It sounds so convenient, as Apple products often do: an app that would aggregate all of a user’s medical records, from test results to medications, in a single place. And, in theory, the military and veterans could eventually be able to take advantage.
But it might take a while.
Apple announced on Jan. 24, 2018, that they would be beta testing a new version of their Health app, based on the Fast Healthcare Interoperability Resources, or FHIR, standard for transferring electronic medical records.
Though the Department of Veterans Affairs told Federal Times that it is “always interested in new methods and technology to improve Veterans’ health care,” health IT experts said that making government-held health data available on commercial applications like the one offered from Apple would require additional levels of effort.
In a fresh warning, Veterans Affairs Secretary David Shulkin said Wednesday there could potentially be delays in providing medical care to tens of thousands of veterans if lawmakers don’t act soon to approve billions in emergency funding for the ailing private-sector Choice program.
“Integrating a commercial solution with a data set as large as the United States Department of Defense’s health records system is a significant effort, but not impossible,” said Shaun Bierweiler, vice president of Hortonworks’ public sector practice. One key consideration is, of course, the security of high-impact data.
Bierweiler said DoD and VA would need to have end-to-end security assurance, as well as a comprehensive view, of both data in motion and data at rest, at all times. That can be a big ask for a commercial vendor.
The federal government also has a history of relying on antiquated systems to store and process data, which are difficult to integrate with new apps.
“The more customized and antiquated a government solution, the harder it is to keep pace and make use of new commercial solutions and technologies,” said David Wennergren, former Pentagon assistant deputy chief management officer and current managing director at Deloitte.
“DoD’s planned migration to a commercial health care solution and the adoption of industry-wide standards will improve the ability of the department to take advantage of mobile devices and applications.”
DoD and the VA are both moving toward the adoption of the MHS Genesis electronic health record system, giving them better interoperability with each other and, potentially, with commercial solutions. DoD beneficiaries can currently access their health information through the TRICARE Online Patient Portal Mobile.
DoD began the initial deployment of MHS Genesis in February 2017, with full deployment planned for 2022. Veterans Affairs intended to contract directly with Cerner, the same company deploying the DoD system, and the Government Accountability Office expected that initial deployment would occur by June 2019.
“The more interoperable and more aligned to common standards that the two departments are, the better able both will be to make use of commercial applications and technology,” said Wennergren.
Defense Health Agency spokesperson Kevin Dwyer also noted that the DoD has lately been “keen on being an early adopter of a variety of technologies to help improve experiences of its members,” as the sharing of information would yield quality outcomes on all sides.
Security and privacy will inevitably remain the top obstacle — not only creating apprehension by DoD, but also adding roadblocks that could require Apple and other commercial providers to take extra steps get apps blessed for military yes. Much like the response to the government procurement morass from many Silicon Valley companies: If the process is too arduous, some might not bother.
“It will be important for DoD to recognize the power and inevitability of mobile devices, web-based apps and the personal involvement of military members and veterans in managing their health,” said Wennergren.
“Security and privacy can be addressed for mobile and commercial solutions, if we’re willing to think differently about how to manage risk. Embracing these new technologies and approaches will deliver tremendous value; avoiding them will just hamper an organization’s ability to keep pace with technological change and emerging best practices.”