Veterans Data Integration and Federation Enterprise Platform. Q&A with George Hou

Q1. The United States Department of Veterans Affairs (VA) has recently launched VDIF EP (Veterans Data Integration and Federation Enterprise Platform). What is it? 

VDIF EP (Veterans Data Integration and Federation Enterprise Platform) is a health information exchange that unifies care information throughout the continuum of care for VA. It acts as an integration and interoperability middle tier, which enables VA to access all of the data associated with a veteran patient across all sites that they’ve received medical care. This longitudinal view enables veterans to receive better, more efficient care, as clinicians now have access to all clinical elements associated with a veteran’s entire medical history.  

 Q2. What are the benefits of having a “longitudinal patient record”?

The largest benefit of VDIF EP is being able to provide better care to the patient. With VDIP EP, the clinician who is sitting in front of the patient knows all the aspects associated with that individual, instead of diagnosing and recommending a treatment plan without having the whole picture. Without that additional layer of interoperability, the clinician may not know if they are recommending a treatment that has already been prescribed and may not be effective, or that could have some harmful effects to the veteran. 

Q3. What role did InterSystems play in this project?

In order to answer that question, I think it’s helpful to set the stage by underscoring the long history that InterSystems and the VA have of working together. We’ve been a proud partner of the VA since the late 1970s, and have collaborated on many projects over the years. This particular project leverages several different InterSystems technologies, including InterSystems HealthShare®, a set of connected care solutions that enable a unified care record across the care continuum. 

Q4. Can you please give a short description of how VDIF EP was designed and implemented?

Before VDIP EP, the VA had its own electronic medical records (EMR), with over 130 different instances of the same EMR across the network of VA hospitals, nationwide. Their goal was to implement a system that unified, aggregated and de-duplicated all information across those 130 instances, and to create a unified patient record for every veteran, regardless of where they sought their care. 

To describe this in less technical terms, what the VA essentially needed was a health information exchange (HIE) that took the data from those 130 VA hospitals, combined it with every other hospital that the veteran could seek care from, and present it in a way that enabled clinicians to look at a single stream of information and understand the veteran’s entire medical history in a virtual lifetime electronic record view. This was implemented and accomplished as a very ambitious, scalable and modern health information exchange. 

Q5. What were the main technical and organizational challenges to produce a longitudinal patient record by aggregating and normalizing clinical data across its existing electronic medical record systems, enabling interoperability? 

For VA, the quest for interoperability has been more than a decade-long journey. Unlike what many may assume, VA does not have a single electronic medical record (EMR); it maintains more than 130 EMR instances, supports 172 VA medical centers and 1,074 outpatient clinics, and provides care for 9 million veterans. One of the unique challenges InterSystems faced was to develop a platform that would connect each one of VA’s 130 EMRs. 

Qx. Anything else you wish to add?

The COVID-19 pandemic has underscored the critical importance of interoperability across the U.S. healthcare system. The launch of VDIF EP reflects a growing trend of healthcare systems actively breaking down silos and working towards more open access to patient data. At InterSystems, we are committed to powering the technology that makes interoperability possible so that we can continue to do our part to improve quality of care for patients, including those who serve our country. 

In addition to the VDIF EP project, we continue to be engaged with the VA on a number of fronts, including the response to COVID-19. Since the pandemic swept the nation, we’ve helped identify resources through the VA system to assist in treating veterans should they be diagnosed with COVID-19. This involves the monitoring of resources for the sake of predictable and scalable response throughout the geographies that the VA serves. We have also supported the VA’s “Fourth Mission” — which is to care for others who are not necessarily veterans and those who have not been previously enrolled in the VA — by helping them expand services to non-veterans as the nation’s backstop for care delivery when other avenues are exhausted. 

News U.S. Department of Veterans Affairs Makes Interoperability Advancements to Improve Care for Veterans

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