FHA Leverages Enterprise Architecture

Gail Kalbfleisch, Director-Federal Health Architecture, U.S. Department of Health and Human Services
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In today’s healthcare environment; federal agencies, public institutions, and private entities need to seamlessly exchange vast amounts of data despite having different systems, software and underlying infrastructure. Countless numbers of processes, policies, standards, and services have been created to support these exchanges. It requires a deep understanding of the complex interactions between multiple federal agencies to successfully navigate the federal health IT waters. In response to these challenges and to bring together federal health IT decision makers, the Office of Management and Budget (OMB) created the Federal Health Architecture (FHA) as an E-Government Line of Business (LoB) initiative. FHA leverages Enterprise Architecture (EA) to support federal agencies and provide a more comprehensive understanding of the federal health IT ecosystem.

Named as LoB in the spring of 2004, FHA is currently located in the Office of the National Coordinator for Health IT (ONC). FHA provides a forum for federal health IT stakeholders to collaborate and coordinate on current and future issues relevant to the health IT landscape. FHA collaborates with more than 20 federal agencies to advance the national agenda for health IT and provides authoritative architecture to federal agencies to enable federal-wide governance of health IT investments. Federal agencies, such as the Department of Defense, Department of Veterans Affairs, and the Department of Health and Human Services, collaborate to advance health information exchange and interoperability with tribal, state, local, and private sectors. Through FHA, federal agencies leverage EA to implement government-wide solutions for interoperable and secure health information exchange.

  FHA provides a forum for federal health IT stakeholders to collaborate and coordinate on current and future issues relevant to the health IT landscape 

EA is the conceptual blueprint that defines the structure and operation of an organization. The intent is to determine how an organizations can most effectively achieve its current and future objectives by providing a comprehensive view of an enterprise and exposing complex interactions. Federal enterprise architects work to develop a thorough understanding of how the federal organizational parts work together and describe the interoperations that exist between them. "[We] do EA …because nobody can keep it all in their head and they shouldn't expect to,” said Defense Health Agency Chief Enterprise Architect Alan "Bart" Bartholomew. EA helps agencies improve business and policy functions by developing clear baselines. This foundation leads to improved organizational awareness, risk management, communications, decision-making, and reduced costs.

Recently, FHA led a cross-agency effort to identify potential improvements to the Federal Enterprise Architecture (FEA) Business Reference Model (BRM) in the Health and Well-Being Sector. The BRM is a classification taxonomy used to describe the type of business functions and services that are performed in the Federal Government. The Federal Health Architecture Council (FHAC) meets quarterly to guide and approve architecture developed by FHA. The FHAC recently sent the proposed changes to OMB for consideration in an upcoming update of the FEA BRM. These changes describe the agencies’ functions and enable policy makers the ability to clearly compare functionality; identify potential cross-agency collaboration; to identify and address gaps which could affect their agency’s mission; and potential areas for shared services.

FHA coordinates and analyzes federal input to the Nationwide Interoperability Roadmap published by ONC. The Roadmap’s high-level goal is to achieve nationwide interoperability to enable a learning health system, with the individual person at the center of a system that can continuously improve care, public health, and science through real-time data access. FHA architects, working in conjunction with the supporting federal agencies, review the Calls to Action, the Commitments and the Milestones (CCM) within the Roadmap. Through this, they can provide analysis of the work that each agency is doing and identify potential opportunities for improved collaboration and potential shared services.

FHA’s value for federal agencies and the federal HIT community stems from its ability to provide cross-agency analysis to identify opportunities to implement agreed upon standards, processes, policies, and services. FHA brings together decision makers in federal health IT for inter-agency collaboration which results in effective health information exchange (HIE), enhanced interoperability among federal health IT systems, and efficient coordination of shared services. By using EA, FHA helps empower business managers to make informed decisions and optimize resource allocation to enable improved, efficient, and accessible technology and health information. This results in higher-quality care, lower costs, healthier populations, and more informed decision makers.

In the upcoming years, FHA will address the architectural needs for large scale health initiatives that will directly affect the federal health IT agencies. FHA’s comprehensive approach using EA will assist agencies as they accomplish their mission and improve the quality of patient care.

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