VHA OI and VA OIT

1. VHA OI and VA OI&T

2. Outline CAC* Working Group Background OCWG Members Summary Results Study Timeline and Actions Data Call Results Recommendations Phase II Issues Summary/Next Steps

3. VA CAC - OCWG Background from Charter Issue: Organizational Consistency VA IT Development Realignment Working Group (DRWG) recognized VISN’s have CACs aligned with OI&T; others with VHA Recommended CAC organizational consistency work group Approach: Establish new work group to provide evaluation of CAC functions Conduct analysis of functions performed by both organizations (VHA & OI&T) Determine appropriate CAC position classification and organizational assignment Establish CAC “Level of Access” for VistA Systems Scope: All CAC personnel – VHA and OI&T VA-wide population included in CAC Roster is over 400 A data call is necessary to quantify, evaluate & classify these personnel

4. OCWG Members

5. Summary Results Defined the functions and position classification of VA CAC personnel Developed criteria to determine individual CAC functional responsibilities and classification for both VHA and OI&T functions Determined appropriate organizational alignment (VHA or OI&T) based on the developed criteria 223 CAC positions reviewed to date for alignment through voluntary data call Recommended initial CAC re-alignment (58 of 223 total) Review of over 200 additional CAC employees to be completed in Phase II Process confirms that VHA & OI&T CACs in 2210 series are most affected Identified and validated Menu Access requirements for specific CAC functions

6. OCWG Study Timeline

7. CAC / Non-CAC Functions Performed

8. CAC Member Responses to VistA Menu Needs

9. Recommendations 165 CAC employees in VHA (160) & OI&T (5) in other than GS-2210 series positions were determined to be performing predominantly (> 50 percent) CAC activities: No action required for the 160 in VHA; OCWG recommends alignment with VHA for the 5 in OI&T after HR review 46 GS-2210 CAC employees in VHA (6) & OI&T (40) were determined to be performing predominantly (> 50 percent) CAC activities: OCWG recommends reclassification & re-alignment to VHA for the 40 in OI&T; For the 6 in VHA, OCWG recommends reclassification & retention in VHA Reclassification or re-alignment actions should occur after HR review 12 GS-2210 CACs assigned to VHA (4) and OI&T (8) were determined to be performing predominantly (> 50 percent) Non-CAC activities: OCWG recommends the 8 in OI&T remain but not as CAC; 4 VHA employees should be reviewed by HR to determine classification & alignment decisions Implement individual - recommended VistA System “Level of Access” as determined by VistA Access Review Team Determination of standing VistA Access Review Team in process

10. OCWG Phase II Issues Address remaining CACs (over 200) who did not respond to Data Call Formalize VHA Clinical Informatics Specialist position series and titles Continue refinement of “Core Menu” listing Identify/pursue other opportunities for collaboration/synergy between VHA and OI&T Determination of “Standing” Informatics Management team to oversee overall performance, approve menu access, resolve issues, etc. Development of Team charter, composition, frequency of meetings, authority, etc. Conduct similar studies for ADPACs and Informatics Managers Identify/address “unique” issues such as: Small facilities with only person performing both IT specialist and CAC functions “Special project” clinicians requiring programming access

11. Summary / Next Steps Summary: Preserved cohesive teams across VHA and OI&T that support the clinical use of VHA’s clinical IT systems Achieved organizational consistency for CAC alignment and access by recommended realignments based on organizational functions Determined the Vista system “levels of access” that are required for CAC performance of functions Next Steps: Decision memorandum submitted for OI&T concurrence & USH approval Begin Phase II OCWG activities Establish HR sub-group to work HR issues affecting employee transfers

12. Final Comments We expect that in 6 – 12 months VA & VHA will have: Supported VHA’s most important asset–its employees Preserved cohesive teams across VHA and OI&T that support the clinical use of VHA’s clinical IT systems Achieved organizational consistency for CAC alignment & access We expect that in 1 – 2 years VA & VHA will have: Identified CAC tasks that require programmer / system administrator access and worked with OI&T to develop mutually acceptable approaches that are appropriate to the CAC role Established a professional career track for informaticists that addresses their HR, education, and professional needs The term informaticist is inclusive of T38, Hybrid T38 and GS employees that are performing the functions of the Informatics career track

13. Questions?

14. Back-up

15. Tasks from Charter Clearly define the functions and position classification of CAC personnel for Work Group discussions Develop appropriate criteria to determine individual CAC functional responsibilities and classification for both VHA and OI&T functions Based on a thorough review of current CAC personnel functional responsibilities, determine each individual’s appropriate organizational alignment, i.e., VHA or VA OI&T Determine if assignment of CACs to either organization (VA or VHA) requires a new title for one or the other Consult with human resource experts during the analysis of the functional responsibilities and position classification requirements for CAC personnel Determine the VistA system “levels of access” that are required for CAC performance of functions. If needed request changes to menu structure to support operations within the appropriate scope of the organizational placement. Recommend transition pathway to achieving this goal Prepare reports of findings and make recommendations to VHA and OI&T leadership not later than June 2007

16. Data Call Metrics / CAC Members who RespondedPhase I

17. CAC Data Call Summary / Metrics – Phase I Results CAC members responded to data call of “functions” performed Participation was voluntary and 50% of CAC population responded Metrics resulting from data call: CAC Population (Approx)            400 Total responses                         223 (~ 50% of CACs) Total VHA 170 (76%) Total OI&T             53 (24%) Percent of CAC Functions Performed Responses w/predominant (> 50%) CAC functions              215 (96% of respondents) Responses w/predominant (>50%) Non-CAC functions (All GS-2210’s)   8 (04% of respondents)