eHMP Architecture

If you want to download and/or install eHMP, go to the OSEHRA eHMP wiki located on Github.

The VA embarked on the VistA Evolution program to evolve, replace and enhance existing VistA EHR systems to achieve interoperability, clinical and technical objectives.  A major part of this program is the enterprise Health Management Platform (eHMP).  eHMP includes Services to support multiple consumers, clients and applications, and a Clinical Practice Environment (CPE) that provides  functionality required to support delivery of the best possible patient care. 
 
eHMP Services and CPE are designed to lead VA away from duplicative, non-standardized interfaces and methods for incorporation of applications and infrastructure.  eHMP provides reusable Services such as Orders Selection and Management, Concept Relationship, Documentation and Business Rules Management.  Developers may take advantage of these services rather than develop their own.  The CPE allows many contributors and specialties to develop User Interface components.  Modularity exists throughout the platform, providing multiple levels for developers to engage, whether at the data level, middle tier or UI.  

Major eHMP System Capabilities Overview

  • Aggregated, normalized, enriched, and indexed longitudinal enterprise patient record with data from VA, DoD, and Community Partners

  • Clinical user application that introduces novel coordinated communications between providers, a new search capability against the longitudinal record, and the ability to fully customize your workspace to match the clinical need

  • Development platform which allows for extension of the ecosystem through both development and content, including activities and clinical decision support rules representing clinical best practices

  • Activity management to provide support for clinical team coordination

  • Order selection and order management capabilities

Platform API Services 

Designed to be consumable by other VA programs, Community Services, Connected Care, and Third-party applications, the VA Enterprise Services provides access to a longitudinal, enterprise, patient record through Vista Exchange (VX).

In order to support both consolidated display, advanced text search, rule processing across the patient record, and activity management, VistA Exchange pre-aggregates the longitudinal patient record through a process: VX-Sync.

Vista Exchange syncs records from all 130 VA VistAs, DoD and VLER Partners (CCDA) to provide a fast, up-to-date, interoperable, and longitudinal patient cache, compatible with COTS solutions, and any other data source as needed.

In addition, the Platform API Services introduces end-to-end Business Process management in the form of Activity Management, a tool for orchestrated and coordinated care. Activity Management is supported by a Clinical Decision Support Engine for applying Rules and Logic in real-time.

eHMP Application User Interface

The UI was the first consumer of the Platform API Services, but now provides capabilities above and beyond what can be found in existing VA solutions. Viewing the longitudinal patient record inside a workspace customized to disease management, or specific clinic workflows, or any required orientation gives Providers and Administrators unique situational awareness.

With access to a longitudinal and interoperable record, Search becomes a powerful way to read historical records, find gaps in care, and account for handoffs between shifts and department transfers

Without eHMP, communications and requests within the VA can only be accomplished through Co-signed notes, and Nurse Orders (or unofficial channels such as log books). With the introduction of eHMP Activity Management, coordinated Requests between providers, teams, and specialty roles can be tracked and escalated to ensure completion. A user-centric workspace has been provided to allow the user access to tasks and activities across the panels of patients that user has responsibility for.

With the addition of writeback capability, ensuring access to workspace information while placing orders or writing notes required unique design patterns. The application design maintains those patterns even during inclusion of third-party content produced with Management Platform.

Overall, the fully 508 compliant, Application User Interface has been designed with insight from the office of Human Factors Engineering who have led feature testing with field users to ensure ease of use, and high adoptability.

Management Platform

Continuing the VA tradition of innovation and grassroots solutions, eHMP Management Platform offers a number of ways for Developers and Informaticists to produce new content and solutions and deploy them to the VA enterprise. Using the Software Development Kit (SDK), developers can produce new Resources to support Platform API Services, or new Applets to support the Application User Interface. Both Applets and Resources handle the often all-consuming overhead of authentication, authorization, 508, common controls and repeatable patterns.

Informaticists can use user-interfaces to produce novel ways to interact with patient data through User-Defined Workspaces, Filters, define new coordinated care activities in support of Consults, Care Plans, Pathways and Protocols. And offer new rules to elevate the Clinical Decision Support intelligence.

The Automated Infrastructure Development Kit (AIDK), a part of the SDK, provides the ability to extend the automated infrastructure scripts, including provisioning virtual machines and deployment of system components. This allows for faster, higher quality deployments of eHMP; local provisioning of eHMP to support developers with private instances of eHMP; enables third party developers to contribute additional system components to the eHMP ecosystem.