#NVSBE2017 Learning Session: Doing Business With VA FMBT

[ Music ]>>So, good afternoon everyone. My name is Patrick Pearcy. To my left is Dr. Paul Tibbetts,
Getsa Palacios, and Linda Ennis. We were expecting one more. He may sneak in here
in a little bit. If you are here for the
financial management business transformation special
program office brief, you’re in the right place. If you’re not, I hope we
entertain you anyways. I’m going to go through
the slides fairly quickly because I think it’s better if
it’s an interactive discussion. So, I don’t mind you asking
questions during my brief or as I’m talking or holding
the questions until later. Either way, it’s much better
if you guys ask questions and engage with me because me
just reading slides is not fun for anyone. On the other hand, I’ve got
to let you know I did not stay at a Holiday Inn, so I’m going to defer any tough
questions to this guy. So, we’re going to
talk a little bit about what’s called the
Financial Management Business Transformation Special
Programs Office or as we sometimes
abbreviate it the SPO. We are part of the
IT organization under the Enterprise
Program Management Office and our mission in
the SPO is to oversee and coordinate all the IT stuff
that the FMBT program requires. Standard boilerplate: I’m not
telling you to do anything for us, don’t worry about it, don’t do it, I didn’t
tell you it. So again, some background. If you’ve been to some of the
other briefings like Bill James, please raise your hands and I
will skip all of this stuff. But I will tell you that right
here is some of the folks that were involved with our
new IT organizational structure and the consolidation effort
and the transformation efforts. So, Dr. Tibbetts, at the
time, was director of office of enterprise development and
I do remember him churning out all the letters one night to change the organizational
structure within OI&T. That was a massive set
of letters going out. Let’s see. We have 4.5 billion
in our budget. That is including
salaries, it’s including all of the IT support costs that
we have at the hospitals, as well as development. Lots of numbers on here. You can read them
later, but it boils down to being a large
organization. Some of the goals and approaches
that we’re trying to do is, again, we want to stabilize
and streamline our processes. We’ve eliminated P mass
and instituted VIP. It reduces a whole bunch of
processes that were out there that were actually hindering our
development and implementation of projects to two decisional
briefs, CD ones and CD twos, a lot fewer artifacts. And I knew I was going to
get the real guy over here for phone a friend,
Dr. Erin Drew.>>My apologies.>>Let’s see. Transparency definitely,
anything we’re doing in OI&T within the SPO we actually —
you can see it, we publish it, we have a website,
which is on VA Pulse. We put weekly updates to it. Our team members, each
one of them, have drafted and published articles
for Pulse, as well as I think we’ve put it out on our public
facing websites also — certain activities. So, we are very happy to share with you what we are
doing within the SPO. Again, part of it is
our meeting here today. So ask questions. We’ll be happy to — we’re also
very accountable for the dollars and we want to deliver
what we’ve promised for our business
side of the house and we’re doing it
in an innovative way. We are doing COTS solutions. So we are implementing
a Momentum commercial off-the-shelf solution
to support our business; so we are not developing,
we are doing integration and implementation
of a COTS solution. And again, we are
partnered with USDA. We are partnered
with our business, Office of Management
Office of Finance. We are partnered with OALC to do all these great
things for the VA. Okay. Bill can talk to
this one much better, but again stabilize,
streamline processes, eliminate material
weaknesses, IT modernization. We are number two in the
department by Dr. Shulkin with respect to modernization, EHR modernization being
number one program. Second program is FMBT, the
financial modernization. All right. Now we’re going to get to us. Boilerplate is done. And notice they also
took out about 60 slides so we could have
those discussions. That’s great. So, we understand within the VA that our financial management
system is a little bit old and it’s a little bit behind
the times, and it has a problem; it has several problems. One was the security of the
system, you know, keeping it you up to date with the
patching, keeping our programs and applications at
the correct level, and we’ve got a whole
bunch of audit issues with the existing system. So, it’s in end-of-life. So, the plan is to replace
FMS with a cloud-based — it’s CGI Momentum Cloud and a commercial
off-the-shelf solution. Momentum is also
called Pegasus in USDA. So, if you hear that name
Pegasus and stuff like that, that’s the same thing
as Momentum and we’ve had to rebrand it. We call it iFAMS, integrated
financial management acquisition system, I-F-A-M-S
okay, financial and acquisition management
system. So, the VA name for
Momentum is iFAMS. Our program is FMBT, and,
of course, you hear Momentum and Pegasus out there. Our goal is to reduce
our audit issues. Our goal is to have a
single authoritative source for financial truth
within the VA. There are a number
of systems right now that have separate
general ledgers. We want to consolidate
and move those into our financial solution. And again, we would like
to increase our reliability and availability of
our financial system. All of that in an effort
to just give better value to our veterans, better value
to our employees doing the work. Our organization structure
is really basically lean. We have a number of directors;
we have six directors. Dr. Tibbetts is our
program executive officer; I’m his deputy. And underneath those
we have the alignment by the various work streams. Dr. Drew is over to my left
here is – well, he’s over to. Well, shoot, he’s
not in order here. So anyways, Dr. Drew is
architecture and engineering, Linda does software
development and integration, Getsa is our legacy
and interface work, and we know Dr. Tibbetts. Not available to be
here is Keith Cox who is actually running
implementation and also data, and Tammy, which is our director
of operations and sustainment and finally, Miss Mickie Krause
that’s not able to be here, she’s holding down
the home fort, dealing with all the
activities that are going on, even while we’re here. A very lean organization. We went out there and specifically handpicked our
folks for this organization, had permission from our
leadership to bring in this team to specifically address
the issues and challenges. So, in architecture
and engineering, we’re going talk a little bit about what we’re
looking for support with. So, architecture
and engineering, network management, performance. Our business partner, Extranet,
I’m taking some of your words out here, Dr. Drew, so add on
or take away as you see fit. Looking for capacity planning, as well as performance
measurements. So, what is the experience by
the end-user at the desktop? So that’s part of the areas that
Dr. Drew is putting in place to make sure we have those
service-level agreements and to make sure that
we can measure them and as we see them
coming close to that area, we can increase the
capacity of the pipes, whatever we need
to do on that part. We are doing a shared
platform approach. So we’re not the
only folks using that Momentum solution
out there. So we are in a cloud and we
are using a shared platform. We have specific
instances for VA, but again, we have shared components
that we have to make sure that we get our appropriate
bandwidth [inaudible]. Also, Dr. Drew is responsible for engineering architectural
documentation. An example is DODEF, another
one will be FIA type of stuff, so those are areas that
he is focused in on. Oh, underneath architecture,
we are also looking at data management, as well as business intelligence,
if you will. So, we’ve got a lot of
financial information that we have to report
up and out. And just by moving it into Momentum does
not solve our problem because we’re not moving
everything into Momentum. We’re moving a certain select
set of information, master data, reference data, and a
potentially open transaction. But we still have to go back to
our Legacy information and pull that forward to do our
business intelligence. One of the approaches
for a data repository for the business intelligence
is implementing a data lake solution. When we talk about data, we
also have to be very careful that as we’re testing,
we do de-identification, we do not put PII or PHI data over into an area that’s
not secured, specifically in what we call the
sandbox environment. So, we want to make sure
that as we do things, we do that data
de-identification, as well as again at the bottom
business intelligence reporting or forecasting of what we
need to do, not only reporting of the Legacy, but
forecasting, moving forward to anticipate the
VA’s needs, etcetera. This one — software
development integration. So I said we’re not doing
any COTS development, we’re implementing
a COTS solution. Well, we’ve got to
talk to and connect up to approximately 120
different systems within the VA, 120 Legacy systems currently
feed FMS or their second-tier or third-tier systems. So, we have to look at each one of those interfaces that’s
currently feeding FMS and make a determination. Is this interface still needed or is the information really
going to be provided by Momentum and we can turn that
thing down or turn it off? And we call that
retire that interface and potentially all the
interfaces means we can retire a system. Second choice is,
well, you know, what that actually is
sending us all we need in FMS and it’s the same stuff we
need in iFAMS or Momentum. So that would be a rewire
or we just basically change where that information
is being pointed to, to point to the iFAMS. So again, it’s some development,
but generally speaking, it’s more of a sustainment
type of activity where they just change the IP
address on a configuration table or something like that. But then we come to the
systems and the interfaces that aren’t providing the right
information to the iFAMS system. It could be lacking
accounting information. It could be in the wrong
format for what iFAMS needs. And those systems we
actually have to go in and do software development of. Not in Momentum but
on the VA systems. Linda has the fun challenge
of taking those 120 systems — oh, by the way that
determination, all that work is actually
Getsa’s job to figure out, okay what are we going
to do with these systems. But Linda has the fun
job then of working with the various system owners, as well as with the software
integrator and developer to change those systems. We are using a VA
messaging bus right now. It’s actually the VAESB
formerly known as EMI and that is how we are
actually communicating from our VA systems to the Momentum solution
over on [inaudible]. So, it’s a bus-to-bus
connectivity across our firewalls with the
different systems connecting into the VA bus and then
being sent over to Momentum. Let’s see. We’re also looking at moving
towards a digital center or a DEVOPS approach
for doing this. So, we know that as we go in
and touch our Legacy systems, and if there is extensive
development, it makes sense to then say let’s move
those into the cloud, along with the Momentum
solution. So, we are looking at
doing DEVOPS so that as we move forward in our
financial modernization, we then can use modern
approaches to keeping our systems
up-to-date. I had a thought there
and I’ll come back to it. One other approach is automated
test-driven development, so as we’re doing our DEVOPS, we do want to in doing
our development effort, we want to bake in
testing up front. Before I go into this one, does anybody have anything
else you’d like to add in? What else you guys want?>>There’s so much.>>Oh. [ Inaudible Comment ] It’s wired, so please,
feel free if you want to come up here and talk. [ Inaudible Comment ] Okay, there’s another session
with these guys at 4:15. Same slide deck, so. [ Laughter ] Oh, yeah. We’re smart,
we didn’t make up more than one slide deck, it’s
got a different title, but it’s the same deck. So, we want to do —
so this program is not about moving software
into Momentum. It’s all about financial
modernization, financial and business modernization. So, it’s yes, Momentum is
a part of the solution, but there’s a lot more
behind-the-scenes going on, on our business side,
where we look at the processes
that we are doing. Oh, no the microphone is there. So, it’s not just
the IT solution. It’s all about the business
side doing those changes within the organization. We have a major challenge
with what’s called a 1358 and getting the VA out of
the business of using 1358s and moving towards more of the
approved tools within iFAMS and Momentum and
those tools there. So, please don’t think the
solution is just putting stuff on Momentum. It’s a lot more than that. We actually have the easy job
and I talked about 120 systems out there and we have to
possibly modify those things. That’s actually simpler
than what has to happen within the business
side as they change an organizational culture. So, definitely we look for
and use more efficient, more effective tools with
respect to program management. Sales Force is a
tool we want to use. It’s been implemented within
the VA so we’re using it to support our monitoring of
the development activities, the Kanban, I believe
you guys call this thing. Data management tools, we’re
looking for tools that allow us to do the end-to-end
data management, not just the migration
activities, but looking at the
data profiling, the data cleansing activities,
and what do we have to do for data archival downstream. So, we’re looking
for those tools. Again, we do look at the infrastructure
routers and circuits. We know we have a certain level
of support already acquired through our Century
Link and AT&T, I believe, are the two folks. But that means we
have to monitor it and make sure we
continue to stay ahead of the capacity requirements
on our side. And by the way, if you’re
looking to do business with us, make sure you’ve got those
demonstrated knowledge skills and abilities on one of our toughest challenges,
which is VistA. Oh man, those VistA internals
for IFCAP and things like that, that’s definitely something
we’re looking for experience in. It’s a — I know
from scheduling, that was extremely
challenging and I see no reason that IFCAP wouldn’t be
just as challenging, to tell you the truth. And by the way, IBM integration
bus is the underlying infrastructure for the
VAESB so that knowledge, skills and abilities not
to write code for it, but to use the tool effectively and efficiently is
what we’re looking for. Going back to some of
our standard boilerplate. Okay, here are — [ Inaudible Comment ] Sure. [ Inaudible Comment ] Knowledge, skills and ability. Sorry acronym, I did that one. And service codes. These aren’t the only ones, but these are the ones you’ll
probably see our acquisitions going out through. All right. I don’t see anybody needs
this one, that’s the numbers. And again yeah, we
do it this way. This is the standard
boilerplate. All right. Here’s the one you guys
probably are looking for. This is how much we have
in our current forecast for this fiscal year with
respect to the dollars in support of Enterprise, the
Enterprise Bus Integration, which is the messaging
bus I was talking about. Program management support,
opportunities software, quality assurance,
IV&V support services. By the way, one was the
integration bus services and the other one was actually
support for the bus itself, so that would be licenses
and that sort of stuff. Software development
integration. Remember those 120 systems? That’s where the biggest chunk
of the funding is aligned to within our organization. And then we actually
have some high level SME, subject matter expert,
support focused on areas that we may not have the best
understanding of; VistA again. And then of course, we have
some circuits in there, infrastructure type of things. Everybody got their picture? Yes, sir. [ Inaudible Comment ] So, some are new opportunities,
some are re-competes. I actually don’t know which
are which from this slide. I can sit there and say
support services actually goes through Enterprise
Ops inside the VA. Software development
and integration, that is a new opportunity
for sure. SME support is a
new opportunity. And GWAX, the WAN
circuits, that’s a re-compete and IBM support, that
acquisition is actually on the street right now. [ Inaudible Comment ] I really — so, for the
IBM support, was that T4NG? It’s actually out there, so I
think the period has been closed and we received the proposals and everything else,
so that’s in process. PMO support, that’s through
FSC, Financial Services Center, I think that’ll be a re-compete
so I wouldn’t — on that one. The others would be T4NG likely. And again, some more circuits
out there, integration support, T4NG definitely on that one. Licenses? I don’t know what
the acquisition plan is, but you know it’s essentially
licenses and material. So, I would let you guys make
the assumption of the GSA or NASA soup type of thing. Analytics again,
that’s licenses. Digital center equipment. That’s material and
data warehouse — that’s more of Enterprise
operations work. So, these are the total
numbers we have in our budget, but some of them may be what we
call service level agreements and memorandums internally
to the VA, so data warehouse would
be a slam if you will. And you have your opportunity
for slide number two picture. Okay. Yes, sir. [ Inaudible Comment ] Yes, it’s — [ Inaudible Comment ] Yes, actually it would. This represents our best
understanding back in June of 2017 and what we are
going to do this year. So, yes, we can adjust, combine
to, to get the better things and stuff like that,
so stand by. All right. Again, this is the standard
boilerplate type of thing, if you want to do
business with us. Certainly, TAC. Watch out for that. You can corner any one of
us out here on the floor and you ask us anymore
about what we’re doing within FMBT SPO, about any
of the opportunities in here. I will give you a hint that the
folks over here are the ones that really do the work
and define what needs to happen within the SPO. I just sort of make sure
the checks can be cashed when they get written. All right. So now we come to
the fun part — questions and stump
the audience. [ Inaudible Comment ]>>Now, I’m going
to walk and engage. All right, so that is
a very good question because you’re going
to think about it. We have our environment. Then, there’s the environment
of our more providers, so you’re absolutely right. So, it doesn’t necessarily
matter what we do per se on our side of the house
because we have to coordinate and collaborate our activities with whomever our
provider is going to be. So, let’s talk about the
cloud hosting environment. Yes, we need to from
a security standpoint, from a process standpoint,
we need to make sure that everyone is
doing their part because when we put
these circuits into place and we put the cross
connections into place, I mean, the monitoring, the performance,
capacity metrics, that is going to be partly us,
partly you guys. So, there’s a dance, a
relationship that we’re entering into that we all have a part. So yeah, so don’t think of this
as what the VA is going to do. Think of this as what
are we going to do and how are we together going
to solve a particular problem. So, but yeah, I absolutely
agree with you. I don’t want to get up here
and tell you that I’m agile, evolutionary prototyping,
or I’m agile scrum if that only is 50%
of the equation. So, we’re getting married folks. You didn’t know this, but what
we’ve outlined are the terms and conditions for marrying
us and so we need to figure out our part so that we
can do this and deliver, and get ourselves to FOC over
the next seven to eight years. And I’m the marrying type,
so who’s in it with it me? Okay, all right, thank you.>>Okay, I think, yeah. [ Laughter ] Next question, please. Yes, sir. [ Inaudible Comment ] Oh, yeah. [ Inaudible Comment ] Linda, why don’t you
take the first part about the software
development type of stuff to various systems because, yes, I think that would
be very appropriate. Is that we have several
environments. One is a production environment and we have a pre-prod
environment that looks very similar
to production environment, but the sandbox environment, as long as we have the
appropriate security controls, we definitely think that
would be a good place for us to open it up and
allow outside vendors to provide superior
solutions to us. I know that we are leveraging
what USDA and CGI have done with interfaces to Treasury
and other government systems, so it makes sense that — let’s expand that idea to
support Concur and DFAS and those type of things. So, Linda do you want to do
yours or do you have anything?>>Okay, so I think —
was the first question about the software itself? [ Inaudible Comment ] Okay, the Legacy environment. A big part of what we’re
looking for in DEVOPS is just that the Legacy environment
— it’s more about life cycle; it’s more about the
life cycle management. We might have a couple of
systems that has a disposition of that when we start looking
at it we can actually have that data consumed
for iFAMS readily. And it’ll stay on the baseline
of the life cycle very quickly and we can monitor
that, measure it, have a performance
metric, and be successful. But the modernization effort
might be something absolutely different and that’s
where you come in. Many people in here, I
can look at and say, okay, I remember when we
did this in VistA. Well, some of these
applications are systems in FMS today still have data
that resides as a tertiary type of system of VistA that’s
going to touch EHRM. So, now you have the two top
initiatives in the agency where we have to think
a little bit smarter on life cycle management. How are we going to
work that system? What’s the best approach
for that systems in DEVOPS? How do we get people engaged? How do we look at the
designing of that system to provision an as-is
system for a to-be future? What does it look like when it’s in a managed service
environment? So, there’s more than just
taking down the application and saying that oh, we can
transform it, consume it, and put it into a cloud. That isn’t what it’s all about. It’s about making
sure that the people that are working the system
today are going to be working in managed services tomorrow. The system itself has to
move through some sort of infinity of DEVOPS. It has to start and
keep going, right? So, we need the assistance
in order to come in and actually test, prove,
know what we’re going to do with these systems. Aaron, as a solutions
architect, can work very readily with my team, with Getsa,
with all of us to sit down and look at that provisioning. How do we test out
that DEVOPS approach? Not everything is going to be
just because we wrote one for, let’s say, IFCAP that
that can be working for CMS or anything else. We have to bend and
move as we move forward. So just because we might
have been successful in one area does not
necessarily mean that’s going to work for all systems. So, we have to be
smarter today on knowing that we might not have
that solution yet. What did we do over here, and
how can we move it over there? So DEVOPS is a really big
one, life cycle management. Someone mentioned measurements. I think EVM plays a big factor
into integration and I would say for everybody in here that’s
something that I would read. When you look at technical
feasibility, when you look at performance standards,
when I look at that, when I read somebody that
can show me something on earned value also
from past experiences, or what they’re doing
today in order to stay where the VA is moving,
to me that’s a strength. And so, that’s the type of
work effort FMBT needs in order to say that we can
probably move IFCAP, but will it stay
on the baseline? It might not, right? But it’s going to move. So, we just have to work a
little bit more on our DEVOPS and start putting
stuff together, working on our to-be state. Not everything that our
solution, Momentum, I look at it from a best practice or
lessons learned approach from other agencies. What did they do? What was the worst part? Let’s make sure that we do
that as a post-mortem over here so we don’t know, you know, mirror what’s happening
in other agencies. I hope that helps.>>Thanks Linda. Oh, there’s a second part.>>There was a second part. It was a question
regarding a data lake. What was the second
part regarding the data lake question? [ Inaudible Comment ] Yeah, so we answered that part, but I think you also mentioned
I think data lake as part of your ask and I got excited. [ Inaudible Comment ] Oh, well, with the data lake, so
here’s how we’re going to plan on using the data lake. So obviously, the organization
has to come up with, for example, their
archival strategy. They may say you know what
we want to keep records for let’s say maybe three years. I’m like okay great and
so with that we now know when to purge the
records, for example, out of that ERP known
as Momentum. Those records then go
inside the data lake. Then there’s another record. We have our record control
schedule regarding what does the law say? How long do we have to keep
those records period before we can purge them? And so, maybe there might be
health information associated with that record. The next thing you know
we’re keeping a record for like maybe 70-plus years. So, we definitely need
something to grow with us. And you’re maybe saying, well
Drew, that’s just the same thing as the data warehouse
and you would be right. But I got another problem too. So now we’re dispositioning
systems, but I don’t want to change, for example, the
way that a data is structured or even formatted
as it is today. I want to preserve its innocence
as we shut these systems down. And so, to be able to
disposition a system and maintain its
native formatting in a virtualized environment? That just screams data lake. So, I want to do it. I need your help, I can’t
do it alone, you know, and so that’s why you saw
data lake, not data warehouse, thrown on this slide
over my right shoulder. Because I want us all thinking
about how do we address, you know, these federal and
these programmatic guidelines for protecting and storing and
retrieving records long-term, 20, 30, 70 years, to include
systems from the days of yore and even longer, to be able
to answer, for example, maybe a GAO inquiry or audit
tomorrow, and we can do that. This requires some data
scientists [inaudible], but don’t data lakes require
a higher [inaudible] knowledge skill set? Absolutely, it’s not
your typical warehouse. But that’s why guys are
here, you represent the gaps that maybe me and my team don’t
have, so I look to all of you and I look to the
data scientists that you guys represent
and I say welcome. Welcome to the problem. Questions regarding a data lake? Yes, Randy. [ Inaudible Comment ] Oh, very — that is
a very good question. What I need to always remind
myself when I hear a question that just causes me to salivate
is that I don’t do innovation because it’s the [inaudible], I need to have the business
guide me in the direction to make the case that
we believe the adoption of block chain helps us solve
a particular business problem, you know. But yes, on my own understanding
of block chain and how it works and the value it can provide,
I would readily say yes, but right now I don’t
have a problem for which that answer fits. Now on an EHR level
that’s a different story, I can talk about block chain
[inaudible] and go all day.>>No, this is FMBT,
this is FMBT okay.>>I got thoughts,
Randy, I got thoughts. All right, any other questions from the audience regarding
the wonderful virtualized data archival world known
as data lakes? All right, but for this where
this is your swim lane — yes? [ Inaudible Comment ] Sure. [ Inaudible Comment ]>>Certainly, ATO
controls as the minimum. So, Dirk welcome, thank
you for the question, not that you have a
security background at all. But, yes. Definitely we are
reliant upon both the ATO for the CGI Momentum
environment, as well as for the
solution itself. On top of that, then
we have to make sure that there are controls
in place that vendors who are accessing
it don’t get access to VA sensitive information without having the
appropriate controls in place and that we don’t expose
any of that information without the right permissions
and approaches in place. I want to go back to something
Dr. Drew said just a few minutes ago. There is no way that the
six directors up here and the folks you see matrixed in down below there can do
everything that needs to happen by the VA to make us successful. We rely upon you in the audience
and your companies to provide that expertise, that
knowledge, skills, and abilities to
keep us on track. Okay? We have a lot of
information in our heads, but it is I’ll say two inches
deep maybe and a mile wide, so we need that focused
attention from the folks talking about data lakes, how you
implement those data lakes, what you have to think about
from a security perspective, what you have to think
about from an access, as well as from an
implementation approach, and we need it across the board. We purposely, because
of resource constraints within our organization, have a very lean
organization structure for FMBT. We do not intend to expand it. This is it. Please. [ Inaudible Comment ] Yes sir. [ Inaudible Comment ] Oh, you start, that
raised the bar a little bit on questions, great one there. So, we actually have — there
is several schedules that are out there for review
by the business. Business — IT will stay
ahead of the business. I think we will successfully
be able to stay ahead of the business because the
business process changes is the harder component to do. Our first milestone, if
you want to call it that, that we’re hitting
is a March 2018 date where we will have the
Momentum instance live and what we’re calling
the prototype environment to support budget
formulation activities. What the business did is work
with our service provider to break the different
financial things into nine different areas,
budget formulation all the way through business
intelligence down at the bottom, and they grouped these different
functionalities together. And as you do things,
in a lot of instances, we found out that you
really can’t just implement a functionality. Budget formulation
is the exception. We can actually do
budget formulation for the department
fairly simply. But then as we move
forward we have to look at other implementation
strategies. One of them is, okay do we
do it by an organization or do we do it by functionality? It turns out we’re looking at an
organizational type of approach where we pick an organization
or a group of organizations and say, okay, you guys are
all moving over to Momentum. So, there’s a lot of work behind
the scenes that we have to do to group and adjust
the systems that feed for those organizations into
the IFAM solution Momentum. So right now, 2018
is the first one. We should go live. So we’ll have the
prototype environment 2018. We’re talking March 2019
for the second wave IOC, as they call it, which is where we’ll have the
first organization in and then it goes out from there. We recognize it’s a challenge to get 153 VA medical centers
plus all the administrations moved over. So, it is a long process.>>Yeah, I have just
a comment here. On the development questions
that came up earlier, I just wanted to
emphasize a few things. Patrick said earlier that
our program is really to implement finance and acquisition best
practices in the department. Yeah, there’s IT
dependencies there, FMS cannot be data [inaudible]
compliant, blah, blah, blah, etcetera, that’s all true. So, there’s a lot of
system stuff, but at the end of the day, it’s finance and acquisition best
practices implemented across the department. No one said this so far, but you
mentioned the work the business is doing, but our program
is heavily frontloaded with business process
reengineering. In all nine of these
areas there are waves of business process
reengineering going on, which is complementary to not modifying the
COTS product right. No changes to the COTS product, but we’re changing
all the people in VA to use this COTS product. And for those of you that don’t
know, part of the rationale that made that easy for us is
a Momentum, for those of you who know Momentum, it’s focused
on the federal market space, so the way it is built is to
optimize federal best practices for finance and acquisition. So, we have no reason, there
would be no rationale for us to change the COTS product. It would be working against our
own logic as to why we chose it, so hence the major
investment in EPR, which I really don’t think we
did with Flight or Core FLX so this is a big push across
the department to do that. The other thing I wanted to say,
keeping that business objective in mind, is three of the things
we’re looking for in development by way of attributes where you
all could help us think through, much like Aaron was
saying help us think through the data lake stuff
and we’re an inch deep and a mile wide in a
lot of our machinations, but you all understand this
stuff better than we do. But the three aspects we’re
really interested in is one, apply a mindset of the
minimal viable product right, to make sure we change only
what we have to change in order to achieve the business
objective. It’s a whole lot of technical
stuff out there we can fix, but if it has nothing to do with
auditability or nothing to do with the business
objectives of the program, we’re not going to fix it. It’s just that I don’t want
to drag it into the scope of the program because it’s
too much technical debt and you can go on and on. I mean the [inaudible]
DR deficiencies all over the place, blah,
blah, blah. If it’s not related to
auditability, I don’t care and we’re not going to take it
within the scope of the program. So, minimal viable product. Number two, agile, extreme, we already talked a
little bit about that. And number three, we have
human centered design. So, if we can bring
those three attributes to fixing the Legacy
environment, I would say we have a
pretty ideal approach to making those Legacy systems
behave the way they’re supposed to behave in that bucket
three that Patrick talked about where they
can’t be turned off, but they likewise are not
behaving properly today. That’s where those three
things I just talked about would ideally apply
if we can work with you all to figure out how to do that. We have initiated discussions
with some industry players out there whose business
model, if you want to know more about it I can tell you after, but whose business model is
exactly these three things all combined into one package. So, you might want to think about how you could help us
think through to relate to you in such a way that we can — the basis of our relationship is
improving the Legacy environment with these three things in mind. Change only what needs to be
changed into a viable product, agile, human centered design.>>Yes sir, he got up first,
I’ll get right back to you. [ Inaudible Comment ]>>Yeah Joe, thank
you for the question. He’s just reminded me to bring
up some over-the-edge stuff here that I think will be useful to get your input
on from all of you. So, the most specific
example I think of what Joe is talking about. Well, let me back up. Our comptroller, our acting
comptroller, I think we’re soon to have a real one, but our
acting comptroller, Ed Murray, brought up a few months
ago that he really in the department would like
to see us for the first time in our history of the VA be able to tie resource utilization
to actual outcomes. Whether that’s health,
whether that’s claim, cycle time on claims, whether
it’s how fast we order a tombstone, you name
whatever the outcome is, and you know the quality
of it and all that stuff. So, we’re great that’s
you know gee coming from the green eyeshade, this is
a really interesting question. I’d want to pull on that thread. So I went back to him and
said I really would like not to drop that conversation. Well, he said great come back. So, anyway that started me on
this journey throughout the VA and it so happens Joe also shows
up in my office in the middle of this journey one day and
that part of the tale relates to market research, which I’m
going to get to in a minute because it’s an important way that you all can influence our
thinking in a positive way. But anyway, that started me
on a journey that so far, it’s been largely through
VHA talking about how — a little bit about on the
outcome side Jim Warner, the VHA [inaudible]
if any of you know him and there’s some VISN level
initiatives, they’re looking at outcomes relative
to resource use. I talked to a lot of them
already at the staff level. I haven’t gotten quite to
the VISN directors yet, but I’m working my way up there. And so, to discover what’s
going on in the department at that level and
go back to Ed Murray and tell him okay this is
what I’ve discovered so far. Here’s what I know
what’s going on. Here’s where I think you
believe we should go. And so, gee Ed I mean
based on what we’re doing and which way you want to
go the next reasonable set of next steps might be what,
blah, blah, blah and get that worked out with him. So, that’s where I am
in that process now. With respect to market
research with all that going on and I would encourage you all
in this regard and by the way, there’s a group of
intermediaries here. I’ll give a plug to
the intermediaries out there like Joe but others. There’s a flock of them
running around here who I call BD consultants. I’ve known them for 850 years. And they — that’s my age. They you know, know the
department pretty well, they know what makes
sense frequently, they know what does not
make sense frequently. So, many of you who are
at least not familiar with the department might
want to think of some of them as an asset to you. But in any case, in that mode of pre-solicitation
market research, no RFI yet, no RFP, no nothing. This is all pre-solicitation
activities, we have, is time and attendance. We have a system
already in deployment. It’s deployed about
two thirds or so more or less throughout the VA, but
it’s only one part of the time and attendance system of this
particular commercial product. It happens to be Chronos. That’s not our name for it, but
that’s the underlying thing. And what we’re deploying,
you know, better than nothing is voluntary
declaration of whether you were at work yesterday and you
know, yes, I came in at 8, yes, I went home at 5. Of course, if you came
in at 9 and went home at 4 you can still
put 8 and 5, I mean, and nobody would
know the difference. But that’s a whole lot
better than what we do now, which is where you
declare nothing. So — but there’s
other things there that that product offers where,
you know, it reads when you walk through the door, you’re wearing
your RFID thing on your badge or something and knows
when you walked in, knows when you walked out,
or you can pick it up from when you first log
on in the morning and when you last log off. I mean there are a variety of
ways where you can get out of that voluntary declaration
of your time and where it’s really
objectively captured, which is not a module
we own yet. In any case, as a result
of that market research, I’ve learned a lot more about
that company, their penetration into the private
sector, the acceptance of that culture change by
our healthcare personnel. That’s a lot of the conversation
I’ve been having so far. And surprisingly enough,
at least certainly by a sample though
it be at those VISNs where they’re undertaking
this kind of thing they see it
yes, culture change. But yes, it’s a necessary thing
that we need to get on with to figure out exactly what
our resource utilization is. Because if we do start
measuring our outcomes and we have no idea what the
cost structure was, well, again, measuring outcomes is better
than not measuring outcomes. But if we have successfully
treated pneumonia in California and successfully treated
pneumonia in Florida and we can’t figure out how much
it costs to successfully treat that pneumonia, we’re better off
knowing that we were successful. But, you know, did it take
a hundred bucks to get that patient well or
did it take one buck to get that patient well? I mean, who the hell knows? I mean, so, and then matching up
knowledge skills and abilities with patient acuity is
also part of this equation. Anyway, that’s the resource
input side to where we are so far in marrying up
the resource input part of the equation to ultimately
what might be outcomes and maybe the Cerners
of the world or quite frankly
stuff we can get out of VistA would even
help us with that right now. It’s not that we just
have to put everything off to the long-term
future of Cerner. But, anyway, I spent
a lot of time on that to tell you all how, one, the
market research is important to us, but how spending
your time and energy with us in this market research
dialogue back and forth, I think can help you all
understand what we need, but more importantly can help
us understand what you have to offer, even more importantly. So, I don’t know did that
sort of get at your question? [ Inaudible Comment ] And that would be a good
conversation to have with those of you who are interested is that sandbox notion
also yes, absolutely.>>To add on to that
we look at you, telling us what we don’t know
we don’t know because we don’t. There was one — yes, sir. [ Inaudible Comment ] I think that was a
comment; I’m not sure. [ Inaudible Comment ] Not for us. [ Inaudible Comment ] Not in the immediate
future, guy. [ Inaudible Comment ] You want to talk.>>That’s all right. [ Inaudible Comment ] But Patrick hit the
nail on the head. I mean, you have to think
about timelines and, sure, I mean Cerner might
become a reality. It might become something we
have to focus on and, you know, maybe let’s say medium
to long-term, sure. But we’ve got a here and now
focus which is of high priority to us and that’s VistA. And even if you look at
some of the presentations that the VA leadership in other
areas have given, for example, at the [inaudible] conference
or FC and all that kind of stuff for the open source
community for example. And the relationships we have
with a lot of the vendors, VistA is going to be
important to us for a long time and for all I know, VistA
is going to continue to be important to us even
after Cerner is implemented. I mean, who knows depending
on what we do with it as Legacy file manipulator,
I mean who knows.>>Health information system.>>For archiving
and everything else. So, we don’t know what that
future is, but in the short to medium term, VistA is
still the big thing for us. And then even for us
with FMBT, by the way, interfacing strategies and
data management and all that becomes very
important with VistA now, but even with the electronic
health record of the future, this could be all kind of
transition considerations where moving some
functionality out of VistA, taking down the menus or
whatever you’re going to do with it, to quote unquote
turn off this functionality when you activate it somewhere
else, all that is going to require knowledge and
understanding of VistA. So that’s going to be
with us a long time.>>So, I don’t see anybody
back here saying, waving at me, saying get finished, but
I know that there are — we can keep going, I
have no problem doing it, I don’t think there’s
anybody else in this room. So, please. But feel free to leave
also, I won’t take it — [ Music ]


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