Scheduling Replacement Project

Scheduling Replacement Project (SRP) –

A New Start

Rosie Perez, Program Specialist

VISN 16/17 Scheduling Replacement Project Team

Presentation Objectives

Provide Scheduling Replacement Project (SRP) OverviewDiscuss key features and concepts related to the use of the new Replacement Scheduling Application (RSA) Highlight RSA scheduling features which support Advanced Clinic Access, priority of care scheduling and clinic wait timesPreparing for the future

Driving Forces

•Reduce Clinic Wait Times / Increase Access to Care– GAO Report on Excessive Wait Times for VA

Healthcare– Performance Measures for obtaining Primary

Care and Specialty Care Appointments

•Improve Quality of Care– Improve utilization of scarce resources– Manage patient preferences and special needs

Driving Forces (cont)

•Improve Customer Satisfaction– Provider ease of use– Patient participation in outpatient scheduling

•Improve Clinic Efficiency– Standardize DSS Identifiers– Improve provider productivity– Need for reserved appointment times for SC patients

•Improve Coordination of Care– Lack of coordination between appointments and

ancillary services (such as Lab, X-ray, EKG)– Lack of coordination between VA facilities

Future Business Process Model

•Schedule at the resource level– Resource Management

•Standardize DSS IDs usage – RSA National Appointment Purposes

•Create electronic pending lists– Waiting Lists, Recall Lists

•Manage group appointments– scheduling, cancellations, rebooking

•Link ancillary tests with appointments– For ancillary services (Lab, X-ray, EKG)

Future Business Process Model

•Determine patient preferences for scheduling–preferred appointment days and times

•Support Advanced Clinic Access initiatives

•Schedule inter-facility appointments

•Schedule at enterprise level

•Schedule beyond existing grid structures (more flexibility)

Project Elements

Business Process

ReengineeringReplacement Scheduling Application

Enterprise (National)

Level Database

Encapsulation

Data Migration

Legacy Shutdown

Scheduling Replacement

Project

New Key Features

Enterprise Level Scheduling

– Administrative Entity tree– National Services

Resource SchedulingAppointment PurposeAppointment RequestPending Lists

New Key Features (cont)

Personal preferencesCarve-outsLink appointmentsResource setsAppointment Purpose setsAccess assignments by roles not keys

–Basic Scheduler–Advanced Scheduler–Super Scheduler

New Vocabulary

•SRP - Scheduling Replacement Project•RSA – Replacement Scheduling Application•AE Tree – Administrative Entity Tree•National Services – Standard Services’ list

for VHA•Enterprise Level Scheduling – VHA

system wide scheduling•Business Process Reengineering (BPR)

•Resource – Person (Specific or Generic Person), Room or Equipment

•Appointment Requests

New Vocabulary (cont)

•National Appointment Purpose (NAP) – DSS ID

•Local Appointment Purpose (LAP) – Reason for the Visit

•Carve Outs – Reserving time for specific patients or appointment purposes

•Appointment Opportunities•Appointment Purpose Sets•Resource Sets•Appointment Pending Lists – Wait List•Patient Special Needs•Patient Preferences•Resource Schedule/Calendar

VistA• Single VistA/Site Scheduling

• Single VistA/Site user privileges assigned

• Clinic based scheduling

• Appointment “slots” (set appointment lengths)

• DSS Identifiers set at the clinic level

• Make Appointment

• Selecting an appointment date from a “grid” of “slots”

• Wait List (initiated from separate actions)

• Reports Generated on Local VistA

RSA• Enterprise Wide Scheduling (AE Tree)

• Enterprise wide user role/privilege management

• Resource (provider, place, equipment) scheduling

• Calendar view with varying appointment lengths

• DSS Identifiers set at the Appointment Purpose level

• Create an Appointment Request

• System giving Appointment Opportunities according to request information

• Pending List (created from Appt Request)

• Crystal Reports generator

Business Changes

Enterprise Level SchedulingDatabase in Austin with backup in

Hines

Enterprise Level Scheduling

Administrative Entity (AE) Tree

VHA Enterprise Level

VISN

Health Care System

Facility/Medical Center

Service

Section

RESOURCE/Provider

From VistA to RSAKey Features & Concepts

From VistA• Clinic Set-up• Multiple Clinics• Make Appointment• Clinic Availability• Wait List• Appointment Mgmt

To RSA• Resource Set-up• Appointment Purpose• Appointment Requests• Appointment

Opportunities• Pending List• Section/Resource

Calendar View

AE Resource Management

Assign resources to Administrative Entity (AE) who supervises them– Should mirror facility organizational

structure–National Service – based on DSS National

Service file #730

Allocate resources to service provided– National standard (organizationally does

not have service; however, provides service)





Calendar View

From VistA Clinics to RSA

Resource Scheduling VistA Clinic RSA

Resource

PC Dr. A New Patient clinic Dr. APC Dr. A Follow-Up clinicPC Dr. A Med refill clinicDr. A Comp & Pen clinic PC Dr. B New Patient clinic Dr. BPC Dr. B Follow-Up clinicPC Dr. B Med Refill clinic Dr. B Comp & Pen clinicPC Dr. C New Patient clinic Dr. CPC Dr. C Follow-up clinicPC Dr. C Med Refill clinicDr. C Comp & Pen clinic

PC New Appt (323000)

PC Follow-Up Appt (323000)

PC Med Refill (323000)

C&P Appt (301450)

RSA Appointment Purpose

RSA National Appointment Purpose

RSA National Appointment Purpose (NAP)– Where DSS Identifiers (aka, stop codes) will be

assigned– Six digit DSS ID created & managed at the

national level– Mimics DSS credit pairs– Supports DSS business rules– Added business rule to restrict use of same stop

code to both primary and secondary position– Promotes DSS ID standardization & reporting– Provides an opportunity to specify high

performance measure type of visits

RSA Local Appointment Purposes

Local Appointment Purposes (clinic equivalent) –Created at the facility level

– Associated to an RSA National Appointment Purpose (NAP) file entry in the RSA enterprise-level national database

NAP LAP

Appointment Purposes

NAP Name 6-digit DSS ID LAP Name

Primary Care New 323000 PC NewPrimary Care Follow-up 323000 PC F/UPrimary Care Med-refill 323000 PC Med RefillGeneral Med C&P Exam 301450 GM C&PCardiology New 303000 Cardio NewCardiology Follow-up 303000 Cardio F/U

From VistA to RSA

Key Features & Concepts

Multiple Clinics Appointment Purposes


From VistA• Clinic Set-up• Multiple Clinics• Make

Appointment• Clinic Availability• Wait List• Appointment Mgmt



Calendar View

Make Appointment Request an Appointment

NEUROLOGY-MedDocAPPOINTMENT TYPE: REGULAR// NO PENDING APPOINTMENTS

IS THIS A 'NEXT AVAILABLE' APPOINTMENT REQUEST? NO Calculating follow-up status.. Select one of the following: 'F' for First available following a

specified date Date (or date computation such as

'T+2M') for a desired date Date/time to schedule a specific

appointment '?' for detailed help ENTER THE DATE DESIRED FOR THIS APPOINTMENT: T+3M (APR 28, 2004)


Request Appointment Screen





Calendar View

From VistA to RSAKey Features &

Concepts

Scheduling Grid Appointment Opportunities





Calendar View

Wait List Pending List

Re-entry of information

15 MINUTE APPOINTMENTSDATE/TIME:DO YOU WISH TO PLACE THIS PATIENT ON A

WAITING LIST ? No// Y (Yes) PC Team: PCT B-GENERALPC Practitioner: GENERAL, DOC A Select Wait List Type: 1. SERVICE/SPECIALTY 2. SPECIFIC CLINICEnter response: 2 SPECIFIC CLINIC Select Institution: AUGUSTA VAMC GA VAMC

509Select Clinic: PCT(C)-NURSE ADMINISTERED

AUGUSTA VAMC Priority1. Future2. ASAP Enter response:


Types of RSA Pending Lists

RSA Scheduling Process

Enter REQUEST

for an Appointment

Enter REQUEST

for an Appointment

Book the Appointment

Book the Appointment

Appointment NOT booked

(Request to Pending List)

Appointment NOT booked

(Request to Pending List)

Placed on Pending ListAccording to Target Date

Placed on Pending ListAccording to Target DateAppointment DispositionAppointment Disposition

Long Term Pending List(Target Date is outside of scheduling horizon)

Long Term Pending List(Target Date is outside of scheduling horizon)

Ready To Schedule Pending List

(Target Date is within scheduling horizon)

Ready To Schedule Pending List

(Target Date is within scheduling horizon)


From VistA• Clinic Set-up• Multiple Clinics• Make Appointment• Clinic Availability• Wait List• Appointment

Mgmt



Calendar View

RSA – Single Resource Weekly Calendar

with Carve Outs

RSA – Single Resource Daily Calendar

with Appointment Details

RSA – Configure Schedule Template

with Carve Out Parameters

Data Migration VistA RSA VistA

What VistA data will be migrated to RSA?

All future appointments

All open Appointment Wait Lists entries•Clinic•Service/Specialty

Why?Support other VistA packages such as CPRS

How?RSA generates new appointment eventVistA appointment event subscriber

•Creates new clinic entry•Generates view alert for administrator

Administrator Processes•View alert: Re-names auto-generated clinic•Mail bulletin sent to mail group•Mail group receives notice of new appointment clinic•Re-define clinic parameters required to process data (lab,

radiology, clinic groups, etc.)

Hospital Location File #44 (HLF) -

New RSA Clinic Entry Created

Hospital Location File #44 (HLF) - New RSA Clinic Entry Created

(cont)

Sample mailman message for re-naming of HLF entry:

Subj: CLINIC CHANGE [#32315] 06/18/07@09:16 16 linesFrom: RSAUSER,ONE In 'IN' basket. Page 1 *New*-------------------------------------------------------------------------------The following entry in the Hospital Location File has been edited/created: Division: TULSA OUTPATIENT CLINIC FIELD OLD NEW--------------------------------------------------------------------------NAME ENGLAND,IHYY MHC 30 MIN 1948 T-MHC ENGLAND 30 MNIEN 1948 1948TYPE EXTENSION CLINIC CLINICINACTIVATE DATE REACTIVATE DATE STOP CODE MENTAL HEALTH CLINIC - IND MENTAL HEALTH CLINIC - INDCREDIT STOP NON-COUNT CLINIC NO NO

Enter message action (in IN basket): Ignore//

Encounter Clinic Created/Maintained (VistA)Attribute of encounter/visitSupports other workload capture packages

Existing Scheduling Appointment Clinic

To be inactivated during deployment

RSA Generated Appointment Clinic

Created from RSA appointment event (VistA)Controlled fields maintained by Admin (VistA)Other fields maintained by stakeholder applications (VistA)Attribute of appointment

Hospital Location File #44 (HLF) -

Types of Clinic Entries

RSA Appointment Interfaced with VistA

Packages

Consult Tracking process Associating stop codes with consult services

remains Migrated Appointments – will be modified to

unlink the consult to the VistA appointment & re-link to migrated appointment.

New Appointments – Appointment Event Subscriber will check each RSA appointment to determine if qualified consult exists. If so, View Alert displays the appointment and prompts user to select a consult in VistA.

RSA Appointment Interfaced with VistA

Packages (cont)Consult Tracking process (cont)

Automatically updating the status of linked consults is supported

Notifications to initializing provider that consult linked appointment has been rescheduled, cancelled or marked as no-show, even if the consult is an inter-facility consult

Update consult comment not supported at this timeCompensation & Pension Exams file entries

C&P exam must be open and pending in VistAChoosing C&P appointment type will display available C&P Requests

RSA appointment is automatically linked to C&P

Preparing for RSA

•Suggested actions for the Hospital Location File (HLF) #44– Inactivate clinics no longer in use– Validate Institution and Division assignment– Validate DSS ID/stop code assignment for

identifying appointment purposes– Review scheduling letters assignment– Assign Privilege Users to help identify schedulers– Assign Default Providers to clinics to help identify

resources

Preparing for RSA (cont)

Suggested actions for the HLF #44 (Cont)– Ensure Service is appropriately assigned

•If appropriate Service is not listed, then assign to None

– Be knowledgeable of the Occasion of Service clinics– Identify Audio call system clinics– Validate Physical Location field is consistently

assigned

•Review all Scheduling Letters– “ZZZ” out letters no longer in use

These actions will assist in your transition to RSA.

RSA User Benefits

•Supports Advanced Clinic Access and Priority of Care Scheduling initiatives– RSA scheduling horizon can be imposed at any AE level

•To recommended 120 days or 30 days (such as Alpha Site-Muskogee)

– RSA defaulted search range •Can serve as a wait time monitor by alerting staff when an

appointment opportunity is not found within 30 days

– RSA carve-outs•Reserve a portion of a resources’ calendar for a specific

appointment purpose or eligibility of appointment

– Carve-outs can be set to be released “X” days prior to appointment date

•Opens appointments to other appointment purposes or patients

RSA User Benefits (cont)

•Supports Advanced Clinic Access and Priority of Care Scheduling initiatives (Cont)– RSA Pending List (aka, Electronic Wait List) offers

priority of care scheduling•Allows ability to set Default to Priority Order based on VHA Directive 2006-028•Appointment data does not have to be re-entered to be placed

on pending list

– RSA Patient Preferences •Appointment opportunities flagged when patient preferences

conflict

•RSA Interfaces – Open Compensation and Pension Exams – Consult Tracking Package

So when can you expect RSA?

Alpha – Sept 2007 thru Mar 2008 (Muskogee, OK)

Beta 1 – Mar 2008 thru May 2008(Muskogee, OK)

Beta 2 – May 2008 thru Sept 2008(Site To Be Determined)

National Release – Begin Oct 2008– Roll out by VISN

Where to get more information?

•Health Systems Design & Development (HSD&D) Project Notebooks websitehttp://tspr.vista.med.va.gov/warboard/anotebk.asp?

proj=441&Type=Active

•Scheduling Replacement Project Management Office (PMO)– Tonya Drew, Project Manager: [email protected]– Irene Smith, Technical Analyst: [email protected]

•Scheduling Replacement Project VISN Team– VISN 16/17 1SRPTeam exchange mail group

Questions?

Scheduling Replacement Project

Technology

Transcript of Scheduling Replacement Project