FedHealthIT’s President, Susan Sharer, had the opportunity to sit down with Dr. Lauren Thompson, the Director at the DoD/VA Interagency Program Office for an update during this exciting time of modernization in Federal Healthcare moving from legacy systems to modernizing the electronic health record capabilities.

This article was featured in the recent FedHealthIT Winter 2020 Magazine.

What is the IPO’s Role in Overseeing the DoD and VA Adoption of and Mapping to National and International Health Data Standards as a Means Toward Interoperability? 

The Department of Defense (DoD) and Department of Veterans Affairs (VA) operate two of the largest Healthcare systems in the United States with 194 hospitals, 1,862 clinics and over 18 million beneficiaries. The DoD/VA IPO jointly oversees and monitors efforts of the DoD and VA to implement national health data standards for interoperability and acts as the single point of accountability for identifying, monitoring, and approving the clinical and technical data standards and profiles to ensure seamless integration of clinically relevant health data between the Departments and private sector providers who deliver care to DoD and VA beneficiaries. The IPO closely collaborates with the Office of the National Coordinator for Health Information Technology (ONC), Standards Development Organizations (SDO), and other public and private partners to support national health data interoperability efforts.

This is an exciting modernization effort for both Departments. We have been working closely together and have accomplished many great things over the past five to ten years and the collaboration has been amazing. The two programs are very much aligned in terms of deployment schedules, functional teams are working closely together, and technical teams are working closely to resolve issues.

The IPO supports the EHR modernization efforts of the DoD and VA, encouraging and enabling collaboration by serving as an interagency resource for EHR modernization and supporting system IT governance and health data interoperability. In order to maintain and enhance inoperability, the IPO, in coordination with DoD and VA, continue regular mapping updates for data quality assurance. The IPO will continue working with the DoD and VA to provide data quality assurance and explore opportunities to refine the process for reviewing and deploying data mapping updates.

Health Level Seven International (HL7®) is a not-for-profit standards-developing organization dedicated to improving electronic health information exchange. As an HL7 Benefactor Member, the IPO participates in HL7’s ballot cycles three times per year, harmonizes votes with the DoD and VA, and attends HL7 Working Group Meetings. The IPO conducts HL7 projects with goals and objectives implemented by a lead and SME(s) and overseen and coordinated by the IPO HL7 support team, enhancing interoperability between the DoD and VA.

The Institute of Electrical and Electronics Engineers’ Standards Association (IEEE-SA) is a consensus building organization that develops, nurtures, and advances global technology by facilitating standards development and standards related teamwork. The IPO collaborates and recommends proposed standards representing the Departments’ mission of maturing data, standards, and interoperability. Moving forward, the IPO will continue to focus on current and emerging standards under medical and mobile devices and facilitate dialogue on security, interoperability, and additional best practices.

What Changes Will we See at the DoD/VA IPO in the Next 6 Months? How Will the New IPO Organization Continue to Drive interoperability?

In 2018, Secretaries Wilkie and Mattis issued a Joint Commitment Statement pledging to align strategies to implement an integrated EHR system. The Joint Electronic Health Record Modernization Working Group was chartered by DoD and VA leaders to develop recommendations for an optimal organizational construct that would enable an agile, single decision-making authority to efficiently adjudicate functional, technical, and programmatic interoperability issues while advancing unity, synergy, and efficiencies.

On March 1, 2019, the VA/DoD Executive Leadership Group approved a course of action, plan of action and milestones, and implementation plan to establish the Federal Electronic Health Record Modernization Office, also known as the FEHRM. Our mission will be to implement a single, common Federal Electronic Health Record to enhance patient care and provider effectiveness, regardless of the location and care. The modern, secure electronic health record will enable an integrated patient-centered continuum of care, to include nationwide health information exchange and adoption of interoperable health care data standards. The Deputy Secretaries of the DoD and VA have appointed Dr. Neil Evans (VA) as the FEHRM Interim Director and Ms. Holly Joers (DoD) as the FEHRM Interim Deputy Director. These leaders will have the authority to direct each Department to execute joint decisions for technical, functional and programmatic functions under its purview and will provide oversight regarding funding and policy as necessary.

The objectives of the FEHRM are the following:

  • Actively manage risks and the operation of the joint EHR Federal Enclave.
  • Minimize risk to the Department’s deployment/implementation.
  • Identify opportunities for efficiency, standardization and system/process optimization.
  • Advance interoperability across the Federal and Private Sector.

The immediate focus is to enhance the joint decision process and transition joint functions to the FEHRM. Bringing this oversight and decision making capability together under one umbrella will allow leadership to come together more regularly, to make and move decisions forward under a single, more accountable entity.

Our program will continue to build and maintain strategic relationships with the public and private partners in health, to remain at the forefront of health IT innovations, trends and emerging standards. We will continue our collaboration with ONC and industry standard partners to ensure the DoD and VA are employing the most current industry standards and our industry partners are able to learn from our experiences. We will continue to bring together the joint view to represent the Federal Government and support implementation and interoperability between commercial and Federal partners.

Tell us About Current Data Sharing Initiatives Between DoD, VA and Their Private Sector Partners and What the Future Looks Like.

Providing world-class Healthcare to Service Members, Veterans, and their dependents is of the utmost importance to both Departments. A key component of this mission is ensuring that DoD and VA electronic health record (EHR) data is interoperable, meaning the Departments and private partners are able to exchange information and use the information that has been exchanged. Through existing software applications, DoD and VA clinicians can now view records in near real-time on millions of patients who have received Healthcare from both Departments. Additionally, DoD and VA providers generate data queries through their current tools well over a quarter of a million times per week.

The Joint Legacy Viewer (JLV)is a clinical application used daily by thousands of DoD and VA clinicians that provides an integrated, read-only display of health data from DoD and VA and private sector partners in a common data viewer allowing access to real-time medical data in the treatment of patients. The JLV eliminates the need for clinicians to access two separate applications by combining data from DoD and VA health information systems and display it chronologically on a single screen. Recent enhancements include a redesign of JLV’s widget filtering functionality and the display of AHLTA clinical notes within the JLV Outpatient Encounters widget. As of the end of June 2019, there were 433,813 total JLV users (103,584 DoD, 313,225 Veterans Health Administration, and 17,004 Veterans Benefits Administration users).

The DoD and VA will also be using HealtheIntent, a cloud based, population health management platform that can receive data from any EHR, existing HIT system and other data sources, such as primary benefits managers or insurance claims. With HealtheIntent, a person’s longitudinal record is aggregated across all data sources connected for a tenant. The Departments remain fully committed to continuing to enhance and measure health data interoperability between their EHR systems as well as with their private partners. Enabling health information exchange between EHR systems in the DoD, VA, and private sector will serve as the foundation for a patient-centric Healthcare experience, seamless care transitions, and improved care for our Service Members, Veterans, and their dependents. Moving forward, the IPO will continue to monitor data sharing between the Departments and report on this transactional data and will continue supporting the Departments’ to advance health data interoperability through the DoD/VA Joint Interoperability Strategic Plan.

Tell us a Bit About Your View of Leadership and Organizational Culture.

In my view, leadership is not a position but a way of being. It is important to build a team and to implant a culture in which everyone has a role to play, is accountable for their part and for delivering outcomes. I view my role as a leader as enabling people to be able to get the job done, of providing a vision that sets the stage for allowing the people within an organization to thrive, to achieve the goals of the organization, as well as their individual goals. The development of people is crucial. We strive to retain our people, help them develop, and when ready, advance to new opportunities.

I also believe in a culture of respect. As a leader, there are times tough decisions have to be made. I believe it’s important that everyone have a voice and the chance to be heard.

ABOUT DR. LAUREN THOMPSON

Lauren Thompson is a recognized leader with 30 years of experience as a manager in the public, private, and nonprofit sectors. She is known for skillful leadership, collaborative approaches, and her strategic vision, balanced by pragmatism. She has an ability to drive change through innovation and is an expert in managing highly collaborative and complex programs. Presently, she serves as Director of the Department of Defense/Department of Veterans Affairs Interagency Program Office, where she is driving transformation in Military and Veteran Healthcare through health data sharing and interoperability across the Military and Veterans health systems and with the private sector. Previously she led the Federal Health Architecture program for ONC on behalf of the DoD, VA, SSA and other Federal agencies. She also led the Standards and Interoperability Framework for ONC, and managed the standards portfolio. She has an extensive career in private sector Health IT and Consultancy Firms, and is a Certified Leadership Coach.

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