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Published Online: 15 May 2009

Obama: Service Members Need Lifetime Electronic Record

President Obama last month called on the Department of Veterans Affairs and the Department of Defense to create a joint seamless health information network.
Appearing at a press briefing with Secretary of Defense Robert Gates and Secretary of Veterans Affairs (VA) Eric Shinseki, the president urged the creation of a joint virtual lifetime electronic health record. The purpose of the record is to create a seamless transfer of health records that would follow an individual from the moment of entry into the military and throughout his or her lifetime.
“Access to electronic records is essential to modern health care delivery and the paperless administration of benefits,” the president said in a statement on the White House Web site. “It provides a framework to ensure that all health care providers have all the information they need to deliver high-quality health care while reducing medical errors. The creation of this joint virtual lifetime record by the two organizations would take the next leap to delivering seamless, high-quality care, and serve as a model for the nation.”
The vision is far from a new one, however, and the complexities of creating a seamless transfer of data between the two vast information systems are daunting. But VA psychiatrist Peter Fore, M.D., a member of the APA Committee on Health Information Technology, said that progress is being made.
“I have heard talk about this for years,” he told Psychiatric News. “The goal of having a seamless transition for veterans moving from the military into the VA system has been around for some time.”
The VA currently has one of the most comprehensive and sophisticated systems for electronic medical records. Fore said the goal of the initiative is not necessarily a matter of creating one unified system, but allowing the transfer of information between the two systems.
“It's a work in progress,” Fore said. “We currently have access to some of the records. We don't get live data, but we can request static reports that come over from the [Department of Defense]. Some of the data have to be standardized in pieces that can move from one system to the next.”
But even matching up identifiers in the two systems to match records of the same patient can be difficult: if the VA system uses a middle initial, for instance, and the Department of Defense system doesn't, the records won't follow the patient. Other obstacles have to do with the architecture of the two computer systems and the development of common data-exchange points.
But Fore said the goal is a worthy one, and while it is likely to take time, progress is being made.
“As a psychiatrist, I would like to know the most complete information about my patient that is available,” he said. “If someone had a first episode of schizophrenia while in the military and was treated for it, I would much rather have that information available to me than trying to recreate what happened from the patient's own history.”
He added that the goal of the seamless transfer of health information had even been a part of the VA's strategic plan prior to the president's remarks in April. The plan calls for the goal to be accomplished by 2011. “It's already partly working, and I think it is going to be more complete as time goes on.” ▪

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Published online: 15 May 2009
Published in print: May 15, 2009

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The goal of an Obama administration initiative is to create a comprehensive system enabling streamlined transfer of medical records that follow individuals throughout their lifetime from the time they enter the military.

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