Last week, the Veterans Health Administration of the Veterans Affairs Department announced it had succeeded in gaining a measure of the long-sought interoperability through a pilot interchange between its electronic clinical information system and that of the Defense Department.
The test sites were Walter Reed Army Medical Hospital in Washington and VA hospitals with polytrauma capabilities in Minneapolis, Palo Alto, Calif., Richmond, Va., and Tampa, Fla.
The pilot was first rolled out March 30 between 256-bed Walter Reed and 93-bed James A. Haley Veterans Hospital, Tampa, according to Brenda Stidham, the VAs polytrauma nurse liaison stationed at Walter Reed. The other three hospitals were brought up between June and Sept. 23, according to Rob Andreev, an independent IT contractor on the project working with Northrop Grumman Corp., the prime IT support contractor for the VAs Veterans Health Information and Systems Technology Architecture, or VistA, system, and its subcontractor at the VA, Science Applications International Corp., which developed the portal at the center of the pilot project.
Messages moving from Walter Reed will come to the VA in the situation, background, assessment and recommendation, or SBAR, format, Stidham said. SBAR is a structure for organizing a summary of medical information, akin to the subjective, objective, assessment and plan, or SOAP, note format in widespread use. SBAR is particularly well-suited for patients in critical condition.
Stidham said that the SBAR format was the consensus choice of a steering group of about 50 nurses contributing to the project from Walter Reed and the VA, a decision that received command approval at Walter Reed and with the VA leadership.
Our nurses find this note much easier to access because they know exactly where everything is, Stidham said.
Pre-pilot, the voluminous records of polytrauma patients transferred from Walter Reed to the VA were scanned and converted to electronic documents using the PDF document format, and then sent electronically, an improvement over shipping paper, but suboptimal in terms of efficiency on the senders end and usability on the recipients.
That took a tremendous amount of effort when a record was 800 pages long and you had to search through that to find the information that you wanted, Stidham said. In addition, There were a lot of last-minute faxing and phone calls taking place.