BOSTON — The U.S. Division of Veterans Affairs during the last yr has made a pointed shift to modernize the company: First with the announcement to interchange its legacy EHR with Cerner in June 2017 and subsequent with a number of platforms to spice up transparency and telemedicine efforts.
However the launch of its open API undertaking in March – as soon as dubbed Lighthouse and now known as the VA API Developer Sandbox – is zeroed in on interoperability and modernization. Led by College of Pittsburgh Medical Heart Chief Innovation Officer Rasu Shrestha, the undertaking has grown with dozens of different hospitals becoming a member of the trouble.
To Ken Rubin, director of requirements and interoperability for the Veterans Well being Affairs Workplace of Information Based mostly Programs, the VA has some fairly large knowledge challenges that it hopes the API undertaking and FHIR can deal with.[Also: FHIR and Open APIs are here to stay – but are they ready for prime time?]
For every affected person, the VA can have as much as 150 years of knowledge, Rubin defined. However one other problem is the rise of consumer-based and direct care and the enlargement of look after veterans into the personal sector.
“About 50 % of veterans’ care occurs throughout the VA. These numbers fluctuate, however the backside line is that there’s an enormous quantity of care occurring exterior the VA,” Rubin mentioned at HL7’s DevDays on Tuesday.
“So even when we resolve interoperability throughout the VA, we’ve solely solved half of the issue,” he added.
The VA is also working to be self-organizing with regards to knowledge, because it automates and transitions its workflows. Particularly as there’s “an enormous spectrum of knowledge that comes again to the VA” from the personal sector, the company must do a greater job of orchestrating that knowledge switch and making certain the following step of care “can decide up and carry that ball ahead.”
Rubin additionally expressed concern about the concept FHIR is a cure-all for interoperability. Whereas it’s nice for getting knowledge on a person affected person, it’s restricted with regards to aggregating knowledge from the system to find out a set of behaviors.
“FHIR is a good instrument, but it surely’s not the one instrument,” Rubin mentioned. “Don’t use FHIR as a hammer to pound screws. Use FHIR in areas the place it must develop.”
“It’s not about choosing a model: The VA will all the time need to help different methods till there’s ubiquity throughout the sector,” Rubin added. “Bear that in thoughts: We’re solely addressing a chunk of the puzzle.”
IT is commonly seen as a drag to productiveness, which is an issue the VA is attempting to resolve by leaning on personal sector builders and suppliers to share knowledge and develop apps to make that knowledge usable, Rubin defined.
“We will’t do it alone. We need to have interaction the ecosystem, that’s why we’re right here. We imagine in the place FHIR goes and it’s a vital instrument within the toolbox,” Rubin mentioned. “Availability of knowledge is critically necessary, however the physique of medical knowledge grows each month – you received’t be capable of hold tempo. Information is critically necessary to knowledge and processing interoperability.”
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