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Health IT Strategic Framework
Attachment 4
Federal Health Information Technology Programs
The following report was issued by the National Coordinator for Health Information Technology under direction of Executive Order 13335, Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator, April 27, 2004.
The Office of the National Coordinator for Health Information Technology (ONCHIT) is responsible for coordinating federal activities relating to health information technology. These covered health information technology activities are defined as any effort in the federal government that meets one or more of the following criteria:
- Efforts that use federal funds to design, develop, standardize, implement, maintain, operate, and/or enhance HIT (e.g., software, hardware or other technology) that is used inside or outside the federal government to deliver, monitor, improve, supply information to, interface with, or use information from a patient care encounter, including financial, clinical, or other information.
- Efforts that use federal funds for projects or programs that evaluate, research, study, or otherwise assess the use, benefit, cost, consequences, or other aspects of the HIT defined in #1.
- Efforts that use federal funds to educate, teach, train, or address human factors about or relating to the HIT described in #1.
- Policies, rules, reports, advisories, or other documents that describe, discuss, or influence the use of the HIT defined in #1.
- Partnerships, grants, contracts, initiatives, or awards between the federal government and/or its contractors with non-federal organizations, including state or local governments or agencies, private companies, or other entities that relate to HIT defined in #1.
- Knowledge management of the experiences gained from HIT implementation across large, distributed health care networks such as DoD, VA, and the IHS will be brought to a central, accessible point.
Many different components of the federal government touch upon health care, so federal leadership in HIT needs to be focused and coordinated. While there is some integration of these efforts, until recently there has been neither a single voice for this effort nor a holistic set of goals for change. The National Coordinator for Health Information Technology has been given the responsibility for coordinating HIT efforts throughout the federal government. As part of the outreach effort, the programs, projects, and policies that involve HIT are being compiled.
According to the FHA initiative and budget documents submitted to the Office of Management and Budget, total federal spending on HIT was over $900 million in FY2004. A list of identified federal HIT programs follows. Federal HIT initiatives range from supporting research in advanced HIT (e.g., high-speed Internet, imaging, and bioinformatics) to the development and use of EHR systems. Overall, the compilation in the following table shows that the federal government has played an active role in the evolution and use of HIT, and further analysis of agency obligations and programmatic activities suggests that there is additional HIT spending within federal grants and other activities. The implementation of this strategy is an opportunity to comprehensively identify HIT spending activities, and to better enable collaboration that leverages these efforts.
VA provides to physicians, registered nurses, dentists, optometrists, podiatrists, nurse anesthetists, physician assistants, and other staff an EHR system known as VistA. The VA's work on the evolution of this EHR and diagnostic imaging is leading the field. The VA first demonstrated the effectiveness of bar coding for improving patient safety in hospital drug administration. This success contributed to the FDA's development of regulation requiring bar codes on drug products.
Another example of federal leadership is DoD's Pharmacy Data Transaction Service (PDTS), which is linked to DoD's EHR system. This utilizes a centralized data repository that records information about prescriptions filled for DoD beneficiaries through Military Treatment Facilities (MTFs), the civilian pharmacy network, and the TRICARE Mail Order Pharmacy program. PDTS enhances patient safety and quality of medical care by reducing the likelihood of adverse drug-to-drug interactions, duplicate drugs prescribed to treat the same condition, and the same drug obtained from multiple sources. This system has detected more than 117,000 potential Level 1 drug interactions over the last three years.
Other innovative activities are under way in the federal government. DoD and VA utilize telehealth applications for radiology, mental health, dermatology, pathology, and dental; for provider/patient education interactions; and as provider extenders. IHS has had an electronic health information system for over 25 years. IHS is currently adapting an EHR to fit the special needs of its hospitals and clinics. CMS is developing programs to promote the adoption and effective use of HIT through the Doctors' Office Quality Information Technology (DOQ-IT) pilot project and the Medicare Care Management Performance demonstration.
Standards adoption has been a core federal program. HHS has acquired the license to SNOMED CTÓ, a medical terminology, for use throughout the U.S. The VA and DoD are developing interoperable health information systems to support the seamless transfer of health information and continuity of services for beneficiaries. To accelerate progress within the government, HHS, DoD, and VA are lead partners in the CHI, one of the 24 e-Gov initiatives supporting the President's Management Agenda. The goal of the CHI initiative is to establish federal health information interoperability standards as the basis for electronic health data transfer in federal health activities and projects, which will facilitate the adoption of these standards in products used in the private sector. These federal agencies also support the FHA effort to develop an interoperable and common architecture for HIT across agencies.
Federal agencies are also stimulating formation of private sector health information exchange. AHRQ will spend $50 million in FY2004 on HIT research and demonstration projects aimed at improving the safety, quality, efficiency, and effectiveness of care. Using a portion of these resources, AHRQ will establish a Health Information Technology Resource Center that will provide technical assistance, expert HIT support, educational services, and other support to HHS grantees. AHRQ will also fund five state-level HIT projects to support health information exchange across these communities. The Health Resources and Services Administrations is accelerating adoption and enabling community health information exchange through several programs including Connecting Communities for Better Health, the BPHC Healthy Communities Access Program, and telehealth programs.
The tools to ensure advances in population health and research are evolving. NIH is working to ensure the development of an infrastructure to support clinical research that will interface with community health information exchange networks. CDC is facilitating the implementation of a public health information infrastructure in a variety of fronts. This effort is already demonstrating results; the reporting times have dropped from an average of 30 days to 1-2 days. Work on and support for the U.S. Department of Homeland Security's BioWatch and BioSense continues, solidifying the infrastructure needed to detect and respond to emerging diseases and a bioterrorist event. Also, CDC is advancing the development of the Public Health Information Network (PHIN), which supports the broad range of public health activities, including interoperability with clinical care. It now includes the National Electronic Disease Surveillance System as a surveillance component, which promotes the use of standards to advance development of efficient, integrated, and interoperable surveillance systems at federal, state, and local levels. BioSense, among other things, fosters the use of standards-based clinical care data for the early detection, localization, and investigation of emerging health events.
The federal government has also acted to develop tools to support personalized care for the consumer. This is being accomplished through Healthfinder and Medline Plus, access to clinical trial information; DoD's TRICARE Online (TOL), the enterprise-wide, secure, Internet portal for use by all DoD beneficiaries, providers, and managers worldwide to access available health care services, benefits, and information; and VA's My HealtheVet.
The following table represents a preliminary, non-exhaustive, list of federal (HHS, VA, and DoD) projects meeting these criteria. ONCHIT will compile a database of programs, projects, and policies from various sources. This information will be for planning, coordination, and knowledge transfer.
Agency/
Organization |
Title of HIT Initiative |
Description of Activities |
Department of Health and Human Services
Assistant Secretary for Planning & Evaluation |
ASPE |
National Committee on Vital and Health Statistics
(NCVHS) |
Policy development and development of standards. |
ASPE |
National Health Information Infrastructure (NHII) |
The NHII is an initiative to improve the effectiveness, efficiency,
and overall quality of health and health care in the United States
-- a comprehensive knowledge-based network of interoperable systems
of clinical, public health, and personal health information that
would improve decision making by making health information available
when and where it is needed. (NHII has been incorporated into
ONCHIT.) |
ASPE |
EHRs in Post-Acute and Long-Term Care |
ASPE has contracted with the University of Colorado Health
Sciences Center to evaluate the current status of electronic health
information systems (EHIS) and electronic health records (EHRs)
in post-acute and long-term care (PAC/LTC) settings. The project
team has reviewed literature, conducted telephone interviews,
and completed site visits to providers that have implemented EHIS/EHRs
in PAC/LTC. The project also contracted with Apelon to conduct
a pilot study of the issues of conforming the nursing home minimum
data set (MDS v.2) to CHI standards. |
ASPE |
Conforming the Nursing Home Minimum Data Set v.3
to CHI-Endorsed Standards |
ASPE and CMS will partner on a project to conform the MDS v.3
to CHI-endorsed standards. |
Office of the Chief Information Officer (CIO) |
|
Consolidated Health Informatics Initiative (CHI) |
The goal of CHI is to establish federal health information
interoperability standards as the basis for electronic health
data transfer in all activities and projects and among all agencies
and departments. The first phase involved establishing a set of
existing clinical vocabularies and messaging standards enabling
federal agencies to build interoperable federal health data systems. |
|
Federal Health Architecture (FHA) |
TheFHA program will define an overarching framework and methodology
that allows initiatives throughout several federal agencies to
proceed coherently, establishing the target and standards for
interoperability and communication that will unify the federal
health community. The FHA will establish a government-wide road
map to achieve the federal health community's mission through
optimal performance of its core business processes within an efficient
IT environment. |
Council on the Application of Health Information
Technology (CAHIT) |
CAHIT |
Coordination HL7 balloting |
CAHIT staff coordinated the HHS engagement with regard to the
HL7 Electronic Health Record Special Interest Group. |
CAHIT |
EHR Acceleration Efforts |
CAHIT staff coordinated a series of planning meetings to best
position pertinent departmental HIT activities (either current
or future) that hold the promise of accelerating EHR adoption. |
CAHIT |
CHI Standards |
CAHIT staff and membership, via council meetings, activities,
and staff briefings ensured the universal integration of CHI standards
in HHS agency activities and programs. |
Agency for Healthcare Research and Quality (AHRQ) |
AHRQ |
Transforming Healthcare Quality Through Information
Technology (THQIT) |
THQIT is a series of three grant programs (RFAs) released in
FY04. The RFAs include the following: 1) demonstrating the value
of HIT, 2) planning grants for future HIT implementations, and
3) providing HIT implementation grants for partnerships of three
or more entities. |
AHRQ |
State and Regional Health IT Demonstrations |
AHRQ recently issued a contract solicitation to establish and
implement state and regional demonstrations of interoperable health
information systems. In the Fall of 2004, AHRQ anticipates issuing
up to five awards. |
AHRQ |
Health Information Technology Resource Center |
The Health Information Technology Resource Center (HITRC) will
provide a state-of-the-art service center for grantees and organizations
that are engaged in health IT diffusion activities (e.g., research,
diffusion, or adoption). |
AHRQ |
Coordination with CMS Medicare Care Management
Performance (MCMP) Demonstration Project |
AHRQ will be supporting a five-year evaluation of CMS’s
MCMP demonstration project to explore the integration of EHRs
in the ambulatory environment. |
AHRQ |
Indian Health Service (IHS) - Resource and Patient
Management System (RPMS) |
AHRQ recently provided funding to the IHS to support needed
enhancements to the IHS EHR. This investment will help to create
a user-friendly data system that can provide community-specific
health care data as well as track the health status of the patient
population. |
AHRQ |
Patient Safety Health Care Information Technology
Data Standards Program: Standards and Interoperability |
This work on health data standards, done in coordination with
the ASPE, will focus of the following four areas: 1) voluntary
industry clinical messaging and terminology standards, 2) national
standard nomenclature for drugs and biological products, 3) standards
related to comprehensive clinical terminology, and 4) nomenclature
and research related to accelerating the adoption of interoperable
HIT systems. |
AHRQ |
Evidence Based Practice Center (EPC) - Evaluation
of the Evidence Regarding Select Health IT Functions |
AHRQ's EPC Program has embarked on a 13-month program to explore
and determine the evidence base associated with certain HIT functions.
|
Centers for Medicare and Medicaid Services (CMS) |
CMS |
Doctors' Office Quality - Information Technology
(DOQ-IT) |
A special study to develop an approach to promoting adoption
and use of information technologies in the physician office and
reporting of information to Quality Improvement Organizations
(QIOs). |
CMS |
VistA – Office her |
Modify / repackage VistA (the Veteran's Administration EHR
software) for the physician office setting. |
CMS |
Medicare Care Management Performance Demonstration |
Establish a three-year, pay-for-performance pilot with physicians
to promote the adoption and effective use of HIT to improve the
quality of patient care for chronically ill Medicare patients.
CMS will offer financial incentives to physician offices that
meet performance standards in delivery systems and outcomes. |
CMS |
Physician self-referral exception: Phase II of
physician self-referral regulations includes exception for community-wide
health information systems |
Removes the regulatory barrier to allow for the furnishing
of technology items or services to physicians to enable their
participation in community-wide health information systems. |
CMS |
E-prescribing hearings to develop, adopt, recognize,
or modify initial e-prescribing standards. Pilot project to test
initial standards. |
Participate in NCVHS hearings regarding e-prescribing standards
in 2004 and 2005. Develop, adopt, recognize, or modify initial
uniform standards not later than Sept. 1, 2005. During 2006 calendar
year, conduct pilot project to test initial e-prescribing standards,
unless the Secretary determines the industry has adequate experience
with such standards. |
CMS |
EMR Focus Groups |
Pacific Consulting Group, under contract with CMS, will conduct
12 focus groups of providers to identify the issues and barriers
that would prevent them from using electronic medical records,
and suggestions they may have for addressing these issues. The
focus groups will be organized as follows: three Part A, three
Part B, three durable medical equipment (DME) providers, two rural
providers, and one billing agent. Six of these focus groups will
be in person, while six will meet via conference call. Focus groups
are planned for the following cities: Boston or New York City,
Florida or Atlanta, Chicago, Denver, San Francisco. |
CMS |
CMS Virtual Call Center |
The goal of CMS' Virtual Call Center is to improve beneficiary
telephone customer service through the implementation of various
initiatives for efficient and effective handling of all types
of inquiries. The first phase involves, among other things, improvements
in the Web-based application that allows phone representatives
to retrieve clinical information about the beneficiary (such as
date of last pap smear or colonoscopy). The second phase involves
allowing beneficiaries to access clinical information about themselves
through a Web-based application. |
Food and Drug Administration (FDA) |
FDA |
Structured Product Labeling (SPL) for prescription
products (e.g., accessible drug information) |
The SPL provides information found in the approved FDA drug
label or package insert in a computer-readable format for use
in electronic prescribing and decision support. |
FDA |
Bar Coding for Prescription Products |
Standardized labeling. |
National Institutes of Health |
NIH |
National Library of Medicine - Grants for Research,
Training, and Access to Informatics Resources |
Research grants and contracts for advanced computer technologies
to facilitate access, storage, and use of biomedical information,
and for the value derived from the adoption, diffusion, and utilization
of HIT. |
NIH |
National Library of Medicine - Grants for Research,
Training, and Access to Informatics Resources |
Support for training of informatics researchers and developers. |
NIH |
National Library of Medicine - Grants for Research,
Training, and Access to Informatics Resources |
Support for Integrated Advanced Information Networks (IAIMS),
Internet connections, and access to digital libraries. |
NIH |
National Library of Medicine - Development and
Implementation of Controlled Clinical Vocabularies |
Support for, and development of, selected CHI standard clinical
vocabularies to enable ongoing maintenance and free use within
the United States. |
NIH |
National Library of Medicine - Development and
Implementation of Controlled Clinical Vocabularies |
Uniform distribution and mapping of HIPAA code sets, CHI standard
vocabularies, HL7 code sets, and other important vocabularies
within the UMLS Metathesaurus. |
NIH |
National Electronic Clinical Trials and Research
(NECTAR) Network |
NIH plans to develop NECTAR, which will link research sites
and ultimately create a “national network of networks,”
in coordination with the national health information network,
by which research information and findings will be shared and
scientific collaborations facilitated. NECTAR includes a research
workflow model, a common lexicon of standard vocabularies to describe
medical and scientific events, and analytical and dissemination
tools. |
NIH |
Cancer Biomedical Informatics Grid (caBIG) |
caBIG is a virtual cancer research network of interconnected
data, individuals, and organizations that will create a common,
widely distributed infrastructure that facilitates the sharing
of data and applications and thereby enhances productivity and
efficiency of research. caBIG infrastructure is based on HHS CHI
standards. caBIG is being pursued as a pilot program that involves
NCI’s caCORE central resources, over 40 of NCI’s cancer
centers, and the FDA. The NCI has created a standards-supporting
infrastructure called caCORE. It is composed of HHS-established
controlled vocabularies, standard data elements, and domain models.
|
Indian Health Service |
IHS |
Integrated Behavioral Health System (BH) |
The BH graphical user interface software application that includes
the ability to track services provided by social work, alcohol/substance
abuse counselors, psychologists, and psychiatrists. Application
includes suicide tracking system (with bi-directional notification
within HIPAA guidelines) as well as embedded guidelines. The requirements
determination has been completed and the software development
process will begin in FY04. |
IHS |
Patient Account Management System (PAMS) |
The PAMS is an enhanced third-party billing system. |
IHS |
Clinical Indicator Reporting System (CIRS) |
The CIRS is a robust reporting system that tracks over 40 indicators
in a standard reporting format. The standards reporting format
is a delimited file that exports locally into Excel and can be
exported for regional aggregation. |
IHS |
Integrated Case Management System |
An integrated case management application is being developed
to facilitate three views of data: patient, provider, and population
health. These systems will allow for integration of varied disease
case management applications that currently exist (diabetes, asthma,
immunizations, etc.). |
IHS |
National Data Warehouse Initiative |
This Initiative is developing a data warehouse for use by epidemiologists,
as well as clinical quality in order to enable analyses on quality
improvement and interface with the clinical indicator reporting
system. |
IHS |
Resource and Patient Management System (RPMS) |
RPMS is the hospital information system utilized by 49 hospitals,
221 health centers, 120 health stations, and 170 Alaska village
clinics. |
IHS |
IHS - EHR Initiative |
IHS-EHR provides order entry, results reporting, encounter
documentation, and other clinical functionality to IHS, tribal,
and urban Indian health care providers. IHS-EHR is a component
of the Resource and Patient Management System (RPMS), IHS's enterprise
health information system. |
Health Services and Resource Administration |
HRSA |
Shared Integrated Management Information Systems
(SIMIS)/ Information and Communication Technology (ICT) |
The SIMIS/ICT provides hardware, software, and support services
for integration of practice management systems among federally
supported health centers (SIMIS), and integration of electronic
health records with practice management systems at consolidated
health centers (ICT). |
HRSA |
Integrated Services Development Initiative (ISDI) |
The program supports integration efforts in five areas one
of which is information management. |
HRSA |
Healthy Communities Access Program (HCAP) |
The HCAP is a community-based program to develop or strengthen
health care safety net delivery systems through providing an infrastructure
that will coordinate health care for the uninsured. Development
of information systems is fundamental to supporting coordination
of efforts that increase access to care. |
HRSA |
Sentinel Centers Network (SCN) |
The SCN is investing in the information systems of participant
health centers and networks to provide timely, patient-level data
to inform policy decisions and quality improvement activities
across all health centers. |
HRSA |
Patient Electronic Care System (PECS) |
The PECS is a program that is developing patient registry information
systems for centers participating in the Health Disparities Collaboratives.
|
HRSA |
Office for the Advancement of Telehealth grants
(OAT) |
Grants support for community-based activities in informatics,
electronic medical records, and telemedicine, including telepharmacy.
|
HRSA |
CAREWare |
CAREWare is a patient, encounter-level software application
distributed to HIV/Aids Bureau (HAB) grantees and providers of
HIV care to help them manage, monitor, and report on all clinical
and supportive care services. The software was originally built
in Microsoft Access, but is now being developed in dotNET to enable
Internet and wide-area connectivity of care providers and grantees.
CAREWare is also being developed for use internationally (in Africa
especially) under the President’s Emergency Plan for AIDS
Relief. |
Centers for Disease Control and Prevention |
CDC |
Public Health Information Network (PHIN) |
The CDC is working to advance public health activities through
standards-based information systems. These systems need to work
with each other and with clinical care systems to support public
health needs. Through PHIN, the CDC and its public and private
partners have been advancing software components and data and
technical specifications that are compatible with federal standards
activities such as CHI, NCVHS, and eGov. |
CDC |
PHIN: National Electronic Disease Surveillance
System (NEDSS) |
NEDSS is an initiative that promotes the use of data and information
system standards to advance the development of efficient, integrated,
and interoperable surveillance systems at federal, state, and
local levels. |
CDC |
PHIN: National HealthCare Safety Network System |
PHIN is an Internet-based system to collect patient data on
measures of health care quality. |
CDC |
Public Health Monitoring |
Most pubic health surveillance and monitoring systems, either
directly or indirectly, get some data from clinical care activities.
These data are used to facilitate public health surveillance through
the timely and efficient transfer and processing of appropriate
public health, laboratory, and clinical care data. Vital statistics
systems also at times get data that originate in other places
in the health system. |
CDC |
Clinically Oriented National Center for Health
Care Statistics (NCHS) Monitoring |
National Health Care surveys provide a picture of how health
care is delivered in the U.S. by collecting data from hospitals,
emergency and outpatient departments, ambulatory surgery centers,
nursing homes, office-based physicians, home health agencies,
hospices, and others on a periodic basis. These surveys address
measurement of diagnosis and treatment, characteristics of health
care providers, trends in use of services, characteristics of
patients, patterns of disease, use of drugs and other treatments,
and emergence of alternative care sites. |
CDC |
Public Health Preparedness Systems |
Preparedness activities such as early event detection, quantification
of outbreak or event magnitude, localization of an event, investigation
of event etiology, the management of possible cases, the laboratory
confirmation of true cases, the tracing of communicable disease
contacts, the administration of vaccines, prophylaxis, and isolation
all potentially interact with clinical-care data and systems.
The PHIN standards have been requirements of the CDC and HRSA
preparedness supplements to help see that the over 2 billion in
preparedness funds that have gone to state and local health departments
and hospitals can meet these information exchange goals. |
CDC |
EPI-X |
EPI-X is the CDC’s Web-based communications solution
for public health professionals. Through EPI-X, CDC officials,
state and local health departments, poison control centers, and
other public health professionals can access and share preliminary
health surveillance information quickly and securely. Users can
also be actively notified of breaking health events as they occur.
Key features of EPI-X include scientific and editorial support,
controlled user access, digital credentials and authentication,
rapid outbreak reporting, peer-to-peer consultation, and CDC-assisted
coordination of investigations. |
Department of Defense / Veterans Affairs Initiatives
|
DoD/VA |
Joint Plan for the Electronic Health Record (JPEHR) |
The JPEHR will provide interoperability between the two health
information systems of VA and DoD. The plan provides for the exchange
of health data by the departments and development of a health
information infrastructure and architecture supported by common
data, communications, security, and software standards and high-performance
health information systems. The plan will support Healthy People
(federal), Federal Health Information Exchange (FHIE), Clinical
Data Repository/Health Data Repository (CHDR), Consolidated Mail
Outpatient Pharmacy (CMOP), Lab Data Sharing and Interoperability
(LDSI), and the Centralized Credentials Quality Assurance System
(CCQAS)/VetPro, Scheduling, and E-portal Systems. (Joint DoD and
VA funding.) |
DoD/VA |
Telehealth |
Development and adoption of telehealth capabilities within
the DoD Military Health System (MHS) and the VA continues to advance.
The steady increase in cooperation between the two agencies allows
for further leveraging of assets, knowledge, and development of
integrated or interoperable programs. There are six joint telehealth
initiatives in progress: VA/DoD Imaging Subgroup, Teleradiology,
Telepsychiatry, Hawaii Integrated Federal Health Care Partnership,
Alaska Federal Health Care Access Network, Case Management (Diabetes),
and e-Learning. |
Department of Defense Initiatives |
DoD |
Clinical Information Technology Program Office
(CITPO) |
CITPO is an acquisition office for centrally managed MHS clinical
IT systems that support the delivery of health services throughout
the MHS. The following are CITPO projects: Composite Health Care
System II (CHCSII), Composite Health Care System Legacy, Clinical
Information System (CIS), Preventive Health Care Application (PHCA),
Defense Blood Standard System (DBSS), Defense Occupational and
Environmental Health Readiness System (DOEHRS), Encoder Grouper
(EG), Special Needs Program Management Information System (SNPMIS),
TRICARE Online (TOL), Nutrition Management Information System
(NMIS), and Veterinary Services Information Management System
(VSIMS). |
DoD |
Defense Medical Logistics Standard Support (DMLSS) |
DMLSS replaces aging military departments' (Army, Navy, and
Air Force MilDeps) specific legacy medical logistics systems with
one standard DoD medical logistics system. DMLSS also manages
Joint Medical Asset Repository (JMAR), Customer Support on the
Web (CSW), Facility Management (FM), Customer Area Inventory Management
(CAIM), Equipment & Technology Management (E&TM), Stockroom/Readiness
Inventory Management (SRIM), Assemblage Management (AM), Universal
Data Repository (UDR), Prime Vendor Program (PV), DMLSS - Wholesale
(DMLSS - W), Customer Demand Management Information Application
(CDMIA), National Mail Order Pharmacy (NMOP), Readiness Application
(RMA), Medical Electronic Customer Assistance (MECA), Distribution
and Pricing (DAPA) Management System (MS), and Electronic Catalog
(ECAT). |
DoD |
Executive Information/Decision Support (EI/DS) |
The EI/DS program provides timely, accurate, and appropriate
decision information supporting the TRICARE Management Activity
(TMA) and DoD MHS mission. The EI/DS program currently consists
of a data warehouse and several operational data marts supporting
nearly 3,000 system users, providing a robust database and suite
of decision support tools to empower the effective management
of MHS health care operations. The EI/DS systems support decision
making by senior MHS personnel and post-decision monitoring of
the effects of decisions. EI/DS products include: MHS Management
Analysis and Reporting Tool (MHS MART), Managed Care Forecasting
and Analysis System (MCFAS), Population Health Operational Tracking
and Optimization (PHOTO), Medical Surveillance, TMA Reporting
Tools (TMART), CHAMPUS/TRICARE Medical Information System (CMIS),
CHAMPUS/TRICARE Utilization Reporting and Evaluation Systems (CURES),
Care Detail Information System (CDIS), and Patient Encounter Processing
and Reporting (PEPR). |
DoD |
Resources Information Technology Program Office
(RITPO) |
The RITPO initiative is a project that consists of a family
of capability-specific applications/systems that support the MHS
"Manage the Business" and "Access to Care"
and information technology requirements. The RITPO project scope
includes providing information technology support for MHS personnel,
scheduling, workload forecasting, and patient safety initiatives.
The following are RITPO projects: Defense Medical Human Resources
System - internet (DMHRSi), Central Credentials Quality Assurance
System (CCQAS), Enterprise Wide Scheduling and Registration (EWS-R),
Enterprise Wide Workload Forecasting (EWF), Patient Safety Reporting
(PSR), and Patient Accounting System (PAS). |
DoD |
Expense Assignment System IV (EAS IV) |
EAS IV is a standard DoD cost accounting/assignment information
technology system that consists of a cost-assignment application
and a data repository. The system receives information electronically
from a variety of DoD financial, manpower, and workload systems,
and allocates this expense information to Medical Treatment Facility/Dental
Treatment Facility (MTF/DTF) direct and indirect work centers.
|
DoD |
Theater Medical Information Program (TMIP) |
TMIP provides a seamless, interoperable medical information
system to support theater health services during combat or contingency
operations within and across all echelons of care. The primary
goal is to provide a global capability linking theater medical
information databases and integration centers that are accessible
to the warfighter anywhere, any time to support the mission. TMIP
includes the following programs: Composite Health Care System
in the Theater of Operations (CHCS NT), Composite Health Care
System II - Theater (CHCS II-T), TRANSCOM Regulating and Command
and Control Evacuation System (TRAC2ES), Defense Medical Logistics
Standard Support Assemblage Management (DMLSS-AM), Medical Analysis
Tool (MAT), Shipboard Non-Tactical Automated Data Processing Program
Automated Medical System (SAMS), Medical Surveillance System (MSS),
and Defense Blood Standard System (DBSS). |
DoD |
Third Party Outpatient Collection System (TPOCS)
|
TPOCS is the MHS information system used to bill for ambulatory
services. |
DoD |
Telehealth |
The use of electronic information and telecommunications technologies
to provide or support clinical health care, patient and professional
health-related education, public health and health administration
when distance separates the participants. Current projects include
Business cases, e-Learning, Policy, Teleconsultation, Pediatric
Consultation, Telecardiology, Teledermatology, TeleENT, Tele Mental
Health, Teleneurosurgery, Teleorthopedics, Telepathology, Teleradiology,
Telementoring, and Telemonitoring. |
Department of Veterans Affairs Initiatives |
VA |
Joint [VA/DoD] Patient Electronic Health Record
(JPEHR) |
The JPEHR plan will provide interoperability between the two
health information systems of VA and DoD. The plan provides for
the exchange of health data by the departments and development
of a health information infrastructure and architecture supported
by common data, communications, security and software standards,
and high-performance health information systems. (See FHIE.) |
VA |
Allocation Resource Center (ARC) (Health Resources
Management)* |
The ARC provides IT services for systems designed to support
the VHA CFO's ability to develop, implement, and maintain resource
allocation methodologies; gather and report on financial aspects
of patient workload and cost; classify patients based on care
and diagnosis rendered; and train and provide information to management
officials throughout VA. |
VA |
Decision Support System (DSS)* |
The DSS transforms day-to-day operational data into tactical
information that can be used by managers to make informed operational
decisions. |
VA |
Decision Support System (DSS) Modernization* |
The DSS will modernize the existing VA DSS information technology
system through analysis, identification, development, and implementation
of system architecture that interfaces with current and future
VA-wide system information technology structures. |
VA |
Fee Basis Replacement (FBR)* |
The FBR will replace a claims-processing system used by VA
that processes claims made by veterans and providers for non-VA
care. The new system will ensure effective and efficient authorization
and payment processing for all non-VA care, including state and
home health care and community nursing home programs. |
VA |
Health Administration Center (HAC) IT Operations* |
The HAC provides a variety of critical programs mandated by
Congress and facilitates delivery of high-quality services to
veterans and their family members. |
VA |
Patient Financial Services System (PFSS)* |
The PFSS will create a comprehensive business solution for
revenue improvement utilizing improved business practices, commercial
software, and enhanced VA clinical applications. |
VA |
Health Enrollment |
Health Enrollment includes functionality to accept and process
veterans’ applications for enrollment, share veterans’
eligibility and enrollment data with all VA health care facilities
involved in veterans' care, manage veterans' enrollment correspondence
and telephone inquiries, and support national reporting and analysis
of enrollment data. |
VA |
Federal Health Information Exchange (FHIE) |
Provides current and historical data feeds electronically from
CHCS I to the FHIE repository node on selected data types for
active-duty, retired, and separated service members. |
VA |
Health Data Repository (HDR) |
Defined as a repository of clinical information normally residing
on one or more independent platforms for use by clinicians and
other personnel in support of patient-centric care. |
VA |
Pharmacy Reengineering and IT Support |
Facilitates improved VA pharmacy operations, customer service,
and patient safety, concurrent with pursuit of full re-engineering
of VA pharmacy applications. |
VA |
Scheduling Replacement |
Will develop a next-generation appointment application based
on business process re-engineering and the Institute for Health
Care Improvement guidelines for open and advanced access to care
models. |
VA |
VistA Imaging |
Will provide complete online patient data to health care providers,
increase clinician productivity, facilitate medical decision making,
and improve quality of care. |
VA |
VistA Laboratory IS System Reengineering |
Will enhance the VA Laboratory Service's information technology
system and associated business processes to address current deficiencies
and meet future needs. |
VA |
VistA Legacy (includes staff) |
The operating system software platform and technical infrastructure
(associated with clinical operations) on which VA health care
facilities operate their software applications. |
VA |
Health Infrastructure |
The health infrastructure is primarily a hardware-refresh project
designed to put VA general office automation support servers,
workstations, and peripherals on a 4-year replacement schedule.
It will consolidate the services of several smaller computer facilities
into an existing larger computer facility on newer hardware, providing
greater reliability while reducing overall computer space and
IT staff. It will establish a working contingency plan for the
consolidated site. |
* Administrative, logistic, and financial systems, which use health data but do not contribute to direct patient care.
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