DoD, VA Laud Bridges Between Electronic Health Databases

One piece of this architecture, the Bidirectional Health Information Exchange, is a data exchange initiative that permits DoD and VA clinicians to view in real time the electronic health care information stored on each other's computer systems.

“VA and DoD are now sharing almost all essential health information that's available electronically in a viewable format,” Dr. Gerald Cross, the Veterans Health Administration’s principal deputy under secretary for health, said at a Pentagon news conference.

“That means that a VA doctor … can look at veteran’s DoD medical record and see if the patient has any known conditions like allergies, and the doctor can look up the vital signs and review the results of all the lab tests taken at a DoD medical facility,” he said.

The system, which is operable at all VA and DoD medical facilities, is one highlight of an electronic information sharing effort between the two departments that dates back to 2001. Pentagon officials hailed the Bidirectional Health Information Exchange, or BHIE, and other cooperative initiatives when they were announced some 11 months ago.

“These enhancements demonstrate the unprecedented level of interoperability that DoD and VA have been able to achieve with our electronic health record systems, and they contribute significantly to patient safety and continuity of care,” Dr. S. Ward Casscells, assistant secretary of defense for health affairs, said during the launch.

A joint DoD-VA task force, called the Interagency Clinical Informatics Board, determined the criteria for which medical information would need to be shared, said Lois Kellett, the acting director of the DoD/VA interagency program office.

“They will keep adapting and continue to expand to meet our clinicians' needs,” she said of the task force’s continued guidance.

At today’s conference, which provided an update on the overall interagency health information sharing efforts, Cross emphasized that the initiatives were about much more than technology.

“Their joint efforts are a testament to the power of collaboration and proof of the great things that VA and DoD can accomplish when we work together on behalf of America's heroes,” he said, adding, “This is about continuity of care.”

An electronic health record is a tool for collecting, storing, manipulating and communicating health information, Dr. Stephen Jones, the principal deputy assistant secretary of defense for health affairs, said. Such records can reduce duplicate testing and adverse drug interaction, increase preventive care and improve the care of chronic diseases, he said.

Jones added that the interagency effort represents a breakthrough in medical information sharing. “In fact, current health information-sharing capabilities between DoD and VA are well ahead of those in the private sector in both scope and scale,” he said.

One of the other initiatives launched in December 2007 was the Clinical Data Repository/Health Data Repository, or CHDR. This software actively synchronizes data between DoD and VA repositories for patients who receive health services from both agencies, according to a Defense Department news release.

Putting data in sync increases patient safety by alerting care providers at DoD, VA and even retail pharmacies to possible drug allergies or harmful interactions, Cross said.

“That means that when a doctor prescribes a drug, the [information technology] interface automatically checks the VA and DoD systems to be sure that the patient doesn't have any allergies to any drug, [and] … isn't taking any other drugs that could cause a harmful reaction,” Cross said.

As of August, CHDR was in production and testing phases at seven sites across the country.