Smaller VA-DoD deal on e-health record angers Hill
By Tom Philpott
Standard-Examiner Contributor - Thu, 03/07/2013 - 4:55pm
The Obama administration pared back its plan to develop a single integrated electronic health record system for the departments of Defense and Veterans Affairs due to shrinking defense budgets and rising costs. If the single system were built “from scratch,” as planned, it would cost up to $12 billion, double the estimate given to Congress two years ago. These details came to light recently during a hearing of the House Veterans Affairs Committee where VA and Defense health officials had uncomfortable moments explaining the new plan.
They also heard the Government Accountability Office criticize the DoD-VA electronic record integration effort as plagued “by long-standing project management and planning weaknesses, inadequate accountability and poor oversight, which often has led to changes in the departments’ priorities, focus and time frames for completing the initiatives.”
VA and DoD officials testified that, while they will not adopt a single e-record health system, they are accelerating plans to make those two systems operate like one, at least from the view of clinicians and patients. “I would like to assure members of this committee that, press reports not withstanding, the DoD and VA remain committed to achieving the goals of the (integrated electronic health record) program: that is common data, common (software) applications and a common user interface,” said Roger W. Baker, assistant secretary of VA for information and technology.
“We are looking to achieve those goals through a lower-risk, lower-cost path than we were on,” Baker added. Maintaining separate health record systems adds challenges for making them behave as truly seamless for users. Something called a graphical user interface, for example, is needed to make two different records look the same. Having separate systems also make developing common software applications more difficult. But VA officials sounded relieved to be able to keep their own health records system, known as Vista. Defense officials, meanwhile, said they are shopping for an e-records system from among commercial sources. They also have not yet ruled out using Vista as the “core” e-record system if ways could be found to modernize it and adapt it to military-unique needs.
Rep. Jeff Miller (R-Fla.), committee chairman, said he and colleagues were surprised and disappointed by the decision. He listed several occasions over the past year, most recently last December, when senior VA and DoD officials gave assurances that progress toward rollout of an integrated health record was steady and its launch in 2017 was on schedule.
“I am concerned that this new approach is a step backwards towards the model that had been previously tried and failed ― namely maintaining two different systems between two different departments and wishfully thinking that the two systems will eventually talk to one another,” Miller said. Veterans’ advocates argue that a single electronic health records system would ease military members’ transition to veteran status, ending the hassle for newly-separated members of having to hand-carry medical records to VA hospitals or clinics. It also could speed processing of VA compensation claims and help to relieve the rising claims backlog.
“A single unified record was something that actually could have made a dent in the process and delivered benefits to deserving veterans faster,” Jacob B. Gadd, deputy director for healthcare in American Legion’s rehabilitation division, told the veterans’ committee.
“The majority of the delay in claims, as we all know, is the collection of medical evidence, which a single unified record could solve…It takes the average claim 257 days to get a decision. Fully-developed claims, when all the information is in place, are averaging just 120 days.” VA Secretary Eric Shinseki and then-Defense Secretary Leon Panetta jointly announced the decision Feb. 5 but awkwardly. Shinseki spoke first and it wasn’t clear from his remarks if the goal of a universal health record was being scaled back or if Shinseki was announcing a breakthrough.
“We had previously indicated our commitment of both of our departments to a single, common, joint integrated electronic health record, the IEHR. And today we affirm again our commitment to achieving the president’s goal,” Shinseki said. Without mentioning the demise of the single system goal, he noted that initiatives to improve interoperability between VA and DoD, by standardizing health care data between departments and by accelerating exchange of real-time data no later than December 2013. More VA and DoD patients, Shinseki said, also will be able to access and download medical records through something called the Blue Button Initiative.
What Shinseki was describing, said a congressional staff member, were the various temporary steps the two departments now must take because they will not be developing a single record system. They will need to share data and somehow give two systems an identical appearance. Panetta spoke after Shinseki that day and referred to the “complex challenges” of creating a single health record for the two large bureaucracies. He recalled the plan Obama announced in 2009 to “build a single customized, integrated electronic health record system from the ground up.”
But after numerous meetings, Panetta suggested, he and Shinseki grew concerned over how long the effort would take and the mounting cost, which lawmakers claims has reached almost $1 billion.
“So we asked the managers of the joint program to take a step back and assess whether we could achieve the president’s directive much sooner and for much less money than had been budgeted,” Panetta said.
New goals, he said, are to “simplify this program, cut costs, and to get our veterans the key benefits of this new system much sooner.” Miller said he appreciated the administration’s concern about the affordability of a merging VA and DoD systems.
“But what is going to serve the service member and the veteran the best? The cheap one or the one that is going to cost a little more.”
Senate continuing resolution advances
POLITICO – 3/18/2013 – by David Rogers
A stopgap bill to avert a government shutdown next week and keep agencies operating through September advanced in the Senate Monday night — powered by a renewed bipartisan partnership in the Appropriations Committee leadership. On a 63-35 roll call, 10 Republicans joined Democrats to limit further debate on the 587-page package, which seeks to greatly expand on the House-passed version of the same continuing resolution or CR. The strength of the vote all but assures passage, and Senate Majority Leader Harry Reid said it was his “sincere hope” that this will occur Tuesday. All indications are once the Senate acts, the House Appropriations Committee leadership is prepared to take the modified Senate CR directly to the House floor, possibly as early as Thursday. “We’ve come very far on this bill,” said Appropriations Committee Chairwoman Barbara Mikulski (D-Md.) in a final appeal to her colleagues. “We have to decide: Do we want to make the perfect the enemy of the good?” “We could actually show that we could govern. … We could actually pass a bill that I believe the House will accept as well. Hallelujah, this in [and] of itself would be a major accomplishment.” Critical to the win was her partnership with Alabama Sen. Richard Shelby, the new ranking Republican on the panel who brings old ties not only to Mikulski but also to Reid. “Granted, not everything’s ideal, but what is here?” Shelby asked. “If we do not move forward, I am afraid there may be no future appropriations bills which isn’t good for anyone in this legislative process.” “We’ve lurched from crisis to crisis. …What we’re asking to do is fund the government until September 30.” Indeed, since Oct. 1 the government has been operating under a CR due to expire March 27, a week from Wednesday. The resolution now ensures a smooth transition but also is pivotal for agencies trying to adapt to the across-the-board cuts ordered March 1 under sequestration. As part of its political bargain with the House, the Senate made no attempt to overturn sequestration. Instead the focus has been to update the base from which the cuts are made by providing departments with more detailed full-year appropriations. The House did the same but for only Defense and Veterans Affairs. The Senate added Justice, Agriculture, Commerce, Homeland Security, the Food and Drug Administration, the National Science Foundation and NASA. Taken all together, more than two-thirds of the discretionary funding for 2013 will now be subject to relatively detailed appropriations. That is no small accomplishment, and in addition, the bill includes scores of so-called anomalies for other departments, including provisions that would free up more than $720 million in highway and transit funds and open the door to up to $50 million in new U.S. aid to Syrian rebels. Nonetheless, there remains considerable pressure for rifle-shot changes sought by a variety of home state interests impacted by sequestration. Meat packers want to shift money in the Agriculture Department’s budget to prevent furloughs of food safety inspectors whose presence is needed to operate been and poultry processing plants. Rural airports want to do the same inside the Federal Aviation Administration’s budget so as to continue payments to private contractors who operate the flight control towers at some 189 small airfields. Final decisions won’t be made until Tuesday, and even with the cloture vote, it will still require some cooperation from all sides to finish. The meat industry is in a strong position to get its way. But if the rural airports or some other interest doesn’t get its amendment heard, objections could be raised. “Remember Easter recess is staring us in the face,” Reid said. And before going home this weekend, the Senate must also complete action on its long term budget resolution.
What's New with the Sequester and the Continuing Resolution?
By Price, Richard March 4, 2013
Sequestration seems to be here for a while and we are still sorting out the impact in the affordable housing world. In public housing, HUD issued a 2013 budget update to local housing authority directors under the Housing Choice Voucher (HCV) program. We previously noted that HUD Secretary Donovan testified that 125,000 vouchers will be lost. The new HUD directive advises authorities on existing strategies to help stretch dollars. One eye-catching number is that the sequestration cuts will result in an administrative fee proration of about 69 percent of fee eligibility. HUD notes this can present challenges to the program. Even if the impact to HCV funding might be mitigated in some way, the question is who will be able to around to implement mitigation and funding?
On Friday, OMB issued its revised sequestration numbers to Congress. Housing and Community Development programs generally faced 5% cuts, in light of recent budget adjustments. The cuts come over the shortened federal fiscal year, resulting in effective cuts of nearly 10% from April through September. The biggest numbers: Community Development Block Grants (CDBG) cut by $965 million; HCVs cut by $938 million; Section 8 project based cut by $470 million (but it isn’t clear if this overlaps with the Administrations planned cuts with FY2013 in any event). At Rural Development, the big cuts are $46 million to Rental Assistance and $26 million to new loans under the Rural Housing Insurance Fund.
The next vote up is to extend or replace the FY2013 Continuing Resolution or (“CR”). House Appropriations Committee Chairman Rogers introduced H.R. 933 today, providing for a continuing resolution through the end of the current fiscal year (September 30th), at FY2012 appropriations figures, less the sequestration reduction and certain other amounts. The bill would restore certain Defense appropriations by including the 2013 Department of Defense Appropriations bill. Presumably, this will create even greater calls for offsets from other parts of the federal budget.
HUD released a letter on Friday saying that its authority to provide mortgage insurance commitments under FHA Multifamily and Healthcare programs is likely to run out by mid-March. HUD expects to prioritize certain projects including affordable projects with a project based rental subsidy or low-income housing tax credits, RAD projects, projects in an area impacted by Hurricane Sandy, and projects for which a firm commitment has already been issued.
T&H awarded the Leadership in Enterprise Architecture Driven Results by the 1105 Government Information Group
November 4, 2013
ARLINGTON, VA, November 4, 2013 -- Thomas & Herbert Consulting LLC (T&H) announced today that the U.S. Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Business Architecture Service, part of Strategic Investment Management, Office of Informatics and Analytics, was awarded the Leadership in Enterprise Architecture Driven Results - Government Project, Civilian Award by the 1105 Government Information Group, the Federated Enterprise Architecture Certification (FEAC) Institute and Zachman International. The award recognizes VHA for developing a Business Function Framework (BFF) connecting various components of the VHA business architecture, which provides a very important line of sight from the VHA strategy layer down to supporting applications. As a business intelligence tool, the BFF supports decision analysis for IT funding prioritization and resource allocation, while also promoting collaboration between VA and other agencies.
The award was presented to Chuck Hume, Director of the Strategic Investment Management Office and Ian Komorowski, Deputy Director of VHA’s Business Architecture Services, on October 30th, 2013, during the Enterprise Architecture Conference held at the Walter E. Washington Convention Center in Washington, DC.
Multiple aspects of the VA Business Architecture work made it worthy of the Award of Excellence. These include:
- Extremely strong stakeholder support and involvement – stakeholders are heavily involved in developing work products and, as a result, have a sense of ownership.
- Architectural success in complex functional and organizational environment – the VHA and federal health care environment is complex, with many organizational entities and constant change. The BA team has had great success in this challenging environment.
- Provision of decisional information provided to stakeholders – business decisions are made using the Business Architecture products.
T&H has been under contract delivering a range of Enterprise Architecture services for the Business Architecture since 2007. One of the most notable outcomes is T&H's support toward the development of the BFF, which was leveraged to create the DoD/VA Health Integrated Business Reference Model (iBRM).
"Congratulations to Mr. Steven Taaffe, Mr. Ian Komorowski, Ms. Donna Marcum, and the entire team for this tremendous achievement," stated Mr. Rodney Thomas, Chairman and CEO of T&H. "As a Veteran, I take great pride in the services and support that T&H delivers on behalf of Business Architecture, and we appreciate doing business with the VHA."
The US Department of Veterans Affairs provides patient care and federal benefits to Veterans and their dependents. The Veterans Health Administration (VHA) operates the nation's largest integrated health care system, with more than 1,700 hospitals, clinics, community living centers, domiciliaries, readjustment counseling centers, and other facilities. More information about VA and its programs is available on the Internet at www.va.gov.
At T&H, we are passionate about the success of our clients. T&H is a CMMI Level 3 certified, Veteran-Owned Small Business (VOSB) with an impeccable track record for delivering outcome-driven solutions for our clients. Learn more about our client achievements and our Enterprise Architecture Center of Excellence at www.thcllc.com.
T&H Proud Sponsor of Morehouse College’s 8th Annual Innovation Expo
April 1, 2014
ARLINGTON, VA, April 1, 2014 – Thomas & Herbert Consulting LLC (T&H) is a proud sponsor of Morehouse College’s 8th Annual Innovation Expo on April 16th – 17th. Established in 2006, this event is the longest running program of its kind dedicated to providing a national platform for stakeholders from Historically Black Colleges & Universities and Minority Serving Institutions (HBCUs/MIs) to gain visibility, experience, and training on how to translate innovative ideas and research into viable businesses.
T&H is affiliated with college’s Entrepreneur Center as part of the Department of Defense (DoD) Mentor-Protégé Program.
This year's theme is “Igniting Innovative Ideas, Addressing Global Challenges.” It builds on years of working across curriculum disciplines to identify, develop, and support the next generation of innovation leadership to help build a stronger global economy.
T&H Sponsors the Northern Virginia Urban League’s Community Service and Scholarship Awards
April 1, 2014
ARLINGTON, VA, April 1, 2014 - Thomas & Herbert Consulting LLC (T&H) is sponsoring the Northern Virginia Urban League's Community Service and Scholarship Awards Dinner in April 2014. The Urban League's focus this year is on Veterans with honorees including General Ronnie Hawkins, Director of the Defense Information System Agency (DISA) and Robert and Jackie Griffin, the parents of Washington Redskins Quarterback Robert Griffin III (RG3).
To learn more about the Northern Virginia Urban League via their web site: http://www.nvul.org/
T&H Participates in the Komen “Race for the Cure” Event
April 1, 2014
ARLINGTON, VA, April 1, 2014 – One of T&H’s Values is “PEOPLE” which we define as, “Our Commitment to our team's success - our clients, our staff, their families and our community.” The most significant community activity that Thomas & Herbert Consulting LLc (T&H) supports each year is the Komen National Race for the Cure for Breast Cancer in the Washington, DC area. This involves T&H staff members actually participating in the race, which is a 5k walk or jog on the mall area of Washington, DC; engaging friends, family, clients and business associates to join our team; and to donate and encourage others to donate. This is the 10th consecutive year that T&H will support the Race for the Cure, which has in some years included support in Chicago and Miami; and we have raised over $10,000 during this timeframe.
This year’s event will be held on May 10, 2014 and we encourage all T&H staff, family, friends, clients and business walkers to attend. To register, please goto www.globalraceforthecure.org and sign up or make a donation under the “T&H Walk Team.
USDA-RD Selects Thomas & Herbert Consulting LLC as Veteran-Owned Small Business of the Year
June 18, 2015
ARLINGTON, Va., June 18, 2015 /PRNewswire-USNewswire/ -- Thomas & Herbert Consulting LLC (T&H) announced today that the company has won the United States Department of Agriculture, Rural Development (RD) Veteran-Owned Small Business (VOSB) of the Year Award. The Award recognizes T&H's support to the CIO's Information Management Branch (IMB) as the firm delivered Enterprise Architecture Modeling training and consulting services for IMB staff in Washington D.C. and Mission Support Development staff in St. Louis. The support was vital for the Agency to assess, architect and effectively develop a blueprint of the organization consisting of business processes, applications, and technology architectures and integrating architectures utilizing a centralized tool. This centralized tool will be used to support thorough reporting and decision-making.
"T&H completed all training sessions on-time without any problems and went above and beyond their training duties to also help us overcome various issues and problems from time to time," stated Khue Bui, USDA-RD IT Specialist. "We were satisfied with the T&H results and highly recommend their services to other Federal Agencies."
"T&H is very pleased to have been selected by USDA-RD for this prestigious award," stated Rodney Thomas, CEO of Thomas & Herbert Consulting LLC. "My team and I take great pride in knowing that our support has helped the Agency to meet key business outcomes via its Enterprise Architecture."
USDA-RD presented the award to T&H at the Small Business and AbilityOne Program Award Ceremony on Thursday, June 11, 2015 at the Agency's Whitten Building in Washington, DC.
The Rural Development Mission Area within the Department of Agriculture is the lead Federal entity in rural economic and community development. RD provides assistance to America via a network of 47 State Offices and numerous field office locations throughout the US, Pacific Trust Territories, Puerto Rico and the US Virgin Islands. Learn more about USDA-RD at rd.usda.gov.
At T&H, we are passionate about the success of our clients. T&H is a successful Veteran-Owned Small Business (VOSB) with an impeccable track record for delivering outcome-driven solutions for our clients. Learn about our client achievements and our Enterprise Architecture Center of Excellence at thcllc.com.
Phone: 703-248-8116 x100
Thomas & Herbert Consulting LLC and RELI Group, Inc. to Develop Innovative Health Solutions for the Warfighter
February 25, 2016
News Release --Arlington, VA, February 25, 2016 - Thomas & Herbert Consulting LLC (T&H), a Veteran-Owned Small Business (VOSB) that delivers management and information technology consulting services for Government, announced that the Firm is working with its Protégé, RELI Group, Inc. to improve the health and well-being of American Warfighters.
T&H is assisting RELI to bring technical experts and partners (JBS Int. and State of WA) in the development of two innovative health care solutions; 1) Healthcare Data Interoperability & Integrating External Healthcare Systems for Prescription Drug Monitoring, which will allow DoD providers to readily and efficiently access information from State PMP’s drug repositories, enabling them to deliver superior care to the Warfighter; and 2) Health Navigator (HealthNAV) Mobile Application, a solution oriented platform that will serve as the online hub to help Warfighters identify and locate any Health-related service and support they need. T&H will also deliver a range of business infrastructure and business development support to RELI, including CMMI and ISO certifications.
RELI Group was selected by the Federal Health Architecture (FHA)/Office of Coordinator for Health IT (ONC) to demonstrate the Healthcare Data and Interoperability Solution at the Healthcare Information and Management Systems Society (HIMSS) conference in Las Vegas, Nevada on February 29th thru March 4, 2016. Please visit their kiosk which will be located at the Interoperability Showcase.
"T&H is thrilled to continue serving as a Mentor while growing our relationship with RELI over the next 3 years,” said Rodney Thomas, Chairman and CEO of T&H. "As an Army Veteran, I am very excited to be engaged in the development of innovative solutions that support the well-being of our brave Warfighters.”
“We are excited to provide a solution for the Pharmacy Interoperability that will allow healthcare providers to have direct access the history of patient prescriptions from the existing state prescription drug registries (e.g. State PMPs) for the patient from their EHR systems.” Stated Sam Elias, CEO of RELI. “This will help minimize over-prescription of the controlled drugs.”
At T&H, we are passionate about the success of our clients. T&H is a successful Veteran-Owned Small Business (VOSB) with an impeccable track record for delivering outcome-driven solutions for our clients. Learn about our client achievements and our Enterprise Architecture Center of Excellence at HYPERLINK "http://www.thcllc.com"
About Reli Group
RELI Group is a SBA-certified 8(a) and HUBZone Small Disadvantaged Business that specializes in Healthcare IT and Population Health serving Federal, Commercial, and Non-Profit organizations. Thru our exemplary work quality, we have built trusted relationship with numerous Government and private organizations. We invite you to visit our web site at http://www.religroupinc.com.
Thomas & Herbert Consulting LLC
Phone: 703-248-8116 x100
It's a great day for T&H's Clients and Partners! Check out our new certifications!
November 14, 2017
T&H is committed to continuous improvement and achieving and maintaining service excellence for our clients! With dedication, support, and good old fashioned hard work T&H has been re-appraised at level 3 of the CMMI Institute’s Capability Maturity Model Integration for development!
ISO 9001 is the international standard that specifies requirements for a quality management system (QMS). T&H’s standard corporate practices are appraised at ISO 9001 2015.
Certification Number: 1465
Original Certification Date: 10/25/2017
Date of Certification: 10/25/2017
Certification Expiration: 10/24/2020
How CMMI and ISO certifications help us add value…
T&H’s agile/software/systems development and business processes are well understood, practiced by our staff, and are fully described in our standards, procedures, tools, and methods. This results in higher quality, lower risk and service excellence for our clients and partners.