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DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Page 1: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

DoD and Veterans Affairs: Health Information Interoperability

Joint Venture Conference February 2006

Page 2: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

2

Topics

• Path to Interoperability

• Federal Health Information Exchange (FHIE)

• Pre- and Post-Deployment Health Assessments

• Bidirectional Health Information Exchange (BHIE)

• Clinical Data Repository/Health Data Repository (CHDR)

• Laboratory Data Sharing Initiative (LDSI)

• Site Implementation Considerations

• BHIE/CHDR Interface

• Other Initiatives

• Summary

Page 3: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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BHIE• 2-way

• Local exchange

• Text data

• Real-time

FHIE• 1-way

• Enterprise exchange

• Text data

CHDR• 2-way

• Enterprise exchange

• Computable data

• Real-time

BHIE

Bidirectional Health

Information Exchange

FHIE

Federal Health

Information Exchange

CHDR

Clinical Data

Repository/ Health Data Repository

The Path to Interoperability

Interoperable Electronic

Health Records

Page 4: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Federal Health Information Exchange

Supports monthly, 1-time transfer of electronic health information from DoD to VA at the point of a Service member’s separation

One-way, enterprise exchange of text data

Page 5: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Federal Health Information Exchange

• 3.27 million unique patients

• 45 million lab results

• 7.19 million radiology reports

• 45.2 million pharmacy records

• 41.8 million standard ambulatory data records

• Over 2 million separated Service members have presented to the VA

• ~2,700 messages transmitted daily in Dec 05 on VA patients treated by DoD under local sharing agreements

As of 31 January 2006

Page 6: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Pre-/Post-Deployment Health Assessments

Enables VA health care providers to access pre- and post-deployment health assessments

on separated Service members

Page 7: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Pre-/Post-Deployment Health Assessments

• Assessments transferred from DoD to Federal Health Information Exchange data repository

• Historical data pull of 400,000 assessments completed July 2005

• Monthly data transfer started in September 2005

• More than 515,000 assessments available on more than 266,000 individuals

• VA began retrieving the data in December 2005

• DoD plans to add post-deployment health reassessments in fiscal year 2006

Page 8: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Bidirectional Health Information Exchange

Enables real-time sharing of electronic health information between DoD and VA for shared patients

Two-way, BHIE sites and all of VA exchange of text data

Page 9: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Bidirectional Health Information Exchange

• Allergy, outpatient pharmacy, demographic, laboratory, and radiology data

• 3,124 FHIE-BHIE queries/week (Jun–Dec 2005)

• Data from DoD BHIE sites available to all VA sites

• Deployment to additional sites in fiscal year 2006

Page 10: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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BHIE Sites

Mike O’Callaghan Federal Hospital

Madigan AMC

NMC San Diego Eisenhower AMC

William Beaumont AMC

David Grant Medical Center

Landstuhl RMC

Brooke AMC

Darnall ACH

NH Great Lakes

NH Camp Lejeune

NH Charleston

Womack AMCNH Camp Pendleton

Tripler AMC

BHIE operational

National Capital Area

BHIE implementation proposed for fiscal year 2006

Elmendorf AFB

Bassett ACH

Page 11: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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BHIE

FHIE

KE

Y BHIE Bidirectional Health Information ExchangeDoD Department of DefenseFHIE Federal Health Information ExchangeVistA Veterans Health Information and Systems Technology Architecture

BHIEDoD

Legacy System

VistA

Page 12: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Clinical Data Repository/Health Data Repository

Will support interoperability between DoD’s Clinical Data Repository (CDR) & VA’s

Health Data Repository (HDR)

Two-way, enterprise exchange of computable data

Page 13: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Clinical Data Repository/Health Data Repository

• Bidirectional exchange of demographics, outpatient pharmacy, and allergy data anticipated in fiscal year 2006

– Support drug-drug and drug-allergy interaction checking

• Bidirectional exchange of laboratory data (chemistry and hematology) next data set

Page 14: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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CHDR

AHLTA CDR

DoD CHDR

Interface

VA CHDR

Interface

VAHDR

KE

Y CDR Clinical Data RepositoryCHDR Clinical Data Repository/Health Data RepositoryHDR Health Data RepositoryVA Department of Veterans Affairs

Page 15: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Laboratory Data Sharing Initiative

Supports bidirectional capability for either DoD or VA to act as a reference lab for order entry

and results retrieval (lab chemistries)

Page 16: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Laboratory Data Sharing Initiative

• LDSI metrics from National Defense Authorization Act (NDAA) demonstration sites

– El Paso, Texas (Started January 2005)• 40 tests mapped – using 25

• 574 tests in January 2006

– San Antonio, Texas (Started August 2005)• 7 tests mapped – using 7

• 142 tests in January 2006

• Adding functionality for anatomic pathology and microbiology

– Anticipate testing in June 2006 (El Paso) and July 2006 (San Antonio)

Page 17: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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LDSI Sites

NMC San Diego & San Diego VA Health Care System

William Beaumont AMC &El Paso VA Health Care System

Brooke AMC, Wilford Hall Medical Center, &South Texas VA Health Care System

NH Great Lakes & VA Medical Center, Chicago

Tripler AMC &Pacific Islands VA Health Care System

LDSI operational

LDSI discussions ongoing

Bassett ACH &Alaska VA Health Care System

Mike O’Callaghan Federal Hospital &Southern Nevada VA Health Care System

Page 18: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Site Implementation Considerations

• Business Case

• Leadership support

• MOU/MOA and sharing agreements

• Facility schedule

• IT and functional and staff availability

• Minimal training required

• None or minimal additional costs for hardware infrastructure

Page 19: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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AHLTA CDR

DoD CHDR

Interface

VA CHDR

Interface

VAHDR

FHIE

BHIEDoD

Legacy System

VistA

BHIE/CHDR Interface

KE

Y BHIE Bidirectional Health Information ExchangeCDR Clinical Data RepositoryCHDR Clinical Data Repository/Health Data RepositoryDoD Department of Defense

FHIE Federal Health Information ExchangeHDR Health Data RepositoryVA Department of Veterans AffairsVistA Veterans Health Information and Systems Technology Architecture

Page 20: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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Other Initiatives

• Inpatient documentation

• Image sharing

• Medical record scanning

Page 21: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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SummarySummary

Page 22: DoD and Veterans Affairs: Health Information Interoperability Joint Venture Conference February 2006

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DoD and VA Are…

• Sharing large volumes of electronic health information

• Making progress on interoperable health records

• Continuing to enhance HIPAA compliant data sharing solutions