VistA Imaging Modernazation Project December 11, 2007 Project Overview

Project Goals and Objectives Improve patient safety through the sharing of medical images between the VA and DoD. Targeted enhancements include; the capability to deliver images produced within any VA medical center, as well as images from outside sources such as DoD medical facilities or community hospitals. Increase timeliness of access to care by improving clinicians’ workflow, thereby increasing the number of patients that can be treated. Targeted enhancements include expanding interfaces to commercial medical devices, including Picture Archiving and Communications Systems (PACS) and systems that provide 3-D reconstruction of radiology images. These capabilities will be delivered through specific developmental initiatives within the program including; Remote Image Views that provide access to images at remote facilities, Telereader capabilities for remote interpretation of images, VA/DOD sharing of images. Additional enhancements will be made to the VistA Imaging scanned document capabilities and diagnostic radiology.

Project History FY2002: Initial Cost Benefit Analysis and project planning and staffing FY2004: VHA P&LMS Stakeholder Workgroups identified Requirements Elicitation Process Industry Assessment FY2005:Business Process Reengineering Request For Information Market Analysis Requirements Prioritization FY2006:DoD Lab/AP Contract Review Updated Cost Benefit Analysis Evaluation of DoD Lab/AP COTS solution (Cerner Millennium PathNet) Acquisition Decision Brief and DoD Position Paper FY2007: Milestone 1 Approval (Prototype Development) Prototype contract award for Cerner Millennium PathNet Prototype VA Test Sites identified Prototype Design Assessment and System Review Prototype Integration Testing Prototype VA Test Environnent identified

VA IT Milestones Feb 2003 Project Initiation (Milestone 0) Feb 2007 Prototype Approval (Milestone 1) Sep 2008 System Development Approval (Milestone 2) Mar 2010 System Deployment Approval (Milestone 3) Mar 2016 Post Implementation Review (Milestone 4)

Estimated Project Timeline Prototype Initiation Feb 08Aug 08Dec 08 IV&V Testing complete July 07 Workflows Complete Functional UAT Complete Sept 08 Integration Testing Complete Field Testing begins Jan 09 National Deployme nt FY2010 – FY2015 7/5/07 The GSA contract with Cerner was signed 2/2008 The localized workflow build will be completed for West Roxbury 8/2008 User Acceptance Testing for LIMS functionality will be complete 9/2008 Full Integration Testing with VistA will be complete 12/2008 Independent Verification & Validation will be complete 1/2009 Field testing begins with West Roxbury followed by Bedford and West Haven 4/2010 IOC (definition: Field test complete and Deployment Approval received) 4/2010 National Deployment Begins 4/2015 FOC (definition: end of National Deployment)

The LIMS prototype will demonstrate Integration with VistA including deployed HealtheVet services, key LIMS functionality and system performance. The duration of the prototype is expected to be 12 months. End to End integration testing (Order-> Process -> Result) HeV Lab Version 1.1 : CPRS  Legacy Lab  Cerner  Legacy Lab Standardization: Consolidated Order Catalog and workflow configuration features that promote standardization Functional: Key scenarios from the following Business Processes: Accept Lab OrderSchedule Activity Collect SpecimenCreate Workflow Activity Receive SpecimenCreate Test Workflow Prep SpecimenCreate Auditable Event Analyze SpecimenCreate Lab Metric Create Standing Report Template Pull Supplies Create Lab Performance Dashboard Add Test Offering Add Specimen to Archive Create Workgroup Log On Performance: Capacity Load Testing to ensure that the deployment topology meets or exceeds the performance expectations of VA. This requires: Capacity Load benchmarking (Cerner) Capacity Load benchmarking (VistA HL7 App) Performance Turn Around Time (common set of tests) Prototype Scope Overview

Budget Original budget for development: $ (FY05 OMB Exhibit 300) Current budget estimate: $ (Full lifecycle cost, 5 yrs O&M) Total expended through FY07: $13.162M

Project Dependencies Computerized Patient Records System (CPRS/Legacy) – VistA Imaging has several interfaces to CPRS that are very important to clinicians. Some of these interfaces improve clinician workflow. Any enhancements made need to be closely coordinated. Standards & Terminology Services (STS) – VistA Imaging has developed a standard enterprise image terminology that is used by clinicians to locate image studies quickly. This standard terminology is coordinated with STS. Need STS involvement with outside partners such as DoD. Radiology Services – VistA Imaging uses radiology workflow indicators to allow radiologists work efficiently. Identity Services – VistA Imaging will be dependent upon Common Services for a role-based access and user management. Enterprise Architecture – VistA Imaging uses standard development tools and the VA’s standard architecture. Any changes in the standard architecture need to be coordinated. Health Data Repository–VistA Imaging is beginning to provide data to information to the Health Data Repository to support associations of images with medical documents. This initiative is being closely coordinated.