Case Study:

Defense Health Agency (DHA), Vision Center of Excellence (VCE) Program Management Support Services

4S supports the VCE Technology Directorate’s Program Management Office (PMO) and provides program management for all VCE projects and research initiatives, including leading data standards and architecture, requirements and configuration management, risk management, system administration, information assurance, and quality assurance.

VCE Master Data Management Strategy and Charter – As required by VCE initiatives, 4S developed domain ontologies leveraging existing available vocabularies to establish a baseline standard for Electronic Medical Health Records. Utilizing ontologies provides an efficient mechanism to construct many-to-many abstract, concrete, and reasoned dependencies across many data sources to promulgate transparency and quality throughout the data value chain.

Our Holistic Approach yields results – 4S efforts create data interoperability for ingesting and aggregating medical record data from Theater Medical Data Store (TMDS), Military Health System (MHS) Data Repository (MDR), Joint Theater Trauma Registry (JTTR), Transportation Command Regulating Command Arid Control Evacuation System (TRAC2ES), and Veterans Health Information Systems and Technology Architecture (VISTA). Our architects utilize National Institutes of Health’s Unified Medical Language System (UMLS) ontologies and vocabularies to ensure data standardization, for example RxNorm links patient medicine prescriptions to a unique RxNorm identifier disambiguating drugs and enabling semantic concept linking useful for finding all patients with similar drugs or allergies. A comprehensive Visual Acuity Data Model providing standardized LogMAR acuity across data sources. 4S implemented an HL7 canonical model to facilitate integration of disparate source systems.

VCE Requirements Analysis and Management (RA&M) process – 4S is responsible for all aspects of management and administration in support of VCE system and Information Technology (IT) operations. Using a four-step process and program-specific governance mapped to a Requirements Definition and Analysis (RDA) processes 4S performed Requirements Analysis. The four-step process includes: Requirements Elicitation, Requirements Analysis, Requirements Validation, and Requirements Management. We follow several guiding frameworks, such as: American National Standards Institute (ANSI)/International Organization for Standardization (ISO), Capability Maturity Model Integration (CMMI), and Information Technology Infrastructure Library (ITIL), and the Program Management Institute (PMI). 4S enforces consistent program management artifacts throughout each project’s lifecycle.

Ongoing Monitoring of Performance Metrics – 4S works to develop and monitor performance metrics for programs supported and/or overseen by the VCE for over 20 projects and initiatives. These inputs include operational availability, risk management strategies, incident, event, and problem reports, and plans to address operational deficiencies. Working to develop Government approved systems/components the team also researches, identifies, and provides cost estimates for industry standard technology hardware and software solutions.

Case Study:

USCBP OCMO Administrative Medical Support Services

4S is currently supporting the Office of the Chief Medical Officer as a subcontractor on the Administrative Medical Support Services contract. The team provides subject matter expertise (SME) and assists with assessments and analyses of projects and studies that require analysis of interrelated issues such as legal compliance, policy compliance, and regulatory compliance.

The 4S team also assists in preparing guidance for compliance procedures and operations and assist with the development of new procedures and guidance dealing with the applicability and impact on privacy of current and developing technologies

On this contract we also provide support to the CBP CMO in medical direction and oversight of CBP medical support to operations, CBP medical support efforts for persons in custody, as well as medical direction and assist with oversight support for the CBP EMR system. In addition, highly trained and experienced 4S staff supports the CBP Emergency Medical Services Program, provides medical direction and assists in the oversight of the CBP medical quality management program, CBP emergency management and contingency response efforts.

Case Study:

US Customs and Border Patrol (CBP), Electronic Medical Record (EMR) PMO

4S provides CBP with program management and technical services overseeing the development, deployment, and operations of an Electronic Medical Record to 175 border patrol stations. The EMR provides medical providers with the ability to document patient medical encounters and subsequent care sharing the data across the Department of Homeland Security (DHS) and the Department of Health and Human Services (HHS). The EMR system is a custom-built application leveraging a DHS operations center platform consisting of a web-based medical care documentation user interface, a SQL Server backend database, and a backend interface to a Salesforce based ESB and Analytics platform.

Program Management Office – 4S serves as the PMO executing this funding. Our responsibilities include the management of the program budget, the development of procurement strategy options, Privacy Act subject matter expertise for Privacy Threshold Assessments and Privacy Impact Assessments, logistical planning for program rollout, establishment and leadership of a systems engineering IPT, establishment and leadership of a functional Requirements Management Working Group, communications planning for the program rollout, stakeholder communications, OMB reporting, as well as training development and training delivery.

Agile Scrum Delivery Methodology – 4S also supported the transition of the software vendor into an Agile Scrum Delivery methodology with 2-week sprints and regular releases. Since our arrival in July, we have re-baselined the program budget, planned 14 million dollars in procurements, pushed the EMR into a deliverable state through careful vendor and stakeholder management, achieved Point of Total Assumption (PTA) and Privacy Impact Assessment (PIA) approval, rolled out the product for a limited user test, supported the logistics and planning of the rollout to all stations and ports of entry across the southwest border and put the entire requirements management and systems engineering lifecycle in place. Hundreds of users have been trained and medical providers will be paperless across CBP by Q2 FY2021.

Case Study:

Defense Health Agency (DHA) J-9 Vision Center of Excellence

As a subcontractor, 4S supports the Defense Health Agency (DHA) J-9 Vision Center of Excellence providing data modeling, statistical analysis, clinical research, and report design on the Data Analytics and Support Services (DASS) contract. Based on analysis requests from the ocular care community, the team analyzes existing statistical and classification models for appropriateness. If none are found, the team will query and analyze Defense and Veteran’s Eye Injury and Vision Registry (DVEIVR) data incorporating other data as necessary from VA and DHA systems, such as Trac2es. The team creates new models and BI system components to accommodate the reporting and analysis self-services of ocular care community users.

The 4S team also supports maintenance and updates of the DVEIVR’s NLP service that includes a machine learning (ML) algorithm trained specifically for DHA/VA optical health data that structures the physicians’ Subjective, Objective, Assessment and Plan (SOAP) notes. This process saves an average of 20 minutes per patient encounter abstraction that is executed by a separate team. Quality assurance (QA) data from the abstraction process is fed back into the ML pipeline to continually improve the algorithm.

Case Study:

4S-Silversword has supported the Department of Labor (DOL), Job Corps office throughout the pandemic in collaboration with the National Office to evaluate and measure the risk and readiness associated with resumption, student enrollment build and continuous operations for the 121 Job Corps Centers across the nation. 4S teams with KPMG and Unified Strategic, to provide data services to USDA Forest Services through the DOL contract since 2020 as follows:

Data Collection and Analysis – 4S has developed external survey tools to collect data for risk and decision making, consolidates the data, provides analysis and trending, The team develops and provides briefing tools to aid Job Corps leadership in communicating the resumption plan and state of continuous operations and onboard strength (OBS) with DOL and executive branch decision-makers, including but not limited to an ongoing forecast of enrollment goals and achievement dates for COVID OBS and newly developed GOAL OBS.

Data Rendering – The 4S team provides, updates and maintains an external facing dashboard that summarizes critical information for the DOL customer.

Case Study:

Fort Bragg Directorate of Public Works’ (DPW) GIS office

4S has been providing Geospatial Information Systems Support (GIS) to the Fort Bragg Directorate of Public Works’ (DPW) GIS office since 2020. Their mission is to manage an Installation-wide geospatial capability and use that capability to support the daily geospatial business needs of all Garrison Directorates and Support Offices. 4S provides GIS and GPS technical expertise that include: expert advice on geospatial products and tools; analysis of problems related to GIS; recommendations on GIS products and services; technical solutions; and overall expertise on geospatial technologies and data. This work includes:

• Conversion of existing geospatial data from various raster or vector formats (e.g., different CADD or GIS digital formats) to the Government provided data standard
• Conversion of existing paper maps, drawings or images to digital vector file formats (through scanning and heads-up digitizing)
• Geospatial data acquisition through the use of Global Positioning System (GPS) technology

We maintain the existing geospatial data layers and keep these layers compliant with the latest Spatial Data Standards for Facilities, Infrastructure, and Environment (SDSFIE) version. Additionally, we update and maintain current, relevant and standardized metadata files for all current geospatial data layers and create metadata for all newly created geospatial layers. Overall, we provide geospatial data analysis to meet Installation business area mission requirements.