Notice ID: 36C24521Q0520
“To accomplish VA MCA, numerous data feeds must be processed into the Decision Support System (DSS) which is a Commercial Off the Shelf (COTS) software package that has been highly modified to accommodate the significant volume of VA data feeds. DSS is hosted on a VA-owned and operated mainframe computer and produces updated cost information monthly. For VHA MCA, 14 financial data feeds and 35 workload data feeds are required for the activity-based costing of patient encounters provided at VA facilities (Medical Centers, Community Based Outpatient Clinics, Mobile Clinics, etc.). The financial data feeds are primarily provided from the VA’s core financial system (FMS). Clinical workload data feeds are primarily provided from the Veterans Information Systems Technology Architecture (VistA), which is currently transitioning to the Electronic Health Record Modernization (EHRM).”
“Currently, MCA cannot conduct full MCA on patient encounters provided by health care providers outside of VA facilities (Community Care). The financial data feeds required for MCA of Community Care are available (from FMS) and are entered into DSS, where they are classified as “exempt” cost and not passed along for use in costing patient encounters provided at VA facilities. However, outside of State Veterans Nursing Homes, there is no clinical workload data available for the full MCA of these encounters.”
Objective
“To assess the feasibility and cost of the acquisition and processing (by DSS) of clinical workload associated with Community Care patient encounters. This includes but may not be limited to:
- Identification of a means of acquiring clinical workload from Veteran healthcare encounters from Community Care providers
- Normalizing the clinical workload data, from the various EHR systems used by Community Care providers, for processing by DSS and use by VHA Program Offices and Health Informatics organizations
- Modifications (if any) to DSS to accept and process the new workload data feeds
- Determining the optimal means of entering Community Care workload into DSS. The most obvious choices are through the addition of MCAO staff or by the MCA Field Staff at each VA Medical Center
- Organizational changes (i.e., adding Full Time Equivalent Staff), and the associated timing, required to conduct and report on MCA of Community Care
- Integrating the process to annually adapt Community Care workload into the current processes used to adapt internal VHA workload. Annual updates are primarily performed to bring in new data requested by VHA Program Offices to provide a more complete accounting of patient encounters in their assigned specialty
- A Rough Order Magnitude (ROM) project plan to accomplish of the above activities
- A ROM full cost estimate, to include contractor, hardware, software and VA staff costs…”
