Official defends Pentagon, VA moves toward e-health

The Defense and Veterans Affairs departments share a lot of electronic health records, contrary to what some observers believe, a VA official said Tuesday.

"We have made significant progress as to those two organizations," Cliff Freeman, director of the program for sharing Defense and VA health information technology, told an audience of IT professionals who serve the federal government.

Last week at a House hearing, Government Accountability Office auditors said the departments have made progress in their long-term ambition to modernize their health systems and in piecemeal initiatives, like two-way viewing of certain data from existing systems. But GAO said much work remains to achieve electronic medical records that can be transmitted seamlessly.

By the end of next year, Freeman told the Association for Federal Information Resources Management, Defense and VA will be able to electronically access all clinically important patient data in Defense records except for information in inpatient records and radiology images. Much of the inpatient data is not in electronic format, he said.

The number of new IT requirements set forth by recent commission reports "is almost overwhelming," Freeman added.

Eventually, veterans will be able to visit one Web site and see all the benefits available to them through Defense and VA. But right now, national e-health standards are not robust or mature enough to support complete compatibility.

Also making matters difficult is the fact that both departments have different budget cycles. With joint projects, each department must juggle timelines to ensure milestones are met in time for the other department and congressional appropriators.

Advances within the Defense/VA health IT program will propel the movement toward a nationwide health information network, said Vish Sankaran, the Health and Human Services Department's program manager for federal health architecture. He addressed the tech professionals after Freeman spoke.

Sankaran noted several forces that are accelerating a shift toward e-health. First, healthcare delivery is moving from a payer-controlled system to a consumer-controlled system. Presidential executive orders also are fueling the transition. And the goal of personalized medicine, or genomics, is dependent upon databases and information-sharing, which will "move us from mass production to mass customization" of medicine.

Finally, companies, like Microsoft and other makers of personal health records are enabling the market, Sankaran said.

Above all, consumers have to drive the market, Sankaran stressed. For example, he said, when he was in search of a pediatrician for his son, he asked the physician's office: "Do you have PHRs? If not, I don't want you to be my doctor."

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