Next Step in DOD-VA Health Records Sharing: Doctors’ Scribbles and Other ‘Unstructured’ Data

Oleksiy Mark/

One of the most important aspects of DOD’s future electronic health records system is its ability to pull in and display unstructured data in raw text from electronic health records.

The Defense Department announced to Congress last week it’s met stringent health records interoperability standards with the Department of Veterans Affairs.

VA should meet the same standards within a few months. That's important news for close to 20 million active duty and veteran beneficiaries on both respective health systems.

The skinny is this: Almost 30,000 clinicians and benefits analysts across both systems can use a Web-based tool called the Joint Legacy Viewer to pull patient data in real-time from close to 300 databases maintained by DOD and VA. That means a clinician seeing a veteran for the first time has access to his or her longitudinal health record – including tours of duty while serving, health summaries, technical medical data and an abundance of other data sets.

That alone is a significant improvement from as recently as five years ago, according to Chris Miller, program executive officer for DOD’s Healthcare Management Systems Modernization office.

In the near future, Miller hopes JLV, DOD’s future electronic health records system and other tools eliminate the need for veterans to have to carry around printed copies of their health records when they visit different facilities. It should also improve the quality of care for active duty personnel or veterans, providing clinicians instant access to reliable data without having to wait, for example, for hard copies of records in the mail.

One of the most important innovations, though, is JLV’s ability to pull in and display unstructured data in raw text from electronic health records.

According to various reports, unstructured data comprises as much as three-quarters of the data contained in a health record, including doctor’s notes and symptom descriptions.

In a demonstration for reporters last week, Brian Jones, user integration physician lead at DHA, showed how the system retrieves doctors' scribblings. Notes jotted down by various doctors during several years’ worth of visits were available with the click of a button. Before the JLV -- and DOD and VA’s improved interoperability -- those kinds of unstructured data sets weren’t available so easily and might require a series of phone calls, faxes, emails or mailings.

A user can view “how the doctor thinks of you and put together a story,” Jones said. “The rest of the story comes in the unstructured data. The intent of the system is to take as much data as we can from both instances and provide the best, most seamless care.”

Given health IT’s rapid rise of importance in recent years, expect DOD and VA to continue exploring ways in which to use this new plethora of unstructured data, including the use of analytics on top of health records systems.

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