VA, Kaiser link electronic health record systems

The Veterans Affairs Department and healthcare giant Kaiser Permanente have begun to share electronic health record information of patients who receive care services from both providers in the San Diego, Calif., area.

The project represents an important milestone in large institutional electronic health record sharing and also advances a presidential priority to create a lifelong virtual record for military families, VA and Kaiser officials said at a press teleconference to discuss their progress.

Physicians at both healthcare systems last month began sharing patient problem lists, medications and allergies records. Until this pilot, VA was unable to electronically exchange patient information with commercial hospitals and specialists veterans are referred to outside the VA healthcare system.

“We need visibility of those patients to understand conditions, what treatments and medications they have had,” said Dr. Stephen Ondra, VA’s senior policy advisor for health affairs. “It improves quality, safety and efficiency.”

When a veteran visits a clinician, prior history data will be available instantly in any clinical office participating in the program. Until this project started, patients often consented to sharing their information but it usually took weeks or even months to receive paper health care documents.

“Now, this information can be transmitted electronically within seconds,” said Dr. John Mattison, chief medical information officer and regional director of KP HealthConnect.

About 40 percent of the 1,200 veterans invited to participate in the information exchange pilot have agreed to take part, Ondra said. He said he expects more veterans who use both VA and Kaiser medical facilities will want to be included as they learn more about the benefits of the pilot.

The information exchange is on a small scale now, which allows VA and Kaiser to focus on technical challenges, such as improving the automation of the process by which patients can opt-in to the health record exchange program, the two physicians said.

Ultimately, VA and Kaiser anticipate sharing data on a regional and national scale and are discussing how to build a “geographic rollout roadmap,” said Mattison. That map may include additional partners, he added, including a California health information exchange.

The other big player is the Defense Department, which will start participating in the project in the in the next three months, the officials said. The VA and the Defense Department are currently working to establish a lifetime virtual record, which President Obama called for last April. Officials called the VA-Kaiser project is a key milestone in that effort.

The program connects VA's VistA and Kaiser’s HealthConnect electronic health record systems using standards established under the National Health Information Network project, Ondra said. The providers use a federally-developed technology gateway and software adapter to align their systems with the NHIN standards. They also have data-sharing agreements in place for the secure exchange of health information when authorized by the patients.

“By linking ourselves to standards, we are not tied to any single system and interoperability can happen with any system using the standards and protocols of the nationwide health information network.” Ondra said. “The NHIN standards allow for any health system to exchange data.”