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InterSystems Technology Supports Quality Care for Veterans Nationwide

InterSystems efforts improve veteran healthcare and accelerate time to care

InterSystems, a creative data technology provider dedicated to helping customers solve the most critical scalability, interoperability, and speed problems, announced it is showcasing Department of Veterans Affairs (VA) programs at the HIMSS annual conference that deliver quality care to veterans nationwide. InterSystems, Cognosante, and VetsEZ are collaborating to improve veterans’ healthcare journeys by streamlining health information sharing. Their solutions help providers obtain a full picture of a patient’s health history and enable veterans’ access to critical care.

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“InterSystems is committed to helping VA achieve its mission of providing benefits to veterans that they have both earned and rightly deserve”

Veteran healthcare needs can be complex and their medical records are often scattered across several points of care. Medical history needs to be aggregated from military treatment facilities, VA providers, and civilian care records. To address the information sharing challenges across VA networks and external healthcare providers, InterSystems technology is used by Cognosante and VetsEZ to implement solutions across VA, two of which are highlighted in this article.

Enterprise License and Support Agreement

VA contracts directly with InterSystems on the new Enterprise License and Support Agreement, which enables VA to quickly build needed solutions without incurring additional software license costs.

Expanding Program Support to Improve Healthcare Access for Veterans

While there are many VA integration partners using the InterSystems license, two VA initiatives will be presented at HIMSS which provide examples of the successful use of InterSystems technology at VA.

Veterans Data Integration and Federation Enterprise Platform (VDIF EP)

The new Enterprise Licensing and Support Agreement includes updates to software used in the Veterans Data Integration and Federation Enterprise Platform (VDIF EP) led by federal solution integrator VetsEZ in partnership with Ready Computing and J2 Interactive. VDIF is a modern, commercially proven, service-oriented cloud hosted middleware used by VA clinicians and administrative staff, as well as providers outside VA. VDIF produces a federated and longitudinal health record by aggregating and normalizing clinical data from VA’s existing electronic medical record systems. In doing so, it reduces the need for clinicians to hunt for medical information from multiple sources – enabling them to focus on caring for the veteran in front of them.

Based on InterSystems HealthShare®, VDIF aggregates and normalizes data from 130 different electronic medical record instances to support providers in 172 VA medical centers and more than 1,000 outpatient clinics. The electronic medical record VDIF collects from VA’s Veterans Health Information Systems and Technology Architecture (VistA) system additionally becomes part of the Consolidated Clinical Document Architecture (CCDA). The CCDA is shared with over 230 private external healthcare systems as part of a Veteran Health Administration (VHA) Veteran Health Information Exchange (VHIE) program, improving veteran care outside VA.

One of the exciting capabilities that VA’s VDIF program recently introduced is API Manager. API Manager enables access to VistA data without requiring knowledge of VistA, RPCs, or InterSystems HealthShare, thus enabling rapid application development and reduced costs and timelines. API Manager automatically generates code to access VistA data including JavaScript, Python, Ruby, and Curl shell commands. It leverages the standard Open API format that is familiar to developers. This initial release contains a developer portal, API catalog, sandbox environment, and an API gateway / load balancer. Additional releases will add support for FHIR R4, additional APIs, and enhanced developer self-service capabilities and result in the full self-service implementation that enables access to VistA data without requiring knowledge of an underlying system.

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VDIF Fast Health Interoperability Resources (FHIR) teams recently released VA Adverse Event Reporting System (ADERS) v1.0 into production. A key product for VDIF, it demonstrated the first use of VA R4 FHIR service in production and expanded VA’s interoperability with the Food and Drug Administration (FDA). Built on the services provided in the InterSystems license, this release utilizes a push model workflow to send veteran COVID-19 immunization adverse reactions to the FDA for further analysis. VHA VHIE stakeholders and Senior Executives expressed high praise for the team for delivering this important capability.

When COVID-19 emerged, the Department of Veterans Affairs (VA) recognized exchanging immunization data with state Immunization Information Systems (IIS) was a critical public health need. VDIF’s Immunization (IZ) Gateway team was able to leverage VDIF’s InterSystems technology to deploy automated reporting of VA immunizations from VA VistA system to the Center for Disease Control (CDC) IZ Gateway this past summer, with a goal of exchanging with 55 participating state IIS’s by end of FY23. VDIF EP’s IZ Gateway project, in collaboration with CDC, the IIS’s, and American Immunization Registry Association (AIRA) is expanding, standardizing, and improving reporting and exchange of immunization data in an effort to meet the public health needs of veterans and better prepare the nation moving forward.

Community Care Referrals and Authorizations (CCRA)

Led by federal solution integrator Cognosante, Community Care Referral and Authorization (CCRA) is an enterprise-wide program used by community care staff to generate timely referrals and authorizations for veterans receiving care in the community. CCRA integrated InterSystems HSRM into a broader solution and transitioned VA from a largely manual and slow process, to streamlined processes that reduced veterans’ wait times for a referral from over a month to just under a week.

“As a veteran who served overseas for three years, I returned to the U.S. with several health issues, and I chose to seek care through CCRA. It was easy to secure an appointment only a few weeks out, at a conveniently located clinic, and my doctor had access to all my military medical history,” said Erik Underwood, former U.S. Army Infantry. “CCRA is a great program that complements the care veterans receive through VA, for everything from routine healthcare to specialists and support for mental health.”

“InterSystems is committed to helping VA achieve its mission of providing benefits to veterans that they have both earned and rightly deserve,” said George Hou, Head of Solutions for the Department of Veteran Affairs at InterSystems. “We are proud to be part of the team continuing to help VA transform its information technology environment.”

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