DoD and Veterans Affairs: Health Information Interoperability

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DoD and Veterans Affairs Health Information
Interoperability
Veterans Service Organizations Military Service
Organizations April 2006
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Topics

• Path to Interoperability
• Federal Health Information Exchange (FHIE)
• Pre- and Post-Deployment Health Assessments
• Bidirectional Health Information Exchange (BHIE)
• Clinical Data Repository/Health Data Repository
  (CHDR)
• Laboratory Data Sharing Initiative (LDSI)
• Other Initiatives
• Summary

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The Path to Interoperability
Interoperable Electronic Health Records
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Federal Health Information Exchange
Supports monthly, 1-time transfer of electronic
health information from DoD to VA at the point of
a Service members separation
FHIE
One-way, enterprise exchange of text data
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Federal Health Information Exchange

• 3.5 million unique patients
• 45.6 million lab results
• 7.27million radiology reports
• 45.9 million pharmacy records
• 44.7 million standard ambulatory data records
• Over 2.89 million separated Service members have
  presented to the VA
• 2255 messages transmitted daily in Mar 06 on VA
  patients treated by DoD under local sharing
  agreements

As of 31 March2006
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Pre-/Post-Deployment Health Assessments
Enables VA health care providers to access pre-
and post-deployment health assessments on
separated Service members and on Reserve and
National Guard members who have been deployed and
are now demobilized
PPDHA
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Pre-/Post-Deployment Health Assessments

• Assessments transferred from DoD to Federal
  Health Information Exchange data repository
• Historical data pull of 400,000 assessments
  completed July 2005
• Monthly data transfer started in September 2005
• VA began retrieving the data in December 2005
• Added PPDHA for demobilized Reserve and National
  Guard in March 2006
• More than 1.2M assessments on more than 519,000
  individuals
• DoD plans to add post-deployment health
  reassessments in fiscal year 2006

As of March 2006
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Bidirectional Health Information Exchange
Enables real-time sharing of electronic health
information between DoD and VA for shared patients
BHIE
Two-way, BHIE sites and all of VA exchange of
text data
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Bidirectional Health Information Exchange

• Allergy, outpatient pharmacy, demographic,
  laboratory, and radiology data
• 4,200 FHIE-BHIE queries/week (1st Qtr FY 2006)
• Data from DoD BHIE sites available to all VA
  sites
• Deployment to additional sites in fiscal year 2006

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BHIE Sites
Madigan AMC
NH Great Lakes
National Capital Area
David Grant Medical Center
Womack AMC
Mike OCallaghan Federal Hospital
NMC San Diego
Eisenhower AMC
William Beaumont AMC
Tripler AMC
Landstuhl RMC
BHIE operational
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Clinical Data Repository/Health Data Repository
Will support interoperability between DoDs
Clinical Data Repository (CDR) VAs Health Data
Repository (HDR)
CHDR
Two-way, enterprise exchange of computable data
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Clinical Data Repository/Health Data Repository

• Bidirectional exchange of demographics,
  outpatient pharmacy, and allergy data anticipated
  in fiscal year 2006
• Support drug-drug and drug-allergy interaction
  checking
• Bidirectional exchange of laboratory data
  (chemistry and hematology) next data set

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Laboratory Data Sharing Initiative
Supports bidirectional capability for either DoD
or VA to act as a reference lab for order entry
and results retrieval (lab chemistries)
LDSI
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Laboratory Data Sharing Initiative

• LDSI metrics from National Defense Authorization
  Act (NDAA) demonstration sites
• El Paso, Texas
• Operational January 2005
• San Antonio, Texas
• Operational August 2005
• Adding functionality for anatomic pathology and
  microbiology
• Anticipate testing in late 2006/ early 2007 in El
  Paso and San Antonio

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LDSI Sites
NH Great Lakes VA Medical Center, Chicago
William Beaumont AMC El Paso VA Health Care
System
NMC San Diego San Diego VA Health Care System
Brooke AMC, Wilford Hall Medical Center, South
Texas VA Health Care System
Tripler AMC Pacific Islands VA Health Care
System
LDSI operational
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Other Initiatives

• Inpatient documentation
• Image sharing
• Medical record scanning

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Summary
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DoD and VA Are

• Sharing large volumes of electronic health
  information
• Making progress on interoperable health records
• Continuing to enhance HIPAA compliant data
  sharing solutions

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Questions