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Joint HIE, FHIR Adoption Support Data Sharing for Veteran Care

DOD and VA FHIR adoption and a joint HIE have helped support data sharing for veteran care coordination, according to FEHRM director Bill Tinston.

The implementation of a joint HIE and FHIR adoption have helped support data sharing for veteran care, Bill Tinston, director of the Federal Electronic Health Record Modernization Effort (FEHRM), noted at a Cerner Health Conference session.

As the DOD and VA work to implement a single common federal EHR system for veterans, Tinston explained that federal officials created a joint health information exchange (HIE) to support interoperability with community healthcare providers. This is especially critical given the MISSION Act, which allows veterans facing extraordinary care access barriers to get that care a non-VA facilities.

Prior to the creation of the joint HIE, interoperability with community healthcare providers was relatively low among VA and DOD healthcare organizations, Tinston noted.

“At this point, we're at about 65 percent interoperability from a data perspective and it appears to us that we're going to get well over 95 percent by the end of this calendar year,” Tinston said.

Tinston explained that in addition to improving clinician access to veteran health information, the joint HIE has helped improve how clinicians view and interact with that data.

“We started with a viewing capability, often a CCD, and presented that in a separate application to providers and clinicians,” he noted. “We've really improved that by integrating it into the workflow, so they now view the relevant information at the point in the workflow when it's necessary for them.”

Tinston noted that DOD and VA have adopted FHIR standards to streamline data sharing in the legacy environment between the two departments.

FHIR adoption makes clinical information more relevant to the provider, Tinston said, as providers can determine what data they want to see based on the kind of encounter they are conducting.

FHIR adoption also makes clinical data much more usable and broadly available to providers, he added.

“We're working with the other health information exchanges to drive those FHIR standards into the data that we're getting from them so that we can have that same richer experience across the board, not just between the VA and the DOD,” he said.  “The standards are what's going to drive the improvements in that usability of data as we go forward.”

Corey Tate, vice president of interoperability at KLAS Enterprises, noted that while recent research has shown FHIR implementation is just getting underway, adoption by federal agencies such as VA and DOD will help accelerate widespread data standards adoption.

“We're in the infancy of FHIR, but there's a lot of hope there, and I think that the government's focus on FHIR and pushing that as a standard is likely to really accelerate and help things,” Tate noted.

Tate emphasized that as the digital health transformation continues, standards adoption will be key to supporting healthcare organizations’ data exchange needs.

“This shouldn't be about adopting one thing,” he said. “It should be making sure that whatever capabilities we're delivering, as people who deliver IT to healthcare systems, work together.”

Tate noted that standards adoption will help support an ecosystem of health IT that providers do not have to think about, which he said should be the ultimate goal of IT vendors.

“I don't want clinicians or hospital administrators thinking about the IT,” Tate noted. “I want them to be able to make the best decisions they can about how health systems interact with one another and support one another.”

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