VA, DOD to use standards to share e-health record systems

The Veterans Affairs and Defense departments will use standards to let them access each other’s inpatient electronic health records systems to effect a joint system. The agencies announced last week that they would collaborate to develop a joint electronic health record system for hospitalized active-duty military personnel and veterans.

Use of interoperability standards will let the departments accomplish collaboration between their separate e-health record systems, said VA secretary Jim Nicholson. But it does not mean that the departments have to use the same record system.

“Let me emphasize that we are talking about data and communications standards, and not a standard electronic health record. No one wants to force a single hardware or software application on everyone. The standards will encourage competition and increase the opportunities to use commercial software,” Nicholson said yesterday at an annual conference of the Military Health System in Washington.

The Health and Human Services Department last week accepted the first set of interoperability standards formulated by the Health IT Standards Panel, a standards-setting collaborative that HHS contracted with and that was recommended by the public/private American Health Information Community advisory group. Standards are a major component of HHS’ health IT efforts.

In Executive Order 13410, President Bush directed departments and agencies involved in health care to use these interoperability standards as they acquire and update health IT systems for data exchange.

Once the departments complete a requirements study, they will announce how they plan to proceed, said William Winkenwerder Jr., DOD’s assistant secretary for health affairs. When implemented, the interoperable systems will be an example for other large health care providers.

A joint system will make inpatient medical records instantly accessible to clinicians in both VA and DOD, which will let physicians make faster and better treatment decisions. It will also assist benefit adjudicators, who must validate the medical history of veterans who seek benefits for service-related injuries.

“We’re going to achieve a joint inpatient electronic records system so that when we have this handoff from you [DOD] to us [VA], it is seamless. It will be digital to digital,” Nicholson said.

Interoperability standards will ensure that different organizations using different systems can still exchange data effectively, Nicholson said. Just as the financial industry has established standards that allow financial information to be available through ATM cards, these standards will enable emergency room providers, for example, to get a medical history they need to provide life-saving care to service members and veterans wherever they present themselves.

VA uses its Veterans Health Information Systems and Technology Architecture program (VistA) electronic health record, while DOD uses the Armed Forces Health Longitudinal Technology Application (AHLTA).

Elsewhere at the conference, Capt. Wyatt Smith, deputy CIO for Health Care Strategies, Military Health System, said DOD was in talks to exchange data with some private providers that treat military patients and with certain states.

DOD wants to set up a health information network using the federally accepted interoperability standards and a Web view of its AHLTA electronic health record so it doesn’t have to conduct one-on-one exchanges with these organizations.

DOD has business partners that manage DOD’s private sector patients, and the organizations already have much of the targeted data, such as referrals and authorizations and consultation results, he said. DOD also is in discussion with Florida, California, Virginia and North Carolina to be part of DOD’s network to exchange certain categories of data, such as lab reports, immunizations and pharmacy orders.

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