President Obama last month called on the Department of Veterans Affairs and
the Department of Defense to create a joint seamless health information
Appearing at a press briefing with Secretary of Defense Robert Gates and
Secretary of Veterans Affairs (VA) Eric Shinseki, the president urged the
creation of a joint virtual lifetime electronic health record. The purpose of
the record is to create a seamless transfer of health records that would
follow an individual from the moment of entry into the military and throughout
his or her lifetime.
"Access to electronic records is essential to modern health care
delivery and the paperless administration of benefits," the president
said in a statement on the White House Web site. "It provides a
framework to ensure that all health care providers have all the information
they need to deliver high-quality health care while reducing medical errors.
The creation of this joint virtual lifetime record by the two organizations
would take the next leap to delivering seamless, high-quality care, and serve
as a model for the nation."
The vision is far from a new one, however, and the complexities of creating
a seamless transfer of data between the two vast information systems are
daunting. But VA psychiatrist Peter Fore, M.D., a member of the APA Committee
on Health Information Technology, said that progress is being made.
"I have heard talk about this for years," he told
Psychiatric News. "The goal of having a seamless transition for
veterans moving from the military into the VA system has been around for some
The VA currently has one of the most comprehensive and sophisticated
systems for electronic medical records. Fore said the goal of the initiative
is not necessarily a matter of creating one unified system, but allowing the
transfer of information between the two systems.
"It's a work in progress," Fore said. "We currently have
access to some of the records. We don't get live data, but we can request
static reports that come over from the [Department of Defense]. Some of the
data have to be standardized in pieces that can move from one system to the
But even matching up identifiers in the two systems to match records of the
same patient can be difficult: if the VA system uses a middle initial, for
instance, and the Department of Defense system doesn't, the records won't
follow the patient. Other obstacles have to do with the architecture of the
two computer systems and the development of common data-exchange points.
But Fore said the goal is a worthy one, and while it is likely to take
time, progress is being made.
"As a psychiatrist, I would like to know the most complete
information about my patient that is available," he said. "If
someone had a first episode of schizophrenia while in the military and was
treated for it, I would much rather have that information available to me than
trying to recreate what happened from the patient's own history."
He added that the goal of the seamless transfer of health information had
even been a part of the VA's strategic plan prior to the president's remarks
in April. The plan calls for the goal to be accomplished by 2011. "It's
already partly working, and I think it is going to be more complete as time
goes on." ▪