Dr. Ocasio is a rare blend of surgeon, engineer and veteran. His unique skill set has cracked one of the toughest IT challenges in federal health.
Tell us about how your work as Chief Medical Officer is helping transform not just electronic health records, but the future of veteran care.
After a multi-year collaboration, in 2016 we deployed the Enterprise Health Management Platform (eHMP) across Department of Veterans Affairs (VA) facilities. It created the nation’s largest, fully-integrated healthcare system. The platform goes well beyond just integrating a veteran’s electronic health record (EHR). For the first time, it enables interoperability between the VA and the Department of Defense (DoD) and external providers in a comprehensive way.
For doctors, the platform makes it easier to look at large amounts of complex patient data and quickly pinpoint relevant portions so they can take quick action. As electronic records become available across VA facilities, veterans are receiving faster, better care and at the same time, it reduces repetitive procedures and costs. We can see how the platform implemented for the VA can be used for the DoD in the future.
Interoperability was the major obstacle to integrating healthcare. The eHMP platform breaks down barriers and allows a system to present veterans’ health data in a unified manner no matter where they received treatment. It’s the cornerstone for modernization at the VA, from improving and expanding VA health services to serving as a continuous platform for innovation.
You’re an early pioneer in the electronic health records field. How does this interoperability breakthrough draw on other pioneering government projects you’ve been a part of?
The platform builds on lessons learned from two other complex implementations. I came to Accenture in 2016 after its acquisition of Agilex Technologies where I’d worked to bring modern Agile development techniques to the federal government. Using Agile, we helped the VA quickly meet a Congressional mandate for its Post 9/11 GI Bill program. Thanks to the innovative automation solution we implemented, the VA now provides education benefits more rapidly, cutting days off the process that enables veterans to obtain funding for tuition, fees and living expenses.
I also led development and deployment of the DoD’s first—and world’s largest—centralized electronic medical record system. Soldiers don’t remain at one location for very long, and each military health facility had its own system. We created integrated EHRs so that service members no longer had to carry paper records to each facility. We deployed it worldwide and for the first time records entered anywhere in the world were accessible to any military health facility. It was unheard of at the time. These were crucial lessons as we envisioned a platform that enables a fully-integrated healthcare system for the VA.
The VA platform opens the door to a new way of delivering care to veterans—a convergence between federal and commercial healthcare providers. How is Accenture leading this vision for a new industry healthcare model?
We’re exploring how veterans can take advantage of private providers in the community instead of receiving care primarily within the VA. One example is large retail pharmaceutical chains with mini-clinics. The VA is interested in this and has a pilot project underway. But once again, interoperability is the hurdle.
Accenture has both federal and commercial health industry expertise. This gives us a unique understanding of how retail clinics operate and how to innovate interoperability solutions for federal agencies that advance patient care—and maximize value for our clients.
With its open source-based platform, the VA is changing the way it innovates healthcare solutions. Was continuous innovation key to your vision?
Yes, the platform streamlines the complexity of innovation that often kills great ideas. It seamlessly integrates changes, including new healthcare apps by third party developers. You might have a pilot that looks great but have you looked at, for example, security and user disability requirements? These can end a promising innovation. The eHMP takes difficult requirements into account and automatically creates software that allows innovations to work well in a larger system.
The challenge is integrating innovation into the fabric of everyday work processes. That’s what’s so difficult, and that’s what we’re tackling. It requires balancing the needs of healthcare providers with the complexities of embedding change in aging IT systems. When you make change to one area of an older IT system it can have unexpected consequences in other areas.
When I look at the future of healthcare innovations, I’m excited by advancements in telemedicine that give patients located in remote areas the ability to receive care. Instead of physically going to a clinic to visit a doctor, telemedicine enables multiple care models, including at-home devices and wearable devices that transfer images to consultants outside a health facility. Patients can receive faster, more comprehensive care at a lower cost.
You grew up in Puerto Rico. How did your childhood and family influence your career?
I’m the youngest and all my siblings are professors. So the fact that I went into medicine makes me a sort of black sheep in the family. My parents were achievers. They grew up in Puerto Rico during the Great Depression and learned the importance of an education. My father is a physicist and my mother worked as an executive assistant before she stopped to care for our family full-time. All of my aunts and uncles pursued professional careers. In Puerto Rico in the 1930s and 1940s, it was not a given that you’d go to college. But we grew up appreciating the importance of education and a career. Although I chose a different field, the joy of teaching others and mentoring younger colleagues is part of my legacy.