DoD, VA Lead Government Efforts to Set Up Health IT
A cross-department health IT system now in testing is moving from merely viewable to actually computable data -- probably the first time this level of interoperability has been achieved in the U.S. and possibly the world, said Dr. Robert Kolodner, interim national coordinator of the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology. The system, called “CHDR” as a composite of the initials for the Veterans Affairs’ and Defense Department’s health IT systems, allows VA and DoD doctors to view prescription and drug allergy information on their patients and makes the information part of the patient’s record in both systems. It alerts doctors from both systems to potential harmful interactions and allergic reactions that doctors from either system have documented.
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CHDR is in testing at a small number of sites. Military doctors speaking at a Pentagon news conference Monday praised the system and the agencies’ other interoperability efforts as leading the nation in the move toward electronic health records.
Congress told the VA and DoD to speed up their interoperability efforts. Dr. Gerald Cross, the principal deputy undersecretary for health at the Veterans Health Administration, said the departments are on target to meet the September 2009 requirements for full interoperability laid out in the 2008 National Defense Authorization Act. In addition to the CHDR system being tested, the departments have viewable data exchange systems. The systems share 50 percent of in-patient data and before 2010 should be sharing 70 to 80 percent of discharge summaries from VA beds, said Lois Kellet, acting director of the DoD/VA Interagency Program Office. Already, VA and DoD doctors are making 328,000 queries a month, she said.
All VA doctors have access to electronic health records, Kolodner said, compared to about 70 percent of private-sector doctors, and EHRs are pervasive in VA hospital settings, while fewer than 20 percent of private-sector hospitals fully use EHRs. Still, the Government Accountability Office has raised concerns about the departments’ ability to meet timetables. In a September report, the GAO said the departments didn’t expect the interagency program office to be fully working until year-end, giving the permanent director and staff only nine months to meet their goals. The GAO pushed the DoD and VA to get the office set up and complete its follow-through plan, which the report said lacked milestones.
In addition to the viewable and computable text data, the departments are testing a system to share images like X- rays and CAT scans. The ViX, or VistA Imaging Exchange, is available at polytrauma sites while the departments gather information about usage, bandwidth requirements and other operating needs, Kellet said. She said the interagency office has expanded the scope of its work to include personnel and benefits information sharing. Kellet also called creating a health information exchange an evolving task. “What do our clinicians need to provide care? That changes over time,” she said.