Electronic Health Records Modernization Improving Federal Health Care Delivery

The departments of Veterans Affairs and Defense joint electronic health records modernization (EHRM) initiative has shown considerable promise for widely improving the delivery of health care and allowing clinicians to provide more effective lifelong treatment to patients.

Speaking at the 2021 ACT-IAC Health Innovation Summit, representatives from VA and Defense Health Agency Federal Electronic Health Records Modernization Office (FEHRM) discussed how this ongoing consolidation process has paid off for caregivers and practitioners across both DOD and VA.

One of the primary benefits of this consolidated EHRM push has been the facilitation of data sharing and access for health care research, an outcome that has bolstered the considerable scope of initiatives ongoing across both VA and DOD.

“One of the benefits is actually having real data that doesn’t have to constantly be moved and modified. If anyone’s done research before, once you’ve touched the data you potentially break all the research that was done on that data, so you have to be very careful to keep it all normalized,” said John Short, chief technology and integration officer at the VA Office of Electronic Health Record Modernization.

“Actually having one system where all the data was measured the exact same way, recorded in the same way, stored in the same way, allows the researcher to have more pristine data. Having that actual data all recorded in the same manner allows researchers to have better value based outcomes, and to be able to actually say for sure, without any doubt, that the outcome they derived and analyzed is 100% accurate, as opposed to having variable errors pop in when you have to move data around and change it.”

The ongoing investment in consolidating health records and medical information has also shown promise for improving the delivery of care, especially as a continuous process from enlistment to retirement age for America’s service members.

“Eventually you’ll have a soldier, sailor, Marine or veteran beneficiary who can go press a button, look at their portal and see this full record. Whether it’s that individual looking at the record, or whether it’s somebody in the community, they’ll be able to look at that long service record. They’ll have this full record available to them whether they’re doing immediate care, whether they’re managing chronic disease, or whether they’re doing research. We’ve migrated all that data, and we think there has been great value in doing that,” Short said.

This convergence of health records and IT management has also paid dividends for making the DOD and VA’s health systems more responsive to unforeseen shocks and in standardizing cybersecurity best practices.

“It was telling what the DOD experienced as the pandemic rolled across the country,” said Bill Tinston, director of the DOD’s FEHRM Office. “We had to respond as a health care system differently since there were new demands. You need to be able to change processes, workflows, procedures, and be able to order new tests like COVID tests all of a sudden. It was a very small installation base at that point, but what we found was that [sites with EHRM] were responsive in ways that they couldn’t have imagined before because it was a single-network delivered set of capabilities. They could make these changes once and have it applied across the entire enterprise.”

The consolidation of health records within a single platform has also brought together information security experts from both VA and DOD to share their particular concerns and find ways of managing these within a single enterprise — ultimately bolstering federal cyber posture.

“Having the operators of the health care system be involved in the evaluation is balancing cybersecurity and performance. And you can’t do it with only one perspective. It’s a multidisciplinary effort, and you have to have all the disciplines at the table, and everyone has to be able to throw their flag and say, ‘I’m really worried about this,’ and have all of those people working together. From a cyber perspective, it is very effective,” Tinston said.