The Department of Veterans Affairs is preparing to launch three pilot programs this summer testing out a new application to provide better patient care by giving doctors access a veteran's entire medical history in a single place.
The new Enterprise Health Management Platform (eHMP) — designed in-house using open source code — pulls in health records from the Defense Department, VA hospitals and care centers and other available databases to give a holistic, real-time view of the patient's history.
The dynamic (and clean) user interface allows doctors to see what tests were ordered and when; what medications have been prescribed in the past; notes on the patient (like if they're a "wanderer"); allergies and more. Physicians with a specialty can also build out customized dashboards to track specific conditions.
Doctors can also adjust the timeline window to focus in on the last few days or the full medical history going back as far as 1960.
"This increases the flexibility of the record based on the setting in which you're seeing it," said Dr. Neil Evans, co-director of connected health at the Veterans Health Administration. "The reason this is important is, if I am wearing my in-patient provider hat, the timeline that matters is approximately the last week because the patient is in the hospital with a lot of data being generated every single day … In a primary care clinic, the timeline I care about is the last decade."
By mapping the data to existing coding standards, the eHMP system also works to increase interoperability between VA and DoD data in a machine-readable format – a problem that has plagued the veteran health sector for some time.
"Currently, you can get the data [from DoD] through a viewer. Here, it's integrated," Evans said. "Because it is computable data — because we're using these standard codes — clinical decision support or drug interaction checks can be run on the entire data set, including data from outside the local facility."
That work can be done now, however the information is disparate, forcing doctors to go through each record individually to find what they're looking for.
Developers at VA unveiled version 1.2 of the app to a group of reporters during a demo June 11. During the pilot stages, the app will be read-only, giving doctors a view of patient records but not allowing them to add any new information directly.
Users will be able to input new information with the next iteration — version 1.3 — expected to roll out in early 2016. The app is on track to roll out across the entire VA enterprise by the end of 2017.
Along with new capabilities from VA, engineers are also creating a software development kit to release to the public, allowing others to create new apps and functionality on the platform.
"We are building this as a platform — a key difference than just building an application," said David Waltman, senior advisor for information strategy at VHA. "It's designed for us to add things."
"In the past we were very localized … if there's a good idea locally, it was developed at that location," said Brian Burns, deputy director of the DoD/VA Interagency Program Office. "This way you still have the innovation at the local level but now it becomes enterprise-wide and available. Somebody's good idea in one place can be somebody's good idea for the entire environment and enterprise."
VA can also use the development kit in future solicitations, giving contractors a specific set of standards to ensure new systems work with the eHMP, Waltman noted.
"We created a system where we bring all that day together and you get a much more complete veteran-centric view of the record, instead of a local-centric view" based on the hospital or care center, Waltman said. "You get a more complete picture of the patient's health history and are able to have a lot more information for decision support."