Multi-Inclusion, Universal Client Electronic Health Record

Transcription

1 Multi-Inclusion, Universal Client Electronic Health Record Quarterly Report: December 02, 2011 March 01, 2012 March 16 th, 2012 Quarterly Report: December 02, 2011 March 01, 2012 Page 1 of 8

2 Table of Contents 1. AWARD INFORMATION CURRENT STAFF WITH PERCENTAGE EFFORT OF EACH ON PROJECT AWARD EXPENDITURES TO DATE COMMENTS ON ADMINISTRATIVE AND LOGISTICAL MATTERS SCIENTIFIC PROGRESS PLANS AND MILESTONES FOR NEXT QUARTER... 7 Quarterly Report: December 02, 2011 March 01, 2012 Page 2 of 8

3 1. AWARD INFORMATION Item Description Award Number: W81XWH Report Date: March 16 th, 2012 Reporting Period: December 2 nd, 2011 March 1 st, 2012 PI: Christopher Goranson Jihoon Kang Telephone Number: (212) x4712 Institution: Parsons Institute for Information Mapping, of The New School Project Title: 2. CURRENT STAFF WITH PERCENTAGE EFFORT OF EACH ON PROJECT Staff Member Percentage Goranson, Christopher 24.3% Ina, Anthony 0% Kang, Jihoon 13.9% Limphongpand, Prin 0% Saxena, Sonny 0% Wanner, Katie 0% Yi, Ann 0% Yoshida, Sayoko 0% Note: percentage effort for each staff member represents the most recent month s activities towards this project and are rounded to the closest number. 3. AWARD EXPENDITURES TO DATE Item This Quarter Cumulative Personnel $7, $16, Fringe Benefits $2, $6, Supplies - - Travel $1, $1, Equipment - - Other - - Subtotal $11, $24, Quarterly Report: December 02, 2011 March 01, 2012 Page 3 of 8

4 Item This Quarter Cumulative Indirect Costs $4, $10, Fee - - Total $16, $35, COMMENTS ON ADMINISTRATIVE AND LOGISTICAL MATTERS Award Expenditures to Date Expenditures detailed above are for the period of December 2011 March These numbers may be different from the official SF-272 report due to differing time periods. Personnel expenditures are for the time period through the university s latest payroll period. Based on activity completed during the end of this quarter and anticipated activity in the next, we anticipate that expenditures into the next quarter will be significantly higher. This is largely due to redefining the SOW and coordination activities with TATRC and CDR Park that occurred during this quarter. Deliverables As outlined in the previous Quarterly Report submitted on December 16 th, 2011, PIIM and TATRC were in discussions to revise the Statement of Work (SOW). In mid-october of last year, TATRC alerted PIIM to an opportunity provide usability / user testing of Essentris and development of a new presentation layer that would work with identified implementations of the software. Since those initial conversations, PIIM and TATRC have reached agreement on a new SOW. Details of the new SOW, including new, approved milestones, are highlighted in the Scientific Progress section of this report. Last quarter PIIM identified a number of key tasks that, if a SOW was approved early in the quarter, we anticipated completing by this quarter. While these were not formal milestones, we believed that they were essential building blocks towards the achievement of overall project goals. Although the revision of the SOW was not finalized or approved early in the quarter, we still had an opportunity to begin or complete a number of tasks that we had identified as important: 1. Definition of mission and objectives with MHS, Essentris Team, TATRC, and other stakeholders. This task is ongoing and has been revised per the modified SOW. 2. Begin learning about the Essentris system, end users, use cases, workflow, and environment where the Essentris system is utilized particularly the beta sites where the visual dashboard will be implemented. This task is underway PIIM visited the Naval Medical Center San Diego as described later in this document. 3. Gathering and reviewing existing documents such as usability test reports, users requests/complaints, notes from developers forums, and other materials. Much of this information is anticipated to exist on CMR Park s project wiki page and in the Basecamp files. This task is underway, some of which was completed during our site visit to San Diego. However it is clear that a more rigorous follow-up is necessary. Quarterly Report: December 02, 2011 March 01, 2012 Page 4 of 8

5 4. Develop methodology and metrics for usability analysis on Essentris based off of previous documentation and workflow reviews. After our initial site visit, it became clear that a local install of Essentris would help towards achieving this task, as well as a follow-up site visit which we anticipate holding next quarter. 5. Conduct project management plans and schedules (i.e., WBS, Gantt chart). This task is underway we anticipate a site visit with CDR Park in late March will help in the development of a formal schedule that will conform to his needs and TATRC. 6. Attend the CCI course in San Diego, CA. This task was completed. 7. Determine IRB requirements for usability testing, and begin application process. This task is underway PIIM is considering hiring a dedicated usability expert for this project once requirements for the usability testing are more thoroughly understood. Personnel As of February 10 th, 2012, Mr. Sonny Saxena is no longer an employee of PIIM. Mr. Scott Weir assumes the IT maintenance duties for PIIM and is in the process of reviewing and fine-tuning all existing PIIM IT infrastructure. PIIM anticipates this change will provide a more robust development and design environment for this project. While there are no immediate plans to hire additional staff, we do anticipate that there may be a need to hire temporary consultant support towards the creation of some of the architecture and model design elements. Details of the architecture and design elements are highlighted in the Scientific Progress section of this report. Concerns for Next Quarter In order to get up to speed on the CliniComp Essentris system, PIIM has identified a need to both crosstrain our own staff following the Essentris formal training, and to install the Essentris ED module at PIIM s offices in New York City. A key concern is the approval of an acceptable NDA between PIIM, CliniComp Intl, TATRC and other stakeholders as necessary. Once the NDA is in place, we anticipate it will take us a couple weeks to gain the necessary familiarity with the Essentris system to be productive during followup site visits. Therefore, we are hoping to quickly resolve the NDA issue and begin working with the Essentris ED module as soon as possible. A key concern from last quarter was the completion and acceptance of a revised SOW. That concern has now been addressed. CDR Peter Park and his team have been supportive of our efforts this quarter, and going forward if we continue to receive such support we believe our project will continue to make steady progress. Quarterly Report: December 02, 2011 March 01, 2012 Page 5 of 8

6 5. SCIENTIFIC PROGRESS Through conversations with CDR Peter Park, Betty Levine, JF Lancelot and other TATRC stakeholders, we believe that the initial test group deployment of Essentris in five locations would serve well as a testing ground for reviewing and testing GUI enhancements that would eventually contribute towards informing the presentation layer for an iehr. CDR Park and others at San Diego and BUMED have identified usability issues with the system and a strong need to perform an assessment and redesign of the Essentris GUI. These conversations have led towards the revision of the SOW, which was approved this quarter. On February 3 rd, 2012 PIIM submitted a formal modification request for the SOW, and on February 13 th, 2012 PIIM received notice from Gay Hayden, Grants Specialist, that the modified SOW had been accepted and approved. We believe that this modification will inform many of the GUI issues associated with the AHLTA system, and we ll now have an opportunity to articulate these findings through a formal review of the Essentris platform. Given that AHLTA may eventually be replaced by an integrated EHR (iehr), the analysis performed on multiple DoD systems and lessons learned will put the DoD in a stronger position for informing the appropriate GUI design for the new iehr system. New Milestones A breakdown of the new milestones is shown below: 1. Develop initial GUI design for the multi-inclusion, universal client. We propose expanding this to a formal milestone that identifies the commonalities between the AHLTA and Essentris GUI and makes recommendations for an overall iehr solution. Identify the enterprise-level scope and future of such integrated EHRs similar to what VA / DoD ultimately have in mind to detail the areas that the IPO office should focus on as they move towards the interagency EHR. 2. Identify initial usability metrics and design heuristics. Make recommendations specific to the Essentris system perform an initial assessment of Essentris user interface to identify all limitations and strengths of the system. PIIM will make recommendations for short-term configurable enhancements and longer-term, more strategic enhancements. 3. Definition of mission and objectives with MHS, TATRC, and other stakeholders. During this milestone PIIM will continue to work with stakeholders to identify how a multiinclusion, universal client Electronic Health Record can be presented within the DoD framework. 4. Outreach to the MHS functional community for expert and end-user feedback. Recommendations for short-term configurable enhancements that could improve the usability of Essentris. PIIM will conduct site visits to assess the end user workflow, meet with Essentris team leads and determine from user interviews and surveys what challenges remain with the integration of the software in day-to-day staff operations. 5. GUI design / redesign iterations. 6. Revise/refine usability metrics and design heuristics. Validate the impact of implementing the initial assessment of Essentris from earlier milestones (#2 above), evaluate efficiency and satisfaction (before and after suggested modifications are made) based on quantitative as well as qualitative analysis using accepted usability methodology Quarterly Report: December 02, 2011 March 01, 2012 Page 6 of 8

7 for the assessment. This validation process will help gauge the success of the refined recommendations made to the system. PIIM will conduct formal usability testing using the GOMS and / or UFuRT usability methods, or comparable methodology to assess the before and after success of the implemented changes. GOMS (Goals, Operators, Methods, and Selection rules a task-and-goal-based method to analyze the success of software systems) and UFuRT (User, Function, Representation, Task a human- and workcentric method to test software systems) (John, and Kieras, 1996; Zhang, and Butler, 2007). 7. Develop user experience and workflows for the GUI. Generate change requests for more complicated and high impact GUI design issues while keeping within the limitations of the system; these would be more strategic changes like support for a new activity. 8. Prepare position paper/guidance document. Develop a position paper / guidance document on how to proceed with an integrated solution. Submit this document for publication in a peer-reviewed publication. Results from this analysis will be presented at an upcoming conference, and PIIM will work to share the results broadly within the MHS community. In late January, PIIM began ramping up for the change in the SOW s new requirements. Jihoon Kang attended and completed the Essentris DOD System Administrator Training, held from January 30 February 3, 2012 in San Diego, California. The course was taught by CliniComp, Intl. and was offered to PIIM at no cost. The structure of the Essentris system, UI components and system administrator functionality were learned and documented. Jihoon met with JF Lancelot, the Essentris system Executive Lead for the Content Optimization Group at CliniComp. The meeting provided PIIM an opportunity to better understand the Essentris system and to share work presently underway towards the development of HealthBoard through Award no. W81XWH Based on these and other conversations, we are confident that the proposed work for the Essentris system will complement the ongoing activities around HealthBoard and the discovery of supporting iehr modeling and architecture that we anticipate performing under Award no. W81XWH During the same trip, Jihoon visited the Emergency Department at the Naval Medical Center San Diego near Balboa Park. Jihoon met with Ms. Lisa Bartolo-Barnett, the current Project Manager of Emergency Care CAG and other ED staff members, including administrators, triage nurses, and administration clerks. Jihoon worked to capture the high-level ED workflow and better understand the utility of the Essentris ED module and CHCS. Towards the completion of the visit, it became clear that further work is necessary to adequately capture the workflow, and PIIM is actively working to schedule a return trip in the coming quarter. 6. PLANS AND MILESTONES FOR NEXT QUARTER We anticipate that the coming quarter will see a rapid ramp-up of activities surrounding this project due to the approval of the new Statement of Work. We have been in discussions with CDR Park to arrange a follow-up visit; we anticipate that there will be a site visit to PIIM s facilities in New York City towards the end of March, 2012 followed by a rigorous workflow session attended by two or three PIIM staff in San Diego, CA. The site visit with CDR Park will provide us with an opportunity to further clarify next steps and plan for completion of the milestones in the coming quarters. The follow-up session in San Diego, CA Quarterly Report: December 02, 2011 March 01, 2012 Page 7 of 8

8 would be held over consecutive days and would allow for a more rigorous collection of the entire workflow. Installation of the Essentris ED Module at PIIM s offices in New York City is also a key accomplishment for early next quarter as it will allow us to begin internally training some PIIM staff on the system itself; better positioning our staff for future site visits and interactions with Essentris users. This would mean that we would also have resolved the NDA issue, which is a key concern outlined above. We are however confident that we can work with TATRC, CliniComp and other stakeholders to resolve this issue. We anticipate that we may also need to supplement this internal training with formal Essentris online training offered by CliniComp. PIIM is developing a formal Project Management Plan based off of our ongoing conversations with CDR Park and others. This document will outline the delivery schedule for the milestones, and will included the WBS and Gantt Chart elements for project schedule and completion details. Depending on findings during the site visit, we anticipate completing the first iteration Assessment Volume defining objectives and framework for conducting the initial Essentris workflow analysis and review, and documenting usability metrics and design heuristics for the GUI against industry best practices. Finally, while the SOW defines the milestones, we will include as part of the Project Management Plan the agreed-upon final project objective and mission statement to address clinical needs with the multiinclusion, universal client GUI. A revised budget and request are also anticipated for a no-cost extension based on the changed SOW and anticipated time frame necessary to complete the approved milestones. Quarterly Report: December 02, 2011 March 01, 2012 Page 8 of 8