VA and DoD Hint at iEHR Mobile?

6-26-2013 10-19-47 PM

Department of Defense and Veterans Affairs have announced that they will begin working on a mobile app that will integrate data from the electronic health records of both departments and combine them into a single mobile platform for clinicians. This is a significant announcement as it follows a failed $12 billion attempt at creating a truly integrated single electronic health record, called iEHR, that was to be used to deliver care across both environments.

In February, representatives from both the VA and DoD announced that they would be halting the iEHR program, which had been funded to deliver the single, integrated health record to better serve both active soldiers and retired veterans. Shortly after the announcement, VA CIO Roger Baker and CTO Peter Levin stepped down from their positions. At the same time, the DoD issued a RFI for a commercial EHR system that would replace its aging legacy system. These events left no room for doubt that the fundamental goals of the iEHR program had been abandoned.

The response from both Congress and the public was immediately voiced. VA and DoD officials were called before Congress to testify on the change in plans. Intense pressure was put on both agencies to redouble their efforts and deliver on their original promises.

In response, the RFI issued by the DoD was suspended while defense officials evaluated whether they could simply adopt the VA’s Vista EHR, a step experts called an ideal plan B. By April, it became clear that the DoD would not simply adopt Vista and instead a broad and disappointing promise was made to deliver a solution that in some way mirrored the original goals of the iEHR project. At the time, no details were given as to how or when this would be accomplished. As plans emerge, it appears that mHealth will hold a central role in the highly anticipated solution.

“We are doing work with the IPO on a VA-DoD mobile app that will be able to pull data from both DoD and VA and display it on a mobile application as well as our mobile application environment." – Kathleen Frisbee, director of web and mobile solutions at VA.

The VA have always been leaders in mobile health technologies. With more than 20 mobile health apps already in use and an experienced staff of health IT agile developers on staff, they are in good position to lead the development of an integrated clinical app. To start, the VA has created a centralized, shared development sandbox for the DoD and VA to work together from. The framework put in place helps ensure that joint-developed apps meet strict quality, usability, privacy, and security standards.

"This is huge, because instead of coming in after the fact and saying, okay you guys need to collaborate. We’re building the foundation that ensures good collaboration because we’re building in the same space," said Frisbee.

With a shared core infrastructure in place, developers from both departments can now begin the work of developing an ecosystem of integrated health apps to address the original goals of the iEHR project. While how much of that original promise will be delivered on, it’s clear that the VA and DoD are putting a great deal of stock in the future of mHealth and the role it will hold in the delivery and coordination of healthcare in complex care environments.

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