Legionnaires receive demonstration on new VA electronic health record

The American Legion has long advocated for the Department of Veterans Affairs (VA) to create a lifetime electronic health records (EHR) system. And last May, the VA signed a $10 billion contract with Cerner Corp. for a new EHR system, which is set to be fully implemented by 2028.

Staff from Cerner gave a demonstration to The American Legion’s Veterans Affairs and Rehabilitation Commission members Feb. 25, during the Legion’s annual Washington Conference, about what the new EHR system looks like and how it will help prevent any errors in medical decision-making and create the best care possible for the more than nine million veterans enrolled in the VA.

VA’s EHR system will not only eliminate the need for a veteran to carry paper records between VA facilities, it will bring together all outside records from different sources into one single viewpoint. Meaning, all patient data from the VA, Department of Defense and community will be aggregated into one seamless viewpoint to allow VA providers access to a patients entire health record.

“No matter where veterans are receiving their care, every member of the care team is going to have the full story,” said Jason Theunissen, senior solutions advisor for Cerner. “This is how we keep everything in one record and keep the care team informed.”

Veterans also will have an opportunity to be actively involved in their own care through the online portal Myhealthevet. Here, they can communicate with their care team through messages or video interaction, as well as have access to their health information, diagnostics, upcoming appointments, medications, discharge care instructions, follow-up care and more. They will even be able to see how many veterans are waiting in the emergency department, and how long the wait time is. The ER doctor is going to have access to the same information that the veteran has available in the online portal and that’s seen in the clinical setting. “This is one longitudinal record without miscommunication no matter what venue of care that we are seeing the veteran in,” Theunissen said.

Another benefit of the new system is that the data coming in is going to be aggregated to keep track of the chronic conditions veterans are managing. Theunissen said Cerner’s strategy to population health is to know who the veterans are, engage with them and help them manage their chronic conditions. The system will allow the care team to see who is doing well with their treatment plan, who is not and who needs an additional follow-up. “This is how we get proactive about things like heart disease, depression, post-traumatic stress disorder, here is how we can ensure every veteran is keeping up with all of their care needs,” Theunissen said.

For example, if a veteran needs further treatment to advance care, such as group therapy, the new EHR system will make it more seamless for the referral, as well as for the therapist to document the veterans treatment in therapy.

“As we talk about managing referrals, typically they are very difficult to manage. They are constantly changing and information resides in different areas,” said Nora Reiling with Cerner. “With Cerner, we are pulling all of that data into one centralized worklist so the referral coordinator can keep tabs on all referrals across different specialties, whether those are inbound or even outbound.”

Then when a veteran goes to group therapy, everyone is on the same page when it comes to caring for him or her. “When they go to group therapy, we are not starting from scratch. All of their information is going to be there (in the EHR) for the group therapist,” Theunissen said, to share how the session progressed or personalized goals established. “So being able to have this information documented, in a personalized manner, once again being able to effectively communicate a veterans needs across his care team.”

The EHR system also allows clinicians to trend information over time. So as assessments are embedded in a patients record, such as depression screenings, the care team can see if depression is increasing for the veteran. “This is how we are proactive about things like suicide precaution, about depression level,” Theunissen said.

Another key component of the EHR is the monitoring of medication. “If mistakes happen in the care of a veteran, chances are it’s around the medication process. If you’re getting care at different facilities, miscommunication can happen,” Theunissen said. With the sharing of data in one central location, clinicians can make sure there are no conflicts with medications and other care that the veteran has been receiving internally or externally. “This is how we bring all this information into one record and make better clinical decisions about the medications that we are prescribing for our veterans. So we are preventing medication errors on the front end.”

The VA received nearly $800 million in funding from Congress for fiscal 2018 to begin the contract. And as a legislative priority, The American Legion wants Congress to ensure this EHR initiative remains fully funded and that VA regularly reports EHR progress to Congress.

"At the end of the day, it's about giving veterans the best care possible," Theunissen said. "Were here to embark and transform the journey. It’s not just for veterans, but really for all of health care."