The Veteran Health Information Exchange (VHIE), formerly known as the Virtual Lifetime Electronic Record (VLER), falls under the VHA Interoperability Office and the Office of Information and Technology (OI&T) Community Care program.
The goal of VHIE is to enable health information sharing between commercial providers and the Department of Veterans Affairs (VA) at the national, state, and local levels, thereby improving delivery of care to Veterans.
The Project Management Office (PMO) and Software Quality Assurance (SQA) support contract tasked B3 Group with providing program and project management support along with SQA testing support as new system enhancements were developed and rolled out into the field. B3 Group was responsible for supporting the entire VHIE team including its business and technical divisions. VHIE projects included eHealth Exchange (eHX), Veteran Authorization & Preferences (VAP), and Direct Secure Messaging (DSM), which all played a critical role in enabling the sharing of Veteran health information between the VA and external community care providers. The team used the Rational tool suite to report on the project’s status.
VHIE was originally launched as a pilot program in 2009, where it evolved rapidly due to the recognized value it brought to the community. Care providers wanted to be part of the program and VA leadership viewed it as a high-priority initiative. However, scalability became a challenge. The user base quickly grew and development of new enhancements were often focused on trying to keep pace with the VHIE standards within the community at large, while the overall performance and scalability lagged behind. While the business team had clear expectations for the program’s functionality, the small technical team did not have the knowledge or resources to meet changing demands. The two groups did not engage in long-term planning, which resulted in a disconnect and frustrations over weaknesses in core performance.
Cohesion and Communication
The pre-existing communications process had a major gap within the technical division: the sustainment team was managing the system’s back-end and responding to ongoing technical maintenance needs, while the software development team was working on new enhancements and functionality, but the two sides were not sharing information effectively.
Some employees felt like they were in the dark, especially those working on the business side. They never knew where the requirements went after handing them over and felt like the information was entering a “black hole.” An update on the backlog would take many days to obtain and would still be incomplete, thus they did not know when things were ready to be deployed for users.
B3 Group recognized that the teams were not following best practices regarding communicating and tracking changes and knew that improved methods would enable everyone to be on the same page. In order to bring everyone up to speed, B3 Group had to develop a cohesive requirements management process that would be inclusive not only of new development enhancements, but also non-functional changes that were being implemented by the sustainment team, often with minimal customer visibility. The desired approach would need to unify communications between all stakeholders so they could access information in an efficient, simple, and expedient manner.
Need for Experienced PMO Capabilities
A project of this level of importance and complexity required a specific skillset and strategic approach. Without legacy knowledge, VA business and technical teams felt somewhat disconnected, especially given the nature of vendor turnover, which caused additional challenges. Members of the B3 Group team had worked on the VHIE program for several years before the commencement of this contract and knew how critical it would be to have an experienced and knowledgeable architect on the team who could help guide technical discussions from the PMO standpoint, rather than from the development or sustainment teams.
B3 Group leveraged the VA-mandated Rational tool suite to implement a comprehensive requirements management process that took the unique challenges and history of the VHIE program into account. The approach was grounded in the idea of a single “product backlog” which captured all changes to an application, rather than a project-specific backlog that was tied to a particular development contract or vendor. B3 Group created an accessible release schedule that could be accessed with the click of a button. Reports were always thorough and up-to-date because all stakeholders were tracking their work through the same repository.
This successful new process was achieved through a variety of methods. B3 Group strengthened internal communication by incorporating members of the sustainment team into the process and into Agile ceremonies, which had not previously been done, and was, therefore, able to share a single release schedule inclusive of all system changes.
By leveraging the expertise of B3 Group’s experienced PMO architect, the team was able to identify technical dependencies earlier in the elaboration process and improve overall communication between the technical teams and the business. One key technical approach was the creation of traceability between DOORS and Rational CM. The new repository streamlined all the information shared by requirements analysts, making it seamless and accessible.
This project is an example of how it is crucial to find the right experts when managing a complex project. Experienced requirements analysts who are versed in the Rational toolset are integral to smooth implementation because they can navigate the tools and use them to develop an effective custom solution for the customer. In addition, a senior architect resource can bring the most value to the customer, especially when a more comprehensive, wholistic PMO approach is needed.
B3 Group received extensive positive feedback from the customer after completing this project. Employees no longer felt like their requirements information was entering a “black hole” because the new solution designed by B3 Group remediated these issues. It enabled a request for anyone in the program to be generated in a matter of minutes. Many VA employees expressed their gratitude that this program is no longer a pain point impacting their daily lives. Now, they can move on to other challenges in their quest to better serve Veterans.