DOD/VA Health records project yielding important lessons

The joint health data exchange pilot project between the Defense and the Veterans Affairs departments is still in its early phases, but already has taught valuable lessons about interoperability, government officials working on the project say.

The Virtual Lifetime Electronic Record (VLER) Health Communities Program was created by President Barack Obama in April 2009 with the objective of creating a seamless lifetime electronic medical record for all service members that will cover them from active duty through retirement.

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Now in its second phase of development, the requirements, designs and test plans for implementing VLER capabilities will need to be developed, reviewed and approved jointly, said Debra Filippi, director of the Interagency Program Office (IPO). The IPO bridges the DOD/VA partnership for electronic health records and was mandated by Congress to establish interoperability.

Also, Filippi and officials from VA and DOD advise adherence to the Nationwide Health Information Network (NHIN) architecture, designed to ease the strain imposed on organizations as they build systems to fit their own needs while still conforming to a national partnership that shares standards.

“Partners should implement systems that are fully compliant with NHIN,” Filippi said. “[We all] need to have the shared knowledge of NHIN standards and relevance [to] all federal, private and vendor stakeholders.”

Linda Fischetti, chief informatics officer at the Veterans Health Administration, said there also needs to be a governing body to oversee VLER’s multi-agency, multi-level execution.

“A fully integrated network is going to increase in complexity. We need choreography to guide implementation. We need tests and other measures [for conformity] across agencies and organizations. Right now, as early implementers, we’re cobbling together all these standards,” Fischetti said.

The first phase of the VLER pilot program, which compiled health record data from the VA, DOD and provider Kaiser Permanente for selected service members in the area, was successfully completed the first quarter of this calendar year, Filippi said.

The second phase, expected to be completed in July, will increase data available in the records and expand to another three communities, she said. She emphasized that the project is still a work in progress.

“This is just the beginning. This is going to explode and take off at warp speed,” Filippi said.