Leaders from the Department of Defense www.defense.gov, the Veterans Health Administration www.va.gov/health, HHS www.hhs.gov, and industry gathered on Capitol Hill to discuss interoperability. The June 3rd event was initiated by the HIMSS Foundation’s Institute for e-Health Policy www.e-healthpolicy.org.
The first panel moderated by Tom Leary, Vice President, for Government Relations at HIMSS included ideas from both the military and veteran point of view. Craig Schaefer, Program Manager, Defense Medical Information Exchange (DMIX), Military Health Affairs www.health.mil, explained how the DOD/VA electronic healthcare mission is to create a seamless health record integrating VA and DOD data, but at the same time, the goal is to modernize software supporting DOD and VA clinicians.
Schaefer gave an overview of the Joint Legacy Viewer (JLV), a web-based Graphical User Interface that enables thousands of VA clinicians and DOD clinicians to look at DOD and VA medical records and provides easy access to integrated view of patient information for medications, progress, along with discharge notes.
There are several advantages to using JLV since it is faster and easier to use, supports VHA users and workflow, and no onsite hardware or software installation is needed. JLV is designed to support frequent enhancements and upgrades with the latest version just released April 2015.
Charles Gepford, Deputy Director of Health Informatics, Office of Informatics and Analytics, at the VHA www.va.gov/vler reports that the VA’s exchange of health information empowers veterans, builds and expands health information exchange networks, improves data quality, and provides data to support clinical decisions and clinical workflow. However, as he emphasized, exchanging health information can only work by developing interoperability.
From the viewpoint of an HIE actually in motion, Lt. Col Francisco C. Dominicci, CMIO, from the Colorado Springs Military Health System http://evans.amedd.mil/msmo focused on how public HIEs, stakeholders, and the Military Health System can best work together. However, as he explained, no two HIEs are exactly alike as a number of the HIEs across the U.S. offer varying levels of technology and services based on the needs of individual local communities.
As Lt. Col Dominicci reports, “The CORHIO HIE www.corhio.org, a non-profit public HIE is one of the largest HIE networks in the U.S. However, the thinking is that while military systems are rich in data, the data does not always match standards used outside of the military.”
The second panel moderated by Neal Neuberger, Executive Director for the Institute for e-Health Policy, included the discussion by Leila Samy MPH, Rural Health IT Coordinator at the HHS Office of the National Coordinator for HIT (ONC) www.healthit.gov.
She mentioned several ideas and thoughts on how to help rural communities and noted that HHS is greatly committed to helping Critical Access Hospitals (CAH), rural hospitals, and other rural healthcare providers.
According to Samy, CAHs have made progress with advanced health IT capabilities but there are still factors ahead that affect their use of health IT, including how to deal with financing and workforce related challenges, the need to pool resources with other hospitals, more EHR capabilities for CAHs, and very importantly, rural health IT funds need to be expanded.
To help rural communities, in April, HHS announced a new grant program for $1 million to support community projects for the Community Interoperability HIE program. The funding will be used to support the flow of health information at the rural community level.
Samy mentioned how one project rolled out through the White House Rural Council www.whitehouse.gov called the “Flex Rural Veterans Health Access Program”, awarded funds to encourage the use of telehealth and HIE to serve rural veterans.
Also, a Veterans Initiated Electronic Care Coordination (VIECC) project helps veterans obtain information from their personal health portal “My HealtheVet” and trains veterans to use Blue Button technology to generate care coordination documents to supply key information.
Vendors on the second panel also contributed ideas on how to actually provide effective coordination of care so needed in local communities. Ty Faulkner Rural Health IT Consultant for Pitney Bowes www.pitneybowes.com reports that the company is launching a pilot program for a large Connecticut-based senior home health company to create effective care coordination for military, VA, and rural families needing home health
Howard Rosen, as CEO, at LifeWire Corp www.lifewiregroup.com, is working with the VA to help veterans with mental health issues, veterans that are a high risk for suicide, PTSD issues, substance abuse, and maternal health. The company is also working with the military on an employee assistance and wellness program, with the University of Washington to effectively provide suicidal prevention outreach to military on active duty.