Obama Announces Joint Virtual Lifetime Electronic Record

WASHINGTON, April 9, 2009 – President Barack Obama announced plans today to create a joint virtual lifetime electronic record that will improve care and services to transitioning veterans by smoothing the flow of medical records between the Defense and Veterans Affairs departments.

The concept, long advocated by officials in both departments, is considered a major step toward improving the delivery of care and services to servicemembers transitioning from military to civilian life.

Defense Secretary Robert M. Gates and Veterans Affairs Secretary Eric K. Shinseki flanked the president as described the initiative to an audience of wounded warriors, veterans and veterans service organization leaders.

“When a member of the armed forces separates from the military, he or she will no longer have to walk paperwork from a [Defense Department] duty station to a local VA health center,” Obama explained. “Their electronic records will transition along with them and remain with them forever.”

No comprehensive system is currently in place to streamline the transition of health records between the two departments, the president noted. “And that results in extraordinary hardship for an awful lot of veterans who end up finding their records lost [or] unable to get their benefits processed in a timely fashion,” he said.

Obama said he’s heard countless stories over the years about veterans who found it almost impossible to get the benefits they had earned – even when their disabilities and needs were clearly evident.

“That's why I'm asking both departments to work together to define and build a seamless system of integration,” he said.

Ultimately, the new system will include both administrative and medical information from the day recruits enter military service, throughout their military careers, and after they retire or leave the military.

“This would represent a huge step toward modernizing the way health care is delivered and benefits are administered for our nation's veterans,” Obama said. “It would cut through red tape and reduce the number of administrative mistakes.”

In addition, it would enable VA sites to access veterans’ complete military medical records, within rigorous privacy and security protections, so VA staffs have the information they need to deliver high-quality care, Obama said.

The president recognized the debt the country owes its servicemembers and veterans.

“We have a sacred trust with those who wear the uniform of the United States of America,” he said. “It's a commitment that begins in enlistment, and it must never end.” But for too long, the United States has fallen short of that commitment, he added.

“Too many wounded warriors go without the care that they need,” he said. “Too many veterans don't receive the support that they've earned. Too many who once wore our nation's uniform now sleep in our nation's streets.

“It's time to change all that,” he continued. “It's time to give our veterans a 21st-century VA.”

Officials call access to electronic records essential to modern health-care delivery and the paperless administration of benefits. It provides a framework to ensure all health-care providers have all the information they need to deliver high-quality health care, while reducing medical errors, they said.

The joint virtual lifetime record will take the next leap to delivering seamless, high-quality care while serving as a national model, officials said.

“As I look out in the audience, especially seeing these folks in their uniforms, I am reminded of the fact that we have the best fighting force in world history,” he said. “And the reason we do is because of all of you. And so I'm very grateful for what you've done to protect and serve this country.”

Related Sites: Department of Veterans Affairs Related Articles: Shinseki Aims to Ensure Seamless Transition Uniform Registration Process to Promote Seamless Military-to-Veteran Transition

Note: The following text is a quote:

http://www.defenselink.mil//news/newsarticle.aspx?id=55490

News
American Forces Press Service
DoD, VA Work to Create Lifetime Electronic Records

By Navy Lt. Jennifer Cragg
Special to American Forces Press Service

WASHINGTON, Aug. 14, 2009 – For servicemembers who still remember hand-carrying their medical records back and forth to appointments, the new virtual lifetime electronic record will help prevent misplaced paperwork and help providers maintain and offer quality health care, the acting director of the program said.

President Barack Obama, along with Defense Secretary Robert M. Gates and Veterans Affairs Secretary Eric Shinseki, announced April 9 that VA and the Defense Department have taken steps toward creating a joint virtual lifetime electronic record, or VLER.

“The president’s vision, as he expressed that day, will permit information vital to health care, benefits and services to be available seamlessly to both departments from the moment a servicemember enters the military until the servicemember’s or veteran’s death,” Navy Rear Adm. Gregory A. Timberlake, acting director of the Defense Department-VA Interagency Program Office, said yesterday in a “DotMilDocs” interview on Pentagon Web Radio.

The steps to create the electronic record exchange began a little more than a year ago when the program office was established as the single point of accountability for the records in response to Section 1635 of the National Defense Authorization Act for fiscal 2008.

“VLER will serve as a model for a nation, especially at this tumultuous time of health care reform, and is intended to be a lifetime, personal record for use by the servicemembers, their families and service providers to ensure a seamless continuum of care and benefits,” Timberlake said.

“The president challenged the departments to work together to define and build a seamless system of integration with one simple goal: when a servicemember separates from the military, he or she will no longer have to walk paper records from a [Defense Department] duty station to a local VA health center,” the admiral said. “Their electronic records will transition along with them and remain with them forever.”

While the electronic record will help to reduce the loss of hard-copy health records, it also is intended to provide a framework to ensure that health care providers have all the information they need to deliver high-quality health care, while reducing medical errors. The electronic record is a critical piece of the health care puzzle because, while the Defense Department and VA can share information electronically, it may not be easily accessible by private clinicians, Timberlake said.

“A significant amount of health care provided to [the Defense Department] and VA beneficiaries occurs by private-sector providers,” he said. “So, we need the ability to make health records available to the providers who need it, regardless if they are a military, VA, or doctor within the public community.”

Numerous, ongoing data-sharing activities are continuing among agencies that share information and are committed to improving health care to “servicemen and women of the present, past and future,” Timberlake said.

“Every day, millions of pieces of health information are shared between [the Defense Department] and VA; however, as Congress mandated and as the departments have acknowledged, there is more work to do to make it flow smoother,” he said.

(Navy Lt. Jennifer Cragg is assigned to Defense Media Activity’s Emerging Media Directorate.)

Related Sites:
“Dot Mil Docs” on Pentagon Web Radio
Related Articles:
Obama: VA Outreach Aims at Seamless Transition

NOTE The following text is a quote:

http://www.defense.gov//News/NewsArticle.aspx?ID=59610

Departments Cooperate on Electronic Health Records

By Army Sgt. 1st Class Michael J. Carden
American Forces Press Service

ARLINGTON, Va., June 14, 2010 – The nation may never become entirely “paperless” in the way it documents patient medical records, but the military and veterans health care communities are on the right path and have the technologies in place to one day be very close, officials said last week.

“There was a time that we didn’t have anything really electronic,” Army Maj. Frank Tucker, a physician’s assistant and chief systems architect for the Military Health Systems’ Joint Medical Information System, said at a June 11 electronic health records open house held here. “But we’ve evolved from there with 100 percent deployment of our outpatient electronic records … [and] are now on a path toward completing [inpatient electronic records] deployment.”

Tucker was part of a panel at the event that discussed advances and plans the Defense and Veterans Affairs departments have in electronic health records. The open house featured some of the latest tools the military uses to digitally input and track troops’ medical information.

First responders on the ground in Afghanistan now have the capability to process troop health information from the heat of battle to a theater-level hospital in real time. Data can be exchanged and updated all the way up the chain to regional facilities, such as Landstuhl Regional Medical Center in Germany, and to Walter Reed Army Medical Center in Washington, D.C., before troops arrive for treatment.

The military first deployed what it considered basic electronic health care records in 1996 under the Composite Health Care System, or CHCS. Everything from laboratory blood work, prescription medications, X-rays and appointment scheduling were available for outpatient documentation.
Through technologies such as the Armed Forces Health Longitudinal Technology system, also known as AHTLA, and CHCS before that, the military relied on paper files to document patient records. Troops injured in battle were transported with their hard-copy medical records, which sometimes were outdated. That method often left health care providers with many unanswered questions as troops transitioned through different levels of care, Tucker explained.

Troops severely injured in Iraq, for example, transition to several facilities during their treatment and recovery. Injured troops likely are seen at their unit aid station, then at a field hospital and moved to a larger facility, such as in Landstuhl. Servicemembers then could move to Walter Reed, and then would transition to the VA health care system if they separate from the military.

It can be difficult, Tucker said, to keep a perfect record of every laboratory result — including prescriptions and treatments servicemembers receive when they’re injured — by the time they’re seen at a VA hospital. Such shortfalls could delay the care and benefits process, he explained.

But today, the VA health system receives only electronic records for servicemembers from the Defense Department, Dr. Ross Fletcher, chief of staff for the VA Medical Center in Washington, D.C., said.

Because of the technologies and integrated electronic records system the Defense Department and VA share, Fletcher said, the VA will never again file paper records. He explained that some electronic documents he sees may be scanned from paper files, but they’re electronic by the time they’re passed to VA.

The shared system is much easier and quicker for his staff to help provide the best possible service for veterans, he said. And because of this capability, he added, the two organizations are “very close” to becoming completely paperless.

“I think we’re very close,” he said. “If I see a record on a wounded warrior in the imaging system, I see everything that the [previous military] doctor saw. As long as I’m seeing everything that doctor saw, that’s a very complete record for me.

“As it moves on and becomes electronic to begin with,” he continued, “it’s faster, much easier to make care happen. I can look things up a lot easier. Electronic health records we use are great now, but it will probably be much better in 10 years as we evolve.”

But a number of factors prevent the departments from becoming completely paperless, several panelists explained.

On the federal government side, Tucker cited growing fields of study, such as traumatic brain injury, and evolving missions troops take on, such as humanitarian assistance, that are difficult for federal health care providers to anticipate. It’s a matter of updating software and deploying systems for medical personnel, he said.

This mostly occurs when documenting inpatient care, he said, adding that military providers also are required to document detainee patient records.
“We still have some gaps; we are still finding those gaps as medicine evolves,” Tucker said. “As those gaps turn into requirements, we will provide capabilities to document, electronically, those shortfalls.”

In the civilian sector, only 11 percent of medical facilities use electronic records, and of those, their system standards vary from those the military and VA use. So the roughly 50 percent of military members, veterans and their families who seek care outside the military and VA systems are unlikely to benefit from the technology, Army Col. Claude Hines Jr. said.

“The problem within the health care sector today is the standards within the nation,” said Hines, the deputy program executive officer of innovations and delivery for the Joint Medical Information Systems. “[The Defense Department] and VA are sharing data based upon standards we created together. The nation wants to move to a national standard. Regardless of what the system is, as long as we follow the national standard, we should be able to share that data.

“Also, when the doctor looks at that data, he has the assurance that it is correct, and the integrity of that data is maintained,” Hines added.

Hines also pointed out that unless those seeking care in the private sector physically bring their records to the military or VA, it’s likely that data goes unnoticed and documented. However, initiatives are under way within the Defense Department to scan such records into their systems, he said.
Ultimately, the long-term intent is for all health records to be shared, Tucker said, adding that troops shouldn’t be hindered with trying to provide proof of their conditions or injuries. The goal is that their health information be provided seamlessly without delay, he said.

“Certainly, there are a number of improvements in information we’d like to see that are shared between both departments [and the civilian sector] that doesn’t impede care and that doesn’t impede our ability to determine benefits,” Tucker said. “We do believe, as we move forward and get these other pieces electronically shared with standards, it will provide greater value to the overall community.”

Related Sites:
Military Health System
Defense Health Information Management System
Department of Veterans Affairs

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