Vet health progress propelled by partnership, vision and IT

Establishing an electronic record program that serves as a single entity for managing troop health has been a long and difficult process. But according to those closest to the effort, hard-earned lessons and close collaboration are yielding some of the best progress yet.

Joint efforts between the Defense Department and Veterans Affairs Department are moving forward, including pilot programs for establishing unified electronic health communities and new IT platforms that converge data, efforts, offices and systems to streamline functionality. The ultimate goal is to find the right technology that gives troops and their medical providers access to health records throughout a service member’s entire career, no matter where they go.

The added challenge is to do it all in an era of fiscal pressure, a panel of government health IT officials indicated at AFCEA Warfighter IT Day on Aug. 28 in Vienna, Va.

“We need IT that captures that record from the area of operations through rehabilitative care, to return of the service member to the force, to veteran status – we have to track it all the way through,” said Dr. Barclay Butler, director of the DOD/VA interagency program office. “Both departments are looking at the value proposition – that is, how do we continue to improve care for every dollar we spend?”

Barclay said a wealth of lessons have been learned from one pilot program in particular, the Capt. James A. Lovell Federal Health Care Center in North Chicago. The five-year demonstration project is the first integrated facility of its kind, serving both DOD and VA populations, after merging the North Chicago Veterans Affairs Medical Center and the Naval Health Clinic Great Lakes.

Under that project, Butler said some of the most important lessons have been in IT.

“A huge lesson learned for us is that we have to have that single medical enclave for networking security. We had three enclaves – Navy, VA and DOD – and I’ll tell you, we had to do unnatural things to get information to flow,” he said. “Because of that we are very specifically building a single medical network enclave. It’s being supported by Teri Takai, the DOD CIO, and Roger Baker, the VA CIO, using the [DOD global information grid] and extending it out to the VA.”

Programs like this have helped bring together the two agencies – in more ways than one.

“This journey of the services together over the past couple decades has created a unified front. The question now is, how do we come together on a clinical platform with a standardized workflow?” said Navy Capt. Michael Weiner, chief medical information officer at the DOD/VA interagency program office. "We're working on the nuances."

With a new governance model making progress, particular focus is one standardization, Weiner said.

“There was a long time where there was nowhere to connect to,” he said. “Now we have consumable data and we’re working to standardize what that looks like.”

Some of the hardest lessons have been learned over the past decade at war, during which thousands of troops have suffered injuries and casualties – rendering reliable electronic health data that much more critical. It’s a constant reminder of the mission at hand, according to Susan Perez, program manager, integrated electronic record, DOD/VA interagency program office.

“That’s the reason we’re here –it’s to serve the warfighter, serve the veteran and ensure they’re treated with love and care and respect, and make sure they get the benefits they deserve and have the information they need,” Perez said. “Whether they’re in a combat zone or back here suffering from a service-connected disability; whatever it is, our job is to serve. So we’ve taken up a one team, one fight attitude.”