Hundreds of vets participate in test of sharing electronic health records

More than 400 veterans in Southern California have agreed to participate in a project to test how the Veterans Affairs Department can improve patient care by sharing electronic health records with a private health provider, a fundamental goal behind the development of a national network the Obama administration is pursuing.

In November 2009, VA and Kaiser Permanente sent a letter to veterans in the San Diego area who had recently received care from both institutions inviting them to participate in the program. They were asked to allow the two organizations to share specific health information electronically. The pilot will determine if the exchange of records results in the delivery of better, faster care and reducing redundant lab tests.

About 40 percent of the 1,114 patients asked to participate agreed to take part in the project. As a result, clinicians today at both health care systems can access records for about 450 shared patients' in the San Diego area around-the-clock. Three out of four veterans receive a portion of their care from providers other than VA, according to the department.

Tim Cromwell, director of standards and operability for VA, said the department was very fortunate to receive the 40 percent response rate, but "we think we can get a higher rate."

The success of the collaboration between Veterans Health Administration, the nation's largest health care system, and Kaiser, the largest not-for-profit health plan in the United States, could encourage other organizations to accelerate their efforts in health information technology. Supporters of health IT argue it will cut costs; reduce medical errors; and improve outcomes by better managing patient data on a secure network that is accessible to authorized physicians, hospitals and insurers. The federal government has backed the nationwide initiative with about $20 billion in stimulus funding.

Kaiser officials said the technological barriers to rolling out a nationwide exchange are minimal, because the technology already is open to the public and is not proprietary. VA can replicate this model with smaller, private sector health systems that don't have the same resources as Kaiser, both VA and Kaiser officials added.

Ultimately, smaller plans and practices will be able to easily find and purchase compatible technologies from commercial vendors. "In the long run, this is going to be solved for them," said Dr. Andrew Wiesenthal, associate executive director of The Permanente Federation. "They'll benefit from the work that we've done."

The more difficult part of the expansion process will be managing consent requests and opt-in responses, he added.

The two organizations are using the Nationwide Health Information Network, a Health and Human Services Department program working to connect disparate e-health records systems nationwide. In this case, the network linked Kaiser's HealthConnect patient records system to VA's VistA e-records network.

"The commitment from all [of us] to do a national rollout is very, very strong," said John Mattison, chief medical information officer for Kaiser Permanente, Southern California.

The Defense Department is expected to join the pilot early this year.