VA Unveils Plans for a Digital Health Platform

The website describes the DHP as “an entirely new approach to healthcare, leveraging public-private partnerships and VA’s vast data stores to create a new paradigm for health services delivery — and public services delivery across every federal agency.” The DHP is a cloud-based technology platform that integrates veteran health care data in real-time from multiple sources such as VA, DOD and commercial providers.

The DHP provides a health care dashboard for use by clinicians and veterans, and is based on open health data standards such as HL7 and cloud technologies. APIs will be used to integrate commercial, military, and VA health data.  Also, predictive analytics will be used to determine the most effective care to be provided given a patient’s condition and aggregated health data.  

VA CIO LaVerne Council first mentioned plans for a digital health platform in her April 2016 testimony before a House Committee on Veterans Affairs' Subcommittee on Health.  Council explained to the subcommittee why it was important to plan and build a veteran-centric digital health platform now to last the agency 25 years and beyond.  

“The EHR today is really just the heartbeat of the organism, and it does not have everything that is needed to mandate and manage care in the community, to deal with the needs of the female veteran, and also to support the overall veteran experience and the clinical management," Council said during the April hearing.

Council and VA Undersecretary for Health, David Shulkin, produced a business case in fall of 2015, then began to move forward with building the modern and integrated health care system that incorporates best-in-class technologies and standards users have come to expect in the private sector.

The DHP uses Fast Healthcare Interoperability Resources (FHIR) created by nonprofit HL7 and is an international open-source standard which allows for secure and trusted information flow. FHIR is starting to be used throughout health care and could show promise as a mechanism to enhance interoperability between VA and DOD EHRs.

"We have 365 data centers within the VA, 130 instances of VistA, and 834 custom systems," Council stated in April. "In addition, they’re spread out ... And it was built as it went. It looks like nothing that you’d see in private industry, and fundamentally, what we’re laying out is a digital health platform that will get us there."

The DHP provides VA’s vision for a comprehensive health care management platform that stretches beyond the capabilities of an EHR system.  VA’s current EHR, VistA, is now 40 years old and no longer meets the agency’s needs. During a Senate hearing in July, Council described the DHP as a “system of systems.” The DHP encompasses more than an EHR, including financial management, CRM, supply chain management, and human resources.  

A VA spokesperson told Meritalk earlier this week, “A decision on the EHR component of DHP will be decided by the department after the business case and cost analysis is complete–as several EHR options are being evaluated. DHP is agnostic to an EHR, and during the proof of concept, DHP was shown to work with VistA, Cerner, and Regenstrief GOPHER (a European EHR).”