VADoD Health Information Sharing

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VA/DoD Health Information Sharing
Mr. Cliff Freeman VA/DoD Health IT Sharing
Program 2006
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Highlights

• VA/DoD Joint Electronic Health Records
  Interoperability Plan Overview
• The Path to Interoperability, FHIE to BHIE to
  CHDR
• Other Ongoing Integration Efforts

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VA/DoD Joint Electronic Health Records
Interoperability Plan Overarching Strategy
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VA/DoD Electronic Health Record
VA/DoD Electronic Health Record

• Joint Electronic Health Records Interoperability
  (JEHRI) Plan Overview
• Developed collaboratively by VA DoD
• Approved by the VA/DoD Joint Executive Council
  (JEC) and signed by the VA Under Secretary for
  Health (USH) and DoD Assistant Secretary of
  Defense, Health Affairs (ASD(HA))
• Approved by OMB
• Provides the roadmap to achieve VA/DoD
  interoperability
• Two Phases
• Phase I One way electronic data exchange
• Phase II Bidirectional and computable data
  exchange

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VA/DoD Electronic Health Record

• JEHRI Goals
• Improve sharing of information
• Adopt common standards for architecture,
  security, communications, data, technology and
  software
• Seek joint procurements and/or building of
  applications where appropriate
• Seek opportunities for sharing existing systems
  and technology
• Explore convergence of VA and DoD health
  information technology applications where
  feasible and within mission requirements
• Develop interoperable health records and data
  repositories

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The Path to VA/DoD Interoperability
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DoD/VA Interagency Initiatives
DoD
VA
One-way, enterprise exchange of text data
FHIE
FHIE
BHIE
Bidirectional real-time exchange of text data
BHIE
Bidirectional real-time enterprise exchange of
computable data
CHDR
CHDR
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Federal Health Information Exchange
(FHIE)Information Sharing in Operation
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Federal Health Information Exchange (FHIE)

• Successfully completes Phase I of JEHRI
  operational at all VA medical centers since 2002
• One-way data transmission from DoD CHCS I to VA
  VistA CPRS
• Allows access to DoD data at the point of care by
  VA clinician
• Successfully deployed and implemented across all
  VA Medical Centers
• Averages over 1100 uses of FHIE/BHIE data each
  week (as of March 2006)
• Permits VHA clinicians and VBA disability claims
  processors to view historical DoD data
  Demographics, Laboratory data, Radiology reports,
  Outpatient Government and Retail Pharmacy data,
  Allergy data, Admission, Disposition and Transfer
  (ADT) data, Consult Reports, and coding from the
  Standard Ambulatory Data Record

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Federal Health Information ExchangeInteroperabili
ty Accomplishment

• VA accesses health information through CPRS
  Remote Data View at the point of care
• FHIE is fully operational at every VA medical
  center
• DoD has transmitted data to the FHIE repository
  on approximately 3.3M unique patients
• VA has provided care or treatment to over 2M of
  the unique patients using FHIE data

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Pre Post Deployment Health Assessment Data

• Re-used FHIE architecture to support the ability
  of VA clinicians to use CPRS to view pre- and
  post-deployment health assessment (PPDHA) data on
  separated Service members
• Operational in VA since December 2005
• DoD has transmitted over 1.2M PPDHA on more than
  512,000 individuals who are separated Service
  members and Reserve and National Guard Members
  who have been deployed and are now demobilized
• DoD continues to send monthly updates provided to
  VA containing data on separating Service members
  and demobilized Reserve and National Guard
  Members
• Analysis underway for delivery of DoD Post
  Deployment Health Reassessment data in the same
  manner

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CHCS-VistABidirectional Health Information
Exchange (BHIE)Bridging the Gap
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Bidirectional Health Information Exchange (BHIE)

• BHIE brings real-time, bidirectional exchange of
  medical information reusing FHIE infrastructure
  between CHCS and VistA CPRS
• BHIE supports the care of shared patients at
  joint sites
• Incremental Clinical Functionality was delivered
  in Cycle I (October 2004). Bidirectional
  transmittal and display of
• Outpatient pharmacy
• Allergy data
• Patient Identification Correlation
• Additional Clinical Functionality was delivered
  in Cycle II. Bidirectional transmittal and
  display of
• Laboratory result data
• Radiology text data
• Operational at all VA sites and select DoD sites

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BHIE DoD Sites Current and Future
Bassett ACH
Madigan AMC
NH Great Lakes
NCA
David Grant FMC
NH Camp Lejeune
Womack AMC
Mike OCallaghan Federal Hospital
Elmendorf AFB
NH Camp Pendleton
Eisenhower AMC
NH Charleston
NMC San Diego
William Beaumont AMC
NH Pensacola
Tripler AMC
Darnall ACH
Brooke AMC
LRMC
BHIE operational
BHIE implementations planned during FY2006
8 DoD host sites 8 DoD Medical Centers, 5 DoD
Hospitals 50 DoD Clinics as of March 2006
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The Clinical Data Repository/Health Data
Repository (CHDR) The Interoperable Health
Record
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The Clinical Data Repository/Health Data
Repository (CHDR)

• Represents the development of interoperability
  between the Clinical Data Repository (CDR) and
  Health Data Repository (HDR)
• Leverage DoD CHCS II/AHLTA experiences and
  lessons learned
• Provide the cornerstone for interoperability
  between electronic health records for DoD and VA
• Next generation systems AHLTA and HealtheVet
• Bidirectional real time exchange of computable
  pharmacy, allergy, demographic and laboratory
  data
• Drug Drug interaction checking
• Drug Drug Allergy interaction checking
• Pharmacy Prototype demonstrated exchange of
  computable pharmacy, allergy and demographic data
  late in FY 04
• CHDR successfully demonstrated to VHA and
  Military Health System Chief Information Officers
  in January 2006
• Anticipated release into production environment
  is summer 2006 between William Beaumont Army
  Medical Center and VA El Paso Health Care System,
  El Paso, TX
• Uses standardized data and terminology code sets
  to achieve computable data exchange

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Other Ongoing VA/DoD Integration Efforts

• Laboratory Data Sharing and Interoperability
  (LDSI) Supports the electronic ordering and
  results retrieval of chemistry laboratory tests
  between DoD and VA facilities
• Enterprise Architecture Joint VA/DoD Shared
  Health Architecture Plan/Charter completed a
  Shared Health Architecture, version 1.0 in
  December 2004
• Scheduling Interoperability Chartered work group
  exploring the feasibility of creating
  interoperable scheduling applications
• e-Health collaboration VA/DoD shared objectives
  for cooperation between TRICARE Online and My
  HealtheVet