Posted on Dec 1, 2015
Is this truly a light at the end of a long tunnel or just smoking mirrors?
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DoD/VA Seamless Transition Update 32 ► JLV System’s Interoperability
After a long struggle for interoperability, the Department of Defense has announced that its Joint Legacy Viewer EHR system has met the National Defense Authorization Act of 2014 (NDAA), meeting EHR interoperability standards. According to DoD’s article at http://www.defense.gov/News-Article-View/Article/630810/dod-meets-interoperabilityrequirements-for-electronic-health-records , the department has combined its multiple EHR systems into one integrated system called the Joint Legacy Viewer (JLV), bringing together information from over 300 data sources. The JLV is reportedly completely secure, requiring government credentials for access. Additionally, the JLV has a mechanism that monitors who accesses certain patient information.
The JLV is also accessible by personnel at the Department of Veterans Affairs (VA), increasing the interoperability efforts between the two departments, aligning with their goals for high-quality patient care through care coordination. "What we really want to be able to show is the progress we've made and demonstrate our commitment to making sure that we're providing tools that are useful for our providers but also making things better for our service-member veterans and their families," said program executive for Defense Healthcare Management Systems Chris Miller. Additionally, the JLV tracks a service-member’s health information throughout his or her entire military career. This includes from his or her start with the military, up until he becomes a veteran and receives benefits through the VA.
Although the DoD has reached the NDAA standards, the agency acknowledges the long path ahead to securing complete and reliable interoperability. In fact, the JLV EHR is still undergoing tests, according to Miller. "We've done a lot to get this information to a point where it's both shared and it's usable, but we recognize that we're going to continue to have to do more things to actually continue to make it as useful as possible," Miller confirmed. It has been a long road for both the DoD and VA in establishing interoperable EHR systems. After ending a project to create an integrated EHR system between the two agencies in 2013, both the DoD and EHR were tasked with creating their own EHRs that were still completely interoperable with one another.
The VA opted to enhance its VistA EHR system, while the DoD opted to adopt a private vendor’s EHR system. Earlier this year, the DoD announced it was going with Cerner as its EHR vendor, and thus began implementation. However, it has taken the VA and DoD longer than anticipated to adequately implement these systems, causing tension between the two agencies and other government officials. Those tensions culminated in a House hearing where members of Congress expressed frustrations at the implementation timelines. “I don’t mean to understate the enormity of the challenge of integrating the two largest federal bureaucracies,” said Congressman Will Hurd (R-TX), “but it’s clear to me that our inability to integrate these two systems is a failure of leadership rather than technical feasibility. This is not an issue of data standardization. This is management 101.”
Additionally, officials from the Government Accountability Office (GAO) reiterated the urgency for DoD and VA to create adequate interoperability goals and timelines. GAO reported that the agencies did not meet the October 2014 deadline allotted them by the NDAA, and that they also failed to create adequate goals or plans for creating interoperability. “Accordingly, we recommended that the departments, working with the IPO, establish a time frame for identifying outcome-oriented metrics, define related goals as a basis for determining the extent to which the departments’ modernized electronic health records systems are achieving interoperability, and update IPO guidance accordingly. Both departments concurred with our recommendations,” said GAO Director of Information Technology Valeria C. Melvin. As the DoD has finally reached the NDAA interoperability guidelines, they will need to carry those goals out in conjunction with the VA, creating interoperability of service-members’ health information throughout all points of their careers.
After a long struggle for interoperability, the Department of Defense has announced that its Joint Legacy Viewer EHR system has met the National Defense Authorization Act of 2014 (NDAA), meeting EHR interoperability standards. According to DoD’s article at http://www.defense.gov/News-Article-View/Article/630810/dod-meets-interoperabilityrequirements-for-electronic-health-records , the department has combined its multiple EHR systems into one integrated system called the Joint Legacy Viewer (JLV), bringing together information from over 300 data sources. The JLV is reportedly completely secure, requiring government credentials for access. Additionally, the JLV has a mechanism that monitors who accesses certain patient information.
The JLV is also accessible by personnel at the Department of Veterans Affairs (VA), increasing the interoperability efforts between the two departments, aligning with their goals for high-quality patient care through care coordination. "What we really want to be able to show is the progress we've made and demonstrate our commitment to making sure that we're providing tools that are useful for our providers but also making things better for our service-member veterans and their families," said program executive for Defense Healthcare Management Systems Chris Miller. Additionally, the JLV tracks a service-member’s health information throughout his or her entire military career. This includes from his or her start with the military, up until he becomes a veteran and receives benefits through the VA.
Although the DoD has reached the NDAA standards, the agency acknowledges the long path ahead to securing complete and reliable interoperability. In fact, the JLV EHR is still undergoing tests, according to Miller. "We've done a lot to get this information to a point where it's both shared and it's usable, but we recognize that we're going to continue to have to do more things to actually continue to make it as useful as possible," Miller confirmed. It has been a long road for both the DoD and VA in establishing interoperable EHR systems. After ending a project to create an integrated EHR system between the two agencies in 2013, both the DoD and EHR were tasked with creating their own EHRs that were still completely interoperable with one another.
The VA opted to enhance its VistA EHR system, while the DoD opted to adopt a private vendor’s EHR system. Earlier this year, the DoD announced it was going with Cerner as its EHR vendor, and thus began implementation. However, it has taken the VA and DoD longer than anticipated to adequately implement these systems, causing tension between the two agencies and other government officials. Those tensions culminated in a House hearing where members of Congress expressed frustrations at the implementation timelines. “I don’t mean to understate the enormity of the challenge of integrating the two largest federal bureaucracies,” said Congressman Will Hurd (R-TX), “but it’s clear to me that our inability to integrate these two systems is a failure of leadership rather than technical feasibility. This is not an issue of data standardization. This is management 101.”
Additionally, officials from the Government Accountability Office (GAO) reiterated the urgency for DoD and VA to create adequate interoperability goals and timelines. GAO reported that the agencies did not meet the October 2014 deadline allotted them by the NDAA, and that they also failed to create adequate goals or plans for creating interoperability. “Accordingly, we recommended that the departments, working with the IPO, establish a time frame for identifying outcome-oriented metrics, define related goals as a basis for determining the extent to which the departments’ modernized electronic health records systems are achieving interoperability, and update IPO guidance accordingly. Both departments concurred with our recommendations,” said GAO Director of Information Technology Valeria C. Melvin. As the DoD has finally reached the NDAA interoperability guidelines, they will need to carry those goals out in conjunction with the VA, creating interoperability of service-members’ health information throughout all points of their careers.
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