Department of Defense

Develop an Open Standard Electronic Health Record for DOD and VA

The importance of Open Standard technology is a critical need for improved sharing and exchange of service-member health information and data between the Department of Defense - Health Affairs and the Department of Veterans Administration community of interest (COI) as indicated in Section 1635 of the 2008 National Defense Authorization Act (NDAA, 2008). A community of interest is a collaborative group of users that must exchange information in pursuit of its shared goals, interests, missions, or business processes e.g. DOD VA sharing and exchange of service-member health information and data (DoD 8320.02, 2004). Currently, the limited exchange of electronic health data between VA’s Integrated Systems and Technology Architecture (VistA) and DOD’s AHLTA electronic health systems is accomplished via the Bi-Directional Health Information Exchange (BHIE). The BHIE is a proprietary web technology that supports the limited exchange and viewing of electronic health information between both systems at a cost of more than $30,000,000.00 million dollars per year. Although both DOD and VA systems use the same technology and purported standards such HL7 for messaging between systems, they still fall short of the promise of interoperability and data exchange. In my opinion, this occurs because of the interpretation of the standards by legacy systems integrators. Take, for example, the application of the HL7 standard. Using the example of AHLTA and VistA, sample message headers for AHLTA might be (last name, first name, middle initial, social security number, carriage return) and for VistA it might be (last name│first name│middle initial│social security number, carriage return). In this example, the only differences between the two message headers are the pipe delimitations, but these small inconsistencies create the interoperability issues and a $30M cost per year. Use of Open Standard technology, can mitigate or eliminate cost and improve access & quality of healthcare.

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Idea No. 7630