Combat & Casualty Care

Summer 2017

Military Magazines in the United States and Canada, Covering Combat and Casualty Care, first responders, rescue and medical products programs and news\Tactical Defense Media

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Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap, which states "…exchange of information between health systems is flowing faster than ever before, and new technology innovations are bringing more usable digital health information to the bedside and beyond. We must build upon this success to create an open, person-centered health IT infrastructure." The DoD and VA achieved a significant milestone in April 2016 by certifying interoperability to Congress required by the Fiscal Year 2014 National Defense Authorization Act. While this certification marked a major accomplishment for both Departments, the DoD, VA, and IPO recognize the health IT landscape is constantly evolving and their efforts must remain ongoing to ensure our beneficiaries receive the best care available. Interoperability and the IPO Today The Departments work alongside ONC, and various SDOs, to identify, implement, and map the appropriate national standards associated with both Departments' EHR systems. Today, the IPO serves as the single point of accountability to enhance health data standards to improve data sharing between the DoD, VA, and their private sector partners. As a result of our collaborative efforts, the DoD and VA currently share more than a million data elements daily. The DoD and VA currently use several tools to support health data sharing. For example, since 2006, the DoD and VA have shared medication and allergy data through the Clinical Data Repository/ Health Data Repository (CHDR) interface, an initiative that exchanges medication and allergy data between the Clinical Data Repository and VA's Health Data Repository. The DoD also utilizes the Health Artifact and Image Management Solution (HAIMS) tool, an enterprise-wide data sharing capability that allows the DoD and VA healthcare providers to access artifacts and images generated during the healthcare delivery process. The Joint Legacy Viewer (JLV) provides care teams with an integrated, read-only display of health data from the DoD, VA, and private sector partners in a common data viewer. Through JLV, more than 320,000 DoD and VA clinicians can view in real-time records of more than 15 million patients receiving care from both Departments. For example, this allows care teams to immediately view their patient's medical history for recorded events that may affect the outcome of the surgery. JLV also reduces the need for patients to carry hard copies of their health records when they visit different facilities. Additionally, complete access to a patient's medical history leads to more informed decisions about patient care. This increase in user activity has garnered tremendous support from care teams, proving JLV as an invaluable resource to our patients and providers. Currently, the DoD shares electronic health data with private sector partners through eHealth Exchange, while the VA uses both eHealth Exchange and Direct Messaging. eHealth Exchange is the nation's largest health data sharing network comprised of federal agencies and private sector partners who share information under a common trusted framework to improve patient care and advance public health reporting through a secure, trusted, and interoperable health information exchange (HIE). Direct Messaging, a provider-to-provider messaging, allows health information to be shared between authorized VA clinical staff and trusted community healthcare partners. The DoD and VA developed external partnerships with many private sector HIEs and continue to add new partners each year. Together, the DoD and VA maintain access to over 120 private sector partners with additional HIEs being tested and on-boarded concurrently. Modernization and the Way Forward In July 2015, the DoD awarded a $4.3 billion contract to Leidos, Inc. to deliver a modern, interoperable EHR. Leidos is the Prime Contractor who, in contract execution, utilizes its Leidos Partnership for Defense Health (LPDH) team that includes Cerner Corporation, Accenture, and Henry Schein Inc. MHS GENESIS is a state of the market commercial off-the-shelf solution consisting of Cerner Millennium, an industry-leading EHR, and Henry Schein's Dentrix, a best of breed dental module. On February 7, 2017, the DoD achieved a major milestone, deploying MHS GENESIS at its first patient care facility, Fairchild Air Force Base in Spokane, Washington. The second deployment occurred on July 15, 2017, at Naval Hospital (NH) Oak Harbor, the first inpatient facility to receive MHS GENESIS. Additional deployments will continue across the Pacific Northwest at the remaining initial fielding sites which include NH Bremerton and Madigan Army Medical Center. The DoD plans to deploy MHS GENESIS to more than 9.4 million beneficiaries and 205,000 medical personnel and staff by the end of 2022. On June 5, 2017, Dr. David Shulkin, Secretary of the VA, announced his decision to adopt the same EHR as the DoD. This decision ultimately results in a single software baseline and enables seamless care between the Agencies without the manual and electronic exchange and reconciliation of data between two separate systems. This decision will, over time, fundamentally solve the problem of transitioning patient health record data between the DoD and VA by eliminating the need for moving data between the two Agencies—there will be one clinical system. With this announcement and the DoD's ongoing deployment efforts, the need to enhance health data sharing is more vital than ever before. As the DoD and VA continue with their modernization strategies, the IPO facilitates collaboration with health IT leaders to ensure the DoD and VA are at the forefront of emerging standards and trends in health data sharing. Specifically, the IPO is working alongside the ONC, Health Level Seven International, the Advanced Technology Academic Research Center, the Institute of Electrical and Electronics Engineers, and other public and private sector partners. Advancements to health data interoperability are the future, and will ultimately lead to better health outcomes for our servicemembers, veterans, and their families. As the DoD and VA continue to build on their successes, the IPO continues to expand these collaborative relationships to advance the interoperability capabilities of today and address the technological challenges of tomorrow. www.tacticaldefensemedia.com Summer 2017 | Combat & Casualty Care | 31 LEADERSHIP PERSPECTIVE

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