Project Highlights

Managing Delivery of Care

Health IT

Emergency Room Patient Care

The challenge:

Technatomy was tasked by the Department of Veterans Affairs (VA) to develop a software product that tracks and manages the delivery of care to patients in VA hospital emergency rooms. This product, 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 ability for EDIS to manage ED workflows is crucial for standardization, measurement, and constant improvement to patient care. Before one piece of code was written, we worked with VA to develop and implement an Agile-based approach that addressed the development process. This approach combined elements of our MARQ method and VA’s Agile-based Software Development Life Cycle (ASDLC) using a time-boxed iterative approach of two-week sprint periods.

Our approach focused on keeping the code simple, testing often, and delivering functional pieces of the application as soon as they were ready. 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 made sure every piece of code was adequately and logically implemented and tested before moving forward to the next functional enhancement.

Leveraging the ASDLC enabled development of solutions to meet customer requirements through collaborating, self-organizing, cross-functional teams that produced smaller, prioritized software releases over shorter timeframes. Our processes focused on transforming business, functional, and non-functional requirements into clear and measurable work items. Our approach enabled us to improve quality as we worked, address evolving requirements, and enhance our ability to evaluate and refine our work processes to achieve increased productivity.  Our VA stakeholders recognized their participation in our Scrums, Sprint planning and review meetings provided them a continual opportunity to see progress and provide input, ensuring meaningful solutions to meet their needs. These Agile ceremonies along with incorporating 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 enable clear transparency and traceability across the project.

The result:

EDIS is deployed across 152 VA hospital EDs and 783 Urgent Care Clinics and community-based outpatient clinics nationwide.  Our Agile SDLC process resulted in enhanced communication between development staff and business stakeholders to address issues and to meet critical agency deployment goals.