Top leaders at the VA have said the recent launch of a program to replace decades-old paper health records with electronic records inevitably will come with hiccups, but they're confident and ready to ensure the effort's success.
“Veterans are in good hands,” said Capt. John Windom, USN (Ret), executive director for the VA's Office of Electronic Health Record Modernization, which will oversee the transition from the old record system to the electronic system. “I can't emphasize enough that we won't let them down. This is just too important.”
The records system is run by Cerner Corp. It will replace the legacy Veterans Integrated System Technology Architecture (VistA). Once the new system is in place, health records will be shared seamlessly between DoD and the VA as troops leave service.
The system was tested by the DoD, giving it a head start on the switch. It is supported by about $1 billion in funding from the VA MISSION Act, which was signed into law by President Donald Trump in September.
VA clinics and hospitals in the Northwest kicked off the transition with training workshops for staff in October, which could last up to 18 months. The VA will phase-in training at each of its centers, by region, over the next 10 years.
Windom said the system takes the burden off veterans to maintain paper records, which were easily lost. He added that sometimes clinicians would reject medical records if the treatment wasn't performed by that service. For example, an Army installation may not recognize a vaccine if it was performed by a Navy clinicians, which sometimes resulted in a servicemember receiving the same vaccination more than once, Windom said.
Servicemembers “are not going to be burdened with making sure they know where a file is or making sure they have copies,” Windom said. “It's in the system.”
The sharing between DoD and the VA means it will be easier for clinicians to view a servicemember's deployment history, which could be important as a veteran receives treatment for service-related health concerns.
“What will be in are the campaigns that you participated in, whether it would be Desert Storm, where there's obviously concern about burn pits and the long term affects those may have,” Windom said. “We won't have to go figure out whether you served during that time because your medical record moving from your active duty environment to your veteran environment will be the campaigns that you served in.”
Capt. Kathy Beasley, USN (Ret), MOAA's director of government relations for Health Affairs, agrees.
“We will now have a record of all the environmental hazards or exposures to those hazards that a service person experiences,” she said. “This will be a key addition to the service record.”
Another advancement is the system's ability to connect clinicians to patients digitally, which can save patients in rural areas from long drives to centers and allow patients to move to areas without nearby VA centers. Unlike paper records, electronic records can be accessed through a computer or smartphone and viewed by the clinician and patient simultaneously even though they are geographically separated, Windom said.
Amid the advancements, there have been reports of some problems with the new system, including whether it can track issues specific to veterans, such as post-traumatic stress disorder and Agent Orange. Windom said the VA is working to identify which data sets need to be tweaked. He noted the VA is responsible for a wider range of care than the Defense Department, which has already begun its transition to the electronic system.
“The Cerner platform is extremely flexible,” Windom said. “Those data entry factors can be added to the solution set.”
VA Secretary Robert Wilkie said the system is a much-needed upgrade to an outdated system.
“The electronic health record, first and foremost, is a medical record,” he said in a recent MOAA interview (Read more from Wilkie here). “It will be a record of a continuum of service … from the time someone enters the military to the time there's a handover (to the VA), it will be interoperable. The other thing it will do is address what I have told the Congress is our administrative, bureaucratic problems here at the department by making appointments and scheduling electronically, getting away from paper, getting away from IT systems that are 10, 20, sometimes 30 years old. So that is going to help.”