VA, Kaiser testing the exchange of electronic health records

The Veterans Affairs Department and Kaiser Permanente launched a pilot project in November in the San Diego area to test how clinicians in both organizations can exchange electronic health records over a national network that the federal government is creating to share medical information.

Veterans in the San Diego area who receive care from both VA and Kaiser will be invited to participate in pilot, which will rely on the Nationwide Health Information Network, which the Health and Human Services Department is developing to foster interchange of medical information between federal agencies and private providers.

"The ability to share critical health information is essential to interoperability," said Eric Shinseki, secretary of VA. "Utilizing the NHIN's standards and network will allow organizations like VA and the Defense Department to partner with private sector health care providers to promote better, faster and safer care for veterans."

The project recognizes "the reality is that most people receive care from multiple providers," said Dr. Andrew Wiesenthal, associate executive director for clinical information support at Kaiser. "Without the ability for caregivers and patients to have access to their data all the time there is the possibility for wasted time and resources duplicating tests and procedures."

Stephen Ondra, senior policy adviser for health affairs at VA, said the project dovetails with the $20 billion in stimulus funds to provide every American with an electronic health record within five years.

The pilot links the two largest health systems in the country, which also operate two of the largest electronic health record systems in the world. VA manages 153 hospitals and 1,140 clinics backed by a workforce of 216,000 employees in the Veterans Health Administration. The department expects to treat more than 6 million veterans this year, all with health records maintained in the Veterans Health Information Systems and Technology system, which it developed in house in 1996. VA's budget for health information technology in fiscal 2010 is $1.6 billion.

Kaiser is the largest nongovernment health care provider in the nation, operating 35 hospitals and 4,321 clinics, and treating 8.6 million patients a year. It employs 167,000 people and recently rolled out a $4 billion electronic health record system called HealthConnect, which it describes as the largest privately funded health record system in the world.

Peter Levin, also a senior adviser to Shinseki and VA's chief technology officer, said the fact that VA and Kaiser use different electronic health record systems will not inhibit the flow of information because the network's standards and protocols facilitate the exchange of medical information just as Internet standards make possible the exchange of e-mails between different systems such as Gmail or Yahoo mail.

The standards serve as the electronic glue between disparate health record systems, he said. Patient information that VA and Kaiser exchange will include identification and demographic records and allergy and medication data. Levin emphasized that veterans will volunteer to be part of the project.

Levin expects about 1,200 veterans to participate in the project, which will go live in mid-December.