Diagnosing and treating patients with incomplete information is often a reality in medicine, but officials at the Department of Veterans Affairs are working to fill those gaps by exchanging information electronically with clinicians outside the VA system.
As part of a pilot program launched in 2009, physicians at the VA and Kaiser Permanente in San Diego have been exchanging data on problem lists, medications, and allergies. It can take weeks for patients to submit requests to get paper records and then bring those to another physician, but the project allows electronic information to be transmitted in seconds.
“The net effect is clearly an improvement in quality, an increase in patient safety, and a tremendous improvement in the efficiency of how we share information and how we deliver the best possible care,” said Dr. John Mattison, chief medical information officer for Kaiser Permanente Southern California.
The pilot involves about 450 veterans who receive their health care at both the VA and Kaiser Permanente in San Diego, and who have agreed to allow their records to be shared. In the future, VA officials want to expand the pilot to include veterans around the country by partnering with other private health care institutions.
In the first quarter of 2010, the Department of Defense will join the pilot in San Diego and begin exchanging patient data with Kaiser Permanente.
This information exchange is especially important for veterans, said Dr. Stephen Ondra, a senior policy adviser for health affairs at the VA. Three-fourths of veterans receive a portion of their care in the private sector, he said, so VA physicians can't provide the best care unless they are able to see the types of treatments and medications patients are getting outside the system. Even though the VA and DOD have been leaders in exchanging information for years, the missing link has been information on care provided in the private sector, Dr. Ondra said.
The pilot relies on standards developed as part of the Nationwide Health Information Network. Using these national standards, clinicians can send electronic patient data securely and privately. The Web-based exchange required patients to opt in at both sites of care. “While this is a major milestone along the way, there is much work ahead of us,” Dr. Mattison said.
—Mary Ellen Schneider