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healthinfocus
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NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation JAL FHCC Order Portability Project Organization Overview • Leidos provides lasting solutions for the world’s most complex problems, including scientific, engineering, systems integration, and technical services • Leidos helps healthcare organizations meet regulatory requirements, optimize technology for their clinical workflows, improve collections and reduce receivables, and keep data safe Background To enhance operational efficiency, promote cost savings, and improve access to medical services, the Department of Defense (DoD) and the Department of Veterans Affairs (VA) established an integrated healthcare center in North Chicago in 2010: the Captain James A. Lovell Federal Health Care Center (JAL FHCC). The JAL FHCC is a consolidated federal health care facility which consists of: • North Chicago VA Medical Center, serving veterans in Northern Illinois • Great Lake Naval Station Health Clinics, supporting naval recruits and trainees In order to successfully integrate these healthcare systems, it was critical to develop ‘near real-time’ interoperability between the DoD’s electronic health record (EHR) system, Composite Health Care System (CHCS), and the VA’s EHR system, Veterans Integrated Systems and Technology Architecture (VistA). Project Details • The objective was to plan and oversee acquisition and implementation of information systems that integrated health care processes at the health system to achieve the following: –– Build a single patient registration process –– Create a medical single sign-on capability with patient context management –– Build orders portability services for pharmacy, radiology, consult, and laboratory process • The project was initiated using a traditional waterfall software development lifecycle with phase-gate acceptance, in accordance with the VA Program Management Accountability System (PMAS) and then transitioned to an Agile System Development Life Cycle • The solution utilized HL-7 encapsulated in XML over SOAP between the two EHR systems and identity management (MVI/DEERS) Value Delivered This comprehensive solution enables near real-time interoperability between the different EHR systems, with the following features: • Unambiguous patient identification • Efficient extraction of information between CHCS and VistA An Initiative of the 71 | JAL FHCC Order Portability Project

NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation • Common ordering semantics for laboratory, radiology, and consult orders • Terminology mapping and transformation services, which ensure optimal communication between both EHR systems Two noteworthy aspects of the solution are: • Algorithms used to match patient identity between the DoD and VA identity management systems and the two EHRs • Semantic interoperability of the orders traversing between the two EHRs Path Forward • Although the implementation at the JAL FHCC was successful, the following policy recommendations should be addressed to expand the JAL FHCC Interoperability Solution enterprise-wide: –– A patient identification process that is standardized across CHCS and VistA, as well as both national identity management systems, MVI and DEERS –– A common process for user credentialing and security for CHCS and VistA to ensure crossagency domain trust –– A national terminology standard and common data model that allows CHCS and VistA to exchange computable data at multiple facilities –– A rigorous analysis, recommendation, and decision-making process that considers existing business process evaluations and reengineering activities along with the technology changes and implementation • In the long term, Leidos also aims to add pharmacy, allergy, and common decision support to the interoperability solution JAL FHCC Order Portability Project | 72

NDHI<br />

NAT IONAL DIALOGUE FOR<br />

Healthcare Innovation<br />

JAL FHCC Order Portability<br />

Project<br />

Organization Overview<br />

• Leidos provides lasting solutions for the world’s most<br />

complex problems, including scientific, engineering,<br />

systems integration, and technical services<br />

• Leidos helps healthcare organizations meet regulatory<br />

requirements, optimize technology for their<br />

clinical workflows, improve collections and reduce<br />

receivables, and keep data safe<br />

Background<br />

To enhance operational efficiency, promote cost savings,<br />

and improve access to medical services, the Department<br />

of Defense (DoD) and the Department of Veterans<br />

Affairs (VA) established an integrated healthcare<br />

center in North Chicago in 2010: the Captain James<br />

A. Lovell Federal Health Care Center (JAL FHCC).<br />

The JAL FHCC is a consolidated federal health care<br />

facility which consists of:<br />

• North Chicago VA Medical Center, serving veterans<br />

in Northern Illinois<br />

• Great Lake Naval Station Health Clinics, supporting<br />

naval recruits and trainees<br />

In order to successfully integrate these healthcare<br />

systems, it was critical to develop ‘near real-time’<br />

interoperability between the DoD’s electronic health<br />

record (EHR) system, Composite Health Care System<br />

(CHCS), and the VA’s EHR system, Veterans Integrated<br />

Systems and Technology Architecture (VistA).<br />

Project Details<br />

• The objective was to plan and oversee acquisition<br />

and implementation of information systems that<br />

integrated health care processes at the health<br />

system to achieve the following:<br />

––<br />

Build a single patient registration process<br />

––<br />

Create a medical single sign-on capability with<br />

patient context management<br />

––<br />

Build orders portability services for pharmacy,<br />

radiology, consult, and laboratory process<br />

• The project was initiated using a traditional waterfall<br />

software development lifecycle with phase-gate<br />

acceptance, in accordance with the VA Program<br />

Management Accountability System (PMAS) and<br />

then transitioned to an Agile System Development<br />

Life Cycle<br />

• The solution utilized HL-7 encapsulated in XML over<br />

SOAP between the two EHR systems and identity<br />

management (MVI/DEERS)<br />

Value Delivered<br />

This comprehensive solution enables near real-time<br />

interoperability between the different EHR systems,<br />

with the following features:<br />

• Unambiguous patient identification<br />

• Efficient extraction of information between CHCS<br />

and VistA<br />

An Initiative of the<br />

71 |<br />

JAL FHCC Order Portability Project

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