- Data Proliferation Fuels Need for Healthcare Interoperability
Improving health IT interoperability was one focus area identified in a memorandum of understanding reached by the VA and IHS in 2010 to expand coordination and resource sharing to improve care for Native American veterans.
The two agencies agreed to work toward “interoperability of systems to facilitate sharing of information on common patients, and establishment of standard mechanisms for VA, IHS, and THP providers to access records for patients receiving care in multiple systems,” the GAO report related.
An IHS official told the government watchdog that while the agencies had done some initial work on interoperability, no systematic solution has been implemented.
Officials Work Around Health IT Interoperability Obstacles
VA and IHS officials identified some ways they could worked around the lack of health IT interoperability.
One IHS headquarters official told the GAO that IHS and VA each could request the sharing of information from an EHR held by the other agency through secure emails. The official cautioned that this was not as fast or efficient as being able to log in to each other’s systems.
VA officials explained that the department belongs to the national eHealth Exchange and that IHS or THPs could join and use it to access information about common veteran patients. IHS officials responded that they investigated the eHealth Exchange, but the testing and onboarding costs “were prohibitive.”
HIS official said that several individual service facilities have invested in joining regional health information exchanges. Two THPs said they were part of locally based health information exchanges, but the VA was not a member of these exchanges.
A VA official said that there is a guide that explains how patient enrollment and eligibility verification can be managed between IHS, THP, and VA facilities. The guide relates how IHS or THP facilities can request veterans’ enrollment and eligibility data from the VA Health Eligibility Center using a spreadsheet that sends requests via email through a secure data transfer service.
The center verifies the information and returns the completed spreadsheet to the IHS or THP facility. The IHS and THP facilities can also contact the center directly by phone for fewer than five veterans per call or their local VA medical center by phone to verify one veteran per call.
IHS or THP facilities could also plan with a local VA facility to have VA employees on site at IHS or THP facilities or have VA-credentialed employees that can access VA systems to share information.
However, an IHS headquarters official noted that not all IHS or THP facilities have the type of relationship with their local VA facility that would allow the setting up of such arrangements.
VA EHR Modernization to Improve Healthcare Interoperability
To improve healthcare interoperability, the VA is implementing a new $10 billion EHR system being provided by Cerner. The VA EHR system is expected to take 10 years to complete and be interoperable with the new Department of Defense (DoD) system, which is also being supplied by Cerner. The same company provides EHRs to some of the THPs as well.
The DoD’s MHS GENSIS EHR system is replacing legacy EHR systems, including the Armed Forces Health Longitudinal Technology Application, the Composite Health Care System, and components of the Theater Medical Information Program-Joint.
An IHS headquarters official related that it is modernizing its IT platform, and interoperability with the VA system will be one requirement of the new system. In addition, participation in more health information exchanges will be part of the modernization effort.
