Leadership Message
Dear colleagues,
As the Federal Electronic Health Record Modernization (FEHRM) office celebrates its fourth anniversary this month, it’s amazing to see our growth in this year alone. We continued preparing for our deployment at the Captain James A. Lovell Federal Health Care Center (Lovell FHCC) and expanded the joint health information exchange by participating in Carequality to reach more than 90% of hospitals in the United States. We also enhanced the federal electronic health record (EHR) with groundbreaking capabilities, such as immunization exchange and reporting and the Individual Longitudinal Exposure Record (ILER) interface. See our latest numbers below, as we continue to work with the Department of Defense (DOD), Department of Veterans Affairs (VA), Department of Homeland Security’s U.S. Coast Guard (USCG) and Department of Commerce’s National Oceanic and Atmospheric Administration (NOAA) to implement the federal EHR.
Working with the Departments, stakeholders and our partners, we continue to transform health care together on a strong foundation that sets us up for success. Read our latest work in this issue of FEHRM Frontline, including ensuring shared responsibilities at Lovell FHCC and implementing a VA Seamless Exchange pilot.
Happy holidays! Thank you for your contribution to the FEHRM’s mission and implementation of the federal EHR. I look forward to continued success in the new year!
FEHRM Thought Leadership
One Record Levels the Playing Field for Patients Needing Specialized Care
Dr. Valerie Seabaugh, FEHRM Deputy Chief Health Informatics Officer
The FEHRM drives the delivery and optimization of the shared EHR of DOD, VA, USCG and NOAA. One of the obvious benefits of a unified health record is the portability of records. We will no longer ask Veterans with disabilities and mobility challenges to haul boxes of paper records with them to appointments.
However, a less discussed but highly beneficial outcome of having a single, common federal EHR is lowering barriers to specialized telemedicine care for federal health care beneficiaries. In the old systems, patient health records had medical information isolated in paper files or in a single instance of an outdated EHR linked to a local clinic or medical facility. Although the Joint Longitudinal Viewer provided information between agencies, specialists’ access to the siloed record to place orders or document care was a major barrier to coordinating subspecialty telemedicine care for patients. If a beneficiary resided in an area without access to a needed subspecialist, the only way to reliably receive care was usually to travel to a referral medical facility.
With a single record, specialists have all the pertinent patient data at their fingertips regardless of patient location. Patients can receive telemedicine consultation from a subspecialist, many times without leaving their homes. Telehealth appointments using video technology lower barriers for patients to receive specialized care and drive federal health care toward an equitable standard of care regardless of a patient’s geographic location or mobility. For example, watch this Voice of a Veteran video to see how a Veteran in rural Arizona benefits from specialized endocrinology care with VA’s Tele-Diabetes Program.
Maintaining the federal EHR as an accurate and complete warehouse of medical information simplifies providing efficient, coordinated and convenient high-quality care. The FEHRM is at the forefront of lowering barriers to patient care by making it possible for today’s recruits to maintain a coherent lifetime record as they transition through their military career, from basic training all the way to becoming a Veteran beneficiary. The federal EHR drives health care toward an equitable future where patients receive the right care, unbounded from location and driven by choice.
JSS-FHCC Focus
DOD and VA Continue Making Progress Sharing Lovell FHCC Deployment Responsibilities
The Enterprise Requirements Adjudication process identified additional capabilities to deploy the federal EHR at Lovell FHCC. Building off the DoD Healthcare Management System Modernization Program Management Office deployment methodology, processes and content provided a baseline of tested processes and materials to deploy at Lovell FHCC. VA methodologies were added to accomplish deployment activities related to VA-specific training, infrastructure and device installation and VA-augmentation of system adoption by VA users. This kind of resource and expertise sharing is one of the major advantages of the shared federal EHR, given that training for all roles happens in the same system and all devices and network infrastructure support the same federal EHR.
Currently, VA is solely focused on Lovell FHCC’s EHR deployment with DOD. So far, DOD has deployed to more than 135 parent military treatment facilities, encompassing 3,000+ physical locations and 185,000+ users. USCG, U.S. Military Entrance Processing Command and NOAA have also deployed the federal EHR.
FEHRM Activities
The State of the Federal EHR
On November 14, the FEHRM hosted The State of the Federal EHR (formerly known as The FEHRM Industry Roundtable). This public event is held twice a year to discuss the current and future state of the federal EHR, health information technology and health information exchange. With the theme, “Achieving Data-Driven Outcomes in the Federal EHR,” this virtual meeting featured updates from FEHRM, DOD, VA, USCG and NOAA leaders on their federal EHR efforts. Another interactive discussion focused on how data enables actionable insights to enhance the delivery of health care for Service members, Veterans and other beneficiaries.
Seamless Exchange Strives to Consolidate Federal EHR Data
Through Seamless Exchange, the FEHRM, DOD and VA dramatically increase the depth and longitudinal nature of the EHR.
To streamline the federal EHR end-user experience, the FEHRM, DOD and VA focused on Seamless Exchange—an enhancement piloted by VA for data retrieval, deduplication and synchronization that will normalize data from numerous sources with varied formats, standards and duplications into a simplified, contextual and usable platform supporting health care. Seamless Exchange joint design decisions and reviews were completed last summer. Commercial sites using and testing Seamless Exchange shared positive feedback on its data deduplication and automated capabilities, ensuring ease of use and easy access to up-to-date, comprehensive information. The VA Seamless Exchange pilot went live at the La Grande Clinic within the Walla Walla VA system on November 7. Clinical Adoption was well received by stakeholders. The plan for expansion of the Seamless Exchange functionality at Walla Walla VA will include adding more functionality, expanding to all clinics at Walla Walla VA and will follow up with an enterprise-wide deployment in 2024. Plans for the FEHRM to expand Seamless Exchange across DOD is underway.
Recent Go-Lives and Capability Releases
- November 15: The latest Cube capability upgrade included the federal EHR's ILER interface and a patient portal modernization upgrade.
- October 28: Waves SOUTH KOREA and OKINAWA included 10 parent military treatment facilities across Asia, adding about 8,000 new users to the federal EHR.
- September 23: Waves LANDSTUHL/LAKENHEATH included 10 parent military treatment facilities and brought about 9,000 new users to the federal EHR in addition to the European locations.
In Case You Missed It
ISO TC 215 on Health Informatics Develops International Standard on Interoperability of Public Health Emergency Preparedness and Response Information Systems
The Role of Data Optimization for the DOD’s EHR and CX Efforts
Pinnacle Awards Finalist William Tinston: 'People Are Far More Important Than Rules'
Exposure Record Supports Veterans Health by Tracking Exposure Events
The FEHRM Funnies
Joke of the Quarter
What did one snowman say to the other?
You smell carrots, too?