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CASE STUDY:

Veterans Affairs Emergency Department Integration Software

Client

Department of Veterans Affairs

The Challenge

Technatomy was tasked by the Department of Veterans Affairs (VA) to develop an enterprise system that tracks and manages the delivery of care to patients in VA hospital emergency rooms. The application, known as Emergency Department Integration Software (EDIS), is an extension to Veterans Health Information Systems and Technology Architecture/Computerized Patient Record System (VistA/CPRS) for tracking and managing the delivery of care to patients in an Emergency Department (ED) or Urgent Care Clinics (UCC). The EDIS system records and tracks patients during incidents of care, displays the current state of care delivery, and reports and extracts data specific to individual Veterans Health Administration EDs.

Our Approach

The functional capability for EDIS to manage Emergency Department resources and activities is crucial for standardization, measurement, and constant improvement of patient care. Technatomy’s team worked with VA to design an Agile-based approach that addressed the entire software development process. Ultimately, this approach combined elements of our integrated quality management methodology and VA’s Agile-based Software Development Life Cycle (ASDLC) using a time-boxed, iterative approach based upon two-week development ‘sprint’ cycles.

Our project approach focused on code simplification, frequent testing, and the incremental release of functional application modules. Within each two-week sprint period, Technatomy completed a full software development cycle including analysis, design, coding, testing, and deployment. We continuously implemented small, functional business-approved components in each sprint as the project progressed and released a working product to the EDIS users for their testing and acceptance. Our approach ensured each release was adequately and logically implemented and tested before moving forward to the next functional enhancement.

Leveraging the ASDLC enabled our development team to meet customer requirements with well-defined software releases over compressed timeframes. Our processes focused on transforming business, functional, and system requirements into clear, measurable work items. Our approach enabled us to improve quality, capture evolving requirements and increase productivity.

The Results

The use of the ASDLC resulted in more frequent, efficient communication between the development team and business stakeholders. We regularly addressed issues and obstacles in a positive, timely manner. Our VA stakeholders avidly engaged our team and provided input throughout the process. They participated formally in our integrated Scrums, Sprint planning and review meetings. And, our customers embraced important process communication tools such as Agile ceremonies. Agile artifacts and information radiators—such as sprint tracking log, sprint planning log, sprint burn-down chart, sprint review document, sprint backlog, and product backlogs—enabled clear transparency and traceability throughout the project lifecycle.

Today, EDIS is deployed across 152 VA hospital EDs and 783 Urgent Care Clinics and community-based outpatient clinics nationwide.