FedHealthIT 2019

Executives & Leaders Winter 2019 INSIDE5SOLUTIONS DISRUPTINGTHE FEDERAL HEALTH MARKETGROUND TRUTH | HOLOLENS | NETIZEN | NCICIOXFeaturing SOLVING FOR THE LAST MILEInterviews Inside The Quadruple Aim of Health Care Transformation withConnected Care: DHA’s Dr. Barclay ButlerAn Interview withVA’s Dr. Neil Evans pg. 46Strategies forConnecting withFederal HealthAgenciesDriving HealthcareResults ThroughStrong ProgramIntegrityHere Come theFederal HealthDeals withKippsDeSanto &Co.’s Marc Marlin Introducing the Women in Leadership Impacting Federal IT and Consulting pg. 40

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Follow us @FedHealthIT FedHealthIT Magazine CONTENTSTable of Contents 10 32 5 A Message from our 46 Executive Vice President Susan Sharer 50 66 6 KPMG: Driving Healthcare Results Through Strong Program Integrity10 Artificial Intelligence: Five Marketing Steps Government Contractors Need to Know for FY 2019 and Beyond By former CMS Senior Acquisition Director Brian Hebbel14 3 Questions Microservice Contracts Must Consider By Milad Bahrami16 Leading The Charge For Positive Disruption Survey Results are In18 CIOX: Helping Solve For The Last Mile Of Clinical Interoperability A Conversation with Paul Roma, CEO, and Mitch Mitchell, Senior VicePresident, Government Solutions24 2018 FedHealthIT Innovation Awards and Networking Event32 Connected Care: An Interview with VA’s Dr. Neil Evans36 Former US Army Surgeon General Patty Horoho: Positive Disruption Requires a New Lens40 IMPACT 2018 - Women in Leadership - Event & Winners46 Dr. Barclay Butler: The Quadruple Aim of Health Care Transformation50 Introducing the 2019 FedHeathIT100 Winners 100 Leaders Recognized for Driving Change in Federal Health IT56 Strategies for Connecting with Federal Health Agencies By Red Team’s Jeff Shen66 Here Come the Federal Health Deals Government contracting Insight from Marc Marlin, Managing Director at KippsDeSanto & Co. Winter 2019 | 3

CREDITS FedHealthIT Magazine Visit us at FedHealthIT.comPUBLISHER CONTRIBUTING WRITERS Follow us on Twitter @G2XHealth andG2Xchange Health Milad Bahrami @FedHealthITwww.G2Xchange.com Megan BeckwithPO Box 922 Dr. Barclay Butler LinkedInAnnapolis, MD 21404 Timothy Comello G2Xchange Health Dr. Neil Evans and FedHealthITEDITOR-IN-CHIEF Brian Hebbel Patty Horoho Copyright © 2018David Blackburn Marc B. Marlin G2Xchange Health. Mitch Mitchell All Rights Reserved.EXECUTIVE VP FEDHEALTHIT Paul Roma Amanda Schrauben V7.1 Materials may not beSusan Sharer Heather Seftel-Kirk reprinted or republished. Susan SharerMANAGING EDITOR Jeffrey ShenApril Doster Have a story to share with us? Connect with us:LEAD EDITOR [email protected] www.fedhealthit.comHeather Seftel-KirkASSOCIATE EDITORSJulie CooperJackie GilbertAndréa LeichtmanMargo McKennaART DIRECTORDanny WestCREATIVE SERVICESMontenero Studios, LLCDisclaimer: Limit of Liabiltiy/Disclaimer of Warranty: While the publisher and authors have used their best efforts in preparingthis magazine, they make no representations or warranties with respect to the accuracy or completeness of the contents of thispublication and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty maybe created or extended by written materials. The advice and strategies contained herein may not be suitable for your situation. Youshould consult with a professional where appropriate. Neither the publisher, nor the authors, shall be liable for any loss of profit orany other commercial damages, including but not limited to special, incidental, consequential, or other damages. 4 | Winter 2019

Follow us @FedHealthIT FedHealthIT Magazine EDITOR’S LETTER2019 – The Way Forward with PositiveDisruption and the Impact of CommunityWe want to thank all of you for your support through 2018. FedHealthIT has Sincerely,had an amazing year and we owe it all to you! Beyond our magazine and the Susan Shareropinions, advice and thought leadership you brought forward and allowed Executive Vice Presidentus to share through FedHealthIT.com from both industry and Government, FedHealthITyou have supported our growing calendar of events, conferences andawards and have come together as a community. Through your openness Winter 2019 | 5and your willingness to share, you have introduced us all to new faces, newideas, and created a venue for shared dialogue to help us build commonunderstanding so we can be motivated by each other’s ideas and celebrateeach other’s successes.This year’s magazine touches on disruption, sharing some of the trends,products and tools that you’re driving. It highlights the winners of theFedHealthIT Innovation Awards, nominated for driving innovation andresults across Federal Health. Showcasing the women in our communityrecognized at our Leading for Impact in Federal Technology, Health andConsulting Conference, we celebrate this diverse group who were nominatedfor guiding, mentoring, and driving the industry. And, of course, we spotlightthe winners of the FedHealthIT100 for driving change and advancement insupport of Health and Human Services, Centers for Medicare & MedicaidServices, Military Health and Veterans Affairs missions.Moving into 2019, the Federal Health community will be focused on positivedisruption, looking for the drivers (technologies), innovators (leaders), andinspiration (new ideas) that have the potential to change the landscapeof Federal Health IT. Through FedHealthIT.com this year, through ourupcoming events and awards – stay tuned - we want to continue to shareinsight from trailblazers in the community; to see how companies andorganizations are succeeding and adapting to new opportunities andchallenges; to spotlight disruptive technologies and ways of thinkingthat will help transform the Federal Health and Consulting landscape.Whether it is a unique partnership strategy; a new innovation center orproject designed to bring the community together; new approaches toacquisition… we invite you to connect and to share what you’re seeing sothe whole of our community can understand.Last year we challenged you to ‘Bring It’ and you did. This year’s challenge:Share insights that will chart the course, help us celebrate the victories thatare sure to happen along the way, focus all that you have on being positivelydisruptive and be part of a transformation that will truly shape the future.We can’t wait to see what the next year brings!

DRIVING HEALTHCARERESULTS THROUGHSTRONG PROGRAMINTEGRITYHealthcare programs consumed 27 percent of Federal spending this year.However, while 69 percent of respondents to a Pew research study saidthat the Federal Government should play a major role in ensuring accessto Healthcare, only 36 percent believed it was doing a good job. Whilenot a panacea to a vexing challenge, strong program integrity agendascan improve mission performance and enhance public confidence inGovernment. An excerpt from a recent paper considerations necessary to by KPMG spells out the need effectively and efficiently achieve for effective program integrity: an entity’s underlying mission in the “Federal program managers are public interest, while protecting facing the challenging task of taxpayer dollars. Put simply, it’s ensuring Healthcare programs about program performance, meet mission objectives and whether in Healthcare, disaster public expectations. Advances in assistance, or national defense, technology are changing the way and the importance of proactively they oversee and operate their managing performance. programs, while the ever-growing scope and complexity of care Megan Beckwith, a Director models is becoming increasingly in KPMG’s Federal Healthcare difficult to navigate.” We asked Advisory Services practice, points the authors of the paper four out that “the term has been questions. Here is what they said: around for decades, with people primarily associating program WHAT IS PROGRAM integrity with combating fraud, INTEGRITY? waste, and abuse, often after the fact.” Instead, she says, “program Program integrity holistically integrity must be strategic encompasses all elements and6 | Winter 2019



KPMG FedHealthIT Magazine Visit us at FedHealthIT.comand preventive and focused on adequately mitigating problems modernization, cybersecurity, andall elements of effectively and so that public expectations, organizational culture. Comelloefficiently accomplishing the broadly defined, are met, and risk emphasizes that “with themission.” She spoke of being management is strategic. Comello explosion of data and powerfulproactive versus just reacting to a says that “in Healthcare programs, analytic tools, program managerssituation. this means having a strong can now see what happened, program integrity framework, analyze why it happened, monitorShe also links program integrity undergirded by five dimensions: what is happening now, andto the expectations in The Office Governance, eligibility and anticipate what might happen inof Management and Budget enrollment, day-to-day operations, the future. Healthcare agenciesCircular A-123, Management’s oversight and monitoring, and have access to incalculableResponsibility for Enterprise continuous improvement.” amounts of untapped HealthcareRisk Management and Internal Comello cites the Affordable Care data that can be turned intoControl, which speaks to risk Act (ACA), stating that, “From information for day-to-daymanagement as “a series of the outset, understanding and operations and decision makingcoordinated activities to direct context around the expectations supporting program integrity.”and control challenges or threats and specific requirements of theto achieving an organization’s ACA were vital in developing the Beckwith speaks about intelligentgoals and objectives.” Finally, she program structure and underlying automation as a “tool tocites the President’s Management regulations, processes, and automate mission delivery andAgenda, which states that: accountability mechanisms. There business processes through“Effective stewardship of taxpayer was a strong priority on results digital technologies that supportfunds is a crucial responsibility and on avoiding a compliance or tasks undertaken by knowledgeof Government, from preventing “check-the-box” implementation workers to, among otherfraud to maximizing impact. approach. Program integrity things, increase productivity,Taxpayer dollars must go to was viewed as going far beyond performance, reliability, andeffective programs that produce compliance to focusing on citizen engagement.” She pointsresults efficiently.” results.” to automating anything from “complex actuarial processes toTimothy Comello, a Partner in Beckwith adds that it’s critical simple documentation processesKPMG’s Risk Consulting Services to establish a culture in which like PDF file reviews.” In stressingpractice, says, “When a new members of the program team the need for system modernization,program is being designed, are comfortable “raising their she also says that, “Outdated,program integrity considerations hand” when they identify a risk that legacy management systemsmust be embedded from day one calls for immediate action. “Team impede effective program integrityinto every aspect of the program.” members should feel support from while consuming upwards of 80He adds that, “for an existing leadership when they identify and percent of agency informationprogram where it has not already correct problems and acknowledge technology budgets.”been done, it is similarly essential mistakes,” she said.to do so, but it may take longer Comello points to cybersecurityand be more difficult to achieve at WHAT ELEMENTS FACILITATE and the potential consequencesthe outset.” STRONG PROGRAM of cyberattacks on the Federal INTEGRITY? Healthcare system given the $1.1 WHAT DOES BEING trillion of current year spending PROACTIVE ENTAIL? Comello and Beckwith highlight and the vast sums of health records five vital facilitators to program containing sensitive, personallyProactivity places a premium on integrity: Data and analytics, identifiable Healthcare information.anticipating and preventing or intelligent automation, system8 | Winter 2019

Follow us @FedHealthIT FedHealthIT Magazine KPMGHe says that, “Cybersecurity ABOUT ABOUTconsiderations are paramount to TIMOTHY COMELLO KPMGprogram integrity, and the impactis only expected to intensify.” Timothy Comello has over 20 The foundation of the U.S. years of experience assisting health system is shifting,Finally, Beckwith says that Federal agencies achieve their creating new and complex“the entire organization, objectives through measuring challenges and opportunitiesfrom leadership down, must client performance, improving for Government Healthcareunderstand and agree that management of enterprisefundamental change is needed and business process risks, program managers,to achieve program goals going assessing financial accounting/ regulators, providers, andforward.” She speaks about reporting processes and related“breaking down organizational Federal program operations, and health plans. KPMG hassilos and deeply entrenched remediating identified enterprise significant experiencecultures that perpetuate the advising Federal programstatus quo.” or process deficiencies. managers in strengthening Federal programs. Continual ANY THOUGHTS TO FEDERAL ABOUT program improvement AGENCIES CONCERNED MEGAN BECKWITH is essential in today’s ABOUT PROGRAM INTEGRITY? environment. Our in-depth Megan Beckwith has substantial understanding of GovernmentComello and Beckwith make it experience leading and programs, regulatoryclear that program integrity is experience, business processnot a magic potion to meeting coordinating engagements with improvement, enterpriseevery mission goal and public a focus on achieving program risk management, dataexpectation for eliminating analytics, cybersecurity,fraud, waste, and abuse. They integrity through review of process and intelligent automationsay that “while establishing and, in certain cases, consideration applications enable us toprogram integrity is tedious, help our clients develop,hard work that never ends, it’s a for specific Government rules implement, improve, andvital enabler to the effectiveness, and regulations around improper maintain the integrity of theirefficiency, and accountability programs. KPMG’s Programof Government programs that payment reporting, and has Integrity Framework includesaddress critical public needs and assisted management in evaluating interconnected dimensionsexpectations in a manner that that work together to driveachieves expected results and internal controls over financial program improvement, alongbuilds public confidence and reporting for both commercial and with extensive methodologiestrust.” and tools. The framework is Government clients and in the designed to help GovernmentThe information contained creation and documentation of agencies effectively andherein is of a general nature and accounting policies and processes. efficiently achieve programis not intended to address the objectives while beingcircumstances of any particular effective stewards of programindividual or entity. This article resources across the entirerepresents the views of TimothyComello and Megan Beckwith only, program life cycle.and not necessarily the views orprofessional advice of KPMG LLP. Winter 2019 | 9

HEBBEL FedHealthIT Magazine Visit us at FedHealthIT.comArtificial Intelligence: Five MarketingSteps Government Contractors Need toKnow for FY 2019 and BeyondBy Brian Hebbel, Former CMS Senior Federal Acquisition OfficialMany articles related to Artificial Intelligence (AI) and Robotics Process Automation (RPA) continue to pile upin both my computer and in hard copy in my office. In fact, over the summer, the Wall Street Journal createda whole weekend supplement section dedicated to AI. The OMB released a Memorandum on August 27,2018 titled Shifting From Low-Value to High-Value Work supporting the use of AI. Industry representativesare attending meetings to determine how AI/RPA will impact their business. However, my viewpoint of AI/RPA in Federal contracting is, “There’s a whole lot going on, but not much is happening.”We all know that AI/RPA is Data” revolution has matured. systems? How can that data resultgoing to have an impact on us IBM’s Watson has more data in the efficient and effectivein the future. It is being used in one system than has ever delivery of Government services?by commercial organizations been collected in the history ofeffectively, but sparingly by mankind. What do we do with all I don’t have the answer to thisFederal agencies. The “Big of the data contained in Federal big question. However, as a 10 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine HEBBELFederal Government contractingofficial with more than 34 yearsof expertise, now retired andworking on the “outside” for oneyear, I’m going to share my recentexperience with AI/RPA and what Ithink Federal contractors need todo to support the Government’sthirst for AI/RPA.Step #1: Determine AI/RPA they are part of legacy systems encourage change by buildingUse Cases that have remained unchanged AI/RPA around use cases whereThere is a lot of chatter regarding for years and the processes are the steps have access to theGovernment AI/RPA use cases. buried in the systems. Government processes.Contractors need to brainstorm anddevelop use cases for Government Currently, the Federal Step #3: Build AI/RPA Modelsbefore putting their toes into this Government does not appear Based On Your Use Cases Usingwater. However, this is hard to do to be buying solutions, but does Information Available to Youwithout collaboration with agency appear to be buying bodies There are a few contractors inpersonnel who are often unfamiliar from large integrators to access the Federal space that are thewith AI/RPA and therefore have how and where AI/RPA can be “leaders” in AI. However, asa difficult time applying the used. Money isn’t being saved stated earlier, it doesn’t appeartechnology to solving specific and it doesn’t appear that many that much is happening on aproblems or saving money. It is problems have been solved larger scale. At Federal agencies,not easy to determine use cases, using this approach. Federal there are thousands of problemsbut it is the most productive way contractors, for their part, waiting to be solved. Therefor industry to intervene, especially appear to be sitting on the fence are thousands of ways to helpif these are aimed at a specific waiting to see what happens agencies save money. The idealagency challenge. Keep in mind next, rather than developing AI/ situation is to work closely withthat sometimes a ‘low hanging fruit’ RPA outcome-based solutions an agency to access informationopportunity can provide the base that can be marketed directly to about related processes.for future opportunities. agencies. However, agency representatives are generally too busy runningStep #2: Get Access to The Federal contractor community the agency and don’t often haveGovernment Processes needs to be the driving force to the time or resources to fullyOnce you’ve found a use case,you need access to the Federalprocesses that are employedto complete the work. Federalagencies have defined processesand associated data, but allowingindustry access to build an AI/RPAtool can be problematic as bothare often buried into systems forwhich access is only granted to afew. Officials may not even knowthe steps and processes because W i n t e r 2 0 1 9 | 11

HEBBEL FedHealthIT Magazine Visit us at FedHealthIT.comcomprehend what information Step #5: Build Trust ABOUTcan be released to your company Ideally, AI/RPA solutions require BRIAN HEBBELor how AI/RPA can help them. the contractor to work side-by-The challenge for industry is to side with the Federal program Brian Hebbel had more thannot ask Government for a problem manager. However, if you 34 years of Federal contractingto solve, but to bring AI/RPA develop an AI/RPA solutiondeveloped scalable solutions, on our own time and your own experience, prior to hisdriven by information available dime, an agency will see your retirement in 2017. He wasto you, to the Government. By passion and you, in turn, may a Senior Acquisition Officialbringing a solution, perhaps even develop a trusted relationship. If (Group Director) at the Centersto a problem they did not know you can develop trust, they may for Medicare & Medicaidexisted, you may find officials provide additional use cases Services, Office of Acquisitionmore willing to meet to hear your and defined processes, that and Grants Management.solution. could present opportunities to Prior to his retirement, he market your AI/RPA solutions toStep #4: Develop A other agencies. was the longest servingMarketing Strategy contracting official at CMS, andWhen it comes to marketing and The U.S. Digital Service hasselling AI/RPA in the Federal encouraged the use of creative provided oversight to threespace, contractors must develop acquisition techniques, contracting divisions awardinga marketing strategy prior to including having contractorsengaging. If you can help an develop cell phone apps as $1,500,000,000 in contractagency solve a problem, save part of the source selection awards in FY 2017 and providingmoney, educate them about process. Contractors also needinformation technology or trends to be creative in terms of how guidance to acquisitionin your area of expertise, they they decide to break into the strategies and schedules,will often be willing to engage AI/RPA field. I’m sure creative solicitation requirements, sourceyour company, regardless acquisition techniques similar selection and resolving complexof existing history with the to those used by the USDS willagency. If Federal contractors be used in the future to procure contracting issues.are serious about moving into AI/RPA services/solutions. He is an author of “How toand winning contracts in the AI/RPA space, they need to think Just like the changes USDS Market & Sell to the U.S.differently about why and how created in Government Government, A View from thethey engage. contracting, AI/RPA contracting Inside”. Brian is the President methods will present new and of BARC Business Advisors LLC,Immediate value can often be unique ways of performing work to Bring Acquisition Results toachieved by delivering use cases at Federal agencies. Don’t sit onthat will eliminate repetitive the sidelines, but think of creative Contractors (BARC).tasks that often require access ways to apply AI/RPA at yourto multiple systems. If you targeted agency. As I said earlier,can eliminate hours of work, there may be a whole lot goingthereby freeing up the Federal on, but not much is happening.official to perform more detailed Federal contractors need to getmeaningful work, this will yield creative now or they may be leftsignificant marketing benefits for in the dust when real AI/RPAyour use case. contract activity starts.12 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine POLLOne word that is required to drive Positive Disruption? index‐analytics.com info@index‐analytics.com Real solutions that work for government. Data and business  intelligence strategy  Enterprise data integration  and visualization Salesforce deployment Training, user coaching,   and outreach Program and project  management  *Positive Disruption word cloud aggregated fromImpact 2018 panel online poll W i n t e r 2 0 1 9 | 13

BAHRAMI FedHealthIT Magazine Visit us at FedHealthIT.com3 QuestionsMicroservice Contracts Must ConsiderBy Milad Bahrami, Vice President of HHS Delivery and Growth Operations at GDIT and former NIH Division DirectorIn Federal procurement and in particular, across the Department of Health and Human Services, the era oflarge procurements to build and maintain monolithic systems has passed.The risk of developing and integrator for mismanaging the What is the best way to breakmaintaining these systems was work and causing inconsistent up the work?far too great for the Government communication to the As you talk to differentto bear. What we are seeing as a Government. The best way to individuals and organizationsresult is the Government breaking address these challenges is to you will find many differentsystems down into microservices have well defined requirements ways of accomplishing this. Myand seeking professional and service level agreements recommendation comes fromservices from multiple vendors. having experience in bothConceptually speaking this as applicable. My second the public and private sectors.sounds great. It will lend itself recommendation would be to When breaking up the work, youto faster and less complicated have open lines of communication should first consider how youprocurements, increase between the service providers, can best create segregationcompetition and spread risk as well as the Government.amongst various vendors. A Project Management of duties. In an IT servicesHowever, with all of those Office can be a good way to contract this can bestbenefits, several other facilitate the management and be accomplished byquestions arise that communication. creating differentneed to be answered. teams for differentLet’s take a look at what functions, such assome of those are: security, architecture, prototype developmentWhat are the risks and and testing. Non-drawbacks in a multi- technical areas, such asvendor environment?The goal is to reduce cost training and organizationalbut at the same time you change management, shouldare having to add a systems also be on the top of your list.integrator to manage all of the How you end up breaking updifferent contractors. Since this is the work could determinea role that can sometimes be filled success or failure.by the Government, when theGovernment outsources that work Are certain technologies betterto a systems integrator, finger positioned than others topointing can occur. Not only support this type of structure?are the various service providers Having spent some time inpointing fingers at each other, but the product world, I know thatthey will also blame the systems most product companies will tell you that health technology 14 | W i n t e r 2 0 1 9 is the answer to your success

Follow us @FedHealthIT FedHealthIT Magazine BAHRAMIwhen creating microservices. I would Technology (GDIT). He worksagree that technology is definitely a with executive leaders at HHSfactor but it is not the determiningfactor. I believe it is more about to ensure GDIT is helpingthe organization and management improve IT effectiveness andof the work. Focusing on how we delivery of enterprise-levelare designing our systems andimplementing continuous delivery will results at HHS.be critical. Do we have the technologyavailable today? Absolutely, but the ABOUT He is a former Divisionbigger question is, do we have the MILAD BAHRAMI Director with the Nationalmindset that is required? Institutes of Health (NIH) Milad Bahrami is a seasoned Business Applications ServicesAs our industry transforms into Federal IT industry expert organization within the Centeradopting these new methods and with over 20 years of for Information Technology,the Government changes how they do experience in both the a former U.S. Food and Drugbusines, we, as Government service public and private sectors Administration (FDA) CDERproviders, also need to evolve in of the Federal Government. IPT Manager, and a formerterms of how we provide services and Milad is currently the Vice Enterprise Reporting Managerwork with each other to provide the President of HHS Delivery with the U.S. Departmentbest value to the Government. and Growth Operations at of Justice. He has earned an NIH Director’s Award General Dynamics Information and was named one of the FedHealthIT100.

POSITIVE DISRUPTION FedHealthIT Magazine Visit us at FedHealthIT.comAs early as 2013, Forbes had released a list of the Most Disruptive Names in Business,defining distruptors as innovators and explaining that disruption “takes a left turn byliterally uprooting and changing how we think, behave, do business, learn and goabout our day-to-day” and that “disruption displaces an existing market, industry,or technology and produces something new and more efficient and worthwhile.”We asked our members to help is AutoSTIG-VM by Netizenidentify the Technology Products Netizen developed AutoSTIG-VM,driving Positive Disruption in the automates the laborious task ofFederal IT and Consulting sectors. The validating the configuration of VMWarefollowing descriptions are taken from servers and clusters in accordancethe nominations. with DISA STIG guidance. Reducing validation time to less than 5 minutesGround Truth by Premise Data and exporting the results into a formatPremise Data, with funding from USAID, usable by existing tools such as eMASS,is helping the Government of Colombia human error is prevented. This tooloptimize its Zika vector control operations was developed in support of securityusing data supplied by health workers engineering efforts and is currentlyand ordinary citizens through Premise’s in use by the U.S. Army Corps ofGroundtruth Platform. Premise’s platform Engineers (USACE) Engineer Researchallows health workers and citizens to and Development Center (ERDC)surveil for mosquito breeding sites based for performing RMF security controlon statistical models. The use of data assessments to achieve authorizationcollected through Premise’s platform has to operate (ATO).replaced pen and paper and enabledpredictive analytics-based operations Shai by NCI, Inc.that have decreased Zika outbreak risk NCI’s artificial intelligence (AI) solution,from an average of 35 percent to under Shai, is a transformative operationalfive percent. AI technology handling repetitive, high-volume tasks using the tools/HoloLens by Microsoft systems agencies already have in place.Military Medicine and Medical Research, Modeled from a platform used byand other components of Military Health commercial hospitals nationwide, Shaiare leveraging Microsoft’s HoloLens leverages robotic process automationtechnologies, and are evaluating to reduce administrative tasks byaugmented reality to support Combat more than 75 percent, cutting costs,Casualty Care requirements addressing increasing efficiency and accuracy, andprolonged field care scenarios due to changing the culture of Government.a changing theatre. With HoloLens, a With Shai, agencies can redirect stafffield medic can initiate a connection to focus on higher-value work—allowingwith a Trauma Surgeon or SME who humans to take of people, not paper.is working remotely. The remote SMEcan holographically insert his hands You can read more about our fifthinto the field of view of the medic and nominee, HealthSource by Cioxprovide even more specificity as to on page 18.recommended life-saving procedures.16 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine POSITIVE DISRUPTIONLEADING THECHARGE FOR POSITIVE DISRUPTION W i n t e r 2 0 1 9 | 17

Interoperability is a key challengeboth industry and Governmentare working to solve. OneAtlanta-based health technologycompany is working to redefinehow Healthcare information isshared among organizationsand agencies. By developingand implementing cutting-edge,HIPAA-compliant technologiesand optimal workflow at a massivescale, Ciox Health is streamliningthe supply chain of medicalrecords, health information andclinical documentation with agoal of advancing the industry bysolving some of its most complexinteroperability challenges.HELPING SOLVEFOR THE LASTMILE OF CLINICALINTEROPERABILITY

Follow us @FedHealthIT FedHealthIT Magazine CIOXReaching across the U.S. “THERE HAVE BEEN created a “last mile” challengeHealthcare ecosystem, Ciox preventing access to the benefitssources, acquires, enhances and MANY ACHIEVEMENTS and true system interoperability.delivers medical records anddiscrete clinical data from virtually ACROSS THE INDUSTRY “We aren’t sitting around waitinganywhere in the country, touching to see what the next technologymore than 100 million patient IN LEVERAGING IT AND is going to be to create therecords annually and managing disruption needed, and weclients with millions of annual INDUSTRY STANDARDS FOR aren’t waiting for all things to berequests for clinical data across a connected so that informationfragmented system. HEALTH INFORMATION flows without friction,” said Roma. “Instead, we’re stepping into theRecently, FedHealthIT’s Executive EXCHANGE (HIE), BUT void to provide immediate accessVice President, Susan Sharer, to critical, relevant information.had the opportunity to sit down WE’RE NOT THERE YET AND What the industry needs rightwith Paul Roma, CEO of Ciox, now is a true technology-enabledand Mitch Mitchell, Senior Vice GAPS REMAIN. THESE ARE service that combines the best ofPresident, Government Solutions technology and people.”at Ciox, to discuss the challenges ESPECIALLY PRONOUNCEDand the opportunities for solving THE FEDERAL CONNECTIONfor the last mile of interoperability. WHEN IT COMES TO The Federal Government POSITIVE DISRUPTION UNLOCKING THE VALUABLE maintains an insatiable appetite IN HEALTHCARE for clinical information across CLINICAL INSIGHTS FROM numerous agencies andThe Healthcare business is departments to serve a varietychanging rapidly including UNSTRUCTURED DATA of use cases, according to Mitchin the focus by Government Mitchell, Senior Vice President,and commercial providers on SUCH AS PROVIDER NOTES, Government Solutions. Cioximproving the way information presents the opportunity for theseis stored and shared across a SUBJECTIVE ASSESSMENTS Government stakeholders tofragmented health IT landscape. leverage the pervasive access to AND NARRATIVES WITHIN rich clinical information that CioxDespite the widespread adoption has established and optimizedof EMRs, Ciox CEO Paul Roma THE CHART.” over many years working with thesays there hasn’t been significant majority of U.S. hospitals, clinicsimprovement over the past facilitate that exchange. This can and health IT vendors. Throughdecade in our collective ability to have a material impact across the the development and ongoingsource and acquire clinical content ecosystem. enhancement of a secure andand pull insights from structured complex technical infrastructure,and unstructured data. Currently, Because EMR incentives (HITECH, coupled with proven workflowdata about patients is created and Meaningful Use/Promoting and processes, Ciox supports alocked in silos, where it can’t be Interoperability, etc.) were massively scalable data acquisitioneasily accessed and used by the designed to promote technology and exchange capability that goespatient or by those who serve that adoption, EMR technologies a long way to address the growingpatient. It remains a challenge for are foundationally designed to requirements that represent thestakeholders to share information, support intra-provider clinical last mile challenge of systemicand intervention is required to and reimbursement workflows. clinical interoperability. While an explosion of digital clinical data followed EMR W i n t e r 2 0 1 9 | 19 adoption, most of the rich clinical context of the patient-provider encounter remains trapped in unstructured free text and notes. Interoperability requirements have emerged but largely promote point-to-point data sharing or “passive interoperability.” This misalignment of objectives has

CIOX FedHealthIT Magazine Visit us at FedHealthIT.com“There have been many While the Patient-Centered disability benefits. Ciox satisfiesachievements across the industry in Community Care (PC3)/Veterans nearly 20 percent of the Agency’sleveraging IT and industry standards Choice programs have improved total demand of 16-20 millionfor health information exchange access and augment the care records per year for related clinical(HIE), but we’re not there yet and Veterans receive in VA facilities, data. The SSA is an examplegaps remain. These are especially the same needs exist to provide of a complex and distributedpronounced when it comes to timely access to clinical data Government agency benefitingunlocking the valuable clinical from those encounters around from access to comprehensiveinsights from unstructured data various use cases, including clinical information andsuch as provider notes, subjective quality reporting, continuity of unstructured data embeddedassessments and narratives within care and data validation and within a clinical record.the chart. These insights are largely coding. Within the Veteransunavailable at scale through the Benefits Administration, the “When we look at the NIH andcurrent implementation of HIE initial determination of disability its clinical research initiatives, wemethodologies, and are critical or eligibility for benefits is driven see an obvious opportunity toto meeting the current and largely by the ability to access bring value by helping to unlockfuture needs of patients and their detailed clinical records and those hidden gems and insightsfamilies.” documentation from across the within the record, perhaps from Healthcare ecosystem. a note or observation that couldFilling the gap and beginning to lead a researcher to a fastersolve for the last mile of clinical BEYOND THE DOD AND VA conclusion or light the way in ainteroperability, Ciox gains new direction,” says Mitchell.access to the larger network Many other departments andof care settings and accesses agencies within the Federal CONNECTIVITYa more comprehensive clinical Government, including the AND THE LAST MILEpayload of information that may Centers for Medicare & Medicaidnot be connected within an HIE Services (CMS), National Institutes Programs on the Federal side haveinfrastructure. of Health (NIH), Centers for come a long way in defining what Disease Control (CDC), Food and they need to get done. Now that TACKLING COMPLEXITY Drug Administration (FDA) and they know what is needed, partners Social Security Administration are required to support them overThe Defense Health Agency and (SSA), are also large consumers the next few years in finishing thatVeterans Health Administration are of comprehensive clinical last mile.examples of complex Healthcare information for a host ofsystems relying on internal direct different use cases, including risk “The network we have establishedcare resources and a large network adjustment, data validation, fraud, took many years to build. Ourof commercial hospitals, clinics and waste and abuse prevention, presence at a vast number ofexternal providers to deliver care to quality reporting, clinical data clinics and hospitals was a slowbeneficiaries. Roughly 60 percent abstraction, retrospective sentinel and gradual process and that footof care delivered within the military event analysis, clinical and basic in the door is not the end. Therehealth system is provided within research and disability benefit is always a challenge regardingthe commercially-purchased care determination. behavioral change; you have tonetwork. Maintaining seamless get people to use the solutionsaccess to rich clinical content from The SSA, for example, has a and services,” says Roma.those encounters can improve the need for detailed medical recordoverall patient experience and and clinical documentation to The second challenge is achievingdelivery of care while reducing support the determination of true IT integration in the absencecosts. impairments related to critical of detailed standards regarding IT20 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine CIOXinfrastructure which may requirelarge logistical efforts to ensureconnectivity.According to Mitchell: “To achievethis high level of interoperability,we’re connecting hospitals andclinics through a digital grid thatwill enable information exchangeand unlock insights beyondwhat current health informationexchanges can do. This will allowfor significant increases in thecapacity and variability of clinicalinformation access that can besupported.”Beyond simply sourcing and By coupling Mitchell’s (sitting) Government health expertise with Ciox’s extensiveacquiring a record, the ability, commercial footprint, Roma (standing) has positioned Ciox and its technologicaltechnology and experience advancements in health information management to close the loop on theto programmatically review fragmented health IT landscape across both public and private public sectors.and abstract relevant clinicalinformation is a critical facet of the and streamline how Healthcare how records are acquired andvalue chain that Ciox has refined information is interpreted. Ciox how relevant clinical information isand honed to scale. HealthSource™ uses artificial abstracted. intelligence and natural languageRoma says the company’s processing technologies to enable THE HUMAN ELEMENTapproach leverages an “access access to a richer clinical dataset,first” mentality. “We now have while reducing administrative With approximately 9,000the presence, the portals and burdens and improving financial employees, Ciox Health is a criticalthe connectivity, so the access performance for a broad array of ingredient in achieving pervasiveis there. The next stage will be stakeholders. access to rich clinical contentdriving deeper into electronic and the exchange of that dataintegration. The average hospital Designed and developed from the across the Healthcare ecosystem.has seven EMRs. We’re now ground up, HealthSource vastly Trained in executing HIPAA-working to ensure we aren’t just improves clinical data exchange by compliant exchange of data, thisconnected to one or a few, but to unlocking previously inaccessible workforce is skilled in ensuringall of them.” and unstructured data and the optimal approach to sourcing incorporating it into the workflow and acquiring clinical data is THE TECHNOLOGY of Healthcare information. The utilized, that the best approach platform transforms and optimizes to systemic interoperability isBuilding on its mission to help established, and that what ispatients, clinicians and otherstakeholders source informationand unlock clinical insightsquickly and securely, Ciox hasintroduced a highly scalableclinical data platform to improve W i n t e r 2 0 1 9 | 21

CIOX FedHealthIT Magazine Visit us at FedHealthIT.combeing exchanged meets the been installing the software in a unique value proposition forrequirements of the organization. organizations around the country, the Government stakeholder.The process is intensely people- modernizing and standardizing “The content from clinicaldriven but leverages complex the release of clinical data to documentation and records wetechnology to satisfy the spectrum authorized requestors. Roma says are able to source and acquireof requirements for clinical that, for Ciox, this component is a is needed by a combinationinformation. no fail mission. “We are invested in of agencies, some with similar ensuring our platform and people requirements for continuity ofIn many cases, complicated rules meet the stringent requirements care, research, registries or safety.that limit what can be shared for privacy and security.” The trend of collaboration amongrequire redactions. Until now, vendor partners, leveraging athere hasn’t been a technology TRENDS: WHERE combination of products, servicesthat can do this effectively at scale. WE’RE HEADED and domain expertise, is positiveHowever, this year Ciox introduced and will serve the agency orthe HealthSource platform, now Mitchell says his team is seeing department in a constructive andcommercially available, and has more collaboration across thoughtful way.” organizations, combining forCIOX STORY | SOLVING THREE PROBLEMS IN CLINICAL DATA INTEROPERABILITY doctor patient hospital payer employer biopharma legal government evidencecontinuing care patient access revenue cycle risk and quality gaps in care mass tort benefit eligibility Connect | Ingest | Transform | Deliver 100M+ 3B+ 400+ 10k+ 3 of 5 650k+health information records annual clinical data EMR systems for Nursing, clinical, and HIM Networked hospitals in the Providers from whom data is reliably handed annually transactions conducted record access medical record experts United States sourced1 22 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine CIOX “At Ciox, we are passionate ABOUT ABOUT about giving our customers PAUL J. ROMA W.B. “MITCH” MITCHELL the ability to abstract and interpret unstructured clinical Paul J. Roma is Chief Executive W.B. “Mitch” Mitchell is Senior information and consume the Officer of Ciox Health. He Vice President, Government large volume of information brings 20 years of executive Solutions with Ciox. Mitch is a required to fulfill their mission,” management experience in adds Roma. “If we’re going senior strategy and management to collectively address the Healthcare companies, enabling professional with over 25 interoperability challenge, organizational transformation developing and integrating and significant performance years passionately building tools that automate the improvements. Paul is an businesses in Healthcare and digestion of information across experienced executive with information technology. He the Healthcare ecosystem a proven record of leading combines expertise in Military must remain a top focus of our successful mission-critical industry.” transformations for Fortune 500 and Veteran’s Health, and companies in the Healthcare Federal Health Programs, Ubiquitousaccesstopatient and life sciences industry. He Health Information Exchange, Patient Engagement and Clinical11Ubiqduaittaouwshaecrceevsesrtiotrpeasttiseanntdin specializes in growth/innovation eHealth Strategy Development, datawwhhaeterevveerrfoitrrmesttsharonudginha strategies and applying Cyber Security and Technology whapterovveirdfeorrmnettwhroorukg1h0xathenext Implementations for Health provdidaetarnasestewtoinrkth1e0xecthoesynsteexmt disruptive technologies to drive Systems, Medical Groups, dataassetintheecosystem performance. Prior to joining Federal, State and Local Ciox Health, Paul was a senior Stakeholders. For 15 years prior22Compliant,consented,secure to joining Ciox, Mitch led teams Comapccliaensst,,cstoonrsaegnetaendd,sdeeculivreeryof partner and Chief Analytics Officer across McKesson/RelayHealth accedsas,tastorageanddeliveryof of Deloitte LLP, where he led and Change Healthcare, data supporting complex commercial global analytics and new product and Federal Health IT and HIE33Understandingendusers’ offerings and was the National Undneersetdasntdoinngoermndaulizseerasn’ d pipe engagements. needinsdtoatnaotormthaelizireuanniqdupeipe Technology Leader for Healthcare indawtaotrokftlohweisrunique and Life Sciences for eight years. workflows ABOUT CIOX Reaching across the U.S. Healthcare ecosystem, Ciox sources, acquires, enhances and delivers medical records and discrete clinical data from virtually anywhere in the country, touching more than 100 million patient records annually and managing clients with millions of annual requests for clinical data across a fragmented system. Ciox is the trusted partner of three out of five U.S. hospitals, more than 16,000 clinics, more than 140 health insurance companies and a growing number of marquee clients in the life science, Government, and legal industries. The company has experience connecting to more than 400 EMR vendor systems and serves a critical role with respect to information aggregation and delivery. W i n t e r 2 0 1 9 | 23

SUBJECT FedHealthIT Magazine Visit us at FedHealthIT.com 2018 FedHealthIT Innovation Awards and Networking Event At the 2018 FedHealthIT Innovation Awards and Networking Event at the National Press Club, more than 300 senior Federal Health IT executives from Industry and Government came together to recognize and honor Federal Health innovation, technology and consulting sector programs nominated and selected by their peers for DRIVINGINNOVATION and RESULTS across the Department of Veterans Affairs, Centers for Medicareand Medicaid Services, Military Health, and the Department of Health and Human Services. 2244 || WW ii nn tt ee rr 22 00 11 99

Follow us @FedHealthIT FedHealthIT Magazine SUBJECT DHA Pharmacy Analytics TRICARE Online (TOL) Lauren Thompson,PhD., Support Services (PASS) Patient Portal (PP) Director, DoD/VA Interagency Defense Health Agency Defense Health Agency, Program Office Solution Delivery Division The Pharmacy Analytics Support with limited access to care in the Section (PASS) is an integralThe Tricare Online Patient Portal VHA system. This project provides component of the Pharmacy(also referred to as “TRICARE a framework for improving access Operations Division (POD)Online” or “TOL”) is the current and increasing engagement for providing data, analysis, andsecure patient portal that gives patients suffering from SUDs and pharmacy benefit information.registered users access to online includes mobile tools aimed at To address Healthcare costshealth care information and recovery, predictive analytics, and support warfightersservices at military hospitals and support and relapse prevention. diagnosed with PTSD and Opioidclinics. Through the portal, users dependency, the PASS teamcan review and download their Encounter Data Dashboard developed effective tools topersonal health information, and Analytics (EDDA) track and monitor prescriptionsschedule/change appointments Centers for Medicare & and drug treatments to ensureat military hospitals or clinics, Medicaid, Medicare Plan and providers optimize treatment andrefill/check status of prescriptions Payment Group patient safety.and enhanced health information EDDA provides a self-serviceexchange. analytics platform to identify HRSA’s Telehealth Resource trends and anomalies related to Center (TRC) Program Enterprise Intelligence & Medicare Advantage data. One of Health Resources and Services Data Solutions (EIDS) the first analytics solutions that has Administration, Health and Defense Health Agency adopted the Agile methodology Human Services within CMS’ Enterprise IT SharedGrown as a solution to some of Services framework, the platform The Telehealth Resource Centerthe MHS’s most pressing mission- blends a COTS BI product with program is a force multiplier for thedriven needs, EIDS PMO organizes an open-source Javascript library nation’s move toward telehealthand consolidates disparate data to offer both high-level trends and virtual care, encouraging localsources to one common Data, and detailed claims data in an innovation, collaborative learningLogic, and Presentation layer. integrated interface. and maximizing value from theThe most innovative aspects: Federal investment. Regional anddriving consensus among national TRCs work together anddisparate customer bases using with the HRSA PM to share bestcutting edge data management practices, tailor technical assistancetechnologies, creating a research and tools for organizations seekingwork bench, and building out a to establish and sustain telehealthcloud ready/capable environment programs.to support its user base. WW ii nn tt ee rr 22 00 11 99 || 2255 Substance Use Disorder Treatment (SUD) VHA Center for Compassionate InnovationThe SUD proof of concept willprovide increased access to carefor up to 1,000 patients diagnosedwith alcohol and opiate addiction

SUBJECT FedHealthIT Magazine Visit us at FedHealthIT.com Genetic Diagnostic Testing (GDx) System Medicare dialysis facilities to Medicare Blue Button 2.0 Department of Veterans Affairs, the CMS’ CROWNWeb system, U.S. Digital Service/ Centers Office of Connected Care this program implements data- for Medicare and Medicaid centric methodologies to produce ServicesGDx reports genetic test results for accurate, complete, and timelyVeterans in a true Virtual Lifetime information that helps system Medicare’s Blue Button 2.0 is aHealth Record. The mobile stakeholders focus on creating new, secure option for patientsapplication allows Veterans and VA broad benefits for national to share personal health dataproviders unprecedented access Healthcare. in a universal digital format,to laboratory test results, allowing connecting claims data tofor viewing and sharing results Clinical Decision Support secure applications, serviceswith Healthcare providers inside (CDS) Content and HL7- and trusted research programs.and outside of VA. The application compliant Knowledge The program expects to fosterfacilitates the integration Artifacts (KNARTs) increased competition amongof genomic information as Development Contract technology innovators to servestandardized, searchable data Department of Veterans Affairs, Medicare patients and theireasily incorporated into clinical Office of Health Informatics- caregivers, finding better waysdecision support systems. Knowledge Based Systems to use claims data to serve patients’ needs. HHS/CMS CROWN Data The KNARTs program is designed Discrepancy Support to support VA’s Healthcare My HealtheVet Core (CDDS) community in achieving Development Health and Human Services/ standardization of clinical Department of Veterans Affairs Centers for Medicare & content by organizing clinical Medicaid Services/Center for knowledge and logic in a way that This innovative My HealtheVet Clinical Standards and Quality is universally shareable via any Core Development solution Clinical Decision Support (CDS) leveraged MHV’s service-basedFocused on analyzing and tool, any Electronic Health Record architecture and large userresolving data quality issues, (EHR), or any IT platform thereby community to expose an under-generating and distributing data improving the ability of clinicians utilized mobile application,quality reports, and improving to deliver patient care and aiming effectively combining VA ITthe integrity of data from to improve the referral process. investment across multiple delivery channels to drive user adoption. This merging of resources from separate contracts and programs to enable VA to better care for the patient is a model for future cross-channel integrations. Customer Experience (CX) Data Capability Department of Veterans Affairs This program created a CX data framework to collect and analyze Veteran experience input across multiple touchpoints as they engage with VA. Using2266 || WW ii nn tt ee rr 22 00 11 99

Follow us @FedHealthIT FedHealthIT Magazine SUBJECT of eligible participants in ana newly-developed platform, has enabled CDER to meet and automated way, replacing manual,Veterans are able to provide exceed every formal negotiated labor-intensive, and error-pronecompliments, recommendations GDUFA goal and facilitated processes.and concerns to inform service regulatory action surpassingrecovery and performance anything in the history of the Diffusion of Excellenceimprovement. generic drug program. Department of Veterans Affairs CDER Informatics Platform Quality Payment Program The Diffusion of Excellence Food and Drug Administration, Submission API (QPP) Initiative empowers frontline Center for Drug Evaluation and Department of Health and employees to solve some of Research Human Services/ Centers for VHA’s toughest challenges Medicare & Medicaid and improve Veteran care andThe CDER Informatics Platform experiences. The Initiative usesprovides holistic drug review The QPP Submissions API a “Shark Tank” style competitionmanagement through integrated broke new ground in software to identify promising practicesdata and work management, development at CMS as the across VA priorities; the best ofbusiness intelligence and first public transactional API in those practices are replicatedreporting, and electronic the history of quality reporting and spread across VHA. Thissubmission capabilities. Enabling programs there, and the first to compelling and engaging modelthe rapid processing, validation, be developed in the open. The expands pockets of excellencemanagement, and analysis of Submissions API allows external within VA.data, this transformative solution partners to submit data on behalfUnleashing data to WW ii nn tt ee rr 22 00 11 99 || 2277transform the future ofhealth informationtechnologyPatient-centered.Interoperable.Digitally connected.Bringing together the right ideas, data and people at theright time can lead to powerful insights. Our knowledgeand experience can help inform your strategy, advancecollaboration, and accelerate your impact and mission.Let us help you make an impact that matters.www.deloitte.com© 2018 Deloitte Development LLC. All rights reserved.

SUBJECT FedHealthIT Magazine Visit us at FedHealthIT.com Enterprise Blood apnea to be diagnosed and treated Mobile Scheduling Management Systems: without having to travel to a sleep Enhancements (MSE) Transfusion (EBMS-T) and center. This VA-developed web Department of Veterans Affairs, Donor (EBMS-D) platform facilitates remote care and OI&T Enterprise Program Defense Health Agency, provides a convenient alternative Management Office Solutions Delivery Division to current in-person management. VA is using Agile and DevOpsIn support of the Armed Services REVAMP also demonstrates practices to optimize developmentBlood Program mission to the potential to lower costs and of its cloud-based 508-compliantprovide “quality blood products improve treatment use. mobile scheduling applications.and services for all worldwide These apps enable Veterans, VAcustomers in both peace and war,” Building a Digital Biobank clinics and VA staff to self-schedulethe Enterprise Blood Management for Military Precisions primary care, audiology, optometry,System strategic modernization Medicine and mental health appointmentsproject enhances MHS blood U.S. Air Force, Air Force within the VA Healthcare system.capabilities, providing enterprise- Medical Service Since the November 2017 releasewide functionality for donor The AFMS “Digital Biobank” of the VA Online Schedulingcenters and blood banks. EBMS platform supports hosting, app, transactions conducted byis used in blood management managing, and analyzing health Veterans have increased by overoperations including collection, data, including de-identified 3000 percent.processing, transfusion and health and military service records,inventory management. genomic data, and exposure Jim Trafficant, Managing data. This effort represents a Director Federal Health, Remote Veterans Apnea groundbreaking opportunity to Accenture Federal Services Management Platform use data to improve the health, (REVAMP) wellness, and performance Department of Veterans Affairs, of Servicemembers and their Office of Connected Care beneficiaries and has providedREVAMP improves Veteran access thought leadership to MHSto care, reduces patient wait times, policymakers to frame clinical andand allows Veterans with sleep technology issues. 2288 || WW ii nn tt ee rr 22 00 11 99

Follow us @FedHealthIT FedHealthIT Magazine SUBJECTExecutive Keynote Panelists Dr. Barclay Butler, PhD., Assistant Director, Health Care Administration, DHAand Dr. Neil Evans, MD, Chief Officer, Connected Care, VHA Measure-Specific Modern Data Analytics DHA Mitigation and Reporting Error Prediction Platform for HRSA Remediation Support Engine (MSREPE) Electronic Handbooks (MARS) Team Centers for Medicare & Health Resources and Services Defense Health Agency Medicaid Services Administration OI&T The MARS team has been widelyThe Measure-Specific Reporting An end-to-end grant support and recognized for its technicalError Prediction Engine program management application, acumen, forward-thinking,analyzes clinical quality measure the Electronic Handbooks (EHBs) and standardized solutions tospecifications to predict the system unifies grant management resolving a myriad of cybersecurityextent of reporting error that processes across HRSA and vulnerabilities. This capabilitywould be expected for that allows users to perform functions has been leveraged by Militarymeasure. Validated based on spanning grants operations, Treatment Facilities (MTFs) andreview of PQRS records, MSREPE program planning, monitoring, programs, world-wide. Givenenables CMS to identify potential and management through one these contributions to Enterprisesources of measure-specific error transparent, enterprise-wide security, MARS staff have receivedand how measure specification system. The program supports accolades from Enterprise, site,revision or planning for reporting a paperless environment with and system leadership; Navalcan reduce errors. improved business efficiency Commendations; and previously and compliance with mandated won the Captain Joan Dooling policies, procedures, and award. legislation. WW ii nn tt ee rr 22 00 11 99 || 2299

SUBJECT FedHealthIT Magazine Visit us at FedHealthIT.com National Plan and Provider NIAAA Alcohol Treatment Encounter Data Processing Enumeration System Navigator System (EDPS) NextGen (NPPES) Project National Institute on Alcohol Centers for Medicare & Centers for Medicare & Abuse and Alcoholism Medicaid Services Medicaid Services, Center for Program Integrity Drawing on decades of scientific CMS implemented the EDPS research, NIAAA and IQ to collect, process and analyzeUsing open source products to Solutions, Inc., developed the MA encounter data used tomodernize NPPES with a simplified Alcohol Treatment Navigator, an calculate MA payments. Theuser interface and enhancements interactive website simplifying the most innovative aspect of EDPSlike a delegation function, search for alcohol use disorder NextGen is its proposed scalableautomated form completion, treatment options. It provides cloud-based architecture,self-service, and smart search a comprehensive, actionable offering the accurate and timelyfeatures has increased usability strategy related to finding high- processing of a growing volumeand met the U.S. Digital Service quality treatment. The Navigator of encounters. The architecturemission. The project improved educates and serves the public and platform allows CMS to meetCMS’ ability to address HIPAA and supports NIAAA to efficiently the HHS goal of modernizingrequirements for standard unique respond to inquiries. legacy infrastructure and programidentifiers and improve efficiency objectives.and effectiveness of electronictransmission of health information.30 || WW ii nn tt ee rr 22 00 11 99

Follow us @FedHealthIT FedHealthIT Magazine SUBJECT SOLOR – System of Logical Representation Department of Veterans AffairsSOLOR creates a transformationprocess to represent and integratecommon terminologies using asingle extensible model. Usingopen source software for thistransformation, SOLOR enablesdevelopers to convert any user-supplied terminologies intoits single model. This dramaticsimplification represents aparadigm shift in how developersconsume terminology, and therebyenables collaborative improvementin medical knowledge, patient care,and patient safety.THANK YOU TO ALL OF OUR SPONSORS PREMIER SPONSOR index analytics BEYOND NUMBERS ISnodftra WW ii nn tt ee rr 22 00 11 99 || 31

CONNECTED CAREAN INTERVIEW WITH VA’s DR. NEIL EVANS

Follow us @FedHealthIT FedHealthIT Magazine DR. EVANSIn June, President Donald Trump this front since the Anywhere to the virtual care and telehealthofficially signed the VA MISSION Anywhere initiative was formally technologies available to supportAct, more formally known as the finalized. Over the past year, the provision of care. SecureVA Maintaining Systems and more than 100,000 encounters email through My HealtheVet,Strengthening Integrated Outside have been delivered via video video visits through VA VideoNetworks Act, or the Caring for connection. That’s roughly 700 Connect, or text messagingOur Veterans Act of 2018. Section visits per day and we expect through VA’s Annie program, are151 of the Act, entitled “Licensure that number to increase as all tools at the clinician’s disposalof Healthcare professionals of more providers are trained and that can enhance the provider/the Department of Veterans become capable of using VA patient relationship and provideAffairs providing treatment via Video Connect, our direct-to- innovative and convenient waystelemedicine”, formalized a new Veteran video solution. to meet the needs of the patient.authority that allows VA employedHealthcare professionals to The combination of our As the clinical communitypractice regardless of the location Anywhere to Anywhere initiative becomes aware of theseof the provider or patient. and the VA MISSION Act allows technologies and as they for delivery of care to Veterans experience how virtual care canRecently, FedHealthIT’s Executive in their homes, workplaces, or enhance patients’ experienceVice President, Susan Sharer, had through community partners, and outcomes, adoption is likelythe opportunity to speak with Dr. and it allows us to connect to increase. Provider adoptionNeil Evans about telemedicine, Veterans with the right specialty of virtual care is critical – andhow it is paving the way as a providers anywhere in the VA by extension drives patientpositive disruption in Healthcare system, and with specific and adoption. Historically, we’ve founddelivery, and the challenges that unique clinical skills they may a provider’s recommendation is aremain. require. powerful motivator for patients to try new technologies and new WHY IS SECTION 151 OF THE HOW DO YOU MAXIMIZE ways of engaging. VA MISSION ACT CRITICAL? THE POTENTIAL? Every week, I see patients in clinicSection 151 of the VA MISSION With a workforce as large as and have experienced the senseAct is critical for VA, establishing VA’s, step one is ensuring the of helplessness busy clinical staffunambiguous authority for VA entire clinical team is aware ofHealthcare providers to deliver W i n t e r 2 0 1 9 | 33care via telehealth across statelines to wherever the Veteranis located. This may not seemtransformative, but this authorityis critical for VA to leverage itstalented clinical workforce acrossthe country, and to be able tobetter support Veterans at homeor in their communities.This new authority allows us toleverage telehealth and virtualcare delivery as part of all ourcore operations. We’ve alreadyseen significant progress on

DR. EVANS FedHealthIT Magazine Visit us at FedHealthIT.comoften feel, as they try to keep have saved him time and trouble, providers at our larger hospitalup and as they try to meet the and there was the added bonus locations. We’ve engaged withexpectations of all stakeholders. of saving the Healthcare system colleagues in the private sectorVirtual care technologies, when the cost and inefficiency of an to share VA’s lessons learnedwell-implemented, can be magical, unnecessary emergency room visit. about telehealth. The interest inmaking the provider’s tasks more telemedicine and virtual care inefficient and simultaneously We’ve seen a lot of creativity in Healthcare at large has increased;delighting the patient. how people are using VA’s new the entire industry is thinking video care solution - regular about how virtual care shouldFor instance, I was recently on wound follow-up visits via video; be integrated into their corea call with a patient and for a group visits involving the Veteran, operations. Every Healthcaremoment, suspected they might their VA provider and an external system is focused on the patientneed an emergency room visit for prosthetist fitting new artificial experience and how to makeevaluation. And then, “Ah ha!” – “I limbs or other prosthetics; mental care less inconvenient, while stillcould spin up a VA Video Connect health visits; collaborative home maintaining high quality.visit and solve this right now.” blood pressure checks, and more.Within minutes, my patient and WHAT CHALLENGESI were connected via video and THE PRIVATE SECTOR REMAIN?after seeing the issue, I was able CONNECTIONto explain what was happening. How do we ensure the increasedHe was thrilled to have an answer VA has been a leader for many adoption of virtual care doesn’tand didn’t have to come to the years, using video and synchronous lead to unintended consequences?emergency room. I was happy to telehealth to connect Veterans who And how do we assure these new visit our community clinics with VA modalities for care delivery don’t34 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine DR. EVANScreate new disparities between better supporting them and their ABOUTthose who have technology and caregivers where they are. NEIL EVANS, MDthose who don’t? We need toensure we provide the same access We can increase the efficiency and The Office of Connected Careto all Veterans, regardless of their capacity of the Healthcare system manages VA Telehealth, Mytechnological means. by connecting available clinical HealtheVet, the VA Mobile staff with the Veterans who needWe’re thinking, at the system level, their services, even if the Veteran program, and VHA’s Innovationabout ways to improve the ability and provider aren’t in the same initiatives. Beyond his role withof Veterans to access technology. location. the Office of Connected Care,We’re in regular dialog with Dr. Evans is also a primary carethe Federal Communications We can increase the quality of physician who sees patients atCommission (FCC) around support the care we deliver by connecting the Washington D.C. Veteransfor broadband expansion and the Veterans with the clinical staff bestneed for Americans to have access equipped to meet their needs. Affairs Medical Center.to affordable high-speed internetfrom their homes and workplaces. Technology allows us to think “THE INTEREST IN creatively about how our Healthcare TELEMEDICINEOn another front, VA is working system adapts and responds to the AND VIRTUALto make devices, such as video- needs of Veterans and citizens. I CARE INenabled tablets, available to think a great example occurred last HEALTHCAREVeterans when they need to year in the aftermath of Hurricane AT LARGE HASconnect regularly and don’t have Harvey. An impromptu telehealth INCREASED;access to a device. emergency management team THE ENTIRE quickly stepped in and provided INDUSTRY ISAnother barrier is the challenge virtual care, helping decompress THINKINGof integrating new virtual care the massive load on the local ABOUT HOWworkflows into VA’s clinical Healthcare providers who were, VIRTUAL CAREenvironment at scale. We’re in some cases, juggling their own SHOULDdeeply involved in the day-to-day personal losses in the midst of the BE INTEGRATEDwork necessary to implement a crisis. We’ve expanded telehealth INTO THEIR COREsuccessful virtual care program, as part of our emergency plan OPERATIONS.”including training, improving for the current hurricane season,technologies, adjusting workflows, having recently stress tested it on W i n t e r 2 0 1 9 | 35engaging with stakeholders, and the 4th of July.making necessary changes. Why else is the telehealth portion THE OPPORTUNITY TO THINK of the VA MISSION Act so BEYOND critical (and exciting)? - Because it demonstrates the supportTelehealth is disruptive. Telehealth we’ve seen at the highest levelshas the power to transform how we of our Government for thethink about Healthcare delivery expansion of VA telehealth and- particularly in a large national because it is a recognition of thesystem like VA. transformative potential of virtual care technologies. The journey isWe can significantly enhance just beginning.the Veteran’s experience by

PATTY HOROHO POSITIVEDISRUPTIONREQUIRES A NEW LENS

Follow us @FedHealthIT FedHealthIT Magazine HOROHORecently, FedHealthIT’s Executive Vice President, Susan Sharer, had the opportunity to speak with PattyHoroho. Currently CEO at OptumServe, Optum’s Federal Health services business unit, Patty is a 30+ year U.S.Army Veteran and served as the 43rd Army Surgeon General and Commanding General, U.S. Army MedicalCommand ensuring readiness and providing Healthcare to Servicemembers, retirees, and their families aroundthe globe. Patty was the first female and nurse to serve in these capacities in the 236-year history of the U.S.Army at the time. Here, she speaks about the positive disruption created during her tenure there and howthat disruption needs to continue to move forward. TRANSFORMATION FROM Our focus was on improving the “HEALTHCARE, HEALTHCARE TO HEALTH overall health of Servicemembers HEALTH AND THEAs the first woman and nurse who were wounded, ill or injured READINESS OF THESurgeon General in DoD, I with a health model that included FORCE CAN’T BErecognized it as a platform from complementary and alternative SOLVED BY ONEwhich to impact change. From medicines as part of their regimen AGENCY. IT TAKESthe start, I considered how we to help them improve and live the A COLLECTIVEwere and could be grooming best possible lives into the future. PARTNERSHIP WITHwomen and others from diverse There was also a focus on changing INDUSTRY ANDbackgrounds and experiences to our view from disease treatment GOVERNMENT,take on future leadership roles. and management to ensuring A MELDING OFWhen I took the job, it was less people were healthier, stronger TECHNOLOGY ANDimportant to me that I was the first and making better decisions to INNOVATIVE MINDS,woman, than it was that I wouldn’t ensure they were able to stay that TO REALLY DRIVEbe the last. In order to ensure the way. We had to move beyond CHANGE.”changes we implemented were disease treatment to a systemenduring, it had to be engraved in of true health that would impact safe care and that means we havethe DNA of the organization and people’s lives now and for the to look at disruption through abased in a desire for change. future. different lens. The challenge really is the speed in which changeThe disruption in Healthcare in DISRUPTING HEALTHCARE is occurring as a result of thethe Army required the same kind AND THE CHALLENGES technology and how disruptive itof change in DNA, the same kind can be. That’s why we need to lookof view through a different lens. Serving on active duty is all about internally at how we can disruptIt required taking our capabilities teams of teams working together and change the way we do things,outside of our bricks and mortar on a collective mission. I found the while keeping the needs of theand pushing them into the life same mission within industry and individual person in mind.space where people live, labor and in my new role at OptumServe.love. It meant empowering people Healthcare, health and the There is a competing friction withto make decisions about their readiness of the force can’t be many outside forces that wanthealth, for the Servicemember solved by one agency. It takes a to disrupt Healthcare. That’s whyand for their families. We knew collective partnership with industry change needs to be somethingwe would be successful when and Government, a melding ofthis was not discussed as a technology and innovative minds,medical program but something to really drive change.embedded in the minds of lineleaders, funded, embedded in People don’t necessarily wantdoctrine and reaching all levels of a disruption in their personalthe military. Healthcare; they want friction to be gone. They want seamless, quality, W i n t e r 2 0 1 9 | 37

HOROHO FedHealthIT Magazine Visit us at FedHealthIT.com“WE HAVE TO LET GO OF OLD TENDENCIESAND PRACTICES THAT WON’T MOVE US TOWHERE WE NEED TO GO.”embraced within and across when disease will occur, to if it ABOUTthe system. The people in will. We have to let go of old PATTY HOROHO, ARMY LT. GEN., RETIREDthe Healthcare system know tendencies and practices thathow to deliver care and how won’t move us to where we Retired Army Lt. Gen. Patricia (Patty)to deliver quality care in a need to go. Horoho joined Optum in 2017 and isway that can use data to drive CEO. Horoho has extensive experienceclinical performance. We Right now, 75 percent of leading large, integrated Healthcareneed to look at industry and our youth are unable to systems, served the Army for 33 years,what it is doing and we need serve in the armed forces, and was appointed as Army Surgeonto find ways to use machine mostly due to health related General, the first woman and nurse tolearning (ML) and artificial issues. If we don’t collectively hold that position. As the 43rd Armyintelligence (AI) in ways that come together, the Federal Surgeon General, she led the Armycan personalize care so we Government, commercial Medical Command and was responsibledon’t just look at it from the sector and industry, in a way for ensuring readiness and health, andlens of a patient, but from the that will really drive the health providing health care to Servicemembers,lens of a person. of our youth so they have their families, and retirees around the the right capabilities and globe. Her military citations include: TheThere must also be a culture for our people to be strong, Distinguished Service Medal, Legionchange based on trust. If if we don’t do that now, we of Merit, Bronze Star Medal, France’speople don’t know where will find we are in a very dire National Order of Legion of Honor,and how they fit within place in the future. Chevalier (Knight), Japan’s Defensethe system, they look at it Cooperation Award Second Class, and thethrough a more negative We have a great opportunity President’s Lifetime Achievement award.lens. There will always be now, but one that will take Other recognitions include being honoredearly adopters who are ready people thinking and acting by Time Life Publications for her actionsto go, a bunch in the middle differently. We sit on a wealth at the Pentagon on September 11, 2001;who aren’t sure and then of data and advances in among nurses selected by the Americanthe laggards. You need to technology that has already Red Cross and Nursing Spectrum tounderstand the full spectrum, changed parts of our lives. receive national recognition as a “Nurseto be able to change the way Healthcare has to be part of Hero”; 2009 USO Woman of the Year;you communicate to each that rapid change. Tiffany Circle Distinguished Womangroup to address their view Warrior; first military Servicemember andand bring the team along. I believe the world watches nurse to receive the New York Institute of what the U.S. does and we Technology’s Riland Public Service Award; WINDOW OF have a global responsibility the Helen Manzen Award from the New OPPORTUNITY to get this right. We have an York University College of Nursing for opportunity to help with these exemplary leadership on behalf of theI believe we have a window advances that will make the health of the nation; honored by the Jonasof opportunity to truly disrupt global society better. That Center for Nursing and Military leadership;Healthcare and to come up should excite us all: to be able and by the American Red Cross with thewith a model that leverages to partner to make change and Women Who Care Humanitarian Award.technology to personalize to leave behind a legacy thatcare for each individual that made a positive difference.changes the question of38 | W i n t e r 2 0 1 9



FedHealthIT and its partner organizations hosted the Leading for Impactin Federal IT, Health & Consulting, Women in Leadership Conference onThursday, October 25, 2018 at the Women’s Memorial in Arlington, VA.This inaugural event recognized women joined us for the program and sharedcreating IMPACT, leading organizations their perspective on IT modernizationand mission-focused strategic programs and digital transformation,across the Federal technology and change management and culturalconsulting community. A very special transformation, and leading for impactthank you to the senior executive to drive positive disruption in Federal IT,keynote speakers and panelists who health and consulting.40 | W i n t e r 2 0 1 9

Carolyn Clancy, MD Julie Boughn Deputy Undersecretary Director, Data and for Health, Discovery Systems Group, Center and Advancement, for Medicaid and CHIP Department of Veterans Services, Centers for Affairs Medicare and Medicaid Services, Department Suzi Connor of Health and Human Services Chief Information Officer, Centers for Disease Genevieve Morris Control, Department of Health and Human Integral Health Strategies, Services Health IT Policy, Former Chief Health Information Theresa Hancock Officer, Department of Veterans Affairs and Director, My HealtheVet, Principal Deputy National Department of Veterans Coordinator, ONC, HHS AffairsStacy Cummings Suzette KentProgram Executive Federal ChiefOfficer for the Defense Information Officer,Healthcare Management Office of ManagementSystems, Department of and Budget, ExecutiveDefense Office of the PresidentAlicia Harkness Vice Admiral BonoPartner, Guidehouse Director, Defense Health AgencyAnna Sever Maureen CoyleVice President,MAXIMUS Chief Executive Officer, Kforce GovernmentLisa Wol SolutionsPresident, Next PhaseSolutions and Services, Inc. W i n t e r 2 0 1 9 | 41

Anjelica Dortch Dawn Halfaker Jeneen Iwugo Lauren ThompsonPolicy Analyst, Office Chief Executive Officer, Deputy Director, Director, DoD/VAof Management and Halfaker and Associates Quality Improvement Interagency ProgramBudget, Executive Office and Innovation Group, Officeof the President Cathy McGrane Center for Critical Medicaid Services, Standards and Quality, Department of HealthKathleen Frisbee, Managing Partner, Scout Centers for Medicare and Human ServicesPhD Concepts and Medicaid Services Jean MoodyExecutive Director Seema Verma WilliamsConnected Care Office,Department of Veterans Administrator, Centers Deputy Director, CenterAffairs for Medicare and for Clinical Standards Medicaid Services and Quality, Centers for Medicaid and MedicareDenise Antinori Y. Michele Kang ServicesGroup Vice President Chief Executive Officer,Public Sector, Sapient CognosanteConsulting Patty Horoho CEO, OptumServe42 | W i n t e r 2 0 1 9

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Andrea Norris Director, Center for Information Technology and Chief Information Officer, National Institutes of Health, Department of Health and Human Services Amy Haseltine Deputy Chief Information Officer, Enterprise Services, Office of the Chief Information Office, Department of Health and Human Services Shannon Sartin Gita Uppal Executive Director, United Senior Health Advisor, States Digital Service, Department of Veterans and the Centers for Affairs Medicare and Medicaid Services Rebecca Miller Nicole Gardner Sector President, Health Vice President, Eminence and Civilian Agencies, Academy, Senior Advisor, Salient CRGT Federal Healthcare, IBM Industry Academy Beth Killoran Member, IBM Global Business Services Office of the Assistant Secretary for Health, Department of Health and Human Services44 | W i n t e r 2 0 1 9

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BUTLER FedHealthIT Magazine Visit us at FedHealthIT.comThe Quadruple Aim ofHealth Care TransformationBy Dr. Barclay Butler, DHAJust days ahead of the October 1 roll out of DHA’s new Military Health System (MHS) multi-year plan,FedHealthIT’s Executive Vice President Susan Sharer spoke with Dr. Barclay Butler, the interim Assistant Directorfor Health Care Administration (AD HCA) in the DHA. As the AD HCA, Dr. Butler is responsible for leadingthe development and execution of the plans for the DHA to assume authority, direction, and control (ADC)of all of the military medical treatment facilities (MTFs) in the MHS over the next three years, and achievingthe DHA’s Quadruple Aim of increased readiness, better health, better care, at lower costs.Fulfilling the Quadruple AimThe underlying frameworkfor transformation within theMHS is the Quadruple Aim,which focuses on the fourkey components of improvedreadiness, better health forpatients, a better experienceof care for both patients andproviders, and reducing percapita cost. This becomes theDHA’s value equation and is thecornerstone of efforts towardsvalue-based care.Phase 1 of the plan to transform The next stage will last a year Next year, the roll out will focusthe MHS includes the DHA while expanding the policies, on the Eastern Region, followedassumption of the ADC of three procedures, and business by the Western Region, and thenof the Services’ hospitals and performance measures to meet finally the overseas MTFs in thetheir external clinics: Womack the goals of the Quadruple Europe-Atlantic and the Indo-Army Medical Center in Fort Aim business plan. This will Pacific areas.Bragg, NC; Naval Hospital include looking at the driversJacksonville in Jacksonville, FL; of each organization in terms Positive Disruption Meets theand Keesler Medical Center in of what is needed, what their Value EquationBiloxi, MS. In addition, three patient population looks like, In evaluating new processes,subordinate Air Force clinics whether there is anything unique technology, and strategies usedare included: the 4th Medical to support (such as a highly to identify what will be a positiveGroup at Seymour Johnson deployable unit, or supporting and worthwhile disruption, weAir Force Base in Goldsboro, a large number of retirees), use our value equation to gaugeNC; the 628th Medical Group and potentially a balancing of the net effect of a particularat Joint Base Charleston in resources across organizations to consideration. Our value equationCharleston, SC; and the 43rd address those external drivers. helps us to understand whetherMedical Squadron at PopeField, NC.46 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine BUTLERan innovative idea improves be used to create an immutable There is Kotter’s 8-Step Processreadiness, overall health, care transactional record, documenting for Leading Change thatexperience, and cost impact. We what a doctor has added to the highlights some key takeaways,don’t want to be distracted by health care record, with data that including: 1) creating a senseshiny new objects that don’t really has been verified and validated, of urgency, 2) acceleratingadd value. Sometimes a simple that the patient has seen it, and the effort and not letting up,change in the care model for a that it can then flow to other care 3) empowering broad-based actionspecific kind of injury or illness can providers for further sharing with and removing barriers, 4) creatinghave the greatest impact across the integrated care team. and communicating the vision, andthe board. 5) building a guiding coalition. Change Management and the Ensuring senior leaders have aWe’re experiencing positive Impact on Culture clear vision of the final goal is thedisruption now in the way we In any type of transformation, the biggest challenge. The Serviceare working to standardize the shift in culture is key. If you can medical departments are steepeddelivery of care across Army, Navy, change what people do and how in their culture and tradition for aAir Force, and DHA to create a they think and feel about their jobs, good reason and now are beingstreamlined MHS that is focused you can change the culture. Within asked to move forward under aon creating efficiency, eliminating the MHS, we’re talking about an new model. It takes time to turnredundancies, and creating savings Army Medical Department that an historic culture and mindset andwhile leading to true reform of the has been around since 1775, and a refocus it on a future vision.overall MHS. Navy Medical Department that has existed since the late 1800s. They Sense of UrgencyBlockchain is one shiny new tool have a way of delivering care that is There are two types of risks.that has potential. As we look to embedded in their very bones. The The first focuses on movingexchange data across a multitude question now becomes: how do too quickly. Here, items may beof vendors, one way to ensure trust you take these differing embedded missed, or mistakes can be madeis with blockchain. Blockchain can cultures and align them? that can lead to operational W i n t e r 2 0 1 9 | 47

BUTLER FedHealthIT Magazine Visit us at FedHealthIT.com“ANOTHER STEP partnership efforts and to engage ABOUT with vendors who have solutions BARCLAY P. BUTLER,INCLUDES that can impact our value equation. We were also charged with using PH.D., MBAEXTENDING more innovative contracting to reach those vendors. Barclay P. Butler, Ph.D., MBA, as aPARTNERSHIPS BEYOND member of the Senior Executive The relationship we have with Service (SES), serves as the ActingTHE TRICARE SUPPORT the Department of Veterans Deputy for Health Care Administration. Affairs (VA) as they are driving Prior to this position, he served as theCONTRACTORS towards the same instance of Component Acquisition Executive (J-4) MHS GENESIS, is that this will and Senior Procurement Executive forTO OTHER CARE now allow for an easy exchange the Defense Health Agency (DHA). of information between the As the J4, Dr. Butler was responsiblePROVIDERS. THESE two Departments. This is an for oversight and approval of all important step for moving acquisition matters for the DHA,VENDORS CAN forward. Another step includes including those undertaken by the extending partnerships beyond Program Executive Officers, as well asPROVIDE EXCELLENT the TRICARE support contractors the Agency’s directorates and offices. to other care providers. These Prior to this he was the Director ofCARE TO OUR vendors can provide excellent Healthcare Technology Integration for care to our patients. They the DHA, and served as the ActingPATIENTS. THEY ALSO also bring a wide variety of Chief for Infrastructure and Operations electronic health records to (I&O), Health IT Directorate, DHA. AsBRING A WIDE VARIETY the mix. The trick here is to get a health technology integrator, he was that health care data back into responsible for progress towards a fullyOF ELECTRONIC the Servicemember’s record. interoperable Healthcare record for We do that by using the Health the DoD through coordination effortsHEALTH RECORDS TO Information Exchange (HIE). with Health and Human Services (HHS) Congress is encouraging us to Office of the National CoordinatorTHE MIX.” continue to develop relationships (ONC), other Federal agencies, private outside of our current boundaries, sector health delivery organizations,failures. Conversely, the other to bring in patients from othertype of risk is in not moving care centers to provide our and Standards Developmentquickly enough. Here, the focus surgeons with a case mix that Organizations (SDOs). Dr. Butleris lost over a couple of years. supports their battlefield skillsets, has over 35 years of experience asThat I would call a critical failure and to be able to move care to a military and civilian Healthcareand this is much more difficult other partners where areas of Information Technologist supportingto overcome. The military is very excellence may exist. the delivery of Healthcare IT servicesgood at identifying and correcting improving quality of care, improving theoperational mistakes, as long as Understanding that our ultimate experience of care, improving militarythere aren’t too many, because goal is the Quadruple Aim of readiness, reducing the cost of care,this can undermine confidence readiness, health, experience of all while delivering improved value.in the overall plan. The goal is care, and per capita costs, ourto balance the transition at the partners who can help us getright pace; we want to be moving there will largely factor into thequickly ahead, but not too quickly equation.to where patients are burdenedby change. It goes without sayingthat we’d never put patient safetyor care at risk in any scenario. Thisis non-negotiable.Partnership OpportunitiesIn 2017, we were chargedwith continuing to extend our48 | W i n t e r 2 0 1 9

Follow us @FedHealthIT FedHealthIT Magazine POLLWhat is required for achieving Change Managementand Cultural Transformation? GROUPIntegrity. Innovation. Collaboration. B3 Group is a fast-growing health IT firm providing end-to-end technology support services to the federal government. Our values-driven team is dedicated to developing innovative solutions for better healthcare outcomes.*Positive Disruption word cloud aggregated from www.b3groupinc.comImpact 2018 panel online poll W i n t e r 2 0 1 9 | 49

Introducing the 2019 FedHealthIT100The FedHealthIT100 honors those individuals recognized for driving change and advancementin the Federal Health Information Technology Market. Nominated and chosen by their peers,some common themes among those who were selected include the desire and willingness tochallenge conventional wisdom, to go above and beyond, to drive innovation, and to give backto the larger Federal Health IT and Consulting community.Aaron Seib Alastair Thomson Allison Andrea NorrisSenior Vice President, Chief Information Officer Oelschlaeger Director, Center forHealth Informatics National Heart, Lung Chief Data Officer and Information TechnologyNewWave Telecom and and Blood Institute, Director and Chief InformationTechnologies National Institutes of Office of Enterprise Data Officer Health and Analytics, Centers National Institutes ofAdriane Burton for Medicare and HealthChief Information Officer Medicaid ServicesHealth Resources and Andrea WrightServices Administration Amy Haseltine Vice President Defense Deputy Chief ProgramsAlan Constantian, Information Officer, Emagine IT, Inc.Ph.D Enterprise ServicesDeputy Chief Office of the CIO, Anita AllenInformation Officer Department of Health Small Business Specialist,Department of Veterans and Human Services Centers for MedicareAffairs and Medicaid Services50 | W i n t e r 2 0 1 9