VA, DOD will decide on common EHR method in March

The Veterans Affairs and Defense Departments will decide by late March the technical method they will pursue to create a common electronic health record. The two departments are able to exchange some patient information now, but their systems are not interoperable, even though many military members and veterans receive treatment in both systems.  

The VA and DOD secretaries are committed to do this together and make the best decision for their two departments as jointly as possible on how they can move forward to a common electronic health system (EHR), said Roger Baker, VA CIO.

“If we can run one EHR and if we’re in agreement on that EHR, that will be wonderful. But I think there are a variety of options between there,” he said in a Feb. 24 tele-briefing with reporters.

The EHR system may not be settled in one decision, he said. “But I assure you it will be very close cooperation between DOD and VA whatever the right technical solution recommended is,” he said.

The two departments have agreed that the EHR will include standards, shared data, common applications and the ability to plug and play those common applications.

Last week, Baker told a congressional committee that a decision was weeks away.

DOD’s current system is the Armed Forces Health Longitudinal Technology Application (AHLTA) and VA's is Veterans Health Information Systems and Technology Architecture (VistA), which has received a number of awards for its effectiveness.

“What we’re focused on now is principles and less on what that means relative to which parts of which packages [of VistA and AHLTA] form the basis for what goes forward,” Baker said.

At the same time, VA must proceed in revamping its VistA system. To that end, VA has been considering open source software with a request for information to gauge industry approaches.

“No matter what happens in the joint session with the DOD, we have to increase the pace of modernizing VistA,” he said. “That’s why we’re exploring the open source avenue.”

DOD has also been considering industry ideas for modernizing its AHLTA electronic health record with a Web-based system.

As it examines the open source model, VA will be influenced by both the work it’s doing with the DOD for a joint electronic health record and also by substantial industry input in order to most easily integrate private sector technologies  into the next version of VistA. Even in its updated form, VistA will still rely on its aging MUMPS code.

“The stuff that works isn’t necessarily going to get replaced whatever way we go through the modernization of the platform,” Baker said.

VistA has 15 million lines of MUMPS code, but the code works, he said. The VistA system is available 99.95 percent of the time in hospitals.

“If we were to go to open source, 10 years from today there still will be MUMPS code inside the product that is known as VistA,” he said.

Click on VA and DoD to read the original Government Health IT article.