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Veterans Health Administration

Rural Health: Exchanging Information

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Dr. Tim Cromwell

An upcoming rural health pilot project will test sharing Veterans’ health records between VA facilities and private health care providers.

The test in southeastern Utah will be among 11 other pilots using VA’s Virtual Lifetime Electronic Record (VLER) to share information with participating local health practitioners. However it will be the first one with a focus on rural health.

Veterans in rural areas often face long distances to their VA Medical Center and unpredictable travel conditions. Teleconferencing has connected Veterans at TeleHealth clinics with their providers at VA Medical Centers.

Dr. Tim Cromwell, Director of Standards and Interoperability for the Veterans Health Administration, has led the effort to make caring for rural Veterans even easier and more efficient. When VA began its pilot program, the Office of Rural Health (ORH) provided grant money. Cromwell says that the timing of the ORH grant requests and the suitability of such a program for rural veterans was important.

“Change usually comes from the coasts and then spreads to the middle of the country. But the veterans most likely to benefit from interoperability were those in remote and rural areas — I didn’t want them to wait another three years to have this technology,” says Cromwell.

The pilot will be operated out of the Grand Junction Colo. VA Medical Center and the Moab Utah Regional Hospital — working with Veterans to create a seamless and secure flow of health information between all of a Veteran’s health care providers.

The goals of the project are to provide Veterans a continuity of care: no matter where they are treated, their health care providers have access to a patient’s latest information.

Expanded Capabilities

Cromwell says results from the pilot will help VA better care for a Veteran who goes to both VA hospitals and private facilities. He says it can provide faster service and enable medical facilities to securely sharing information.

“We have a group to measure the tangible outcomes. Everyone thinks that with interoperability you’ll have better care and lower costs. For example, instead of ordering a CAT scan a doctor can look at the one a Veteran had at the VA a month before.”

Not only do Veterans receive information on their health condition faster, health care providers can have an expanded view of the Veteran’s health.

For example, a rural Veteran may go to the emergency room at his local hospital. The attending physician may then require that the Veteran follow up with his VA primary care provider the next day. Instead of waiting days for the records and possibly repeating tests, a patient can provide electronic consent to share his records and inform the VA provider in minutes.

“This way you’ve got information today as to why the ER physician thought the patient needed to be seen today, and any lab results. It’s just much better health care if you can get all that information coordinated,” says Elaine Taylor, RN, TeleHealth Coordinator at the Grand Junction, Colo. VA Medical Center.

Taylor has been meeting with Veterans one-on-one to let them know they can mutually share their patient information between the Moab Regional Hospital and VA facilities. If they are interested, Veterans then can contact the Grand Junction VA Medical Center’s Release of Information Officer and complete a consent form.

The top priority of the program is to ensure Veteran health information is protected and that none of the Veterans health information is shared without the written consent of the Veteran.

“We will keep the privacy and security concerns upfront. We have to learn how to honor that as we go into this electronic age,” says Cromwell.

The program is scheduled to launch in July 2011.

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