VHA Office of Information

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VHA Office of Information
My HealtheVet (MHV) VAs Personal Health Record
System
ITAA Panel E-Health Records Enabling Options by
Addressing Authentication and Security October 7,
2008
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My HealtheVet Personal Health Record

• A robust electronic health record that contains
  authentication, authorization, and accounting
  features
• Provides veterans the capability to enter and
  access their own e-health record outside the
  direct control of the hospital
• Veterans, family, and clinicians work
  collaboratively allowing better health
  decisions/improving quality of care

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My HealtheVet Personal Health Record

• Patients and veterans want
• Secure, timely access to health information
• Active role in managing their own health
• Ability to make informed, educated health care
  decisions
• Ability to refill prescriptions and have access
  to their medical or health record online
• One stop shopping for benefits and services
• Ability to communicate with healthcare providers
  electronically and securely
• Ability to control who has access to their
  information

This has greatly improved my health care.
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Three Tier Access Model

• Registrants
• Personal Information
• In Case of Emergency
• My Profile
• My Account
• Change Password
• Account Activity History
• Printable Wallet Size Health Information Card
• Get Care
• Track Health

• Visitors
• Prescription Refills
• Prescription Refill History
• Self-entered medications, herbals, OTCs, and
  Supplements
• My VA Medication List
• Research Health

• In-person Authentication (IPA)
• My Complete Medications List (VA and
  Self-entered)
• Prescription Names
• Lab Data
• Appointment Data
• Future
• Additional data/extracts (21 areas)
• Participate in secure messaging

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Challenges for Implementing MHV

• Legality of information ownership
• Responsibility of VHA providers to be aware of
  and act on self-entered data
• Security of the system and information
• Privacy concerns of patient and VHA

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Principles of Ownership

• The veteran "owns" his/her My HealtheVet Personal
  Health Record
• The VistA Computerized Patient Record System
  (CPRS) is the authoritative VA medical record
• The veteran can request that a copy of his/her
  VistA record be electronically extracted and sent
  to the My HealtheVet system

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Disclaimer of Responsibility to Act

• VHA health care providers cannot access the
  information entered by a veteran into MHV
  therefore, there is no expectation or
  responsibility for the provider to act on this
  information unless it is discussed during care.
• A disclaimer is provided to the veteran when
  he/she logs into their MHV account addressing
  this point.

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Privacy Issues

• Authentication of individual prior to MHV account
  access
• Documented request for health information to be
  extracted and provided to MHV account
• Review of health information per statute to be
  provided prior to being extracted
• Policies addressing request for amendment of
  extracted health information

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In-Person Authentication (IPA) Process

• Prior to receiving health info, every veteran
  must be In-person Authenticated (IPA)
• Excepta small group of veterans who are
  grandfathered
• Qualified staff perform the IPA

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IPA Process

• Veteran must
• Be registered with VHA as a patient
• Present to Medical Center or Outpatient Clinic
  where information resides
• Complete MHV orientation
• Present VIC card or other form of ID
• Sign MHV Participation Form

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In-Person Authentication
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Veteran Responsibility to Privacy

• VHA health care facilities responsible for
  educating the veteran regarding his/her
  responsibility regarding privacy.
• Veteran owns information in MHV account, so
  VETERAN is responsible for ensuring his
  information is kept private.

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Amendment Requests

• Since veteran owns information in MHV it cannot
  be amended.
• Veteran must make request to amend the original
  or official VA record maintained by the Medical
  Center or Outpatient Clinic.
• Once amended in original or official records the
  corrected information can be extracted to
  veterans MHV account.

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MHV Future Opportunities
New capabilities that are possible with existing
technology Exchanging health information with
collaborating non-VA healthcare systems using a
My HealtheVet Health Summary (Virginia Health
Information Network, DoD) Providing and hosting
Web based tools for tele-healthcare and
coordination of care (Secure Messaging,
Self-entered health information, medical device
interfaces, health reminders) Out-reach to
Homeless Veterans and rural Veterans (Secure
Messaging, health reminders, support for
community based collaborative care, personalized
home page for Homeless Veterans) On-line
Appointment Scheduling (dependent on scheduling
re-engineering)

• Emerging capabilities with new Web technologies
• Mobilizing My HealtheVet onto Mobile Phones and
  handhelds.
• Interoperability with other Personal Health
  Records (Google, Microsoft).
• Social Media (Facebook, Second Life, Medical
  Blogs).
• Interactive TV.
• Online group therapy support.

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www.myhealth.va.gov
celebrating 5 years of online access to VA
health care