New Hampshire HIE links to VA to serve veterans

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The New Hampshire Health Information Organization (NHHIO), which operates a statewide health information exchange, recently established a connection with the Veterans Administration to enable hospitals and other provider organizations to get additional health information about vets they are treating.

Veterans often do not get all their healthcare through the VA, and other providers typically have had to rely on paper-based methods when dealing with VA, says Jeff Loughlin, a veteran and executive director of NHHIO.

Thus, an electronic connection will speed and improve the quality of care, he believes. “This connection helps to remove some of the barriers in communication and care that veterans face on a daily basis.”

The initiative was launched after an outreach coordinator at the Manchester VA contacted Loughlin and they worked to enable an electronic exchange of information. To accomplish their mission, they needed to establish and sign multiple agreements—the project uses the Direct Protocol secure messaging standard for exchange of health information, and VA, which was not using Direct, needed agreements written and signed to ensure participants follow certain processes of the VA.

Most states connected to VA use a shared data repository to exchange information; New Hampshire is one of a handful of states that has moved to the Direct Protocol, Loughlin says.

Because electronic communication only started two weeks ago, it is difficult to assess progress thus far. Orion Health is the vendor providing Direct services. Two other VA offices in New Hampshire are getting ready to enable providers in their regions to exchange data electronically with the VA.

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Along with the connections will come educational initiatives to explain to providers the benefits of electronic connectivity with VA and workflow changes they’ll need to make. The benefits include improved patient safety and data security, and putting information in providers’ hands quicker, while no longer relying on faxes.

One reason the connectivity came together was because the timing was right, Loughlin explains. Linking with VA was not a priority because providers were focused on achieving meaningful use of electronic health records, and VA wasn’t ready for Direct during that period, anyway. With meaningful use winding down, VA’s outreach to Manchester was the impetus to get Direct secure messing rolling, with help from a Manchester VA board member who was a veteran and served as a patient advocate.

Providers will have the option of getting PDF files, discrete data elements, a summary of care or a progress note, based on providers’ workflows, the technical ability of their staffs or the capabilities of the providers’ vendors.

Direct connectivity is only one piece of improved sharing of health information in New Hampshire, Loughlin notes, as the industry waits for more advanced capabilities such as the CommonWell, CareQuality and FHIR interoperability initiatives to mature. “There is no single solution, so we are trying to maximize the benefits of all of the solutions,” he adds.

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