Why Data Standardization in Health IT Interoperability Matters to Veterans and How It Can Be Implemented at the VA

Written by
Amber Werline
Published on
June 6, 2023

Picture this scene – A 46-year-old male veteran has developed a bilateral lower extremity swelling which has unfortunately resulted in large hives. The veteran goes to a non-VA external provider nearby who identifies that the patient has an allergy to a new medication he is on. The external care provider documents the new allergy, assessment, and treatment in their system which then sends a patient summary record, CCD (Continuity Care Document), to the patient’s VA PCP (Primary Care Provider).

Once the VA PCP receives the CCD, the common concern we see is that although the veteran’s new allergy and medication updates have been received by the VA, these updates are NOT automatically incorporated into the VA VistA electronic medical record system. Although the information is available in report form (the CCD), the VA provider isn’t alerted to the allergy and medication changes until they’ve read through the document in the VA’s JLV (Joint Legacy Viewer).

That means, when the veteran follows up with their VA PCP for the medication change, the VA PCP reads through the external CCD and manually enters the new allergy, as well as updates their current medication list, in VA VistA. With this current process we see a potential delay in the data being easily accessible and trackable for the VA providers.  While it’s important that providers still review and validate external data, what we see here is an opportunity for improvement in provider workflow through interoperability.

Interoperability assists with timely access to external data, but the next layer is, how can we effectively and efficiently automate external data into the VA system? By implementing seamless exchange, we are able to provide a timely and more accurate picture of what medical decision making needs to occur for the best patient outcome. The VA’s Electronic Health Record Modernization (EHRM) program is implementing Oracle-Cerner Millennium that solves this external data integration problem through a record reconciliation process.

This is the heart behind why we are experts who are passionately providing the latest technological advancements in health IT interoperability to the VA. The question we continuously ask ourselves is, “How can we assist VA providers with timely access to external data where we are able to better utilize the data to improve the patient’s outcome?”

One example is we can better utilize standards such as FHIR (Fast Healthcare Interoperability Resources), SNOMED (Systematized Nomenclature of Medicine), RxNorm, and LOINC (Logical Observation Identifiers Names and Codes) for standardization of the format and content (i.e. allergies, problems, meds, procedures, labs, etc.) so that the external data can be incorporated in the patient medical records.

It’s through data standardization that the data can then be connected from system-to-system and validated. Using a standard method of exchange (such as FHIR) provides us with the ability to exchange data between health care organizations and agencies within and outside the VA. This in turn allows for more complete and accurate patient data. This data can then be processed within the VA systems and can be assessed for enhancements to VA provider workflows.

Use of FHIR and EHRM system are some of the advancements that help aid in improvement of interoperability between VA and non-VA systems to support patient care.  With each new day there are advances in technology and interoperability to be considered.  Our purpose is to continually identify advancements and implement innovative ways to support the veteran's and the betterment of their care and outcomes.

By: Amber Werline (Systems Analyst at InnoVet Health) 

About Us: 

InnoVet Health is an IT consultant company specializing in AI and business intelligence, digital services, and health interoperability founded by MIT-alumni & informatics experts. Learn more about us on our website or reach out on LinkedIn.

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