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Joint Interoperability Initiative of the Department of Veterans Affairs & Department of Defense. Lemuel Dizon Northwestern University HIT 405 Interoperability, Standards and Integration. Vision. Department of Defense (DoD) Military Health System (MHS) Armed Forces Health Longitudinal
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Joint Interoperability Initiative of the Department of Veterans Affairs & Department of Defense Lemuel Dizon Northwestern University HIT 405 Interoperability, Standards and Integration
Vision Department of Defense (DoD) Military Health System (MHS) Armed Forces Health Longitudinal Application AHLTA Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Veterans Health Information System and Technology Architecture VistA AHLTA VistA Interoperability Share Health Data
Scope of the Problem Congressional Mandate – NDAA 2008 Deadline –September 2009 Strengths Limitations Capabilities
Medication, Pharmacy, Laboratory, Nursing, Diagnostics, Dietary VistA ArchitectureApplication View CPOE Clinical Notes VI Viewer CPRS Health Data Repository BCMA VistA Imaging
VistA Architecture Computerized Patient Record System (CPRS) Computerized Order Entry (CPOE) Bar Code Medication Administration (BCMA) VistA Imaging -image management system -multimedia data -DICOM, PACS -EKG’s, pathology images, gastroenterology(endoscopic) images, laparoscopic images, scanned paperwork
Consult Tracking, Order Entry, Lexicon, DEERS, Security, MPI/MPL, Immunization Architecture AHLTASystem View AP Interface Application Platform Entity EE Interface People, Information Interchange, Communication
AHLTA Architecture Application Software Entities -Consult Tracking -Order Entry -Lexicon -Immunizations -Defense Enrollment and Eligibility Reporting System -Security -Master Patient Index/Master Patient Locator
AHLTA Architecture Application Program Interface Application Platform Entity External Environment Interface External Environment -People -Information Interchange -Communication
Standards MUMPS Massachusetts General Hospital Utility Multi-Programming System -healthcare -hierarchical database -ANSI standards X11.1-1995 -ISO standard 11756-1992 -ISO/IEC 11756-1999 language standard -ISO/IEC 15851-1999 Open MUMPS Interconnect -ISO/IEC 15852-1999 MUMPS Windowing Application Programmers Interface
Standards VistA EMRs communicates Continuity of Care Record (CCR) Continuity of Care Document (CCD) Bi-directional HL7 messages Mirth open source
Integration Issues Interoperability Architecture Development Programming Language Shared Standard CCR/CCD Legacy Systems of VistA Large Scale Project
Analysis System Architecture Not Developed Project Management Structure Not in Placed Project Management Plan Lacking
Recommendation Architecture for an electronic interface Select a Lead Entity Project Management Organization (PMO)
Conclusion & Implication Expectations: Falls short Valuable Lessons: Success Vs. Failure NHIE