1. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES 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

2. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 2 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?

3. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 3 “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

4. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 4 Cost and Workload Assignment Today EAS IV MTF/DTF REPORTS Unit Cost Tables Workcenter Costs Workload/Performan ce Interfaces Reports EAS IV Central Repository DoD Executive 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)

5. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 5 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 Ambulatory CPT Data Patient Acuity Data ADM Data FTE, Salary Expenses Outpatient/Ancilla ry Workload Support Expense Allocation Data (Monthly) FTE, Salary Expenses WORKLOAD FINANCIALPERSONNEL = Projected for EAS IV EAS SA Personnel System (Air Force)

6. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 6 Current Workflow Processes PGU I ADM WAM CHCS I EAS SADR / SIDR CHCS II CCE MDR

7. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 7 Variation 1 on Current Business Processes A Possibility Primary Business Process Patient 1 Initial Documentation CHCS I/ II EWSR Outcome Provider 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 Edited Documentation CHCS I/II 3 Approved/ Final Documentation CHCS I/II

8. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 8 Variation 2 on Current Business Processes A Possibility Primary Business Process Patient 1 Initial Documentation CHCS I/II EW SR Outcome Provide r DMLSS EI/DS (OLAP) *Theater and Infrastructure cover entire process. CCE CDW CMBB EAS By: Work Ctr, Facility, CPT, DRG (Dx), Provider Ancillaries 2 Edited Documentation CHCS I/II 3 Approved/ Final Documentation CHCS I/II

9. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 9 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

10. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 10 MHS IM/IT Program Management Oversight Structure Access to Care Provision of Care Population Health Improvement Manage the Business Theater Medical Information Program Information Management (IM) Proponent Committee (08/SES) TRICARE Executive Committee (09/SES) Theater Functional (IM) Steering Committee (07/08) MHS Chief Information Officer Director, Information Management Program Executive Officer MHS IT Organization Information Technology (IT) Program Review Board (06/SES) TRANSCOM Command and Control Evacuation System Information Management Information Technology Assistant Secretary of Defense (Health Affairs) Clinical Information Tech Program Office Defense Medical Logistics Standard Support Resources Information Tech Program Office Executive Information/ Decision SupportTechnical Infrastructure Medical Readiness 10

11. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 11 Purpose of the IM Requirement 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.”

12. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 12 Overview of the IM RDP

13. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 13 Information Management Requirements Development Process (RDP) Five Phases:

14. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 14 Requirements Development Process - Operational View 14

15. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 15 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

16. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 16 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)

17. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 17 RDP SCR/SIR Flow (Developer) Tier 3 Functional Proponent (Validate & Prioritize) UBO, UBU, MMIG,... Info only Functional Users POs Information Management Services Help Desk PM/ CCB SCR Submission SIR (re-categorized SCR) Assignment SCR/ SIR SIR SCR SIR Budgetary Process SCR Submission MHS Requirements Repository Status Prepare RDS Inputs or RFCS SCR Submission Development SRWG IM/ SIR Provide SCR Status Provide SCR/SIR Status SCR Submission SCR Submission Incl. MMIG POC

18. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES 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) 18

19. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 19 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

20. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 20 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).

21. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 21 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

22. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 22 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 imit_reqs@tma.osd.mil or Manage the Business (MtB) at ruth.rosen@tma.osd.mil imit_reqs@tma.osd.mil

23. Documenting Counts CodingBilling CORECORE COMPETENCIES COMPETENCIESCORECORE COMPETENCIES COMPETENCIES MEPRS Conference 2005 23 Questions?