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CCOORREE

CCOOMMPPEETTEENNCCIIEESS

Military Health System (MHS)Information Management and the

Requirements Process

Andrew B. Cornell, Sr., FACHE

For: Ms. Ruth Rosen, Deputy IM, MtB

TMA/IMD

1 September 2005

MEPRS Conference 20052



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Fundamentals

• Question: What do you get when you automate a really poor business process?

• Answer: A really fast poor business process!

• Have you ever seen the MHS automate a poor system?




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“On” Versus “In”

• In his book, eMyth, Michael Gerber states that many businesses fail not because their entrepreneurial owners do not work hard in the system, rather they fail to work on the system.

• Too often well intentioned people work hard in their jobs but not on integrating how their functions integrate to optimize the business of the enterprise




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Cost and Workload Assignment Today

EAS IV

MTF/DTF REPORTS

•Unit Cost Tables•Workcenter Costs•Workload/Performance

•Interfaces•Reports

EAS IV Central Repository

DoDExecutive

Information/Decision Support System (EI/DS)

MTF/DTF

Personnel Data•Uniform Chart of Account Personnel System (UCAPERS)•Standard Personnel Management System (SPMS)•EAS Stand Alone (EAS-SA)

Financial Data•Standard Finance System (STANFINS)•Standard Accounting Reporting System/Field Level (STARS/FL)•Air Force Base Standard Accounting System (AFBAS)

Workload Data•Composite Health Care System (CHCS)•Ambulatory Data Module (ADM) •Workload Management System for Nursing-Army (WMSN-A)




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Cost and Workload Assignment Interfaces

DMLSS (DoD)

STANFINS (Army)

STARS/FL (Navy)

CRIS(Air Force)

ADM(DoD)

WMSN-A(Army)

CHCS II(DoD)

DMHRSi(DoD)

CHCS(DoD)

Repositories

EI/DS/(DoD)

SPMS(Navy)

UCAPERS(Army)Logistic

s Data

O & M Expenses

O & M Expenses

O & M Expenses

Ambulatory CPT Data

Patient Acuity Data

ADM Data

FTE, Salary Expenses

Outpatient/Ancillary

Workload Support

Expense Allocation Data

(Monthly)

FTE, Salary

Expenses

WORKLOAD

FINANCIAL PERSONNEL

= Projected = Projected for EAS IVfor EAS IV

EAS SA Personnel

System(Air Force)




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Current Workflow Processes

PGUI

ADM

WAM

CHCS I

EAS

SADR/

SIDR

CHCS II

CCE

MDR




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Variation 1 on Current Business Processes

A Possibility

Primary Business Process

Patient

1 InitialDocumentation

CHCS I/IIEWSR

OutcomeProvider

DMLSS

EI/DS (OLAP)

*Theater and Infrastructure cover entire process.

CCE

CDR

CDW

CMBB

EAS

By: Work Ctr,Facility,

CPT,DRG (Dx),Provider

Ancillaries

2 EditedDocumentation

CHCS I/II3 Approved/ Final

DocumentationCHCS I/II




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Variation 2 on Current Business Processes

A Possibility

Primary Business Process

Patient

1 InitialDocumentation

CHCS I/II

EWSR

OutcomeProvider

DMLSS

EI/DS (OLAP)

*Theater and Infrastructure cover entire process.

CCE

CDW

CMBB

EAS

By: Work Ctr,

Facility,CPT,

DRG (Dx),Provider

Ancillaries

2 EditedDocumentation

CHCS I/II

3 Approved/ FinalDocumentation

CHCS I/II




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IM Presentation Objectives

• Become informed about the MHS Information Management (IM) and Information Technology organizational structure

• Gain an overview of the MHS IM functional requirements development process (RDP)

• Be able to submit requests for changes and improvements in MHS automated information systems (AIS)

• Understand how your submissions are reviewed, tracked, and implemented




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MHS IM/IT ProgramManagement Oversight Structure

Access to Care

Provision of Care

Population HealthImprovement

Manage the Business

Theater Medical Information Program

Information Management (IM) Proponent Committee (08/SES)

TRICAREExecutive Committee (09/SES)

Theater Functional (IM) Steering Committee (07/08)

MHSChief Information Officer

Director, Information Management

Program Executive OfficerMHS IT Organization

Information Technology (IT)Program Review Board (06/SES)

TRANSCOM Command andControl Evacuation System

InformationManagement

InformationTechnology

Assistant Secretary of Defense(Health Affairs)

Clinical Information Tech Program Office

Defense Medical LogisticsStandard Support

Resources Information TechProgram Office

Executive Information/Decision Support

Technical Infrastructure

Med

ical

Re

adin

ess

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Purpose of the IMRequirement Development

Process (RDP)

“The purpose of the IM RDP is to document guidelines and procedures in support of the Director, IM, in the execution of a centralized process to clearly define, document, analyze, and manage functional requirements at appropriate times in the AIS life cycle. The IM RDP is a repeatable, consistent, and traceable process that supports the MHS stakeholders.”

“The purpose of the IM RDP is to document guidelines and procedures in support of the Director, IM, in the execution of a centralized process to clearly define, document, analyze, and manage functional requirements at appropriate times in the AIS life cycle. The IM RDP is a repeatable, consistent, and traceable process that supports the MHS stakeholders.”




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Overview of the IM RDP




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Information ManagementRequirements Development

Process (RDP)

Five Phases:




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Requirements Development Process - Operational View

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Your Role in the Requirements Process

• Think about your business activities:– Is a change needed to an existing Military Health System

(MHS) automated information system (AIS)?– Do you have a requirement for a new MHS IM capability?

• Document your recommended change on an issue paper IAW DoD 6010.13 (MEPRS Manual), Chapter 5, and pass it to your Service MEPRS POC.

• When the MMIG validates recommended changes, they will then pass them to TMA/IM using the required Requirements Development Process (RDP) form




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Common Submission Types

• System change request (SCR)– Changing a current requirement or adding a new requirement in an

existing automated information system (AIS)• System incident report (SIR)

– Notifying that an error has been observed in hardware, software, documentation, or other AIS-related item

• Maintenance change request (MCR)– Requesting routine change in the ongoing operation of an AIS (e.g.,

update to a common database table)• Capability gap

– Identifying a new requirement for functionality that does not currently exist (e.g., a requirement resulting from a new legislative mandate or DoD policy)




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RDP SCR/SIR Flow

(Developer)Tier 3

Functional Proponent (Validate & Prioritize)

UBO, UBU, MMIG,. . .

Info only

Functional UsersFunctional Users

POsPOs Information Management

Information ManagementServicesServices

HelpDesk

PM/CCB

SCR Submission

SIR (re-categorized SCR)

Assignm

ent

SCR/SIR

SIR

SCRSIR

Budgetary Process

SC

R

Sub

mission

MHSRequirements

Repository

Status

Prep

are RD

S Inputs or

RF

CS

SC

R

Sub

mission

Development

SRWGIM/

SIR

Provide S

CR

Status

Pro

vide

SC

R/S

IR S

tatu

s

SCR

Submission

Submission

SCR Submission

Incl. MMIG POC



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Functional Proponent

• A recognized authority, representing a MHS functional activity, empowered to review and recommend actions regarding change submissions and other requirements

• Usually represented by a work group composed of TMA, Army, Navy, and Air Force medical representatives

• Examples:– Uniform Business Office (UBO) Work Group– Unified Biostatistical Utility (UBU) Work Group– MEPRS Management Improvement Group (MMIG)

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Submissions Tracking

• All Submissions are maintained in the MHS Requirements Repository (DOORS) with supporting documentation with access available via DOORSnet

• With each submission, TMA/IM staff check the DOORS database to ensure there is no duplication of this requirement in the MHS




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After Prioritization

• After the Submission is prioritized for funding, the IM staff will ensure all supporting documentation is prepared to move the submission forward in the process (whether current year or within the POM):

• Time is a critical decision; current year requirements can end up worked through the process but be unfunded.

• Requirements management includes significant additional supporting documentation.– Architecture: Operational Views– Request for Cost, Scheduling, and Implementation– Place in the POM Document to be presented to the Functional

Integration Work Group (FIWG).




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Challenges

• Many Agendas are in Play– BRAC– CHCS I Transformation– Joint Military Medical Command– . . .

• Most Productive Course of Action: Reengineer Business Processes to be as efficient and effective as possible regardless of the “politics” that might be at play




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Summary

• The Military Health System has a standardized process for functional requirements management

• You have an important role in submitting requests through your Service MMIG POC to improve automated information systems and to identify other AIS-related requirements

• For additional information contact [email protected] or Manage the Business (MtB) at [email protected]




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Questions?

Documents

Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES Military Health System (MHS) Information Management