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VA to Make National VLER Deployment Decision

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After pilots finish in 2012, will the next step be to link to NwHIN?

Some light was shed on the progress that the Department of Veterans Affairs (VA) has been making on its Virtual Lifetime Electronic Record (VLER) project at a National eHealth Collaborative (NeHC) webinar earlier this week. The VLER project was mandated by President Obama in April 2009 to drive the linking of private sector and veteran data to “contain administrative and medical information from the day an individual enters military service throughout their military career, and after they leave the military."

The VA, which has 153 hospitals and more than 1,300 sites of care, has been working on several interoperability projects and pushing toward nationwide deployment of the VLER, according to Tim Cromwell, VA’s director of standards and interoperability. “In terms of the electronic health record and the use of technology, throughout the country the VA is in a very good position to help develop the interoperability projects that we all need,” he said.

The VA currently has 11 VLER pilots running in 10 states, which include Virginia, Minnesota, New York, California, among others. The VA over the next six months will measure the richness of its database to see if it is robust enough to support Nationwide Health Information Network (NwHIN) deployment, and in July 2012 will make a ‘go’ or ‘no-go’ decision. “We will present data, and our secretary will decide if it’s time to go to a national deployment, meaning that we wouldn’t do pilots and individual health information exchange relationships anymore,” Cromwell said. “We would do a national roll-out and any other member would be able to acquire data on veterans provided they have provided their authorization.” The VA, which has 20,000 veterans providing authorization to data exchange, is behind their September target of 50,000.

When asked how the VA planned to utilize the Direct protocol, Cromwell said that one immediate usage that needs to be addressed is console tracking. He said the VA purchases a lot of specialty services like mammography outside its sites, so information can come back in a variety of formats like a printed report given or mailed to the veteran or via disk. Cromwell said the VA is working on a console tracking app in the VA’s EHR, CPRS (Computerized Patient Record System), which will marry up requests and results. “What we think is there is a way that we can extend the boundaries of console tracking so that the authorization would go through the fee care office and get authorized and the authorization would be pushed out electronically to the fee care provider,” he said. “And they would push back the results to the VA, and eventually it would get back to the place in the software where it needs to go.”