My Health e Vet

1. My HealtheVet Supporting research data needs Ken Weingardt, PhD Todd Wagner, PhD December 12, 2008

2. Types of MHV Access • Three-tier model • Open use • Registered Users • In Person Authenticated Users • Except for open use, system logs • All user activity. • Registered & IPA users can enter • And save information.

3. Activity log data The administrative portion of the MHV database or “transaction logs” can be made available for research Transaction logs includes demographic information from registration, logs each “user transaction” such as date/time entered account, how long they spent on the site, which pages they visited. This information can be linked to individual patients in CPRS to examine relationship to health care utilization and patient level outcomes.

4. PHR self-entered information • MHV is a Personal Health Record and NOT a VA record. As such, researchers cannot access: • Patient Self-Entered Information (e.g. vitals, health journal) • Patient CPRS records extract, labs etc • Secure messages to providers • Medical records imported from outside VA • *Unless…

5. MHV Delegation Veterans will soon be able to delegate access to their complete MHV record to family members, caregivers and other interested parties including researchers. Default option is no delegation Researchers doing prospective studies may ask participants to delegate full MHV access prior to randomization

6. Support prospective studies MHV patient record flag in CPRS can be used to target veterans for study recruitment. Preparatory to research (with an approved IRB protocol and a Waiver of HIPAA Compliant Authorization) an HSR&D Investigator doing a prospective study may look at CPRS to identify veterans at her/his facility who have MHV accounts. MHV

7. Support prospective studies • Example: Patient education for HTN • Get local approvals • Identify MHV users with HTN in ViSTA • Obtain informed consent • Obtain delegated access to PHR data • Pull self-entered BP data • Track outcomes • *MHV does not support randomization at this time MHV

8. Support retrospective studies Linkage between MHV transaction log data and CPRS/ VA administrative data would be permissible. Transaction log data includes real SSN, translate to SCRSSN can then match with Austin.

9. MHV will NOT support The administration of online surveys or other data collection efforts through MHV A system allowing veterans to opt-in or opt-out of research during the registration process.

10. MHV Legal documents System of Record – specifies ownership of data and accessiblity Terms & Conditions – specifies contractual relationship between MHV user and VHA. Privacy Policy – specifies how the data will/will not be used. *Documents need to be amended to support research. System of records must be posted for public comment. Terms and Conditions must go through OGC review

11. Research Collaboration next steps discussion

12. Inform Engage Activate My HealtheVet PHR VA EMR • VistA/CPRS is the authoritative VA medical record. • Veteran "owns" his/her My HealtheVet Personal Health Record (PHR). • Veteran will access extracted data sent to My HealtheVet from VA Electronic Medical Record (EMR). • Veteran control of access to information (via delegation). CPRS  VistA BCMA VistA Imaging