The future of interoperability

There's more work to do to for the VA and the Pentagon to improve health data sharing.

Shutterstock image: monitoring factors of healthcare.

The Department of Veterans Affairs and the Department of Defense stood up their Interagency Program Office to tackle the problems of getting their disparate electronic health records systems to talk to each other.

The office was conceived as a way to improve data interoperability between military and VA systems, after a plan to create a joint DOD-VA system failed. DOD is going its own way with a commercial system, and the VA is sticking with its homegrown VistA system for now. But the IPO is still at work, trying to bridge the systems and pave the way for an interoperable future.

"I think unfortunately there is a common perception that interoperability is a single unified effort and it's really not," IPO Deputy Director Steve Schliesman said in an Aug. 31 interview with FCW. "I mean, when you look at the total spectrum of what interoperability means we have for a complete service to a veteran, it's so much more. ...  What you are really looking at is the aggregated efforts of many different programs and projects across both the Veterans Affairs and the DOD."

VA and the DOD both jointly certified that they were interoperable as related only to a specific provision of the 2014 National Defense Authorization Act. VA officials have touted the success achieved so far with a system called Joint Legacy Viewer, which integrated the two systems for users. But on Capitol Hill, lawmakers have remained skeptical of these results.

"It's an evolution," said Schliesman, who has been in his current job only about 60 days, but has spent seven years in senior IT positions with VA. He added that other programs such as the Integrated Disability Evaluation System is also currently in the process of being mapped out and made more seamless. But that is an "ongoing effort." He added, "As long as technology continues to advances and we continue to expand the services to the veterans, we are going to be doing everything we can to keep pushing that envelope forward."

One of the challenges, he said, they face is that the definition of "fully interoperable" means different things to different people. So, the 1.5 million data elements exchange between the two agencies to Schliesman means they are on the right path, but others may not view it that way. 

And the Pentagon's coming commercial system doesn't signal a coming end to the joint DOD-VA effort,  Schliesman said.

"I firmly believe it's going to continue on," he said. "The reason I say that is because I am going to fight my best to make sure that happens and that's primarily because of the mission. Interoperability is a continuum. As we expand across the spectrum of the data and information exchange, there are more and more projects and more and more places where we can make this process even more efficient."

With a new administration taking over in January, Congress will also be looking to the VA for answers on where they stand with major systems, including VistA. Schliesman said that VA is paying close attention to DoD and though there has been no decision made as yet on purchasing a commercial off-the-shelf product to replace it, they will "continue to evolve" the VistA system.

"It's the end result," he said. "People are trying to define a process when we should be defining an end result."