DoD and VA still can’t share records
SO here we are, two years after the Defense Department and the Veterans Affairs Department agreed to provide a seamless transition for transitioning service members’ health records between the agencies and they still can’t get the job done. In fact, they estimate it’ll take six more years to complete the project says Leo Shane at Stars & Stripes;
Information technology experts say departmental infighting is hobbling the effort, and question whether the agencies will be able to stick to even the six-year estimate, considering their rocky past.
Veterans groups are frustrated as well, especially with a wave of Iraq and Afghanistan veterans already beginning to seek health care services at VA facilities.
“Every year they talk about a new plan,” said Jacob Gadd, Deputy Director for Health Care at the American Legion. “They just need to pick one that works and move forward already.”
Yeah, how many of you spend that much time picking software? But who is surprised? Certainly not me. At Walter Reed Army Medical Center, the premiere health care facility in the country, the Army can’t share medical records between clinics in the same building, let alone with the DVA.
As I’ve written before, I have complete confidence in the doctors and nurses at Walter Reed, but the administration sucks canal water. I could have two or three appointments on the same day and fill out the same forms for each clinic because there’s no file-sharing network in the hospital.
Now when I retired in 1994, my records were sent by the Army automatically to the VA facility near my home who immediately contacted me and set up appointments for me. What the hell happened between 1994 and now that the two agencies are fighting over interoperability?
I’m sure it’s contractors who are fighting over whose crap they’ll use. Fire ’em! Anyone who is working for the Defense Department and Veterans Affairs and doesn’t put 100% of their efforts towards the welfare of the troops…just send ’em down the road with empty pockets.
Category: Veterans Issues, Veterans' Affairs Department
Neither agency wants to give up their respecitve EHR (electronic health records) and the fat budgets that go with them. The VA is committed to VISTA and the DoD is hooked on ALTHA (CHCS). The joint project in Great Lakes is a fustercluck. They need to scrap both systems in favor of a cradle to grave EHR in a common operating environment (the cloud). Billions of dollars have been pissed away on this and we’re falling behind more every day.
The military and the VA use the VA’s ViSTA system. Same programs, same database. The metadata, taxonomies – the same. There are some different applications, such as when a naval ship is at sea, so it can’t up/download new data.
It’s like you and your neighbor buying the exact same car.
This is about money and power: who owns the database – the giant server farm(s) necessary to host the applications and SM/vet records?
Who will see their bureau grow, and receive promotions in the GS ranks – power: real power, real money – goes to the victor.
They can share data today. Storage, archiving, config management, and so on: all political, all about money and power.
DaveO,
That is not remotely correct. With the exception of a Bidrectional Health Information Exchange (BHIE) at GLAKES, there is no systems relationship between VISTA and ALTHA (CHCS).
They do not share the same server farms, nor is data collected, stored, or managed in the same way.
More information at http://dhims.health.mil/
which happens to be where I work.
Open Channel D sends
Having gone through the VISTA architecture, I doubt CHCS will acquit itself as either unique or worthy of being a stand-alone system of systems. The technical aspects present no issue. The political aspects ensure failure.
The Details again?
Glad you geeks are on our side… now start kicking ass in the next cubicle!
Fact is Jonn is unusually optimistic.
Anyone who is working for the Defense Department and Veterans Affairs and doesn’t put 100% of their efforts towards the welfare of the troops…just send ‘em down the road with empty pockets.
I’ll bet $10 (all I can afford) that as individuals each and every person involved short of the top tiers firmly believe they ARE supporting us.
As a medic let me tell you that the Headache between CHCS and AHTLA (this is just in the DOD mind you) was an utter nightmare. Meds might be entered into one, but did not automatically go to the other, you had to check both, lest you cause a med reaction. (which sadly happened a little too often)
I know pretty much every MedO in pretty much every unit has bemoaned this system. It got so bad that at one point I actually got in on a Great Plains regional AMEDD CSM sensing session. Pretty much EVERY solder there bitched about the systems used. There was acknowledgment, and also an admission that this was something the Surgeon General knew about, but apparently there was no better system to use.
I haven’t a clue what the VA uses, but if its like any other Government agency, it’ll be completly different.
The best advise I can give to anyone, is GET A COPY of your records. Its free, and they HAVE to do it.
I’m a VA Mental Health Care Provider. I have no problem seeing records from veterans who have been seen at other VA facilities. CPRS and the VistaWeb application to look at remote records took some getting used to when I came to the VA, but it’s not that hard to work with. I do wish some of the search features in CPRS could also be used when looking at remote records, but it’s still workable.
What we can see of DOD records is totally variable. With some veterans I have seen actual progress notes from when they were seen through DOD. This includes notes from veterans seen in theater and ones treated at Landstuhl, Walter Reed, Naval Medical Center San Diego, etc. The process was cumbersome, but the information could be found. Other times I just see that they were seen with a diagnosis code, provider and maybe a procedure code. Needless to say the notes are a lot more useful to me and it seems like the more they try to “fix” the problem, the fewer of the notes I see (including notes that I used to be able to see but have now “disappeared”). We’ve been told that we can only see information which has been made available by someone on the DOD side, but I have no idea how it happens.
I’m going to repeat Doc Bailey’s advice with one addition:
DO get a copy of your records, in fact start keeping copies from day one if you can.
DON’T ever give your only copy of the record to anyone, especially the VA. I don’t care how much it costs at Kinko’s, keep your originals!
You’re not entitled to the originals, they are the property of the DoD. When you retire, they are the property of the VA.
You may have a copy. I recommend you keep at least two and a one digital copy.
Yes, by all means, get a copy of everything. This includes records of care received outside the Direct Care System. Most of that information is NOT included in your permanent record. And since more than 60% of care for AD and ADFM’s is not provided by the direct care system, you could be missing the bulk of your healthcare experience.
Also, before you retire, go back to EVERY MTF that ever treated you and ask the for a CHCS/AHLTA printout of your treatment record (started in 1993). I’d start a year in advance of retirement just to be safe.
Do not get your retirement physical until this information has been gathered.
I am retiring in April after 37 years in Navy Medicine. If you are in the Navy/Marine Corps, you should have ZERO confidence that once you retire, they will do the right thing by you. The VA is worse.
Open Channel D sends.
When I retired on ’08, Navy Medicine was still having problems this AHLTA (new upgrades with it ‘breaking’ the system, providers not getting proper training with it, lack of compatibility with CHCS I, VA system, etc…) that providers were openly complaining to the AHLTA “IT geeks” about how user unfriendly it was – same problems as mentioned above. It’s a cash cow for the contractor that is “developing it”, and it’s a money pit.
If your retiring, get at least TWO copies of your medical records (talk to your patient admin officer at your MTF to have this done), one for turning over to the VA, the other to hold on to. Original records go to your respective service’s personnel office to be retired (along with your service records). Do it well before you retire – you can have it done when you PCS from each duty station throughout your career. Also, if you get treated at civilian medical facility, KEEP COPIES OF THEIR TREATMENT RECORDS!!! This can be a big help when you apply for your disability rating with the VA.
As for the Great Lakes VA/Navy joint facility – I was there when it was in the planning stages, and thought at that time that it was going to be a huge problem, with not just the EHR, but with how the military and VA do business.
PintoNag brought up Obamacare and its impact a while back, and it’s worth noting: Obamacare will require new applications, reports, and so on.
By extension, even if the VA and DOD were sharing, more than likely the whole thing will be forced to change (again) after 2013. Unless the SCOTUS decides Obamacare is unconstitutional, or enough TEA Partying conservative Republicans and Democrats win and toss out that law, these may be ‘the good ole days’ in terms of VA/DOD medical records.
Were I in a position to make such possible, I’d like to have a portable digital medical record that can downloaded and used by any care provider: VA, Tri2GetCare, local ER, or my private doc. Go in for a flu shot at the clinic, go home and upload the new record to my file. ER doesn’t know about my allergy, no problemo.
I’ve never understood why MY record of military medical mistakes made, aka my medical record, is the Gov’t’s property in the first place.
Egads man! From the perspective of one whose VA experience is limited to a home loan, the GI Bill, and a future hole in the ground, this stuff sounds like a nightmare!
I can’t speak to DOD/VA, but I know from my side of the house that EMRs (Electronic Medical Rocords) are going to be mandated into law. Right now, all private civilian medical entities are being “encouraged” to develop them. Different governmental agencies are pushing for this across the board, and just like with digital television, the mandated, enforced changes are on the horizon. And somewhere, somehow, some way, those systems will all be required to talk to each other.
And, DaveO, I can clear up your confusion about medical records being the property of the medical institution. When patient privacy became a legal issue (it really took off in the late 70’s – early 80’s), it fell on the medical institutions to secure the patient’s records (because they became legally responsible if they WEREN’T secured). To do that, laws had to be passed that made the records PROPERTY, and it was clarified that those records were the PROPERTY of the issuing institution. And so, they got plucked right out of the patient’s hands. Now, you have to fill out paperwork requesting your own records, and I have heard of places that make you sign a waiver just to SEE your own records.
PN: thanks – learned something new today!
Now to bug my congresscritters to change all that…
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