Did DoD-VA meet EHR deadline? Depends on whom you ask.

The Departments of Defense and Veterans Affairs have met a September 30 milestone to make their respective electronic health records interoperable – at least according to one set of criteria.

Yet interoperability goals set by the recently-retired chief of the Interagency Program Office have not been fully met. IPO is a joint DoD/VA office which given the lead on health record interoperability and in developing the military Lifetime Virtual Electronic Record.

For Navy Capt. Michael Weiner, acting deputy program officer of the Defense Health Information Management System, the two departments have met the relevant interoperability criteria, which were set by the Interagency Clinical Informatics Board, he said.

ICIB is a professional organization of clinicians from both DoD and VA.

These included making DoD inpatient discharge notes available to the VA; increasing the number of electronic gateways deployed between the two systems; enhancing the sharing of social history; creating the ability to view scanned documents between systems; and making available DoD periodic health assessments and separation physicals to the VA.

"These were the agreed upon metrics and measures of success and we have achieved them all," Weiner, told Government Health IT.

However, Rear Adm. Gregory Timberlake, the now retired head of the IPO, committed earlier this year to the complete and computable interoperability of six categories of data by September 30. Not all of these are now shareable in computable form, Weiner acknowledged.

Those six classes of data--for prescriptions, laboratory results, radiology results, and physician, nursing, and therapist notes--were to augment the exchange of drug interaction and allergy information for shared DoD/VA patients previously available. Lab results and radiology results are still not shareable in computable format, according to Weiner.

At a breakfast talk yesterday, VA chief information officer Roger Baker described the latest progress on interoperability as the first phase in the creation of a joint DoD/VA Lifetime Virtual Electronic Record which will include benefits information as well as health interactions with outside providers.

“A true lifetime virtual electronic record has to include the private sector,” Baker said. He cautioned, however, that such a scheme raises "highly complex problems" surrounding the protection of private and sensitive information.

DoD, the VA, and Kaiser Permanente, a private health network and insurer, have started a pilot project in San Diego, said Weiner, which will result in a connection among the three electronic health record systems over the National Health Information Network (NHIN) in early 2010. NHIN is a demonstration project sponsored by the Department of Health and Human Services Department on the secure exchange of health data.

"We are already building a concept of operations," said Weiner, "and hope to build upon a successful pilot to other areas of the nation so that we can be tied together to the civilian health care community."

Any national effort still needs to settle on standards, Weiner added, after which individual systems must "place adapters on their own systems so that we can use those standards."