Defense-VA joint health record to deploy early

The Defense and Veterans Affairs departments will install an integrated electronic health record in hospitals in Norfolk, Va., and San Antonio in 2014, two years ahead of schedule, Roger Baker, VA chief information officer, said Wednesday.

In March 2011, Veterans Affairs Secretary Eric Shinseki and then-Defense Secretary Robert Gates agreed to develop a joint health record for active-duty military personnel, retirees and veterans. The interagency program office that manages the project did not have a director until February 2012, when Barclay Butler, former vice president for health care solutions in the government division of Harris Corp., was tapped for the job.

Defense and VA originally had planned to take four years to develop the building blocks of the iEHR, but Baker said senior leadership in both departments and Butler decided the system should be fielded in San Antonio and Norfolk by 2014. Both areas have high concentrations of military personnel and veterans.

This abbreviated schedule will require quick development of joint pharmacy and lab software, Baker said, with middleware software known as an enterprise service bus serving as the glue for various programs in the iEHR. VA awarded Harris an $80.3 million contract for the enterprise service bus in March.

Defense runs two hospitals in San Antonio: the Army-operated San Antonio Military Medical Center, the largest inpatient facility in the department with 425 beds; and the Air Force-run Wilford Hall Ambulatory Surgical Center, the largest outpatient hospital. The South Texas Veterans Health Care System operates hospitals in San Antonio and Kerrville and serves 93,000 veteran patients.

In the Norfolk area, the Army operates the 30-bed McDonald Health Center at Fort Eustis, which also handles about 700 outpatient visits a day and the Navy runs the 500-bed Naval Medical Center in Portsmouth. VA operates a 468-bed medical center in Hampton as well as clinics in both the San Antonio and Norfolk areas, all of which will use the iEHR starting in 2014, Baker said.

When the two departments complete the iEHR deployment, it will stand as the largest electronic health record system in the world, serving 7.8 million veterans and 9.7 million military personnel through 59 military hospitals and 152 VA hospitals with a combined staff of more than 350,000.

Baker also disclosed that VA has started to test an EHR app for the Apple iPad at its medical center in Washington, which serves more than 500,000 veterans annually.

In October, in response to strong demand from clinicians, VA kicked off a pilot program using 1,000 iPads. Clinicians there have said the iPad EHR app is a “significant time-saver” because it brings together all the information they need to care for patients on a single portable device, Baker said.