Defense Department, VA Work to Integrate Health Records

By Sgt. Sara Wood, USA
American Forces Press Service

Aug. 3, 2007 - The Defense Department and the Department of Veterans Affairs took the first step this week toward developing a joint electronic health record system that will better serve wounded servicemembers and veterans. The two departments hired an independent contractor to make an assessment of how best to create the joint system, which will bring together inpatient records from more than 200 hospitals. The integration of these systems was a recommendation that came from various commissions after substandard conditions at Walter Reed Army Medical Center here were brought to light earlier this year.

"That's what this contract is, a first step in helping the two agencies design the requirements to move forward with a joint inpatient record, which would mean that (Defense Department) doctors and VA doctors, when they pull up their screen, they're going to have the same information. The patient, when they go from one inpatient facility to another, they'll have the same data there," Dr. Stephen L. Jones, principal deputy assistant secretary of defense for health affairs, said in an interview.

Integrating the two departments' health records has been a goal of the Defense Department and VA for a long time, Jones said, but the recent emphasis on military health care has accelerated the process. The new system will still take time to develop, but once it is in place, it will improve the quality, safety and efficiency of military health care, he said.

The integration of the systems comes at a convenient time, because both the VA and the Defense Department need to update their inpatient records systems, said Charles Hume, deputy chief information officer for the Military Health System. He noted that it is a huge undertaking, because electronic medical records are still not commonplace in the U.S., and no existing system can handle the large amount of data the military health system contains.

"We frankly are the pioneers in this effort. Nobody else has tackled it," Hume said.

The Defense Department and VA already share patient information in certain cases, such as sharing prescription, lab and radiology, allergy and discharge information for separated servicemembers. Also, the Defense Department provides all patient records for severely wounded warriors to VA polytrauma centers where they go for treatment.

Before this initiative came up, the two departments already had a strong working relationship, Dr. Paul Tibbits, deputy chief information officer for the VA, said in an interview. That relationship has served as a foundation for the current collaboration, he said.

"We have an extremely strong working relationship between the two departments in information technology, and I think it's gotten better because of this process, and it's just proven to be a very effective partnership," Tibbits said.

As the contractor moves forward with its study, the two departments will continue to collaborate and move forward with information sharing as much as they can, Hume said. The study will take a year, and while that may seem like a long time, it is necessary so all the technicalities and requirements of such a complicated and expensive system can be worked out, he said.

"We're talking about a very expensive and difficult system we're going to implement," he said. "We need to make sure we do it right, so we need to take the time to fully make sure we understand the requirements of that system and precisely what we're going to do. It's a cooperative process from the get-go, and as soon as we identify areas where we can begin to engage, we'll begin to engage."

Bringing in a contractor with industry expertise to do the study is important because the two departments need to ensure the technical aspects are worked out, and information standards are aligned within the system, Hume said. Jones pointed out that once the system is in place, it also will help make health care standards consistent throughout Defense Department and VA facilities.

"The whole effort in electronic health records is improve the quality of care, improve the safety of care, and improve better follow-up and tracking to ensure individuals are coming back and getting needed care," Jones said. "We want to ensure that we're focusing on what the physicians need, on what the administrators need, on what the case workers need, not what we think they need."

A joint inpatient medical record will possibly save the two departments money as well, Tibbits said. The extent of those savings will be determined by the study, he said.

Tibbits also pointed out that veterans will benefit greatly from a joint system, in that the determination of benefits will become much more efficient and effective. "Every veteran would have a much higher likelihood of being aware of and receiving every benefit to which they are actually entitled; it would become a much more organized and expeditious process," he said.