Mar 23 2017

VA Can Push Interoperability by Becoming a Digital Leader

With a history of innovation, the VA has the chance to drive regulation around the better exchange of healthcare information.

As the Veterans Affairs Department faces decisions about its digital future, experts are urging the VA to push for the development of technical standards that will enable better information sharing between all aspects of the healthcare chain.

“The world isn’t beginning and ending with the VA,” said Aneesh Chopra, former chief technology officer for the Obama White House, at Politico’s March 21 event focused on digital healthcare in the VA. “We’re living in a healthcare delivery system where every doctor — whether you serve veterans directly or indirectly — everyone wants to be able to download apps to reduce their documentation burden. Or wants to better coordinate the care with their patients or connect with their colleagues with whom they referred to ensure they have a good feedback loop.”

From Patient-Facing to Physician-Facing Exchange

Chopra noted that during the previous administration, the VA was successful in developing a healthcare record- exchange tool for veterans in the system. Just 90 days after former President Barack Obama promised an online portal to access, download and share medical records, the VA launched Blue Button, which allows patients to do just that.

But providing access to patients is only half of the equation. With interoperability lacking across healthcare organizations everywhere, the VA could push for technical standards that would enable better record-information exchange for physicians.

“The regulation only requires patients to be able to access their data via apps,” said Chopra. “There is not a single line of regulation today requiring any kind of EHR vendor to allow a doctor to have the same internet access that their patients will have, because that’s just not where we are, and we could, with leadership from the VA and others, accelerate that loop.”

Pushing interoperability for physicians and patients is the next logical step, argues Chopra, who believes that the VA can build on its history as a leader in digital healthcare to forge new standards.

“Why can’t everyone have the internet in healthcare?” asked Chopra. “The VA can bring it to life by encouraging the development and use of open standards in a way that we haven’t seen yet because we have only done [so] much with regulation.”

Cloud-Based Interoperability Could Ease Care

As the hospitals within the VA collaborate with specialists outside the system, an EHR exchange network that allows other physicians to access care records stands to make it easier on the patient to receive care. Rep. Phil Roe targets the cloud as the best technology to facilitate that collaboration.

“The VA systems and the private systems have got to be able to use a cloud-based technology, where I can use my electronic health system in my office and send that information. Right now I can’t do it,” said Roe.

Moreover, interoperability through a cloud-based system is key in substantiating and processing healthcare claims, according to Garry Augustine, executive director of Disabled American Veterans (DAV), an organization that represents more than 1 million veterans in the VA’s system and processes nearly 300,000 claims a year.

“Not only is it important for the treatment of the veteran, but for claims representation, we need to have access to the treatment records to substantiate claims,” said Augustine. “Without that substantiation you can’t get that claim granted. So, it’s very important that that information gets back to the VA and [the DAV] has access to it.”