# Presentation: 792564

## VA-DoD Health Information Technology Sharing Program

**VA-DoD ****Health Information Technology Sharing Program**

**An Overview Brief**

- December 2008

## Program Overview 

**Our Purpose: **
- Support the Nations Veterans by:
- Providing programmatic, analytical, and administrative support to VA/DoD collaborative health IM and IT projects and programs.
- Serving as the primary liaison between the VHA Chief Health Information Officer and the DoD Military Health System Chief Information Officer.

**Notes:**
 We have an understanding of the IT environment in both departments; this includes years of experience working in the DoD health IT environment, both at user and enterprise levels 
 Our staff has been here since VA/DoD health IT data sharing began
 We have worked for years with our DoD counterparts
 We offer historical perspective and continuity to ongoing health data sharing initiatives 

## VA-DoD Interoperability Overview 

- DoD

- VA

**One-way, enterprise **
**exchange of text data**

**Bidirectional, real-time**
**exchange of text data**

**Bidirectional, real-time, enterprise **
**exchange of computable data**

**FHIE**

**BHIE**

**BHIE**

**CHDR**

**CHDR**

**FHIE**

## VA/DoD Health IT Sharing Accomplishments 

- Federal Health Information Exchange (FHIE) supports the one-way transfer of all clinically pertinent DoD data available electronically to VHA providers and VBA claims staff
- Providers can view historical health information on more than 4.0 million patients through CPRS
- Pre and Post Deployment Health Assessments and Reassessments forms on over 942,000 individuals are available to VA
- VA and DoD share data to support the *seriously wounded *
- DoD key military facilities send radiology images and scanned paper records to VA polytrauma centers

**VA and DoD are sharing data *****one-way***** on separated service members and seriously ill and wounded patients**

**Notes:**
Re-used FHIE architecture to view historical pre- and post-deployment health assessment (PPDHA) and post-deployment health reassessment (PDHRA) data on separated Service members  

PPDHA and PDHRA data are collected prior to and immediately following deployments by Service Members, Reserve and National Guard members:  
Patient identity
Deployment locations
Immunizations
Hazardous exposures
Physical and mental health assessments

Operational in VA since December 2005
DoD has transmitted over 1.97M PPDHA and PDHRA forms on more than 793,000 individuals who are separated Service members and Reserve and National Guard Members who have been deployed and are now demobilized
DoD continues to send weekly updates to VA containing data on separating Service members and demobilized Reserve and National Guard members

## Bidirectional Health Information Exchange (BHIE) allows VA and DoD to share viewable data at all VA and facilities

BHIE reuses FHIE infrastructure to bring real-time, bidirectional exchange of current medical information 
BHIE interfaces with both AHLTA and DoD’s inpatient standalone Essentris CIS to ensure VA receives ambulatory data from DoD facilities worldwide and inpatient data from the all the major military treatment facilities.

The Clinical Data Repository/Health Data Repository (CHDR) interface allows VA and DoD to  share computable allergy and pharmacy data which supports automatic drug-drug and drug-allergy interaction checks at 7 locations where active dual patients receive care from both VA and DoD health systems

Computable data are standardized so they are able to automatically generate alerts and reminders
VA and DoD are working to begin sharing computable laboratory data through CHDR

- BHIE reuses FHIE infrastructure to bring real-time, bidirectional exchange of current medical information
- BHIE interfaces with both AHLTA and DoD’s inpatient standalone Essentris CIS to ensure VA receives ambulatory data from DoD facilities worldwide and inpatient data from the all the major military treatment facilities.
- The Clinical Data Repository/Health Data Repository (CHDR) interface allows VA and DoD to  share *computable *allergy and pharmacy data which supports automatic drug-drug and drug-allergy interaction checks at 7 locations where active dual patients receive care from both VA and DoD health systems
- Computable data are standardized so they are able to automatically generate alerts and reminders
- VA and DoD are working to begin sharing computable laboratory data through CHDR

**VA/DoD Health IT Sharing Accomplishments **

**VA and DoD are sharing data on shared patients *****bidirectionally***** in viewable and computable format**

## VA/DoD Electronic Health Record Summary 

- Progressive and incremental approach to data sharing
- One way viewable text
- Bidirectional viewable text
- Bidirectional computable standardized data
- VA receives all clinically pertinent historical data on separated Service members
- VA and DoD are sharing current health data in viewable format bi-directionally
- Images and inpatient data are the exception
- VA and DoD share computable allergy and pharmacy data which supports automatic drug-drug and drug-allergy interaction checks

## VA/DoD Electronic Health Record Strategy

- Developed collaboratively by VA & DoD to support health data sharing
- Progressive and incremental approach to data sharing
- One way viewable text
- Bidirectional viewable text
- Bidirectional computable

**Current: Joint Electronic Health Records Interoperability (JEHRI) Plan**

- Being developed collaboratively by VA and DoD
- Supports sharing health and administrative/personnel data
- Will increase the types of data shared and enhance the mechanism for sharing data (e.g., inpatient, images, more computable data)

**Future:  Information Interoperability Plan**

## Joint Inpatient Electronic Health Record Study

- Similar inpatient requirements present the opportunity to explore a “seamless” approach for a joint inpatient electronic health record
- Timing is right
- DoD is planning on adding electronic inpatient capability to its electronic health record known as “AHLTA”
- VA is planning to modernize its overall “VistA” electronic health record capability including inpatient functionality
- Status: Study is completed and concluded with recommendation to use a common services approach to achieve Joint Inpatient capability.