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After a morning of Congressional tongue-lashings Wednesday during a House hearing on iEHR, the Veterans Affairs and Defense Departments publicly issued a statement reasserting that they are jointly committed to working toward an iEHR endpoint similar to the project’s original goal.
Here, then, is that statement:
VA and DoD remain committed to a single, joint, electronic health record — both Secretary Shinseki and former Secretary Panetta reaffirmed our commitment to this in public statements on February 5.
In short, VA and DoD are seeking to achieve the same program goals: common data, common applications, and a common user interface, but we look to achieve them with less cost and less risk and accelerate the availability of needed functionality.
Secretary Shinseki called Secretary Hagel yesterday to congratulate him on his confirmation by the Senate as the next Secretary of Defense. In that conversation, both leaders emphasized their desire to meet soon and build on the strong partnership between the two departments on common priorities for Troops, Veterans, and Military Families.
That iEHR will figure prominently into that first meeting is a safe bet, if only because of the rumors circulating that it has been euthanized.
During the House panel, VA CIO Roger Baker began by saying that “first, we would like to dispel any notion that VA and DoD are moving away from a single, joint, electronic health record. What has changed is the strategy that we will use to accomplish that goal.”
As that strategic shift was discussed Feb. 5, nearly lost among the multitude of subsequent iEHR obituaries, was the triptych of “quick wins” Baker outlined; ways that the VA and DoD responded to the Secretaries request to put into action some of the iEHR work so as to better serve patients in the short-term, rather than waiting until the original 2017 timeline.
Instead of building a single electronic health record system that both agencies would then implement, the tack in strategy has the VA sticking with its own VistA as the core EHR, while four architectural layers will reside on top: the common enterprise services bus, data, applications, and graphical user interface.
Thus, the focus is on integrating the data and presenting it in a way that clinicians, regardless of which department employees them, will all be able to see the same patient information.
“In order to achieve the desired data interoperability between both Departments, both “cores” will conform to an agreed-upon set of standards that enable the secure and interoperable exchange of information,” Baker said in his testimony. “While the immediate focus is on accelerating data interoperability between the two Departments, our end goal remains the same — to make certain that we are creating a single, joint electronic health record for each Servicemember and Veteran.”
Central to the department’s data interoperability is the agreed upon 3M Health Data Dictionary that, as Baker explained, is open to the industry so anyone can use it. Robert Petzel, MD, the VA’s under secretary for health, said that the Office of the National Coordinator for Health IT (ONC) expects it “will be a beacon. Everybody’s records will be saying the same thing.”
What remains unknown as this point — and was among the feistiest discussion topics during Wednesday’s House hearing — is what course DoD will pursue for its core EHR technology.
The DoD’s RFI for an EHR platform closed end of day Wednesday and assistant Secretary of Defense for health affairs Jonathan Woodson, MD said the evaluation process, which will include the VA’s VistA, “should be complete by the end of March.”