FEHRM releases interoperability strategy

The strategy from the Federal Electronic Health Record Modernization program office offers a set of goals that are more about health outcomes and empowering patients that specific technological benchmarks.

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The Federal Electronic Health Record Modernization (FEHRM) program office, stood up last December to help guide more than $21 billion in joint efforts to modernize health records at the Departments of Defense and Veterans Affairs, issued its interoperability strategy to Congress late last month, as required by the fiscal year 2020 National Defense Authorization Act (NDAA).

Under the defense bill, the FEHRM took over for the long-established Interagency Program Office, which managed data exchange and cooperation between legacy DOD systems, notably Alta, and VA's homegrown electronic health record system Vista. With DOD and VA spending billions to implement the Cerner Millennium electronic health record platform, there's more at stake.

"DOD and VA are continuing to drive toward more seamless care as patients navigate within and between the federal health care systems, most notably through the implementation of a single, common federal EHR," Dr. Neil Evans, former interim director of FHERM, wrote in the introduction to the strategy. (William Tinston, former program executive officer for Defense Healthcare Management Systems, now heads the FEHRM.)

The NDAA sought a few key deliverables in the strategy – plans to prevent vendor lock-in when it comes to patient health data, a single longitudinal record covering service members from induction through separation all the way to the end of life and seamless exchange capabilities with nongovernment providers "that are more adaptable and far reaching than those achievable through bi-directional information exchange between electronic health records of the exchange of read-only data alone."

The strategy from the FEHRM offers a set of goals that are more about health outcomes and empowering patients than specific technological benchmarks. Congress will be looking to FEHRM for more actionable strategy with specific deliverables, but overseers are pleased with the effort.

“To finally create a modern, secure health information ecosystem that serves our men and women in uniform throughout their lives, collaboration between VA and DoD is key. The strategy outlined in the DoD-VA Interoperability Modernization Strategy that was released this week is evidence of stronger cooperation than we have seen in the past," Rep. Phil Roe (R-Tenn.), ranking member of the House Veterans Affairs Committee and a physician, said in an emailed statement to FCW.

The strategy "outlines some important goals like enabling seamless care and empowering servicemembers and veterans to own and control their health data," Roe said, adding, "I hope subsequent strategy documents will include specific goalposts and timelines so the Departments can be held accountable for results."

On the technology front, the strategy pledges VA and DOD to "acquire and implement best-in-class IT capabilities that enable health and benefits team members to deliver a seamless health care and benefits experience to beneficiaries." The strategy states that "[c]apabilities must deliver value and integrate human-centered design principles and an understanding of workflows and how the product is used by the end user. Where possible, usability testing should be conducted in the environment where the capability will be used. Additionally, DOD and VA maintain exclusive control over beneficiary health data."