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WEB-BASED MILITARY HEALTH RECORDS SYSTEM CALLED
A BUREAUCRATIC, NOT A TECHNICAL, CHALLENGE --
Commercial vendors who develop and manage
Web-based
health record systems say a recommendation by a
presidential
commission to develop such a system for
soldiers and
veterans would be a relatively easy task.
For more on the Dole-Shalala Commission and
their recommendations, use the VA Watchdog search
engine...click here...
http://www.yourvabenefits.org/sessearch
.php?q=dole+shalala&op=and
Story
here...
http://www.govexec
.com/dailyfed/0807/080207bb1.htm
Story below:
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Web-based military health records system called
bureaucratic, not technical, challenge
By Bob Brewin
bbrewin@govexec.com
Commercial vendors who develop and manage Web-based health record
systems say a recommendation by a presidential commission to develop
such a system for soldiers and veterans would be a relatively easy task.
In its recently released report, the Commission on Care for America's
Returning Wounded Warriors said the departments of Defense and Veterans
Affairs must be able to transfer health and benefits information and
"move quickly to get clinical and benefits information to users." The
panel was appointed by President Bush in the wake of reports of poor
treatment of wounded soldiers at Walter Reed Army Medical Center.
Defense and the VA have been working for at least five years to
integrate their systems, but they remain "fragmented and
compartmentalized," and a simpler one needs to be developed to handle
health data interchange, the commission recommended.
The panel, co-chaired by former Sen. Bob Dole, R-Kan., and Donna
Shalala, secretary of the Department of Health and Human Services in the
Clinton administration, recommended that Defense and VA develop within a
year a Web-based portal to present all health care and benefits
information from the two departments. The system also should provide
patient records to recovery coordinators (who work directly with wounded
soldiers in military clinics and hospitals), clinicians and other health
care professionals in both departments.
Craig Froude, executive vice president and general manager of WebMD
Health Services, the market leader in Web-based health records systems,
said such a system already exists in the commercial health care market.
What the commission envisions is what WebMD provides to more than 100
hospitals and health care networks through its private portal business,
Froude said.
WebMD manages health care plans for large employers such as American
Airlines, Dell and IBM, as well as major insurers including WellPoint,
Froude said. These private portals integrate health care and benefit
information onto Web-based systems or dashboards customized for
patients, clinicians, plan coordinators or other users, Froude said.
WebMD's portal also can make pharmacy information available to patients
and clinicians and display radiological images on the clinician
dashboard. This "unified interface" can link to benefit information,
Froude said.
Froude said WebMD private portals serve 30 million people and the public
WebMD site processes 40 million visits a year. That scale is larger than
the one that Defense and the VA manage each year. Defense's Military
Health Care System manages records for more than 9 million
beneficiaries, and the VA treated 5.5 million patients in 2006.
Froude said it would be daunting to develop a complete health care
portal to integrate all health and benefits data from the two
departments within the commission's 12-month time frame. "This is a huge
undertaking," he said, and it would take more time. But, Froude said,
using a phased development approach, some functionality could be up and
running within a year.
Chakri Toleti, co-founder of Galvanon, a health care Web-portal
developer owned by NCR, called the job of stitching together Defense and
VA health information systems "relatively easy" and said his company
could easily meet the deadline set by the commission. Toleti said
Galvanon has set up the portal framework for health care systems with 20
or more hospitals serving hundreds of thousands of patients in four
months.
Galvanon uses Web services that find and expose data to a portal well, a
technique established in the banking and health care industries. He said
since Defense and VA have developed electronic health-record systems, it
would not be difficult to build interfaces that can locate, package and
display the data on a portal.
In less than a year, Intermountain Health Care in Salt Lake City, which
serves more than 1 million patients in 21 hospitals and clinics,
developed portals to serve clinicians and patients, said Belle Rowan,
director of clinical channels for the Intermountain e-business division.
Intermountain used Enterprise Java Bean technology from Sun Microsystems
to integrate data from back-end systems into the Web portals. The
project required about nine months of coding. "It was time-consuming but
not difficult," Rowan said.
Robert McFarland, who served as the VA's assistant secretary for
information and technology and chief information officer from January
2004 to April 2006, agreed that the technical challenge of building the
Web-based system is not a problem. Application interfaces and digital
hooks can tie together the disparate data structures and incompatible
health systems of the VA and Defense. He said automating benefits would
prove more of a challenge for the Veterans Benefits Administration,
which "is in the nineteenth century" when it comes to handling claims
because it primarily uses a paper-based process.
The bigger challenge, McFarland said, will be the political and
bureaucratic environment, in which Defense and the VA have stridently
independent business units. "Sharing information [between Defense and
VA] has been the right thing to do for the past 20 years, and it's not
rocket science," McFarland said. "But there has to be a desire on both
sides to make it happen."
Based on his experience, McFarland said that only Congress can force the
two departments to meet the commission's recommendation by passing laws
that leave little wiggle room.
But companies like WebMD and Galvanon may find the federal government a
frustrating place in which to work, having to deal with the bureaucracy,
turf wars, infighting and politics evident in Defense and VA
organizations, McFarland said. That means the battle over the Web portal
contract would most likely go to "the Beltway Bandits, who have played
this game for years," he said.
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Larry Scott --
