Rarely is the response to a new government initiative a unanimous round of "thumbs up," but so far that seems to be the case regarding yesterday's (April 9) announcement that The Defense Department and the Department of Veterans Affairs will collaborate on building an electronic database of administrative and medical information for U.S. servicemen and women.Since developing a broad electronic health records (EHRs) initiative is a prominent feature of the Obama Administration's economic stimulus plan, it makes sense to start (or at least focus) on a defined segment of the population -- current and past military personnel. But, apart from the specific technology, architecture and technical administration aspects of this program, there will be other challenges in pursuing the goal of EHRs for the military -- challenges that insurance technology executives know only too well. These include collaboration among different and sometimes competing interests (in this case, the Department of Defense (DOD) and the Department of Veterans Affairs (VA), which historically have not worked together as closely as one might imagine); and concerns about privacy and security. In fact, the ways in which the military EHRs initiative addresses the privacy issue could provide some interesting best practices (or actions to avoid) for private-sector players.
"Currently, there is no comprehensive system in place that allows for a streamlined transition of health records between DOD and the VA," President Barack Obama said at yesterday's announcement, "and that results in extraordinary hardship for an awful lot of veterans who end up finding their records lost, unable to get their benefits processed in a timely fashion. And that's why I'm asking both departments to work together to define and build a seamless system of integration with a simple goal: When a member of the Armed Forces separates from the military, he or she will no longer have to walk paperwork from a DOD duty station to a local V.A. health center. Their electronic records will transition along with them and remain with them forever."
An interesting discussion about the many "pros" and the few "cons" of the military EHR program took place last night on public television's "The NewsHour with Jim Lehrer." The panelists were Steve Robinson of Veterans for Common Sense, a veterans advocacy organization; Dr. Donald Berwick, president and CEO of the Institute for Healthcare Improvement, an independent, not-for-profit group working on patient care issues; and Dr. Deborah Peel, founder and chair of the Patient Privacy Rights Center, a health privacy watchdog group. Here is a video of the discussion: