MHS Enterprise Architecture Presentation: Sharing Day 2006

1. Military Health System (MHS) Enterprise ArchitecturePresentationHRM Architecture Sharing Day 2006 Nancy Orvis Chief, Operational Architecture and Health Data Management October 25, 2006 Contact Information: nancy.orvis@tma.osd.mil 703-681-5611 x6830 MHS Enterprise Architecture Website: http://www.tricare.osd.mil/architecture/index.stm

2. Agenda • Introducing the MHS Team • Key MHS Websites • FY06 Accomplishments • New development • Uses of the Architecture • FY07 Planned Efforts • Background Slides • Detail - What’s New in MHS EA v5.5

3. Key MHS Websites • OSD/HA Military Health Care Website • http://www.ha.osd.mil • Military Health System (MHS) CIO • http://www.ha.osd.mil/mhscio/default.htm • MHS Defense Business Transformation (DBT) • http://www.ha.osd.mil/dbt/index.htm • MHS Enterprise Architecture Website • http://www.tricare.osd.mil/architecture/index.stm

4. MHS FY06 Accomplishments MHS EA v5.5 Updates • Integrated Dictionary (AV-2) updates • Operational Concept Graphic (OV-1) decomposition • Interface Exchange Requirements to Activities • Data Standards List (OV-7a) • Definitions added to data entities in OV-CRUD • Data Management Plans published • Two New systems packages added • Systems Evolution (SV-8) • Systems Technology Forecast (SV-9) • Technical Standards Profile (TV-1) and other TV related documents

5. FY06 MHS EA Accomplishments Operational Architecture and Data Standards • Matured OV-5 Node Tree into IDEF0 OV-5 Activity Models • Reverse engineered using historical OV-2 Activity-centric Diagrams • Validated with Portfolio Managers and Functional Requirements Analysts • Balanced Inputs and Outputs • Generated OV-2 and OV-3 • Achieved DoDAF/CADM Compliance • Enhanced Information Traceability

6. OV-2 2.1.2 Monitor Health Status / Progress Demand/Referral Mgmt. Staff, Enterprise-wide Scheduling Staff, Enterprise Customer Clinical Data Mgmt. Staff, (update) Demographic Master Enterprise-wide Registration Staff, Data Person Index Health Risk Assessment Staff, Customer Care Management Staff Enrollment/ Demographic Data Eligibility Management Pop Health Staff Resource Center (update) (e.g., JCAHO, Enterprise-wide NCQA), Scheduling Staff Beneficiary External Financial / Population Risk Sources Demographic Reduction Plan Patient Data Schedule Policy & Recommended Care Plan Case Manager Care Team Guidance Customer Health Care Enterprise-wide Beneficiary Information Registration Customer Customer Health Care Staff Approved Care Information Plan Customer (update) Approved Encounter Care Plan (Administrative) Body of Health Demand/ Data Services Knowledge Referral Clinical Data Information Mgmt. Staff Screening/ Customer Treatment Approved Demand/ Protocols Staff Care Plan Referral Mgmt. Customer Staff Health Care Care Customer Information Management Risk Information Factors Care Health Risk Management Assessment Staff Staff FY06 MHS EA AccomplishmentsIDEF0 Activities Conversion

7. FY06 MHS EA AccomplishmentsOperational Architecture and Data Standards • All Enterprise Operational View Products are now in Telelogic’s System Architect. • Allows for integration with System View and Technical Standards View products • Allows for sharing and coordination with Service Components, HRM, and other federal and national health architecture efforts

8. FY06 MHS EA AccomplishmentsOperational Architecture and Data Standards • Established Data Entity Attribute linkages to Information Exchanges for the Patient Safety Reporting business capability • Added Related Data column to MHS Information Exchange Matrix (OV-3) • Allows for more detailed physical schema generation (SV-11)

9. FY06 MHS EA AccomplishmentsOperational Architecture and Data Standards • Portfolio Management: • Performed FY08 POM Operational Architecture analysis of each Portfolio capability • Mapped Capabilities to Operational Activities to highlight areas of redundancy or possible gaps in the Portfolio (e.g. which MHS activities do not have POM funding at this time)

10. FY06 MHS EA AccomplishmentsOperational Architecture and Data Standards • Data Management Plan Status - 16/24 plans fully signed: Bart Insert Data Management Plan Screen shot • Health Care Service Region Codes • States and Outlying Areas • Zip Codes • Country Codes • Certificate of Credible Coverage • HIPAA ANSI X.12N 834 Enrollment Transaction • HIPAA ANSI X.12N 837 Dental Care Transaction • Adjustment Reason Codes • CPT/HCPCs • ICD-09-CM • Provider Taxomony

11. MHS Enterprise Architecture FY07 Plans • Publish version 6.0 of the MHS Enterprise Architecture to the website • Website will have a new “look-see-feel”, as it will be linked to published artifacts from Telelogic’s System Architect. • Continue to refine and further define metadata for modeling and sharing model artifacts

12. FY07 MHS EA PlansOperational Architecture and Data Standards Requirements Development Process: • Operational Architecture will be part of the initial requirements development phases. • Operational Architecture will begin to drive requirements development vs. “check the box” at the end of cycle • Allow for immediate linkage or identify gaps to Operational Architecture • Provide target opportunities to further mature the Operational Architecture

13. FY07 MHS EA PlansOperational Architecture and Data Standards • Establish linkages from Information Exchanges to Data Attributes and Data Standards across the Enterprise • Highlights opportunities for service-oriented design opportunities • Supports Net-centricity strategy • Develop Query/Reporting Capabilities of the EA repository

14. FY07 MHS EA Plans Operational Architecture and Data Standards • Baseline Composite Health Care System (CHCS) • Legacy core health information/workflow an integral part of “To-Be” vision • Further decompose to 4th and 5th Operational Activity Level to support key activity workflows, such as Patient Registration • Refine ICOM’s and IE’s to be more detailed

15. FY07 MHS EA PlansOperational Architecture and Data Standards • Capture Business Rules (OV-6a) and link to Operational Activities within Telelogic’s System Architect • Enhance linkages to MHS Requirements Repository (DOORs Telelogic tool) • Prototype linkage of an MHS Metadata Registry with the EA Repository

16. FY07 MHS EA PlansSupport the President’s Agenda through theOffice of the National Coordinator for Health IT Health Care Industry Compliance Certification NHIN Privacy / Security Biosurveillance Consumer Empowerment Chronic Care Electronic Health Records Breakthroughs Standards Harmonization Coordination of Policies, Resources, and Priorities Office of the National Coordinator -Health IT Policy Council-Federal Health Arch. The Community -Workgroups Industry Transformation Infrastructure TechnologyIndustry Health IT Adoption Consumer Value Health Information Technology Deployment Coordination

17. Background Slides

18. What’s Newin Version 5.5 of the MHS Enterprise Architecture

19. Background The purpose of this document is to highlight some of the products that are new or have been updated in v5.5 of the MHS Enterprise Architecture. The MHS Enterprise Architecture site has been updated to reflect the improvement of the Architecture. The home page of the public site can be accessed at this URL address http://www.tricare.osd.mil/architecture/

20. System Packages Two new System Packages have been added, since going through DBT submission process, to the “System Specific Products” page: - DBSS: Defense Blood Standard System - TPOCS: Third Party OutpatientCollection System Location:http://www.tricare.osd.mil/architecture/arch_sv/systemspecific.stm

21. AV-2 Updates Updated Operational Node definition: - Customer Old definition: MHS staff authorized to request or receive materials or supplies. New definition: MHS staff, including clinicians, administrators and other staff at Medical Treatment Facilities or In-Theater, who are authorized to request or receive materials or supplies. New IER definition: - Non-Credentialed Staffing Requirements New definition: The quantity and qualifications of non-credential personnel needed to execute medical or business activities. Location: http://www.tricare.osd.mil/architecture/arch_av/AV2root.htm (View the word documents)

22. OV-1 Updates Added Department of Homeland Security as new Component to MHS OV-1 Location: http://www.tricare.osd.mil/architecture/arch_ov/OV1_55/ov-1.html

23. OV-1 Updates Core Process Area Updates:3.5Perform Medical Surveillance 4.8 Perform Medical Situation Awareness Location: http://www.tricare.osd.mil/architecture/arch_ov/OV1_55/ov-1.html • (Select the Core Process Area names to access the hidden hyperlinks)

24. OV-2 Updates The following OV-2 diagrams were updated based on EWS-R analysis and AHLTA Block 3 analysis: - 1.3.1 Establish and Maintain Schedules - 1.3.2 Retrieve and Verify Beneficiary Information - 1.3.3 Verify Eligibility - 1.3.4 Authorize and Schedule Services - 1.3.5 Check-In Patient - 1.5.2 Manage Healthcare Service Completion - 2.3.3 Initiate Care Plan and Perform Intervention or Service - 2.4.4 Provide Care Team with Access to Beneficiary Health Information Location: http://www.tricare.osd.mil/architecture/arch_ov/OV2_55/diagram29e6c6acd72f11d6bcc0000000000000.htm

25. OV-7a UpdatesData Standards List - New Policies were added: DoD 8320.02-G, "Guidance for Implementing Net- Centric Data Sharing", April 12, 2006 Defense Discovery Metadata Specification (DDMS) (version 1.3, July 29, 2005) - The list of Message Formats was also updated. Location: http://www.tricare.osd.mil/architecture/content/OV-7a.xls

26. OV-CRUD Updates Location: http://www.tricare.osd.mil/architecture/content/crudmatrix55/CRUD%20Matrix%20for%20pub%205.5_071306.xls A new tab has been added to show the entity definitions. Please follow the link below for full listing of definitions.

27. Data Management Plans