Sharing Military Health Records Between VA and DOD Won’t Work, VA Official Says

By Alex Grubbs | July 19, 2016 | 10:41 AM EDT

Sen. Mark Kirk (R-IL) displays a graphic of the Dept. of Veterans Affairs' outdated computer technology. (Screenshot of Senate Appropriations Subommittee hearing on July 13, 2016.)

( – A top IT official from the Department of Veterans Affairs (VA) told Congress that the VA is currently unable to maintain military health records on one system shared by the Department of Defense (DOD).

“The reality is there is no system that can support both DOD and the VA at the same time. It will not scale,” LaVerne Council, the VA’s assistant secretary for information and technology, testified at a Senate Appropriations Subcommittee on Military Construction, Veteran Affairs and Related Agencies hearing on the VA’s electronic health record system, VistA.

Scalability is the ability of a computer system to handle a growing volume of data.

“There is no system that will support all the things you have to do - to do the clinical management and the clinical operations at the same time,” Council said last week on Capitol Hill.

But Sen. Shelley Capito (R-WV) pointed out that computer systems like Amazon’s can scale and questioned why the VA’s electronic health system cannot.

“At the same time. There is no system that will support all the things you have to do - to do clinical management and clinical operations - at the same time,” Council responded.

In her written testimony, Council said the VA “requires an interconnected system of systems, based on a single platform, which supports an electronic health record (EHR) as one of several components.”

However, David Waltman, an executive and senior advisor to the undersecretary for health in the Veterans Health Administration, said that with several advancements in IT, the department is hopeful that its computer system might be fully interoperable with DOD’s by mid-2018.

According to its website, VistA, or Veterans Health Information Systems and Technology Architecture, “is VA's award winning Health Information Technology (IT) system. It provides an integrated inpatient and outpatient electronic health record for VA patients and administrative tools to help VA deliver the best quality medical care to veterans.”

Citing a total of $771 million that VA has already spent on VistA, Council stated that “these investments will also deliver value for Veterans and VA providers regardless of whether our path forward is to continue with VistA, a shift to a commercial EHR platform as DOD is doing, or some combination of both.

“Fundamentally, our efforts to improve information systems are about data, not software. Regardless of the software platform, we need to be able to access the right data at the right time….

“VA is at a historic crossroad and will need to make bold reforms that will shape how we deliver IT services and health care in the future, as well as improve the experiences of veterans, community providers, and VA staff,” Council concluded.

However, Valerie Melvin, director of information management and technology resources issues at the U.S. Government Accountability Office (GAO), testified that the VA previously said that one shared electronic healthcare record system for active and retired military would be the solution.

“We did say that we did encourage one system as the way [forward], and they in fact stated that one system was in fact the way to go when they went with an integrated electronic health record approach in 2011,” Melvin said.

The VA and DOD have been collaborating to create interoperability between the government agencies’ health records systems to allow faster access to these records for veterans.

The DOD currently participates in an EHealth exchange, “which is a public private partnership of both government, including DOD, providers and private sector providers providing data through health information exchange organizations,” Dr. Lauren Thompson, director of the DOD/VA Interagency Program Office at DOD, testified.

However, Thompson acknowledged that not all health providers who treat veterans have access to this information because they are not part of the health exchange.

Sen. Capito noted that the challenge of not all veteran health providers having access to the data adds another layer of complexity to the goal of achieving interoperability between the two departments’ healthcare records systems.

A 2015 GAO report recommended the two agencies work together to create a strong healthcare network to serve the nation’s active military and veterans. However, the attempt was unsuccessful due to nature of the agencies’ different IT systems.

“[The VA] has also faced significant information technology challenges that contributed to GAO’s designation of VA healthcare as a high risk area,” the GAO report said.

"The departments have not identified outcome-oriented goals and metrics to clearly define what they aim to achieve from their interoperability efforts," Melvin noted. "A modernized VA electronic health record system that is fully interoperable with DOD's system is still years away."

Committee Chairman Mark Kirk (R-IL) showed a visual display of the technology used at the VA, which dates back at least 40 years, saying that the technology needs to keep up with the times.

Kirk said he is hopeful that “we can reach a new 22nd century level of care for veterans. I want to make sure analytics are a deep part of this electronic healthcare revolution that we have for VA and DOD.”

Sen. Tom Udall (D-NM) brought up the VA’s past scheduling scandal that has left thousands of veterans on long waiting lists for healthcare appointments.

“There is a product that we call CareNow. It’s a mobile access for the veteran which will allow them to schedule with the [doctor in] real-time,” Council responded. “We are working with the doctors now to put that in full testing.”

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