David Shulkin, MD, the new Secretary of Veterans Affairs, would like to see his agency’s information technology needs met by commercial-off-the-shelf software. However, whether that transformation will result in the VA replacing its legacy electronic health record system with a commercial EHR is a decision that Shulkin needs more time to consider.
During a March 7 House Veterans’ Affairs Committee hearing, Shulkin told lawmakers that he’s come to the conclusion that the VA internally “building its own software products and doing its own software development” is not the path forward for agency. While Shulkin did not mention the VA’s decades-old Veterans Health Information Systems and Technology Architecture (VistA) by name, he seemed to hint that the agency would be replacing its legacy EHR with a commercial system.
“The Department of Veterans Affairs is seeking to move to commercial solutions to the greatest extent possible,” according to a VA statement in response to a query from Health Data Management.
“As mentioned in public statements, [Secretary of Veterans Affairs] is committed to a decision on the COTS vs. VistA upgrade by July 1, 2017. The time leading up to July will be required to do a full assessment of the options in the context of the Digital Health Platform and work that is still required to make an informed decision.”
Confirmed as VA secretary by the Senate on February 13, Shulkin has wasted no time in trying to establish a “change in direction” at the agency when it comes to IT.
The VA is currently finalizing plans for how to implement a cloud-based Digital Health Platform (DHP), designed to integrate veteran data from agency, military and commercial EHRs—as well as apps, devices and wearables—so that the information is available to providers in real time. As such, DHP is envisioned as the future path for providing next-generation healthcare to millions of the country’s veterans.
In a DHP proof-of-concept conducted last September and October, the Georgia Institute of Technology successfully demonstrated mature and emerging interoperability technologies from both the public and private sectors.
As part of the proof-of-concept, 21 system application programming interfaces were created to control how specific types of data flow into and out of the DHP, which included data exchanges with a Cerner EHR (representing the Department of Defense and a community hospital), Epic EHR (Duke University Medical Center) as an academic medical provider.
By leveraging HL7’s emerging Fast Healthcare Interoperability Resources (FHIR) standard, the public-private collaboration built an API gateway around the VA’s VistA EHR system, which was accessible via open-source interoperable API gateway connections. DHP’s API-based architecture is not tied to any proprietary systems opening up the possibilities of connecting to a robust portfolio of interoperable web services, apps, devices or EHRs that leverage FHIR and other open APIs.
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