Systems Center ATLANTIC Theater Medical Information Program Maritime

Systems Center ATLANTIC Theater Medical Information Program Maritime

Systems Center ATLANTIC Theater Medical Information Program Maritime (TMIP-M) for USNAC 14 January 2015 Alan Wells, TMIP-M Deputy Program Manager Agenda Systems Center

ATLANTIC Program Overview Organizational Chart SSC Atlantic TMIP-M Program Office Responsibilities TMIP-M Deployments TMIP-M Versions Ship Installation Process Verification of Encounters/DNBI TMIP-M Product Deployment & Release Process CANES CITRIX DT/OT for TMIP-M version 4.0.0.0 Questions 2 Systems Center ATLANTIC PROGRAM OVERVIEW 3 Program

Overview Systems Center ATLANTIC The Theater Medical Information Program (TMIP) Family of Systems, managed by the Deployment & Readiness Services (D&RS) Extends Garrison-based AHLTA and CHCS capabilities to deployed medical units TMIP-M enables Complete clinical care documentation Medical Readiness monitoring Immunization Tracking Medical supply and equipment tracking Patient movement visibility Environmental Health surveillance Radiation Health Virtual Lifetime Electronic Record (VLER) Bi-directional Health Information Exchange with VA 4 Systems Center ATLANTIC

ORGANIZATION 5 TMIP-M Organizational Chart Systems Center ATLANTIC 6 Systems Center ATLANTIC RESPONSIBILITIES 7 SSC Atlantic TMIP-M Program Office Responsibilities Systems Center ATLANTIC

SSC Atlantic TMIP-M PMO is responsible for: Deployment of D&RS TMIP-J software applications to all Navy Medicine operational MTFs afloat and ashore Implementation and sustainment training Naval Capabilities Advocate to the TMIP-J program Formal documentation and routing of Naval Capability requirements through the TMIP-J Requirements Management process Coordination with Navy Communications and Hardware Infrastructure Programs of Record (PMW-160) Developmental/Operational Test Support 24/7 Help Desk through NAVY311 Engineering and Integration with CANES/EA/ISNS SAMS/MMM Sustainment 8 Systems Center ATLANTIC TMIP-M DEPLOYMENTS 9 TMIP-M

COMNAVAIRFORCE SHIP TMIP-M VERSION SAMS/MMM VERSION CVN 68 2.0.5.0 P1 SAMS 9.0.3.1 ISNS CVN 69 3.0.5.0 MMM 1.1.0 CVN 70 2.0.5.0 P1

SAMS 9.0.3.1 ISNS CVN 71 2.0.5.0 P1 SAMS 9.0.3.1 ISNS CVN 72 2.0.5.0 P1 SAMS 9.0.3.1 ISNS** CVN 73 2.0.5.0 P1 SAMS 9.0.3.1 ISNS CVN 74 3.0.5.0 MMM 1.1.0

CVN 75 2.0.5.0 P1 SAMS 9.0.3.1 ISNS CVN 76 3.0.5.0 MMM 1.1.0 CVN 77 2.0.5.0 P1 SAMS 9.0.3.1 ISNS Systems Center ATLANTIC ISNS/CANES CANES

CANES CANES 10 Systems Center ATLANTIC TMIP-M VERSIONS 11 TMIP-M Versions Systems Center ATLANTIC I2R1 Version 2.0.5.0 (Oracle 10.2.0.5) Version 2.0.5.0P1 (Oracle 10.2.0.5) I2R2 Version 3.0.5.0 (Oracle 11.2.0.3) 12

TMIP-M Versions, Cont. Systems Center ATLANTIC TMIP-M is currently installed onboard 160 ships and 9 MTFs 160 ships are installed with either TMIP-M I2R1 version 2.0.5.0 or 2.0.5.0P1 OR i2r2 VERSION 3.0.5.0 All I2R1 sites are installed with Oracle Version 10 Version 2.0.5.0P1 is a patch that enhances RADHEALTH capabilities Applicable to CVNs, LHDs, LPDs, LSDs, LCCs, and submarines Upcoming TMIP-M I2R2 version 3.0.5.0 (CANES) ships are: USS NIMITZ CVN 68 (Mar 15 Jun 16) USS CARL VINSON CVN 70 (Aug 15 Feb 16) USS THEODORE ROOSEVELT CVN 71 (Mar 16 Sept 16) USS ABRAHAM LINCOLN CVN 72 (Jan 15 Oct 16) (SCN) USS HARRY S TRUMAN CVN 75 (Sept 16 May 17) 13 Systems Center ATLANTIC SHIP INSTALLATION

PROCESS 14 Ship Installation Process Force Level Ship 3 Weeks CHECK INTO RMMCO SET UP TRAINING SUITE ARRIVE AT SHIP CONDUCT NECESSARY SHIPBOARD TRAINING CONDUCT INBRIEF (2 DAYS) COMMENCE OFF SITE TRAINING OF MEDICAL DEPARTMENT (3 DAYS)

COMMENCE BUILD OF SOFTWARE ONBOARD SHIP (5-10 DAYS) COMMENCE OVER THE SHOULDER WITH MEDICAL DEPARTMENT (9 DAYS) CONDUCT ON SITE MAINTENANCE TRAINING WITH SHIPS IT PERSONNEL (3-8 DAYS) Systems Center ATLANTIC COMPLETE OVER THE SHOULDER TRAINING VERIFY AHLTA-T AND SAMS/MMM DATA REACHED TMDS/NMO

CONDUCT SOVT CONDUCT OUTBRIEF (1 DAY) 15 Verification of Encounters/DNBI Systems Center ATLANTIC How can providers verify encounters are sent to TMDS? Ensure encounter notes are completed/signed in AHLTA-T Verify messages have been sent by TF Admin Log into TMDS and verify encounters are posted DNBI Information is collected at the Theater Medical Data Store Data is only sent if encounter is signed Recent review of fleet unit showed 300 encounters unsigned. Oldest encounter was 19 months old USFFC/PACFLT attention

16 Systems Center ATLANTIC PRODUCT DEPLOYMENT AND RELEASE PROCESS 17 Incremental Releases Systems Center ATLANTIC Deploy D&RS incremental releases to all Ships, Submarines and Operational MTFs I2R2 (WIN7 Compliant)

System Acceptance Testing completed November 2012 MOT&E completed July 2013 Navy Integration and IA testing completed February 2014 FOT&E completed August 2014 (CVN 74) Full fielding decision received October 2014 I2R3 Final Release TMIP moves to sustainment D&RS expects delivered to services 23 December 2014 Navy will upgrade all sites to I2R3 (FY16/17 FY22) 18 Systems Center ATLANTIC CANES & TMIP-M 19 CANES & TMIP-M Systems Center ATLANTIC TMIP version(s) 2.0.5.0 and 3.0.5.0

Compatible with and Approved for CANES Currently installed on 3 CVNs (3.0.5.0) Currently installed on 13 DDGs (2.0.5.0) Currently in possession of IATO for 3.0.5.0 Expires 19 Mar 2015 Requires PKI/CAC Waiver Recent CVN experience: Outstanding Support from both Medical and ADP I2R2 technically complex results in need for more dedicated ADP support as well as more involved medical administrator training Two issues/concerns (from our perspective) Encryption delta between CANES and Shipyard impacted MMM ORACLE password change every 60 days was concern for ship 20 Systems Center ATLANTIC CITRIX 21 CITRIX

Systems Center ATLANTIC Currently in possession of IATO for CITRIX Approved version is 4.X CITRIX is approved under TMIP-M version 3.0.5.0 22 Systems Center ATLANTIC DT/OT for TMIP-M version 4.0.0.0 23 TMIP-M Developmental Test (DT) / Operational Test (OT) Systems Center ATLANTIC COMOPTEVFOR requires CANES CVN/LHD for OT D&RS released version 4.0.0.0 to services on 23 Dec 2014

D&RS requires Operational Test community to perform MOT&E in July/August 2015 Navy Plan for DT Conduct 1st phase between 28 Jan and 8 Feb in SPAWARSYSCEN Atlantic Lab Conduct 2nd phase between March and April in SPAWARSYSCEN Pacific (CANES) Lab Conduct 3rd phase from 4 -22 May in SPAWARSYSCEN Atlantic Lab Conduct 4th phase in July 2015 onboard OT platform (TBD). Final tune-up (TECHEVAL) to ensure ship and system is ready prior to MOT&E. SPAWARSYSCEN Atlantics top three priorities in testing version 4.0.0.0: PKI/CAC enabled ICD-10 codes available ORACLE 12 performance 24 Questions? Systems Center ATLANTIC Alan Wells TMIP-M Deputy Program Manager Space and Naval Warfare Systems Center Atlantic

(757) 443-0684 (Office) (757) 676-3853 (BB) [email protected] 25 TMIP-M Systems Center ATLANTIC BACKUP SLIDES 26 TMIP-M Staffing FY12 v FY13 (impact of funding cuts) I nformation Assurance TMIP IPT Lead Greg Vick

Bill Cole Project Lead Systems Center ATLANTIC Admin Assistant Maria Wallace Project Manager Alan Wells I mplementation Training Fleet Support Engineering Alan Wells Toyya Howell

HMC Brandon Conder LT Cathy Lopez Steve Geels Advanced Planning Tom Freese TMIP Team Lead/ System Administrator Functional Analyst Rey Galang Functional Analyst Functional Analyst System Administrator/ Functional Analyst Wayne, John Functional Analyst

Functional Analyst Functional Analyst Functional Analyst System Administrator KANDAHAR System Administrator TMIP Help Desk Lead SAMS 8 SME Help Desk Help Desk Help Desk Tester Engineering

Marc Stroz Integrator Technical Test & Evaluation Integrated Logistics Support Pauline Sullens Debi Lupton Tester Tester Tester Legend System Administrator Ariel Ramos System Administrator

Government Government Recent Report Contractor Contractor Part-Time 27 Understanding the Value of an EHR in the Department of Defense Systems Center ATLANTIC 28 TMIP Family of Systems AHLTATheater AHLTA

Warrior AHLTAMobile TeleHealth TRAVAX EIC TMDS MSAT MAT/JMAT JTTR JPTA BHIE-T TMIP CHCS Cach (TC2) DCAM PMITS DMLSS T-DBSS DOEHRS - IH Systems Center

ATLANTIC SAMS TRAC2ES GEMS Mobile MEDIC GCSS Electronic Health Record Patient Movement Command & Control Medical Logistics Mission Pillars 29 Medical Data Integration: Today Systems Center

ATLANTIC Community Based VA BHIE Regionally Based AHLTAGarrison MSAT Read Only GCSS GCSS JTTR GEMSSAMS

CDR TMDS Inpatient SAMS JPTA Web Entry AHLTATheater AHLTATheater CDM Defense Blood Standard System (DBSS) Composite Health Care System (CHCS) Current Partial

TRAC2ES TMIP CHCS Cach (TC2) AHLTAMobile AHLTA Mobile Planned TMIP CHCS Cach (TC2) Current 30 Key Capabilities Systems Center ATLANTIC Modular, scalable healthcare documentation system built to operate in low to no communications

environments. Supports Service members continuum of care from the battlefield to the home front. Captures and manages health information in support of the militarys electronic health record (EHR). Supports the delivery of advance medical care in the most challenging conditions. Shares DoD pertinent clinical data with the VA. 31 Current TMIP-M Capabilities Systems Center ATLANTIC AHLTA-Theater Outpatient Treatment Documentation TMIP CHCS Cach (TC2) Technical Refresh of CHCS-NT Inpatient Treatment Documentation

Pharmacy, Laboratory, Radiology Support Shipboard Non-tactical Automated Data Processing Program (SNAP) Automated Medical System (SAMS) Health Systems IMR, Exams, Immunizations Environmental Health Water, Pest, Sanitation Radiation Health Naval Dosimetry Program 32 Current TMIP-M Capabilities, Cont. Systems Center ATLANTIC Military Situational Awareness Tool (MSAT) Command and Control Medical Surveillance

Classified/SIPR TMDS WWW access to patient data Medical Surveillance All providers authorized accounts Unclassified NIPR 33 TMIP-M Product Deployment Process Systems Center ATLANTIC Separate approval processes for Theater and Afloat Units TMIP Release received from D&RS AHLTA-T/SAMS9/MMM AHLTA-T/TC2/DCAM/PMITS

Separate approval processes for each ship class, or submarine; and for each individual ship 34 TMIP-M Release Workflow Within Navy Systems Center ATLANTIC TMIP Release received from D&RS TMIP-Maritime Review Engineering/Training Fielding Decision Considerations New Capabilities Timing of next release from D&RS

# of baselines in the Fleet TMIP-M Decision to Field Yes, commence interoperability, IA testing and external release processing No, wait for next release 35 TMIP-M Testing and External Release Process Systems Center ATLANTIC Approximately 6 month testing and approval process DAY1

DAY120 DAY60 DAY180 IA C&A Testing for Theater Interoperability Testing Army Gold Disk Navy Gold Disk IA Testing for Afloat Units Interoperability Testing ISNS Early Adopter CANES

SWAN SUBLAN PC NMCI External Release Approval for each individual Afloat Unit; Normal requires shipboard Availability or Waiver is required 36 Systems Center ATLANTIC OPTEMPO 37 TMIP-M Organizational Chart Systems Center ATLANTIC

X X X X X X X X X X X X X Legend Government Contractor Contractor Part-Time 38 TMIP-M OPTEMPO

Systems Center ATLANTIC Reduced Budget Results Recent Loss of Key Personnel Tim Rice left and took job with USNS COMFORT to support TMIP-M Dissatisfied with multiple responsibilities and being placed in tasks not originally signed up for Assignments were necessary due to loss of 13 personnel in FY-13 Workforce Composition 2 of 3 System Administrators are in late 50s 1 of 3 System Administrators will leave in near term for medical school No budget to support bringing new System Administrators to train prior to departure of current staff 39 TMIP-M OPTEMPO, Cont. Systems Center ATLANTIC

Reduced Budget Results Multiple Tasking Installation team supports help desk and test team when not on road External Release supports SAMS 8 requirements in addition to multiple versions of TMIP-M. Specifically had to do all work to prepare for SAMS 8.3.3 (ICD-10) release for dissemination to fleet. Although it will be a mail out all requirements for installation had to be met. Engineering team supports: Multiple testing requirements from D&RS, PMW-160 and SAMS development Multiple integration engineering requirements from D&RS and PMW-160 40 TMIP-M OPTEMPO, Cont. Systems Center ATLANTIC Reduced Budget Results Impact to Fleet Support

60% reduction of Help Desk staff/support in FY13 Prior to reduction five personnel on help desk staff; two remaining Necessary to adjust working hours to cover forward deployed forces resulting in only one help desk technician on site at any time Approx. 30% additional sites to support since FY13 budget reduction; 40% for FY-14 and 45% for FY-15 41

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