Bidirectional Health Information Exchange (BHIE)

Overview  
BHIE is a secure, bidirectional and real time display of viewable electronic health information between the Departments of Veterans Affairs (VA) and Defense (DoD).   Using BHIE, VA and DoD are currently sharing almost all essential health information available in electronic format.  BHIE also is a significant component of the VA and DoD strategy to achieve the requirement contained in Section 1635 of the 2008 National Defense Authorization Act (NDAA).  This legislation required VA and DoD to achieve “full” interoperability of health information by September 2009. 

Background
BHIE extended the capability of the one-way Federal Health Information Exchange (FHIE) to permit VA and DoD to share viewable clinical data bidirectionally when shared patients present for care.   A “shared patient” is one who is eligible to receive care from both VA and DoD because of status or sharing agreement and who is registered as a patient in both systems.  For example, BHIE provides VHA clinicians the ability to view data on active duty Service members who are receiving care at VA facilities, retired service members who are TRICARE eligible and receive some care at VA, and demobilized Guard and Reserve members.   BHIE supports the secure sharing of protected electronic health data between VHA’s Integrated Systems and Technology Architecture (VistA) and DoD’s AHLTA in real time for DoD patients receiving care at VA facilities, and when a veteran returns to a DoD facility for health care.

BHIE supports patient identification correlation and real time bidirectional transmittal and display of:

• Outpatient pharmacy and prescriptions
• Drug and food allergy data
• Laboratory results including chemistries, hematology, surgical pathology, cytology and microbiology reports
• Laboratory orders
• Radiology text reports
• Pre and Post Deployment Health Assessments and Post Deployment Health Reassessments
• Inpatient discharge summaries from DoD’s major military treatment facilities
• Clinical theater data
• Vital sign data
• Progress notes and ambulatory clinical encounter notes