Defense, Veterans Affairs Step Closer to Integrated Records

By Army Sgt. 1st Class Michael J. Carden
American Forces Press Service

Jan. 6, 2010 - The Defense Department soon will join a Veterans Affairs Department and Kaiser Permanente partnership designed to improve the way military veterans and the nation receive health care, the VA's top health affairs policy advisor said today. For the past month, Kaiser Permanente and VA – the nation's two largest electronic medical records systems – have been working to integrate their standards for veterans through a pilot program in San Diego using the Nationwide Health Information Network. The network was developed by the Health and Human Services Department in 2008, and allows government and several private sector health care providers like Kaiser to share health exchanges, such as integrated delivery networks, pharmacies, labs and patient information.

More than 400 San Diego veterans are participating in the pilot.

The partnership has been successful so far, and is the culmination of decades of work in the medical community, Dr. Stephen L. Ondra, senior VA policy advisor for health affairs, said in a press conference from Kaiser Permanente's Otay Mesa Outpatient Medical Center in San Diego.

The Defense Department plans to join those efforts in San Diego within the first quarter of this year, he said.

"It's a very exciting moment for us," Ondra said. "This is the very first multi-party exchange to the nationwide health information network. [VA] feels committed and responsible to go forward to extend this to other providers and across the nation as we build on this effort."

VA is the largest integrated health system in the nation, serving more than 5.4 million veterans. More than half of those veterans seek some of their medical services outside the VA. Also, there are more than 1.5 million veterans who don't use VA health-care services at all, said Ondra, a former Army surgeon and Gulf War veteran.

Although, VA and the Defense Department are leaders in health information exchanges, Ondra said, it's important for their systems also to be integrated into the private sector.

"We've got to take care of those patients, and we really need to have the visibility ... to understand conditions and to understand what treatment they've had, what medications, what allergies they've had," he said. "Those are all things that this exchange will do. It improves quality, safety and efficiency."

Ondra explained that the network isn't so much a system as it is a set of standards and protocols, meaning that no organization is tied to any single system. Interoperability in sharing health record information and administrative data can occur in any system that follows the nationwide standard, he said.

"[The network] empowers the private sector with standards to develop more choices that are always good for consumers," he said. "With a standard, it opens up space for new solutions and ultimately it aims to lower cost and better the health system for the public."

Ondra noted that such an integrated system will relieve the burden on patients and families who are often ill. With the network, and with patients' consent, they won't have to "scurry back and forth between providers with records," he said.

"This is about making patients' lives and health better ... doing something that is sustainable for our country," he continued. "We are committed to making their lives better."

As the partnership moves forward and grows, Ondra said the medical community is one step closer to President Barack Obama's vision of a lifetime electronic records system. He called the initiative the embodiment of Obama's commitment to servicemembers, veterans and improving overall health care for the nation.

Ondra also said their efforts are in keeping with VA Secretary Eric K. Shinseki's commitment to transform VA into a 21st-century organization centered on patients.

"This healthcare record-sharing initiative is the most exciting development I've seen in my [25-year] medical career," Ondra said. "This has the greatest potential to improve and change how we deliver care than anything that's happened in my lifetime."

Along with the efforts in San Diego, a number of other private institutions have expressed interest in joining the VA and Defense Department partnership. Ondra expects several more pilot programs to be established this year, he said.