VA, Kaiser seek to expand health data exchange project

The Veterans Affairs Department and Kaiser Permanente say their patient health data-sharing project is a success that paves the way for a second phase, which will add Defense Department patient data and expand to more locations and health care organizations.

“This is a very exciting moment — and also a challenge,” said Dr. Stephen Ondra, VA’s senior policy adviser for health affairs. “We want to extend this to other providers.”

The VA and Kaiser began the progam in November to have veterans who receive care from both the VA and Kaiser to assemble their health records in one place electronically. It enables doctors to check if the patient was previously diagnosed or administered medications or treatments. The VA and Kaiser use the Health and Human Services Department’s Nationwide Health Information Network that has standards for secure, private and accurate exchange.

It is common for veterans to get care from private health care plans. But exchanging paper-based medical records between the VA and private plans requires signing numerous forms, and typically takes several weeks, said Dr. John Mattison, chief medical information officer of Kaiser Permanente Southern California.

Electronically, the timetable for health data exchange is much faster. “Now this process happens in seconds,” Mattison said. The VA and Kaiser are sharing patient problem lists, medications and allergies records.

The net effect is improved quality of care, patient safety and efficiency, Ondra said. For example, one of the first veterans who participated was deemed by Kaiser to be at risk of severe allergy attacks. That information was shared electronically with the VA.

About 460 veterans in the San Diego region have consented to share their records, and more are signing up. One of the lessons learned from the project thus far is that there need to be more automated procedures for seeking the volunteers, informing them of the terms and obtaining and managing their consent and privacy protections, Ondra said.

The VA and Kaiser anticipate expanding the program nationally to other VA facilities, and possibly adding more partners.

In addition, starting in the first quarter of 2010, DOD will begin sharing data from military personnel in the San Diego area in the VA/Kaiser exchange. The project is considered a phase of the VA/DOD Virtual Lifetime Electronic Record project, said Ondra.

The demonstration projects links VA's VistA software and Kaiser’s HealthConnect record system. For the exchange, Kaiser and the VA use the federal Connect Gateway to the NHIN as well as software adapters to their own systems.

For cybersecurity, Kaiser is voluntarily implementing security standards that are compliant with the Federal Information Security Management Act (FISMA), Kaiser officials said. Under law, however, FISMA only applies to federal entities. Determining how to handle FISMA compliance has been a problem for health data exchange between federal agencies and private entities.