First Exchange Between VA, Private Sector Has Smooth Start, Officials Say
A health exchange pilot in San Diego is paving the way for all institutions, large and small, to participate in a nationwide exchange, said officials from the Department of Veterans Affairs and Kaiser Permanente. They spoke about a month into the first “multi-party exchange” (WID Nov 27 p2), which should also include the Department of Defense within the next few months. The two health care institutions are exchanging basic data -- problem lists, allergies and medications -- using the Nationwide Health Information Network (NHIN) protocols. The VA invited 1,144 veterans who were already receiving care at both places to participate, and about 40 percent responded, said Tim Cromwell, director of standards and operability at the VA.
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The NHIN standards will allow any health system to exchange data and empower the private sector to develop more choices for consumers, said Stephen Ondra, senior policy adviser for health affairs at the VA. “By linking ourselves to standards we're not tied to any single system,” he said. Speaking of his 25 years as a surgeon, Ondra said, “this is the most exciting moment I've seen in my medical career.”
It’s a relatively simple technical matter to extend the pilot throughout the country, said John Mattison, chief medical information officer for Kaiser Permanente in Southern California. There weren’t any technical surprises, the group said. Because the software is open source, the technical solution is pretty straightforward, said Andrew Wiesenthal, associate executive director of the Permanente Foundation. Ensuring patient privacy is the trickier matter, he said. Mattison said “privacy and security remain at the top of our priority list.” The program is opt-in, and patient consent for exchange must be recorded at both ends before data can be exchanged. Smaller entities that don’t have the technical and legal resources of Kaiser will be able to piggyback on the work Kaiser and the VA have done, officials said. The “gateway” to the NHIN and the “adapter” for conforming data are replicable, which will reduce costs, said Ondra. Further, as health technology gains acceptance, more solutions will become available, he said. In the long run, Wiesenthal said, the exchange problem will be solved for small practices and institutions by the work the larger groups have done.
In addition to adding the Defense Department to the mix, the VA expects additional pilots around the country this year that will include other private sector partners. Officials are also using the San Diego pilot to create an evaluation mechanism, Cromwell said. An outside vendor will look for measurable outcomes to test the common assertion that health IT is beneficial to both the budget and patient health, he said.