Pivotal Insight, LLC

Success Stories

Success Stories


The Naval Ordnance Safety and Security Activity (NOSSA) Operations Directorate engaged Pivotal Insight to develop and support a strategic management framework in order to proactively plan, execute, and measure strategic and tactical activity at all levels of the organization. Components of the strategic management framework included Organization-wide strategic planning, business execution planning, organizational change management, performance measurement, customer satisfaction, facilitation and process improvement.
“We are very grateful for the DDESB Briefing support you provided to NOSSA and appreciate the valuable input and insight you provided in addition to developing the briefing in a well-formatted manner, and especially appreciates the extra time you spent on the weekend and evenings due to the urgent nature of this support. A big thank you from all of us!
     -- Director of NOSSA Operations Directorate Manager”

Clinical Informatics Systems/Anesthesia Record Keeping (CIS/ARK) Services

A Pivotal Success: De-duplicate, convert and migrate critical clinical data for VHA

Within the Veterans Health Administration, the CIS/ARK program is a nationwide effort to implement a coordinated, uniform and integrated CIS/ARK solution, while allowing individual Veteran Information Support Networks (VISNs) to manage and direct the actual acquisition and implementation to reflect local needs and constraints.  The Office of the Chief Nursing Informatics Officer (OCNIO) coordinates and oversees governance of the CIS/ARK systems throughout the system life cycle within a decentralized structure supported by the VISNs.  OCNIO ensures coordination of terminology requests and reviews through monthly Change Control Board (CCBs) meetings for Anesthesia, ICU and PACU, in addition to ad hoc meetings to review substantive clinical terminology requests.  Pivotal worked with OCNIO to ensure the both the existing CIS/ARK terminology and new terminology requests from the VISNs were mapped to national standards, primarily SNOMED-CT, to ensure any clinical data generated by the CIS/ARK systems can be stored and re-used for future clinical decision support and/or clinical research by the VA.

Pivotal provided direct support for OCNIO’s efforts to normalize and standardize its clinical data to national standards such as SNOMED CT, LOINC, and RxNorm.  Pivotal analyzed the CIS/ARK Terminology and existing Data Base Optimization, and Sustainment efforts for the CIS/ARK project and provided detailed Terminology Sets, Implementation and Use of Terminology Reports analyzing the existing terminology data store.  Pivotal oversaw and coordinated the development of standardized, vendor-neutral interface terminology for all of VA’s inpatient critical care and anesthesia clinical areas using clinical terminology best practices.  Pivotal coordinated with the Office of Knowledge Based Systems’ (KBS) Terminology division to coordinate terminology efforts and solutions and conduct technical deep dives to resolve complex terminology issues, identify gaps in the current data set, prepare recommendations on how to normalize the data to meet VHA and national standardization requirements and address OCNIO, KBS and VISN concerns in a timely an effective manner.    

Pivotal conducted a detailed analysis of the legacy Archiver platform and identified a number of weaknesses in the platform that would impede OCNIO’s ability to convert existing CIS/ARK data to comply with national standards and be able to maintain that compliance going forward.  Pivotal analyzed available methods and tools, including approved applications on the OI&T Technical Reference Model and developed a whitepaper outlining both a short and long-term strategy for migration and compliance that described both the clinical terminology approach to the data and alternative platforms to support the data and ensure compliance with national standards.  Based on Pivotal’s analysis, OCNIO directed Pivotal to implement the long-term solution and by FY16Q3, Pivotal migrated OCNIO onto its new platform – DTS – and worked to harmonize and standardize data to SNOMED-CT.  In addition, Pivotal has analyzed and de-duplicated a clinical dataset consisting of 60,000 CIS/ARK clinical terms to a unique set of 14,000 and normalized and standardized to SNOMED-CT 1400 terms by the end fiscal year 2016.


A Pivotal Success: Business Case Analysis for VHA

The Veterans Health Administration (VHA) needed to develop the business and programmatic infrastructure in support of the Information Technology (IT) lifecycle management for all VHA IT systems and portfolios. This included the need for due diligence in analyzing and documenting a best-value analysis that considers not only cost, but other quantifiable and non-quantifiable factors supporting an investment decision.

Pivotal was selected to help develop a Business Case Analysis (BCA) capability within VHA Office of Health Information (OHI). This included development of a comprehensive business case analysis (BCA) template and application of the BCA for 8 different initiatives: Resource Management System (RMS), Medicare Claims Pricing Schedules (MCPS), Replacement Scheduling Application (RSA), VistA Lab IS Reengineering (LSRP), Appointment Card, VetPro, Clinical Registration and Tracking (CTR) and CBO Correspondence and Fulfillment

  • Developed OHI’s BCA template, leveraging Pivotal’s previous business case analysis experience along with industry best practices and key components of VHA’s current practices and in-house expertise.
  • Quantified the costs of current resource management operations within the nursing community across VHA, supporting VHA analysis of potential investments
  • Justified accelerated migration of a Class III application (Appointment Card) to Class I status.


A Pivotal Success: Project Management Support for HHS

HHS was implementing a multi year plan to consolidate several in use, Operating Division-unique business systems into a single, fully integrated, consolidated application serving the entire Department. This included consolidation of HHS asset systems into an COTS asset management system, the Property Management Information System (PMIS), in order to: 1. Eliminate redundant and outdated asset systems; 2. Produce accurate, timely, reliable, and enterprise asset information for decision-making; 3. Streamline operational activities to achieve more efficient and cost-effective business performance; and 4. To achieve unqualified audit opinions on annual financial statements.

HHS engaged Pivotal to provide comprehensive support of PMIS, including program management, acquisition management, and CPIC execution. Pivotal was retained in the initial phase of this project to develop the business case for capital planning and investment control purposes (OMB 300 and 53) and to outline the basis for proceeding with the development. We subsequently maintained the project plan, funds, and task orders in coordination with the Government, as well as provided technical oversight of three (3) contractors and a budget over $12 million. We also facilitated communications for PMIS, including funding requests and the PMIS change control board, as well as developed/revise policies to reflect the new system.

  • PMIS successfully consolidation of 7 legacy systems and integrated PMIS with the enterprise financial and acquisition systems within 3 years. The project is now in the steady state phase.
  • The PMIS project achieved an ROI of 41.5% for FY05 through FY12.


A Pivotal Success: Acquisition Support for DoJ

The Department of Justice, Office of Justice Programs (OJP) faced a challenging operational environment, including increased workloads, decreased professional staff, complex regulatory guidance, and increased size, scale, cost, and impact of mission-critical acquisitions. OJP sought to leverage strategic sourcing to improve operations and reduce total ownership costs.

OJP engaged Pivotal to better understand the value and potential approaches to strategic sourcing, including : understanding the potential for savings with a high degree of certainty; Devising sourcing approaches to demonstrate substantial savings ; improving OJP procurement processes and practices, including transferring strategic sourcing knowledge to OJP staff.

Pivotal and OJP identified two initial candidates for strategic sourcing: Help Desk and Enterprise Operations at the Office of the Chief Information Officer (OCIO), and the training and technical assistance (TTA) efforts for Office of Juvenile Justice and Delinquency Prevention (OJJDP) and the Office of Victims of Crime Center (OVC TTAC). Pivotal provided comprehensive acquisition support for theses procurements including market research, solicitation/PWS development, and source selection support. These contracts were awarded on schedule, without protest, and yielded over $25M in cost savings over a five year period.