Case in Point: DoD and VA Prove Partnership Means Win for Patients

Initially certified through the MHS Defense Business Transformation (DBT) Program in September 2005, the Joint Electronic Health Records Interoperability suite, JEHRI, is a true model of federal agency interoperability. What started as a simple collaborative effort between the DoD and VA in 1998, JEHRI has since emerged as a coherent plan driving the exchange of health data between the MHS and the VA. Through JEHRI, the DoD and VA are developing a health information infrastructure and architecture supported by common data, communications, security and software standards and high performance health information systems.

Unlike other MHS investments focused on unique system modernizations, JEHRI is a joint plan deployed in two phases: (1) one-way electronic data exchange (executed by the Federal Health Information Exchange (FHIE)) and (2) bidirectional (executed by the Bi-directional Health Information Exchange (BHIE) and Laboratory Data Sharing Initiative (LDSI) and computable data exchange (executed by the Clinical Data Repository/Health Data Repository (CHDR)). These exchanges enable the transfer of protected information including outpatient pharmacy data, laboratory orders and results, radiology results, consult reports, allergy information, discharge summaries, admission information, pre- and post-deployment health assessment information, diagnostic codes and procedure codes.

JEHRI is an investment that enables the creation of efficiencies between departments and business processes, reduces complexity between systems, and focuses investments on collaborative efforts. The sharing of clinical data between the DoD and VA has decreased redundant tests and procedures and reduced dependency on paper records. The result is a process that supports electronic sharing of health data leading to a reduction of costs associated with photocopying, filing, indexing and tracking of paper medical records as veterans transition from active duty into the VA Healthcare System.

FHIE has been successfully deployed and implemented across DoD and VA. As of June 2006, FHIE has enabled the transfer of historical data from DoD Composite Health Care System (CHCS) to the FHIE data repository which is accessible by VA VistA CPRS including:

• 3.5 million unique patients
• 1.8 million correlated patients
• 46.9 million lab results
• 7.4 million radiology reports
• 47.1 million pharmacy records
• 46.3 million standard ambulatory records

BHIE is operational at all VA sites and select DoD sites worldwide including 13 medical centers, 14 hospitals and more than 150 clinics. Since May 2006, BHIE has enabled the bidirectional exchange of current medical information for:

• Over 1.5 million unique correlated patients
• Over 628,000 unique new patients (not in the FHIE data depository)
• 8,690 weekly FHIE/BHIE queries in 3rd Quarter FY06

LDSI is operational between six DoD and VA locations where one Department uses the other as a reference laboratory. The El Paso and San Antonio, Texas, locations have processed over 8,200 chemistry laboratory tests using LDSI.

Both DoD and VA continue to spearhead their collaborative efforts with JEHRI. The agencies are committed to further streamlining their data exchange and their adoption of health IT. Through JEHRI and their continuous alignment to privacy and security regulations, DOD/VA have made significant strides in the delivery, quality and continuity of healthcare. Today, JEHRI is the recognized federal model for electronically exchanging health records. It exemplifies how federal agencies can take the lead in health IT adoption and prime the marketplace.