SSA to begin e-health record sharing with VA, DOD

The Social Security Administration plans to start sharing health information electronically with the Veterans Affairs and Defense departments in 2010 to speed the processing of claims by veterans who apply for SSA disability benefits, the agency’s top health IT executive said Nov. 6.

In February, SSA, VA and DOD will begin working to exchange structured, machine-readable health data across a network that conforms to nationwide health information network (NHIN) standards, said Jim Borland, SSA’s special advisor for health IT.

SSA’s health information sharing project with the military will follow an NHIN-based test of care coordination and electronic record sharing in January between DOD, VA and Kaiser Permanente, which often treat patients in common.

“VA has been exchanging information with Social Security for years, but it has been digital paper, like PDFs,” Borland said at a meeting of an advisory panel on SSA’s future technology systems and health IT strategy.

The development of NHIN services has been critical to SSA’s expansion of electronic health information exchange, Borland said. In Virginia, where SSA gathers electronic health records from healthcare providers via MedVirginia, a central Va.-based health information exchange,  SSA’s disability determination process has been cut in half, from 90 days to 47 days, he said.

“Moving from paper to structured data over the NHIN, Social Security can use decision support systems to make disability determinations and solve business problems,” he said.  SSA wants to increase the number of providers it shares electronic health records with when it awards up to $24 million in contracts in January, Borland added.

Dr. David Blumenthal, the national health IT coordinator, who also spoke on the panel, said HIE represented a significant component of ‘meaningful use,” down to the patient-level. The question is whether the current “network of networks” model of the NHIN an be used by consumers, small practitioners and others interested in moving information around to follow patients.

“We are beginning to think of future versions of the NHIN,” Blumenthal said. “Exchange has to occur between not only large organizations but small providers.”

The Health IT Policy Committee, which advises Blumenthal, will form a separate workgroup in January to study the NHIN model. The committee is beginning to look at additional approaches, such as software as a service and others, to support health information exchange, he told Government Health IT.  

“What we understand is we need to have a robust, broad, widely serviceable exchange capability,” Blumenthal said.

Borland said he anticipates that as the NHIN matures, there will be many models, such as proprietary hubs and labs that will deploy their own connections to the NHIN.

In February 2009, SSA was the first agency to request and receive patient information using NHIN  standards and specifications. SSA uses the federally developed Connect software, an implementation of the NHIN, to exchange information with MedVirginia.    

SSA’s Medical Evidence Gathering and Analysis through Health IT (MEGAHIT) system receives, analyzes and processes the structured data. SSA will also test sending and using the data in other areas of the disability process, such as in hearings for appeals by disability applicants, Borland said.

Among its other health IT projects, SSA is mapping data elements for medications, lab reports and continuity of care documents with Microsoft’s HealthVault personal health record software. SSA plans to conduct a demonstration of exchanging information over the NHIN with the Microsoft application.