VA, DOD to expand virtual EHR program

The Veterans Affairs and Defense departments intend to expand their Virtual Lifetime Electronic Record (VLER) pilot program, officials said today.

The next series of demonstrations will involve exchange of additional types of data, including lab data, Dr. Steve Ondra, senior policy adviser for health affairs at the VA, said at a Health IT Day conference sponsored by the Bethesda chapter of AFCEA.

The current phase of the VLER pilot program involves adding new datasets and signing up new patients and providers at a location in Hampton Roads, Va., which should be operating by July 31, Ondra said.

In 2009, the VA and DOD started the first pilot demonstration for VLER in San Diego, which involved sharing veteran and military health data with Kaiser Permanente through the Nationwide Health Information Exchange. The NHIN, sponsored by the Health and Human Services Department, is a system of protocols and standards that allows for secure data exchange over the Internet.

That VLER San Diego demonstration was a success and has proven that secure health data exchange can work, Ondra said. “We found out a lot, and what we learned we will bring to the Virginia Tidewater Area pilot,” he added.

What makes VLER different from numerous other VA/DOD data exchange and interoperability programs is that VLER is the only program that involves data exchange with the private sector, where veterans receive about half their care, he said.

“The VLER is not an acquisition program. The VLER is a strategy of standards-based health information exchange,” Ondra said.

Meanwhile, other VA/DOD health information exchange efforts are ongoing on legacy systems. That will continue and eventually the VLER will take the place of the legacy systems, Joseph Gardner, deputy director of the VA/DOD Health Information-Sharing Directorate, said at the AFCEA event.

“We are building the VLER cautiously and in small steps,” said Norma St. Claire, director of information management for the Office of the Undersecretary of Defense for Personnel and Readiness. She estimated it would be at least a year or two before the VLER is exchanging significant amounts of clinical data.

One of the hurdles that must be overcome is identity verification and management of patients and users of the system, St. Claire added. “We have a problem in making sure that 'Joseph Smith' in this system, and 'Joe Smith' over there, and 'J. Smith' over there, are the same person,” she said. “We try not to use Social Security numbers too much. We are challenged in identity management.”