The Department of Veterans Affairs' (VA) implementation of the Virtual Lifetime Electronic Record (VLER): Findings and lessons learned from Health Information Exchange at 12 sites
The Department of Veterans Affairs' (VA) implementation of the Virtual Lifetime Electronic Record (VLER): Findings and lessons learned from Health Information Exchange at 12 sites
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DOI：
10.1016/j.ijmedinf.2014.04.005
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发表时间：
2014-08-01
影响因子：
4.9
通讯作者：
Cromwell, Tim
中科院分区：
文献类型：
--
作者：
Byrne, Colene M.;Mercincavage, Lauren M.;Cromwell, Tim
目的：我们描述了退伍军人事务部（VA）虚拟终身健康电子记录（VLER）在12个社区与私营部门医疗保健组织和国防部（DoD）交换健康信息的试点阶段，主要发现，经验教训和对全国推进健康信息交换（HIE）的影响。2009年12月至2012年10月，采用混合方法监测和评价了VLER健康交换试点阶段的实施情况。选定的成就，贡献，挑战，和早期的经验教训，是相关的全国性的HIE的增长discussed.Results：退伍军人患者和供应商的接受，信任和感知价值的VLER健康交换被发现是高的，和供应商的使用稳步增长。确定了改进提供者使用的挑战和机会，例如更好的数据质量和与工作流程的集成。推进HIE的主要调查结果和经验教训identified.Conclusions：VLER健康交换已经取得了很大的进步，在推进HIE全国解决重要的技术和政策问题，阻碍了可扩展性，并通过增加信任和信心的价值和准确性，HIE用户之间。VLER Health Exchange在全国范围内推进了HIE互操作性标准和患者同意政策。政策，方案，技术和卫生信息技术（IT）标准的影响，以推进HIE改善医疗保健的交付和协调进行了讨论。试点阶段的成功导致2013年在全弗吉尼亚州部署了这一数据共享能力。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Purpose: We describe the Department of Veterans Affairs' (VA) Virtual Lifetime Health Electronic Record (VLER) pilot phase in 12 communities to exchange health information with private sector health care organizations and the Department of Defense (DoD), key findings, lessons, and implications for advancing Health Information Exchanges (HIE), nationally.Methods: A mixed methods approach was used to monitor and evaluate the status of VLER Health Exchange pilot phase implementation from December 2009 through October 2012. Selected accomplishments, contributions, challenges, and early lessons that are relevant to the growth of nationwide HIE are discussed.Results: Veteran patient and provider acceptance, trust, and perceived value of VLER Health Exchange are found to be high, and usage by providers is steadily growing. Challenges and opportunities to improve provider use are identified, such as better data quality and integration with workflow. Key findings and lessons for advancing HIE are identified.Conclusions: VLER Health Exchange has made great strides in advancing HIE nationally by addressing important technical and policy issues that have impeded scalability, and by increasing trust and confidence in the value and accuracy of HIE among users. VLER Health Exchange has advanced HIE interoperability standards and patient consent policies nationally. Policy, programmatic, technology, and health Information Technology (IT) standards implications to advance HIE for improved delivery and coordination of health care are discussed. The pilot phase success led to VA-wide deployment of this data sharing capability in 2013. (C) 2014 Elsevier Ireland Ltd. All rights reserved.