Health

Gates, Shinseki detail joint health record management and development plans

The top officials at the Defense and Veterans Affairs departments approved a management structure for development of a joint electronic health record, and confirmed plans to use commercial software for the project "wherever possible and cost effective."

Defense Secretary Robert Gates and VA Secretary Eric Shinseki detailed plans for the joint health record in a May 2 memo obtained by Nextgov, which also endorsed VA plans to use an open source model for development.

The memo said VA's plan to use open source software is "consistent with development of a single common platform" and added Defense will "actively participate" in VA procurement to select a custodial agent. That agent will manage a code repository used to update health record software.

Gates and Shinseki agreed to establish a high-level advisory board, chaired by Elizabeth McGrath, Defense deputy chief management officer, and Roger Baker, VA's chief information officer, to ensure program execution and oversight.

Overall management of the joint record will be handled by a program executive and a deputy selected by the two secretaries, and congressional sources said a search has already started for candidates for these positions.

The two departments, the memo said, should take the following critical steps toward development of the joint record:

-- Complete development of a common data model;

-- Finish negotiations for data center consolidation;

-- Select a common graphical user interface;

-- Acquire a common enterprise service bus, which manages messaging between applications;

-- Set up the open source custodial agent;

-- Select data models;

Deputy Secretary of Defense William J. Lynn III cautioned that development of the joint record will not be easy. He told a hearing of the Senate Armed Services Committee on May 18 that "it is important to keep in mind the difficulty of what we are trying to accomplish."

Lynn added, "Developing large-scale [information technology] systems is difficult for any organization, public or private. Jointly developing an interoperable system across two major federal departments is more difficult still.

"Secretaries Gates and Shinseki appreciate this," Lynn said. They remain personally involved, and have directed us to approach this project bearing several lessons in mind. To the extent that other large joint IT systems have succeeded, they have been based on a common data foundation, common service bus and common service broker. We are closely observing these lessons and are confident they will lead to the best possible outcome."

A common health record will have an impact beyond the two departments, according to Lynn. "A standard approach will not only improve the long-term viability of how information is shared between VA and DoD, it will also enable the meaningful exchange of information with other government and private sector providers. Both DoD and VA are currently executing pilots to demonstrate the value of this approach," he said.

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