Bidirectional Health Information Exchange (BHIE)

24 April 2007 1300 EDT

IHS Briefing

Mr. Greg W. Donham

Draft

DRAFT 2

Interagency Briefing Agenda

Overview of BHIE

Architectural Approach of BHIE

BHIE Deployment and Statistics

CHDR and the Future of Interoperability

DRAFT 3

Steps to interoperability

Federal Health Information Exchange (FHIE), provides clinicians at all Veterans Health Administration facilities with the capability to access DoD health information on separated and retired members of the Uniformed Services.

Bidirectional Health Information Exchange (BHIE): BHIE permits DoD military treatment facilities to share clinical data capable of computational actions with any VA medical center when a shared patient presents for care.

Clinical Data Repository/Health Data Repository (CHDR) enables the VA’s Health Data Repository (HDR) and the DoD’s Clinical Data Repository (CDR) to share outpatient pharmacy and drug allergy information for Active Dual Consumer (ADC) patients.

DRAFT 4

DoD/VA BHIE Project : NDAA Funded

The goal of BHIE is to improve the service to provide outstanding health care to our Veterans by:

Providing a more complete electronic text and image record of patient care over time Providing timely and accurate clinical information to the health care provider and patients Displaying and, if possible, avoiding the duplication of medical tests Providing a more complete record of external care for VA patients

DRAFT 5

Interoperability Goals

Provide the best healthcare possible to the U.S. Military and our veterans

Operate a joint system for initial one-way transfer of electronic health information from DoD to VA that contributes to veterans’ health

Provide on-demand electronic health information to assist in the compensation process

Ensure compliance with HIPAA regulations and security requirements with existing systems

Create an environment for storing very sensitive information

Use a patient-focused information technology familiar to authorized VA and DoD users

DRAFT 6

DoD

CHCSSharingFacility

CHCS CHCS

MHSData Repository

FHIE/BHIE Framework

FHIE/BHIEFramework

FHIE Repository

HL7

PDTS

SADR

K61

Pre/Post

PDHRA

VA MPI

VistA VA Host

(Station 200) VistA LocalVAMC

VA

-Correlation of Patient Identity

-Information Locator

-Security

-Optimization

-Adapter/Connector

CPRS

High-Level FHIE/BHIE Architectural ComponentsHigh-Level FHIE/BHIE Architectural Components

RDV & VistAWeb

Query Access

VistALink

PIDS/ Correlation

DoDWeb Server

DoD GUI

CACHE’

VitriaIE

HL7/ADTWS/XML

HL7/ADT

WS/XML

DMSS

CIS

DRAFT 7

BHIE Capabilities

BHIE delivers Patient Identification Correlation and real time bidirectional transmittal and display of:

Outpatient Pharmacy; Drug and Food Allergy; Surgical Pathology Reports; Cytology Results; Radiology Text Reports; Microbiology Results; Chemistry & Hematology Results; Laboratory Orders CliniComp/Essentris Emergency Department Notes and

Discharge Summaries Medical Images (as of 3 May 2007)

DRAFT 8

BHIE Implementations

Madigan AMC - Oct 04* William Beaumont AMC - Feb 05 Dwight D. Eisenhower AMC - Sep 05 Naval Hospital Great Lakes - 14 Sep 05 NMC, San Diego – Balboa - 21 Sep 05 National Capital Area - 14 Nov 05 Mike O'Callaghan Federal Hospital - 30 Nov 05 Landstuhl Regional MC, Germany - 20 Mar 06 Tripler Army Medical Center - 05 Apr 06* Womack Army Medical Center - 26 Apr 06* David Grant Medical Center - 18 Apr 06 Wilford Hall Medical Center - 10 May 06

* BHIE-CIS Implemented

Brooke Army Medical Center – 10 May 06 * Bassett Army Community Hospital - 26 May 06 NH Jacksonville – 7 Jul 06 NH Charleston – 1 Aug 06 NH Pensacola – 3 Aug 06 NH Camp Lejeune – 11 Sep 06 NACC Groton – 16 Sep 06 NH Lemoore – 27 Sep 06 NMC Portsmouth – 27 Sep 06 Leonard Wood ACH – 12 Mar 07 Darnall AMC – 27 Mar 07 Fox Army Health Clinic – 3 Apr 07 Martin Army Community Hospital – 4 Apr 07

Interagency installation and training completed at:

DRAFT 9

BHIE Sites: Current and Pending

BHIE operational

BHIE implementations planned during FY2007

NCA

LRMC

Mike O’Callaghan Federal Hospital

David Grant MC

Bassett ACH

Elmendorf AFB

Madigan AMC

NHC Great Lakes

Eisenhower AMC

NHC Charleston

25 DoD host sites = 15 DoD Medical Centers, 18 DoD Hospitals & over 190 DoD Clinics

(Access to over 2.1 Million correlated patients)

Tripler AMC

William Beaumont AMC

NMC San Diego

NH Camp Pendleton NH Camp Lejeune

Womack AMC

NH Pensacola

Darnall AMCMacDill AFB

NH Jacksonville

NACC Groton

NH Corpus Christi

Wright-Patterson AFB

Martin ACH

NH Lemoore

NMC Portsmouth

Minot AFB

BHIE-CIS operational

Leonard Wood ACH

Fox AHC

Kirtland AFB

Brooke AMCWilford Hall

Evans ACH

DRAFT 10

Questions