State of Florida, Department of Health
The Department of Veteran Affairs Office of Research and Development (ORD) Services
The Veteran Affairs (VA) Office of Research & Development (ORD) works to improve the
health and wellbeing of veterans. Through labs and clinics, research is conducted to provide healthcare solutions to veterans, often times at a researcher’s discretion. There are several systems the VA uses to manage and track ORD budgeting and funding. Most ORD-funded studies are initiated by investigators, most commonly by clinicians who perform research that is specific to the patients they treat. This allows a wide range of veteran healthcare issues to be addressed by interested parties with intimate knowledge of the issue they’re researching. But investigator-initiated studies also mean that research may be a grassroots movement that requires community-facing avenues through which researchers receive funding. One such avenue is the electronic Research Administration (eRA) system. Research proposals are submitted, and the eRA system (including the eRA Commons, IMPAC II, and ASSIST systems), manages over $30 billion in grants for both research and non-research purposes. This system is an organizational hub for users to track awards and submit progress reports and invention statements. In order for funds to be allocated to a project, they must be entered into the Research and Analysis Forecasting Tool (RAFT). Funding data for approved projects is transferred electronically from the eRA system to the internal-facing RAFT system. The web-based application and information is maintained by the Central Office. RAFT has the largest number of approximated users, with 400 users total. These internal and external systems interface with systems with both internal and external components in order to make the data transfer process simpler.
GeekSI’s main role in the maintenance of these systems is to assist users in creating accounts on the various platforms, and troubleshoot any advanced technical issues users have with the portals and in delivering their applications for grants. As a result, we must be familiar with all of the platforms in the ORD system as well as understand the technical issues faced by the development teams and be able to effectively communicate these issues to users. Miscommunication between the business side and development side of projects can make setting and completing user stories a challenge, and it is a Business Analyst’s job to understand both the technical and business aspects of a project, in order to identify and prioritize technical and functional requirements.
Communication between the hundreds of users who navigate these ORD funding systems and the programmers who create and maintain them is the priority of a Business Analyst. They must understand what the systems need to do and how they need to do it, as well as understanding the end users’ experience with the system and what technical requirements are necessary to change in order to improve user experience. A Business Analyst can address a variety of different issues in many settings. GeekSI’s role specifically is the navigation of users through the myriad of Legacy ORD funding systems whose age and number can make seamless navigation difficult. Through our Business Analysis work, we have a greater understanding of how communication between these systems works, as well as how to relate customer concerns to technical changes. We have the ability to understand all sides of a project, from software design to user experience, and we are proud to demonstrate this ability through our ongoing Business Analyst work on the ORD project.
Health Management System (HMS)
GeekSI along with other staffed partners implemented the Health Management System (HMS) for this Florida (FL) Department of Health (DOH) project approved through the FL Legislature. HMS is a web based public health clinic and case management system used daily by over 15,000 users statewide in the provision of health services. It replaced an existing Health Clinic Management System (HCM), a legacy character based system implemented in MUMPS deployed within each County Health Department (CHD) within the State of Florida. It is a web application that was implemented in Intersystems Cache, an Objected Oriented (OO) framework and database that is the next generation of MUMPS technology, deployed to each CHD. We verified its 508 compliance to meet ADA requirements. Facilitation of requirements and Analysis was conducted with a wide span of Subject Matter Experts (SME) statewide represented and organized with Special Interest Groups (SIG) for each HMS component. The requirements for both system and business processes were captured using UML and Use cases within the Rational Tool Suite. HIPAA compliance was maintained, as well as ensuring security measures taken to protect patient data.
HMS components include:
• Patient Registration
• Clinic and Medical Scheduling
• Billing for private Insurance, Medicare, Medicaid, special grants, and other funding sources, including electronic X12 Electronic Data Interchange (EDI)/XML interfaces to clearinghouses
• Case Management for programs ranging from diseases such as Tuberculosis (TB) and HIV to preventative care such as Healthy Start, Dental and Immunizations.
• Lab Ordering with public and private laboratories, including electronic Health Level 7 (HL7)/XML interfaces with LabCorp and Quest Diagnostics encompasses automatic lab results posting
• Radiological Exams Order and Exam results for X-Rays, CT-scans, MRIs, ultrasounds
• Prescription and medication disbursement and tracking
• Provider Management, with NPI
HMS has multiple integration points to a diverse set of health registries, including those for disease surveillance interface via PHIN to meet CDC reporting requirements. These registries included STD, HIV and TB. Other non-disease related registries integrated with HMS were Breast and Cervical Cancer, Blood Lead, and Immunizations and Healthy Start/Prenatal registries. We understand the necessities and complexities of interfacing health data and the importance of sharing health data across the enterprise. Integration is not just a technology problem but an incongruence of medical language and structure problem, requiring coordination at the enterprise level to overcome. Where necessarily, we reviewed implemented and integrated taxonomies for ICD9/10, CPT, CDT, HCPCS, SNOMED, and LOINC. We are familiar with the standard health interchange formats such as HL7, X12 EDI, NCPDP, and also are experts and the health technical architecture. We evolved the DOH integration strategy by viewing maturing the Integration Broker form data file management to an Enterprise Service Bus, brokering web services to share data modeled upon SOA. We supported the effort to incorporate a Master Person Index (EMPI) of all clients of the State of Florida.
Elimination of Veteran Homelessness (EVH)
The Elimination of Veteran Homelessness (EVH) is an initiative that demonstrates the Department of Veterans’ Affairs (VA) commitment to the preventing and ending homelessness among Veterans, and their families. VA is poised to assist homeless and at-risk Veterans through the provision of a comprehensive Continuum of Care (CoC) that includes:
Outreach/Education, Prevention, Treatment, Income/ Employment/ Benefits, and Housing/Supportive Services provided in collaboration with Federal, State, Local Governments and community partners.
GeekSI’s role in the EVH project was to provide Initial Operating Capability Testing and Development support for the VA’s Office of Information and Technology Web portals, namely the Homeless Management Information System (HMIS) Repository and the Veterans Re-Entry Search Service (VRSS). Our team, along with other partners, oversaw all aspects of the EVH projects and enhancements, and created User Testing Manuals and Checklists, developed Test Cases and Test Scenarios. We performed those testing duties and compiled the final Test Evaluation Summary (TES).
For this Business Intelligence (BI) project, GeekSI provided the project management, analysis and technical architecture services to replace the disparate and incongruent set of multiple MS Access databases comprising the State Trauma Registry (STR) to the targeted next generation trauma registry. The new trauma data warehouse necessitated the standardization of over 500 files of 180 data fields in varying file formats, submitted each quarter from every hospital with an approved trauma center.
GeekSI developed the business architecture, performing analysis of as-is business processes and developed to-be (target) business processes for the re-engineering of the STR We worked closely with stakeholders, which included Trauma Surgeons, Trauma Medical Center Directors, EMS nurses and staff. We created an STR roadmap to include an interim solution for the STR as part of the Business Intelligence solution (data warehouse) in SQL Server 2008 to support integration, analysis, reporting services, that included the technical architecture. The interim solution was necessary to mitigate the continued risks involved in the use of the unstable MS Access database files used to import data files containing extensive amounts of data and file format errors from each hospital. We transitioned the project from ad-hoc development to agile, with daily scrum meetings. During the interim solution phase, we spearheaded the creation of a new data standard interface, creating a new FL Trauma Data Dictionary standard, designed with an XML schema and modeled the BI schema that addressed issues with current trauma Data Standard.
For the final solution, we composed the business case, developed scope and performed gap analysis for a buy vs. build solution, including a Request for Information (RFI), adhering to the DOH IT governance and EA processes.
Trauma Registry IT Services
U.S. Department of Veteran Affairs
Multiple Sclerosis Surveillance Registry (MSSR) Enhancements
The causes of Multiple Sclerosis (MS) are still relatively unknown. The Multiple Sclerosis Surveillance System (MSSR) enhancements project extended the existing data points used to research causes, diagnosis and treatments for MS. The enhancements requested as part of this project were also needed to provide further insight into the utilization, cost and morbidity of Veterans with MS to improve treatment, identify funding and oversight needs for the entire MS program at the VA.
MSSR is a Business Intelligence (BI) project, interfacing with the VA’s health-related Corporate Data Warehouse (CDW), an Oracle DB, to export and import MS specific data including medications prescribed, laboratory results, and demographics. The original data sources feeding the CDW are primarily decentralized and customized instances of VistA across the VA provide a disparate, non-centralized source of clinical MS data that makes reporting and analytics difficult. The CDW addresses some of the issues, but has data quality issues and holes with respect to MS.
GeekSI began the MSSR enhancements project by reviewing and confirming existing requirements, development and testing artifacts, including user stories and acceptance criteria. We then held Joint Application Development (JAD) sessions with SMEs and data source SMEs to verify the current data workflows from a business process perspective by performing the initial analysis of the state of the data sources targeted for the enhancements. This included examining interfaces to CDW, existing Extract Transform and Load (ETL) code, availability of data, expected accuracy of the data, timing of data transfers and their frequency. The SMEs included clinicians and epidemiologists, statisticians, epidemiologists to review existing data models and schema within the CDW to identify potential tables and fields as sources for the data enhancements. Once the fields were confirmed, we then reviewed sample data to determine the quality of the data prior to targeting the information for export. We then developed the ETLs to export and import the data into MSSR’s MS SqlServer database from CDW. We developed Master Test Plans, Test Cases and Scripts to verify the data imported.
541511 Custom Computer Programming Services
541512 Computer System Design Services
541519 Other Computer Related Services
541611 Administrative Management and General Management Consulting Services
Florida Women Owned Small Business
Socially Disadvantaged Business
Economically Disadvantaged Women Owned Small Business