Single screen for viewing integrated health records a work in progress

Janus graphical user interface developed at joint Defense-VA hospital in Hawaii is just one part of the solution.

The open source Web-based graphical user interface dubbed Janus will be just one part of a system that will allow doctors to view patients’ Defense and Veterans Affairs department integrated electronic records in one place, VA Chief Information Officer Roger Baker said during his monthly media briefing Thursday.

Developed at the joint Defense-VA Pacific Telehealth and Technology Hui (Hawaiian for association, society or community) in Honolulu, the Janus user interface provides clinicians with a common view of patient data pulled from the electronic health record systems operated by the two departments. Janus has been used at the combined Defense-VA hospital in Honolulu since 2003.

The Janus interface combines data from the Defense Armed Forces Health Longitudinal Technology Application and the Veterans Health Information Systems and Technology Architecture on a single screen, eliminating the need for clinicians to access two separate applications to obtain complete patient information.

The Janus interface also has been deployed at the joint Defense-VA hospital in Chicago and VA Secretary Eric Shinseki and Defense Secretary Leon Panetta saw it in operation during a May visit to the hospital. Shinseki told a combined House Armed Services-Veterans Affairs Committee hearing July 25 that the Janus interface was “impressive and it represents a major step forward for the iEHR.”

In May 2011, Baker said the two departments had selected Janus as the iEHR interface, but Thursday he said it would serve as only part of the interface. Janus, he said, works primarily with outpatient information and the integrated health record interface will need additional portlets to access other clinical databases, such as mental health information.

The two departments plan to deploy the integrated health records in stages from 2014 through 2017 and Baker said the graphical user interface is the component of that system “most amenable to change and advancement.”

Both Shinseki and Baker have strongly backed open source software for the iEHR and Janus was added to VA’s Open Source Electronic Health Record Agent library in May.

Veterans Affairs then tapped that open source code to install Janus as the user interface in its Palo Alto, Calif., hospital this July, marking the first use of code from the open source repository. Shinseki told the House hearing in July that “this augers well for both iEHR’s success and for open architecture, standards based and modular solutions to our most challenging IT problems -- at VA, DoD and across the federal government.”