 1 VA’s Critical Decision 1 (CD1) Event occurs when a product is ready to begin the process of moving to the Product Phase. This is done to acquire contract resources for the Product Phase if required. The approval is given by the VIP Triad, defined as the Portfolio Director, the Product Owner and the Receiving Organization, at a CD1 Event. For major COTS programs, Business Epics and Subepics are used to define the scope of the project, which feeds the Project Management Plan. Compliance Epics to are used to ensure requirements are met by the vendor documentation, or need to be incorporated into the PWS or SLA.

Cerner Gateway Alignment Per the Cerner Gateways Overview document, Cerner’s Project Initiation Gateway requires that a product or program demonstrate, at each site:

Please refer to VIP Major COTS Program Interface Development Guide for guidance on interface architecture artifacts. The Project Initiation Gateway review is expected to occur four weeks prior to the Future State Validation Gateway. VA will review all Cerner artifacts to confirm the VA document requirements have been met.

2.4 Product Configuration

Figure 4 Configuration The length of a build in VIP is 90 calendar days. Each build ends with completed user acceptance testing (UAT) and a push to pre-production. While each build is expected not to exceed three months, it is not required to take the full three months. VIP provides a flexible development framework in which Agile teams can release as rapidly as they are capable. Given that Major COTS Programs are engaged with a product vendor, builds are replaced by configuration cycles. A configuration cycle cannot be longer than 3 months in duration, and can have multiple sprints within it, and each sprint can be considered its own configuration cycle. Regardless of the length of the cycle or sprint, as determined by the Product Team, everyone will follow the standard configuration cycle.

Cerner Gateway Alignment Prior to reaching Cerner’s Validate Gateway, Future State Review (FSR) occurs to ensure that key stakeholders are aligned in their understanding of necessary adjustments to workflows and configuration of the tool to enable successful implementation. This review is expected to take two weeks. Please refer to VIP Major COTS Program Interface Development Guide for guidance on configuration, interface development, integration, and data migration from VistA to Cerner.

Additionally, during Cerner’s Validation phase, additional VA-required documents[footnoteRef:3] that Cerner will provide should be made available for VA review and approval. These include the System Security Plan, Security Assessment Plan, Information Security Contingency Plan, Privacy Incident Response Plan, Privacy Impact Analysis, Disaster Recovery Plan, Audit & Accountability Policy, and Facility Security Plan. [3: See applicable VIP Compliance Epics.]

Per the Cerner Gateways Overview document, Cerner’s Validate Gateway requires that a product or program demonstrate:

After successful pass-through of the Validate Gateway and VA approval, the project can move into User Acceptance Testing (UAT), Maintenance Training, and Integration Validation. The Cerner VA Deployment Playbook, describes this stage as:

“Maintenance Training: Local IT staff or biomed staff is trained on local configuration, including areas such as device connectivity and printer set up. They will be trained to assist with the install and prep activities as well as how to work with the sustainment process post-go-live. Other clinical areas are included. Scheduling and Surgery personnel will be taught how to create and maintain things such as scheduling templates and preference cards.

Integration validation I-II (IV1 & IV2): This event is designed to help enable facility personnel to validate the interaction of VHA Design solutions with foreign systems during patient care scenarios. This hands-on testing event serves as a check-point to measure conversion readiness. It’s best practice to conduct two of these events, layering in functionality as needed.”

2.5 Critical Decision 2 Event

Figure 5 Critical Decision 2 Event The VIP process Critical Decision 2 (CD2) Event occurs after all (pre-IOC) testing is complete and the Product Manager believes the build or product is ready for release and addresses all relevant compliance requirements. This decision event should answer the following questions:

· What are the systems this product interfaces with and is it compatible with all of them?

· Who are the stakeholders and teams directly affected by this new product, and are they aware of the impending release?

· Does the system meet applicable Compliance Epics, SubEpics, and User Stories?

· Has all required regression and end-to-end testing been completed, and all documentation updated?

The VIP Triad approves or disapproves the product for release. This decision event reviews the full product and if nothing significant changes in the product’s technical environment or security profile, approvals are not required, by VIP policy, for future releases. This means the only release that requires a full CD2 review is the first release into production. Once this first release occurs, subsequent CD2 events may be held at the discretion of the Portfolio Director [or designee, as found in approved Delegation of Authority (DOA) memo], simply to ensure the proper requirements have been updated and the appropriate parties are prepared for the additional release(s).

Cerner Gateway Alignment Per the Cerner Gateways Overview document, Cerner’s Train Gateway requires that a product or program demonstrate:

According to the Cerner VA Deployment Playbook, training will consist of both Superuser and End-user training.

“Superuser” training: This is in-depth training for superusers who have been engaged throughout deployment. Since it’s not their first engagement with the system, less time will be spent on functionality and more of the focus will be on application.

End-user training: This training is mandatory for all system end users with varying classroom attendance times. Most end users will be required to attend 16 hours of classroom training.”

2.6 Release Preparation & Release

Figure 6 Release Preparation & Release The period between Release approval and actual release is expected to be less than two weeks. Activities in this phase include preparing final release communications, making final environment updates if necessary, and finalizing site logistics. In order to support consistent decision-making for the Initial Operating Capability (IOC) evaluation, the majority of the VIP artifacts for this phase are still required for major programs. However, the vendor provided documents may be accepted in their original format.

If no significant defects were identified during the IOC, the Release Candidate continues on to National Release. Prior to National Release, all product data must be entered into the proper Rational Tools repository. Additionally, the Product Team must update the POLARIS Calendar with scheduled dates for release. Full Operating Capacity (FOC) occurs when the final national release is implemented.

Cerner Gateway Alignment Per the Cerner Gateways Overview document, Cerner’s Activate Gateway requires that a product or program demonstrate:

The Activate Gateway occurs approximately one week prior to go-live. According to the Cerner VA Deployment Playbook, the decision to go-live is supported by the go-live readiness assessment kickoff event.

“Go live readiness assessment kickoff (GLRA): The local hub and spoke team conducts this assessment to help ensure facility readiness. If each event is executed and issues are resolved, the facility should be on-track to hit the go-live date. However, the GLRA addresses the variables that are identified as risks. Once they’re identified, continued GLRA calls will help ensure issues are resolved.”

3 VIP Reporting Requirements To ensure comparable data, all VIP reporting requirements must be adhered to for major programs. Further detail on these requirements, as extracted from the VIP Guide 2.0, are provided below.

3.1 VIP Dashboard and External Reporting Requirements

VA has several external reporting commitments which it must continue to meet. These take the form of ad hoc reports (generated from the VIP Dashboard) for various external customers like the Government Accountability Office, the Office of Inspector General, etc.

In addition to these ad hoc reporting responsibilities, there is a major reporting responsibility called the Monthly OMB Major IT Business Case Details Submission. OMB requires agencies to submit product data (approximately 40 data elements per product activity) from the Agency directly to the OMB Federal IT Dashboard via Extensible 23 (XML) transfer. The ability to meet our monthly 300B reporting requirements will still be met by VA via the VIP Dashboard. Product teams are required to make timely updates to the dashboard regarding costs and schedule. Product Managers should ensure that actual start and completion dates are entered into the dashboard within 3 business days of the planned dates. For example, a build is scheduled to complete on Jan. 12, 2017, which is a Thursday. The product must input the actual delivery date no later than Tuesday, Jan. 17, 2017, close of business.

3.2 IBM® Rational Tools Suite

The mandatory use of the IBM® Rational Tools Suite is critical to the success of VIP, as well as the thorough streamlining of release processes. Teams must use Rational Tools Suite and fully populate the tool with all required product information. The Rational Tools Suite allows data to be entered once and then reused multiple times as “data views” utilized by various Rational users. Proper use of Rational Tools supports one of the goals of VIP, which is to provide traceability among requirements fulfillment, requirements testing, and testing results.

The IBM® Rational Collaborative Application Lifecycle Management (CALM) Toolset will be used to provide a single Agile product lifecycle management tool to track execution details. All OI&T products will be expected to follow this requirement. This requirement includes the expectation that all OI&T products follow the OI&T Agile product management process and use the Rational Tools Suite to:

· Manage scheduled product sprints and backlog

· Manage product requirements

· Manage product risks and issues

· Manage product configurations and changes

· Manage product test plans and execution

· Manage product planning and engineering documentation

· Manage /administer source control and baselines The IBM Rational Collaborative Application Lifecycle Management (CALM) Product Data Repository will be used to provide a single authoritative product data repository. All OI&T product data and artifacts will be required to be managed in this data and artifact repository. Additionally, the OI&T Release Management Office will support the new, single release process for all of OI&T and will begin looking for necessary product data and artifacts in the appropriate Rational Tools repository.

OI&T products that have not previously engaged the OI&T Rational Support Team for implementation of the Rational Tools in the VA are required to initiate contact with the team in order to arrange for usage. For those products that are not currently compliant, phased implementation of Rational Tools use will be arranged.

3.3 VIP Request (VIPR)

The OI&T VIPR system is used by ITAMs and other designated individuals to provide a single intake process to request new and changed business needs to current or future automated business processes. VIPR accepts requests to enhance existing information or technology solutions or to develop/acquire a new solution based on changes to workflows, business needs, policies, legislative changes, and other drivers to meet VA business needs. VIPR starts the process of capturing high level Epics as statements of need for clinical, business, administrative, operational, and/or infrastructure that support the day-to-day operations and work activities of the VA. As an interim solution to support VIP, this Microsoft SharePoint-based application serves as a central repository for stakeholder business requirements submitted for new solutions deliveries. Additional policy and procedure on use of VIPR is available on the VIPR site.

3.4 POLARIS Enterprise Release Calendar

The POLARIS Enterprise Release Calendar has been implemented across OI&T as the single authoritative release calendar for all of OI&T, and serves as a central repository for production platform change information, release management coordination and deployment activity scheduling. The POLARIS calendaring process and tool must be used to track software installations, hardware replacements, system upgrades, patch release and implementation, special works in progress, and other deployment events in the VA production environment.

The VA PM will be required to provide updates to the enterprise release schedule.

3.5 Oracle Primavera Progress Reporter

Oracle Primavera Progress Reporter is used to provide a single product time tracking process for OI&T staff to track hours necessary to complete OI&T products and work efforts. OI&T staff is required to report product time and role-based time equaling their scheduled tour.

Appendix A: Cerner Gateways Overview image2.png image3.png image4.emf image5.png image6.png image7.png image8.png image9.png image10.png image11.png image12.png image13.png image14.png image15.emf

Gateways Overview 08212018.pdf

Gateways

Description

• Project status checkpoints at critical milestones to ensure value achievement

• Key Gateways include successful completion of key milestones:

o Site Kick-off o Future State Validation o Testing complete and Training Ready o Go-Live o Post Go Live Measurement

• Evaluation of critical items and key risk factors across people, process and technology

• Reviewed by Client and Cerner leadership teams

• Assess risks to determine if they can be mitigated in time to prevent impact to the project and keep the project on its current timeline

What are they?

• Mechanism to monitor critical items throughout the project

• Ensure key risk factors are proactively identified, managed, and mitigated

• Pre-determined entry and exit criteria

• Goal - keep the project on time and ensure value achievement

When?

• Designated checkpoints at critical times in the project

• Weekly Project Meeting Agenda Item

• Official Executive Approval and Sign Off Required

Gateway criteria incomplete?

• Documentation of risk plan, owner and due date

• Reviewed regularly to limit impact on the project

• Potentially unable to pass into the next phase if risks not mitigated

Project Gateway #1: Project Initiation

• Four weeks prior to Future State Review (FSR)

• Checkpoint: Your organization and the project team demonstrate they are aligned in their goals, resources and plan.

• To confirm:

o Necessary resources are engaged o Project timeline and scope are finalized o Preliminary value objectives are identified and measures defined o Hardware / infrastructure procurement plans are in place o Executive Sponsor and/or Accountable Leader(s) are assigned and engaged o Project governance is in place o Change control process introduced

Project Gateway #2: Validate

• Two weeks after Future State Validation (FSV)

• Checkpoint: Your organization confirms agreement on the future state workflows.

o Future State Workflows complete o Design Decisions complete o Data Collection complete o Training Strategy is finalized o Change control process is in place and being utilized

Project Gateway #3: Train

• Prior to the start of training, after testing

• Checkpoint: Your organization demonstrates readiness for new workflows and technology.

o Training plan is complete and ready to be executed o All solutions are configured and aligned to best practices o System is properly localized o Training materials and TRAIN domain reflect future state workflows o Testing is complete and all major issues resolved

Project Gateway #4: Activate

• One week prior to go-live

• Checkpoint: Your organization demonstrates readiness for new workflows and technology.

o Pre-conversion checklist complete, cutover checklist ready o All significant issues are resolved o End user training and related competencies are complete o Go-live support plans in place and ready for execution o Post-Go Live support and issue management plan is in place

Final Checkpoint: Measure

• Approximately 60 days post go-live (IOC facility)

• Goal: Your organization achieved the value targeted by the project o Super-user and end-user’s competency, confidence and satisfaction targets were achieved.

o Value objectives are trending toward goals.

o Performance and operational metrics are trending positively and that no unresolved significant solution issues remain o Issues and changes are being managed effectively.

Gateways

Description

What are they?

When?

Gateway criteria incomplete?

Project Gateway #1: Project Initiation

Project Gateway #2: Validate

Project Gateway #3: Train

Project Gateway #4: Activate

Final Checkpoint: Measure image1.emf