Veterans Affairs Chief Information Officer Roger Baker, above, described the so-called electronic service bus as "the heart of the [integrated electronic health record]" for service members and veterans. (Thomas Brown / Staff file photo)
The Veterans Affairs and Defense departments achieved a major milestone last month in their quest to develop an integrated electronic health record (iEHR) system for service members and veterans.
The agencies selected Fairfax, Va.-based ASM Research Inc. to manage a critical portion of the iEHR, called the enterprise service bus, which will allow various components of the future system to communicate with each other and with VA and DoD health information stored in data centers. The contract, which was awarded under VA's Transformation Twenty-One Total Technology, or T4, program, has a ceiling value of $102.6 million.
The enterprise service bus is "the heart of the iEHR," VA Chief Information Officer Roger Baker said in an interview. "Everything will talk to it or through it."
Baker said VA and DoD are still finalizing an estimated four- to five-year development plan for the iEHR. Development of the iEHR is tied to the larger Virtual Lifetime Electronic Record that will enable better sharing of veterans' health and benefits data, but the iEHR is a separate program that requires its own oversight, he said.
"The iEHR is all about building a single medical record that's usable from accession until burial for the individual," Baker said.
The iEHR will include four layers — a graphical user interface for clinicians to see health data, 127 medical applications to submit and retrieve data, the enterprise service bus and data centers storing health information.
For example, if a clinician wants pharmacy data about a particular patient, the enterprise service bus, or middle layer, can quickly determine which database the information is stored in and present it to the clinician in a standard format. The goal is to ensure that any application can communicate with any database.
"By building a single medical record system, when you leave the DoD and show up at a VA hospital, it will be as if you went from one DoD hospital to the next DoD hospital," Baker said. VA doctors will "know everything" and "see everything" about a patient's medical history.
At the Capt. James A. Lovell Federal Health Care Center in North Chicago, and Tripler Army Medical Center and VA's Pacific Islands Health Care System, both in Honolulu, clinicians are testing a graphical user interface that gives VA and DoD clinicians a common view of patient information. The interface tool can capture patient information from separate electronic health records managed by VA and DoD and present it as a single medical record to the clinician, Baker said.
The focus for DoD has been to provide clinicians with an electronic health record that is always available, retrieves information quickly and is easy to use, said Mary Ann Rockey, technical director at the DoD-VA interagency program office. That will continue to be a priority with the new system.
The clinical community and the business community are driving the next-generation electronic health record, said Navy Capt. Michael Weiner, deputy program manager and chief medical officer for the Defense Health Information Management System.
Weiner said VA and DoD include clinicians in their decision-making for the integrated electronic health record. Before they settle on new features, like laboratory modules for the system, they will consult with lab offices and technicians from all the services and VA to see what works best.
Starting in March, VA will begin moving 126 systems that make up its electronic health record to data centers managed by the Defense Information Systems Agency. Data from DoD's electronic health record already is stored in DISA data centers. Both departments expect that co-locating data in DISA data centers will make it easier to share health data.