Case in Point: DoD/VA Transform Business Processes to Care for our Most Seriously Wounded Warriors

Bi-Directional Health Information Exchange is "a superb example of the commitment our departments have made to work hand in hand to provide quality and continuity of care for our beneficiaries"

-- Dr. S. Ward Casscells, Assistant Secretary of Defense for Health Affairs

"The ability to electronically share [radiology] images significantly improves the continuity and quality of patient care. With all the images immediately available, VA physicians can begin assessment and treatment plans even before the patient arrives."

-- Dr. Stephen Scott, Director of the Tampa VA Polytrauma Center

In the March 2007 Congressional Report, we followed Army SGT Tom Humphrey's journey through the Military Health System, from the battlefield in Iraq through his rehabilitation in Pomona, California. His story revealed both the complexity of the military medical environment, and the heroic efforts of the three Service medical departments, the VA, a network of civilian partnerships, and the service member's loved ones to restore the health of our wounded warriors. Successful outcome for SGT Humphrey and for every other wounded warrior is dependent upon our medical team's ability to access up-to-date, complete medical information at each point along the continuum of care.

Our most critically injured soldiers, sailors and airmen need the collective strengths of the DoD and the VA to return to their families. This means that the privilege of providing care must be split between the two departments while ensuring that care itself is seamless to the patient. Today, many of the larger DoD medical centers transfer patients to VA Polytrauma Centers for continuation of inpatient care. With these transfers, the DoD must move large amounts of medical information accumulated while under DoD care. Transferring medical records, including radiology imagery, is important for the VA receiving care teams in order to provide proper care. Without image information, for example, clinically unstable patients may need to be re-imaged unnecessarily, exposing them to additional risk.

Since our last report, a joint VA/DoD Imaging workgroup developed an approach to sharing radiology images and electronic medical records between the two departments. The workgroup leveraged existing technologies to electronically move radiology images from the radiology image storage repositories at our three primary DoD wounded warrior care facilities to the repositories at the four VA Polytrauma Centers. Additionally, the workgroup established a process to combine electronic health record information from DoD systems with scanned paper medical documents in a single electronic file that can be accessed by the clinical care team at the receiving VA Polytrauma Center. As a result, this initiative has significantly enhanced the coordination and quality of care delivered to our most seriously injured patients.

This project represents an important and necessary step towards the bidirectional sharing of health information between the DoD and VA. As our service members continue to rely on strengths of both departments for their care and recovery, the ability of the two departments to share information will be brought to bear when and where it is needed the most - in support of our wounded warriors.