Interoperability And Va Nat Data Centers
- 1. 21st Century Healthcare Role of VA National Data Center Program in Shaping the Future of the Medical Internet
- 2. The Five Information System Ages of Patient Care Age Period Information System Hospital Care 1950’s – 1960’s paper Ambulatory Care 1970’s Paper Primary Care 1980’s Paper and Computer Managed Care 1990’s Computer Home Care 21st century Computer, personal health devices
- 3. VA Information System Age VA is in the 4th stage (Managed Care) Extensive use of electronic medical record Extensive use of physician order entry VA working on transition to 5th stage (Home Care) Emerging networks for telemedicine Emerging networks for home telehealth Infrastructure changes will be required National data centers will play central role in transition Systems Engineering and Information Protection need to be considered
- 4. Ages of Integration Stage Name # Elements Description 0 None 1 Stand alone systems (Lab) 1 Interfaced 10 Linked w/ interface (Lab, X-ray…) X- 2 Integrated 100 System framework (one center) 3 Large-Scale 1000 Large- Regional network (hospital with clinics) 4 Very Large 10,000 Multiple health networks Scale (VA, DOD…) 5 Global 100,000+ “Medical Internet”
- 5. VA Age of Integration VA in Stage 3 (large scale) Regional networks (VISN and Region) VA in transition to Stage 4 (very large scale) Connectivity with DOD VA participation in Stage 5 (medical intranet) Will require data exchange with Regional Health Information organizations in private sector VA will be leader in transition with all Federal Medicine organizations (Public Health Service, Indian Health Service, CDC, FDA, etc) National Data Centers will play central role in integration and transition to Stage 5 Systems Engineering and Information Protection need to be considered
- 6. RDP To-Be Vision To- ONE-VA RDP END-STATE Becoming the “Gold Standard” VISN Location • Establish four national data REGION 1 REGION 2 RDC Location processing centers serving the VA business needs REGION 4 23 1 • Build In COOP/ Disaster Recovery 20 12 11 2 19 21 10 4 • Build Standardization in IT 15 3 Business Structure, Process Guam 5 and Technology 9 6 21 22 18 16 • Build Tiered Network/Security 7 Management Framework Philippines 21 REGION 3 17 • Become “Gold Standard” not only in IT Security, but also in Alaska 20 Hawaii 8 Achieving Efficiencies 21 Puerto Rico 8 • Framework for interoperability in national health information networks
- 7. Present: Today’s VA VHA Vision Statement To be a patient centered integrated health care organization for veterans providing excellence in health care, research, and education; an organization where people choose to work; an active community partner and a back-up for national emergencies
- 8. VA Strategic Plan IT is Required tool Cutting edge technology and information systems Information sharing between VHA and VBA, DoD, other federal agencies, and other providers Integration of systems to improve information sharing and business processes Implementation of IT security measures Timely access to data for decision making
- 9. Interoperability1 Level 1: non-electronic data non- Mail, telephone Level 2: machine transportable data Fax, scanned documents, PDF formats Level 3: machine organized data Structured messages but non-standardized data non- Level 4: machine interpretable data Structured messages with standardized data 1. Walker et al, The Value of Health Care Information Exchange and Interoperability. Health Affairs. Web Exclusive, Jan 19, 2005
- 10. DoD/VA Interagency Initiatives Level II Level III Level IV Bidirectional CHDR Interface FHIE Health Information Exchange (BHIE) •One-way •Bi-directional •Bi-directional •Not real-time access •Real-time access •Enterprise exchange •Text data •Text data •Real-time access •Computable data Path to Interoperability
- 11. Veterans Health Information Exchange Formative Stage = business = technical How we see the future National Health Info Network RHIO RHIO VA VA
- 12. Interoperability End State VA information will be bi-directional and bi- real time with Private sector Regional Health Information Organizations Infrastructure of NDCP will promote safe and secure data sharing with RHIOs Facilitating information exchange from NDCP will be easier than facilitating from 128 separate databases.