Defense-VA Medical Records Scanning System Not Ready for Prime Time

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VA views system as a 'game-changer.'

The Defense Department plans to deploy by Dec. 31 a bulk scanning system to turn paper medical records into electronic files for transfer to the Veterans Affairs Department, but the system remains “far from ready for prime time,” knowledgeable sources told Nextgov.

The bulk record scanning project is a “game changer” that will allow VA to quickly obtain the medical information it needs to process disability claims, Allison Hickey, VA undersecretary for benefits, told the Senate Veterans’ Affairs Committee in March. The Pentagon transfers medical treatment records for 300,000 discharged personnel annually, with some containing hundreds of pages. Forty percent of records are still in paper form.

Defense plans to adapt its Healthcare Artifacts and Imaging Solution -- originally developed to store, manage and provide access to medical imagery -- to handle the medical records scanning. Department officials were on track to start scanning records in September, based on December 2012 testimony from James Neighbors, director of the Pentagon’s Defense/VA Collaboration Office, before the House Veterans’ Affairs Committee.

A Feb. 22 internal memo from a panel of the Defense/VA Joint Executive Committee provided to Nextgov said the military services will use the new tool to scan paper files into the Defense Armed Forces Longitudinal Technology Application, and then transfer that information to VA’s paperless claims system, which will be configured to capture the incoming files.

“All loose paper medical documentation will be scanned into HAIMS allowing [Veterans Benefits Administration] claims adjudicators direct access to scanned medical data in the HAIMS repository or access to the information via an interface between VBA’s internal systems,” Neighbors said.

A source familiar with the scanning project who declined to be identified told Nextgov that “the connection from HAIMS to AHLTA has been difficult to accomplish [and] a test at Scott Air Force Base [in Illinois] did not go well.” He added that training on the new system has been pushed back to July.

The internal memo said that in order to meet the Dec. 31 bulk scanning deadline, HAIMS requires enhancements to its “Print to PDF” function. Another source questioned the utility of using PDF files, as they can be hard to search for data. Scanning of medical records is “at best an interim solution,” the source said.

This source added that meeting the Dec. 31 deadline for deployment is marred by internal squabbling and turf wars at both the Military Health System and the VA.

The House Veterans’ Affairs Committee also has concerns over funding of the bulk scanning system. In an April 16 letter to Defense Secretary Chuck Hagel, committee members questioned whether the Pentagon has the funds it needs to support the scanning and electronic records transfer process.

“We request that DoD confirm current funding approval, and, if necessary, coordinate with VA and this Congress to forecast and ensure this initiative’s funding needs are met,” committee members wrote. “We note that all concerns regarding funding of this initiative must be resolved promptly and in coordination with VA and this Congress.”

The Feb. 22 internal memo said the bulk record scanning project depends on funding for new personnel and hardware. Defense and VA have not responded to a query on whether or not that funding has been approved. They also did not respond to questions on the deployment schedule of the bulk scanning system and whether it will be ready to meet the Dec. 31 deadline.