Joint Legacy Viewer
The Joint Legacy Viewer (JLV) is a browser-based graphical user interface used for viewing real-time medical information. It is capable of retrieving patient data from both the Veterans Affairs (VA) and Department of Defense (DoD) electronic medical record (EMR) systems and combining, normalizing, and displaying the information in customizable widgets,. The system can be used by VA and DoD providers to help coordinate and facilitate care as Veterans transition between these departments. More recently, a community version of the viewer is being offered to third-party providers as a means of sharing medical records of VA patients that are referred for care outside of the VA system.
The JLV was originally developed in 2001 as “Janus”, named after the Roman god of gateways and doors, through a joint effort by the Tripler Army Medical Center and the VA Pacific Islands Health Care System in Honolulu, Hawaii. Funding was provided through the Senate as a joint DoD and VA venture with a goal to improve the interoperability between the two facilities. The initial release of Janus could only view data from the VA system. However, as development continued the system saw significant improvements in the user interface, performance, responsiveness, and feature set. In 2013, the DoD/VA Interagency Program Office (IPO) was directed to focus efforts on integrating the VA and DoD health data. Janus was, by this time, being used at a handful of VA facilities across the country in various different flavors, and was seen as a promising solution. Based on Janus, development of a unified enterprise-wide platform, dubbed the Joint Legacy Viewer, began.
The initial “Data Federation Release 0” of the JLV on December 31, 2013 was deployed to five VA Polytrauma Rehabilitation Centers as well as the Alaska VA Healthcare System. It used a new widget-based web platform that enabled display of seven different data domains and was able to provide access for up to 225 users. The next major revision, JLV version 2.2, was released in September 2014 and was made available to all VA Medical Centers on October 1, 2014. This update added support for eight additional data domains and included additional features such as “break the glass” functionality, improved performance and capacity, added support for up to 3,500 total users, and addressed various software bugs and security vulnerabilities.
JLV 2.4 was released July 2016. This update added usability enhancements and increased functionality of the widget interface as well as added a report builder function. Plans for future versions include adding the capability to view VA scanned documents and radiology images directly, blood bank integration, and audiometric data support. As of 8/2016, there were over 188,000 individual users with representation from every VA medical center in the country.
Access: the JLV can be accessed via a web browser on any computer connected to the VA network, including via the VA Citrix Access Gateway, simply by visiting the URL. Credentials are automatically passed by use of the PIV/CAC cards. The community version does not require direct access to the VA network and, but instead of PIV/CAC cards providers must use a VA supplied username and password combination. Internet Explorer 11 is the preferred web browser.
Configuration: the JLV user interface is highly configurable and settings are saved on a per-user basis. System themes and the displayed widgets are all customizable. Five different themes are available to select from including “Default” (dark), “Green”, “Blue”, “Gray”, and “Accessible”. The “Accessible” theme is compliant with Section 508 of the Rehabilitation Act of 1973.
Workspaces: The main interface can be separated into tabbed, user-defined workspaces. Each workspace can contain different widgets in different layouts and multiple workspaces can be created as needed. Workspaces can enable the user to create quickly accessible workflow specific views of patient information.
Widgets: As the main interface is widget-based, with each widget comprising a different type of data, widgets can be added, deleted, and moved around the screen as desired to meet different workflow needs.
|Admissions||Dates of admission and discharge for each episode as well as ward and site|
|Allergies||Allergen, reaction, severity and site where recorded.|
|Appointments||Date, provider, clinic and site|
|Clinical Reminders||VA only reminders including due date, when last completed, reminder type and site where reminder is in effect|
|Community Health Summaries||VA community partner information, including C32, C62 and CCDA documents.|
|Consult Encounters||Consult information including date, type, status and site|
|Documents||Health records from multiple clinical domains to include scanned DoD documents|
|Immunizations||Immunization history including date, vaccine name, reaction if any and site|
|Inpatient Medications||Inpatient medications including status and where prescribed|
|Inpatient Summaries||Discharge notes, including date, type and site; other DoD inpatient care notes|
|Lab Panel Results||Lab orders and panels and the associated results|
|Lab Results||Lab results including microbiology and anatomic pathology|
|Outpatient Medications||Outpatient medications including last fill, status, expiration date and site where prescribed|
|Outpatient Encounters||Date, clinic, provider and site for each encounter|
|Orders||Patient orders with order date, status and site where written|
|Problem List||Problems, including onset, when updated, status and site where recorded|
|Procedures||Medical procedures with date/time performed, provider, and location|
|Questionnaires and Deployment Assessments||Questionnaires administered, as well as pre and post-deployment health assessments|
|Radiology Reports||Radiology exams ordered along with the corresponding report if available|
|Social, Medical and Other Histories||DoD only Histories including date reported, type, any findings, status and site where recorded|
|Vitals||Vital sign information including date taken, type, result, the units and where taken|
Patient Search: If the patient context feature is not used, the JLV is capable of searching for patients by DoD ID, SSN, First/Last name, Date of Birth, Address, and Telephone. The system also maintains a list of recently viewed patients for convenience.
Report Builder: Version 2.4 added the capability to combine multiple data elements into a report that can be saved as a single PDF file and exported or printed as needed.
The Veteran Access Community Viewer is a separate viewer system but is largely based on the JLV. The Community Viewer was created to give non-VA providers who have a care agreement with the VA access to a veteran's VA medical records. While the display and functions of the Community Viewer are similar, there are limitations on what data is provided.
- Joint Legacy Viewer Frequently Asked Questions. Department of Veterans Affairs. October 2016. Retrieved 22 October 2016 from https://www.vapulse.net/docs/DOC-57124.
- Joint Legacy Viewer Town Hall- September 2016. Department of Veterans Affairs. 2 September 2016. Retrieved 22 October 2016 from https://www.vapulse.net/docs/DOC-52897
- Saiki, Stanley M. Introducing Janus 3.0 - DoD/VA patient record common data view. 2010. Pacific Telehealth & Technology Hui. Honolulu, HI.
- Reese Omizo and Brian Jones. 2015. Joint Legacy Viewer: Displaying DoD/VA Health Records at Joint Centers. 2015 Defense Health Information Technology Symposium.
- Joint Legacy Viewer (JLV) Introductory Training. Department of Veterans Affairs. July 2016. Retrieved 22 October 2016 from https://www.vapulse.net/docs/DOC-47372
Submitted by T. Brady Wright, MD