DoD, VA to accelerate EHR integration

By Tom Sullivan
09:26 AM

Whereas the Defense and Veterans Affairs (VA) departments are working toward a joint iEHR that would, come 2017, wrap all patient data into a single record accessible to clinicians in both departments, U.S. Defense Secretary Leon Panetta and VA’s Secretary Eric Shinseki pushed their staffs to accelerate data exchange and interoperability where they can now, rather than waiting.

“What the Secretaries challenged us to do was find some high-value quick wins that would provide real value across the organizations ... and utilize those most critical data areas in a standard format,” said Roger Baker, VA chief information officer. “By early 2014 we will be able to we will be able to exchange the most important medical information on every one of our patients between our organizations.”
Baker outlined three ways the departments are adjusting the project in a call with reporters Tuesday afternoon. Those major areas are:
  • Increasing availability of the joint GUI. The departments are working to deploy the joint graphical user interface to five VA polytrauma centers and 2 DoD polytrauma hospitals, which is where the most seriously-injured service people are treated. “What this user interface allows us to do is make certain that the information necessary to provide optimum care is available to clinicians so they can see information from both DoD and VA care providers at the same time as they’re working with a patient,” Baker said.  
  • Moving forward on data exchange and interoperability “quick-wins.”  The long-term goal, Baker said, will fulfill the promise of the Virtual Lifetime Electronic Record (VLER) system to make medical data accessible inside the VA and DoD and available for patients to download. “What this entails is the exchange of information in the most critical clinical areas between VA and DoD in a computable format so that it’s usable by clinicians as a single medical record in those areas,” Baker said. The project spans 7 domains of patient data, including allergies, clinical notes, lab results, medications, prescriptions, said Jonathan Woodson, MD, DoD assistant secretary of defense for health affairs.
  • Accelerate the delivery of functionality of iEHR and reduce cost and risk. This marks a change in the strategy. “For the broader integrated electronic health record program, the secretaries agreed to revise the strategy to base it on existing core of technology, in other words technology of an exiting electronic health record system, and move forward from that point,” Baker said. To that end, the DoD will evaluate their choice of that core while the VA is looking to VistA, Baker added. “We had significant conversation with the secretaries about how that strategy will help us to reduce cost and risk and deliver functionality sooner,” Baker said. “Our goal is to make certain that we are creating a single medical record for all patients.”
Despite the alterations, the departments’ approach to the iEHR “remains fundamentally consistent,” according to Elizabeth McGrath, DoD’s deputy chief management officer. McGrath continued that iEHR will ultimately include “the utilization of common data standards, the pulling together of authoritative data sources, taking a service-oriented approach, data-driven, the utilization of an enterpriser services bus that enables us to move data to the place it needs to be in a standard way.”