Supporting VHA’s Transition to a New Electronic Health Record

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Supporting VHA’s Transition to a New Electronic Health Record

Posted on 06.24.24

Designing and implementing a lean, responsive, tiered decision-making model to support electronic health record modernization (EHRM)

The Department of Veterans Affairs (VA) is in the process of implementing a new electronic health record (EHR) system. To ensure efficient management of this significant modernization effort, the Veterans Health Administration (VHA) Office of Health Informatics (OHI) is instituting a tiered decision-making approach across the enterprise to support systematic and streamlined management of this large-scale undertaking.

Within OHI, the Client Portfolio Management Office (CPMO) is entrusted with the mission of supporting and overseeing EHRM activities on behalf of VHA, serving as an integration point between VHA and VA. CPMO has wide-ranging responsibilities, including strategizing and executing plans to address functional EHRM issues, designing decision-making processes tailored to stakeholder needs, supporting the EHRM National Councils and overseeing projects and programs essential for successful EHR deployment.


Transition to a new federal EHR

Modernizing VA’s EHR is a highly complex, multi-year effort that will impact more than 9 million Veterans and VHA staff at over 1,200 sites of care across the country. VHA has had inconsistent visibility, coordination and transparency related to EHRM due to the complexity and scale of the federal EHR implementation. OHI identified the need to create a new division to coordinate EHRM efforts on behalf of VHA. This centralization was required to enable alignment across the VHA Central Office (VHACO), Veterans Integrated Services Networks (VISNs) and VA Medical Centers (VAMCs), which is critical for shared decision-making and prioritization.


VHA hired Aptive HTG, a joint venture that includes Aptive Resources, a business management consulting firm, to provide support in the following areas: program administration and management, tiered decision management, research and analysis, and communications and change management.

Program Administrative and Management

Aptive HTG designed tailored program management processes for CPMO, leveraging industry best practices along with extensive International Organization for Standardization (ISO) and Capability Maturity Model Integration (CMMI) experience to ensure efficient alignment of team resources to execute against CPMO requirements.

Aptive HTG team leaders partner closely with VHA to assess and adjust strategic plans and resource alignments to ensure we are providing the required expertise within defined delivery and cost schedules. Our team includes subject matter experts and program managers with specific VA EHRM domain knowledge to rapidly address emerging program priorities.

Tiered Decision Management

Aptive HTG is supporting the development, implementation and sustainment of a tiered decision-making process to facilitate issue identification and mitigation across the entire organization. Our team collaborates with the field and key program offices to design and implement efficient processes for issue intake, mitigation, resolution and reporting. This work streamlines how stakeholders collaboratively prioritize and resolve EHR challenges.

Risk Management

Aptive HTG uses a four-step approach of risk identification, analysis, mitigation and monitoring/reporting to ensure awareness and rapid response. We collect critical information for risk mitigation and communicate the impact to key VHA offices and stakeholders. Our team maintains an up-to-date risk register that includes risk identification, program impact, priority levels, responsible parties and target dates. By collaborating closely with VHA stakeholders, we develop and implement targeted strategies to mitigate risks and ensure the success of the overall EHRM mission.

Research and Analysis

Aptive HTG develops key performance indicators and metrics, conducts project assessments and produces analysis reports. We create after-action reports to evaluate events, measure success and identify lessons learned for future improvements. Additionally, our team supports data analytics and enterprise studies to generate insightful reports, empowering program offices and stakeholders to make informed decisions.

Communications and Change Management

The Aptive HTG team crafted a comprehensive EHRM communications strategy and executive-level plan to maintain consistent messaging and visibility. We assess the best communication channels and methods to enhance engagement and communication across the agency. EHRM necessitates substantial change throughout the organization, including updates to issue management, program oversight and EHR deployment processes. Using Prosci Change Management principles, we evaluate change readiness, provide tools to implement change and create resources to support end-user adoption.


Bringing visibility and awareness to the federal EHR

Aptive HTG has helped stabilize and structure the daily environment by clarifying CPMO purpose, objectives, structure and operations. Our team has successfully supported the transition of the EHR National Councils from VA to VHA. We also helped with the redesign of the issue management strategy, development of an integrated EHRM communications strategy and management of more than 30 individual projects contributing to the feasibility and success of federal EHR deployment.

The VHA’s EHR modernization underscores the importance of strategic decision making and effective management in large-scale health care initiatives. By partnering with experienced consultants like Aptive HTG, organizations can navigate complexities, mitigate risks and achieve transformative outcomes in health care delivery.