Virtual Lifetime Electronic Record (VLER)

Virtual Lifetime Electronic Record Health Initiative

The VLER initiative embraced by the Military Health System through and to all the eHealth Exchange partners to electronically share health information with HITECH compliant to different health information systems from the Department of Defense, Department of Veterans Affairs, and other federal and private sector partners. who have eHealth Exchange. “VLER Health is a program that shares few parts of the Veteran health record between the Department of Veterans Affairs (VA), the Department of Defense (DoD), and selected private health care providers over a secure and confidential network known as the eHealth Exchange. This program is free and voluntary for Veterans.”

The VLER Health Information Exchange (HIE)

It is intended to

1. enhance access to consistent patient care by providing and sharing data from and to multiple healthcare providers
2. enhance quality of patient care by immediate access to necessary information at the point of care
3. improve patient safety and reduce medical errors by providing availability of at least sufficient demographic, medical and medication background
4. alleviate or eliminate repetitive laboratory tests, radiology tests, immunizations, which could saving huge profits on patients
5. enhance efficiency of care and administrative processes by avoiding the need for to acquire information from other healthcare providers and subsequently have important information at hand’s reach

VA and DoD in view of testing the effectiveness to HIE implementations with private sector partners initiated pilot studies in 2010. By October 1, 2011, twelve production pilots were established. These sites were considered as proving ground for exchange of health data between VA, DoD, and private partners via eHealth Exchange (formerly the Nationwide Health Information Network (NWHIN)), and furnish the results to the broader national rollout of the VLER initiative. Out of 12 sites, four sites had shared information from DoD/VA, while rest were from only VA. They are: sites with exchange partner

• San Diego - California Kaiser Permanente (KP),
• Hampton, Virginia - MedVirginia,
• Spokane, Washington - Inland Northwest Health Services (INHS)
• Puget Sound, Washington - MultiCare Health Systems
• Richmond, Virginia - MedVirginia,
• Asheville, North Carolina - Western North Carolina Health Network (WNCHN)
• Indianapolis, Indiana - Indiana Health Information Exchange (IHIE)
• Buffalo, New York - HEALTHeLINK
• Minnesota, Minnesota - Community Health Information Collaborative (CHIC)
• Charleston, South Carolina - South Carolina Health Information Exchange (SCHIEx)
• Salt Lake City, Utah - Utah Health Information Network (UHIN)
• Grand Junction, Colorado - Utah Health Information Network (UHIN)

VLER HIE conducted rural pilot study in the community of Moab, Utah with a 2010 population of 5046. VLER HIE was started on 10/3/2011between the Grand Junction VA Medical Center (VAMC) and Moab Regional Hospital community became active, utilizing the Utah designated health information exchange, Utah Health Information Network (UHIN). By May 2013, one (a Home Care Nurse) out of 4 VA clinicians from the Moab VA Telehealth Clinic and one primary care provider from the Grand Junction VAMC have retrieved Moab Regional Veteran health information from the eHealth Exchange.

Currently, VLER Health is available at only few locations for active duty service members and veterans. This service is provided to family members who receive care at the following clinics:

• Madigan Army Medical Center: Family Medicine (Falcon team) and Internal Medicine (Maple and Evergreen teams)
• Naval Medical Center at San Diego, Balboa: Branch Clinic Kearney Mesa

VLER Initiative was developed to be HIPAA and the Privacy Act with the help of current methods and technology to securely share the health information through a common platform. Now a days the Defense Manpower Data Center (DMDC) has taken charge from Personnel and Readiness Information Management’s (P&R IM) over day-to-day activities and support of VLER Initiative including planning and project management.

Health care providers can only view a list of health problems, allergies, medications, vital signs, immunizations, and some laboratory test results, with few new features of discharge summaries, immunizations, procedure notes. While we cannot share the entire health record, more information will be shared as the program grows, including doctor’s notes, discharge summaries, etc.

VLER HIE program Evaluation

VLER HIE pilot program was assessed and evaluated by Westat, an experienced survey organization, between October 1, 2011, and March 31, 2012.

Based on evaluation of pilot sites

1. It could meet most of technical capabilities
2. Widespread acceptance by healthcare providers and Veterans
3. Future improvements to be focused were issues of data display in the user interface (VistA Web) security, patient identity, and matching using SSN with simple sign-on provision etc.

VLER HIE team formed a VA eHealth Exchange Business Readiness Survey created by The survey will facilitate the VLER HIE Team to assess possible exchange partners for their technical and data readiness optimizing the sharing of pertinent, clear data with VA clinicians. Survey results and VLER HIE can team up with exchange partners can integrate for a smooth and incessant flow of data between them will be play a vital role in patient care.