1. Bidirectional Health Information Exchange (BHIE) 24 April 2007 1300 EDT IHS Briefing Mr. Greg W. Donham Draft

2. DRAFT 1 Interagency Briefing Agenda  Overview of BHIE  Architectural Approach of BHIE  BHIE Deployment and Statistics  CHDR and the Future of Interoperability

3. DRAFT 2 Steps to interoperability Federal Health Information Exchange (FHIE), provides clinicians at all Veterans Health Administration facilities with the capability to access DoD health information on separated and retired members of the Uniformed Services. Bidirectional Health Information Exchange (BHIE): BHIE permits DoD military treatment facilities to share clinical data capable of computational actions with any VA medical center when a shared patient presents for care. Clinical Data Repository/Health Data Repository (CHDR) enables the VA’s Health Data Repository (HDR) and the DoD’s Clinical Data Repository (CDR) to share outpatient pharmacy and drug allergy information for Active Dual Consumer (ADC) patients.

4. DRAFT 3 DoD/VA BHIE Project : NDAA Funded The goal of BHIE is to improve the service to provide outstanding health care to our Veterans by:  Providing a more complete electronic text and image record of patient care over time  Providing timely and accurate clinical information to the health care provider and patients  Displaying and, if possible, avoiding the duplication of medical tests  Providing a more complete record of external care for VA patients

5. DRAFT 4 Interoperability Goals  Provide the best healthcare possible to the U.S. Military and our veterans  Operate a joint system for initial one-way transfer of electronic health information from DoD to VA that contributes to veterans’ health  Provide on-demand electronic health information to assist in the compensation process  Ensure compliance with HIPAA regulations and security requirements with existing systems  Create an environment for storing very sensitive information  Use a patient-focused information technology familiar to authorized VA and DoD users

6. DRAFT 5 DoD CHCS Sharing Facility CHCS MHS Data Repository FHIE/BHIE Framework FHIE/BHIE Framework FHIE Repository HL7 PDTS SADR K61 Pre/Post PDHRA VA MPI VistA VA Host (Station 200) VistA Local VAMC VA -Correlation of Patient Identity -Information Locator -Security -Optimization -Adapter/Connector CPRS High-Level FHIE/BHIE Architectural Components RDV & VistAWeb Query Access VistALink PIDS/ Correlation DoD Web Server DoD GUI CACHE’ Vitria IE HL7/ADT WS/XML HL7/ADT WS/XML DMSS CIS

7. DRAFT 6 BHIE Capabilities BHIE delivers Patient Identification Correlation and real time bidirectional transmittal and display of:  Outpatient Pharmacy;  Drug and Food Allergy;  Surgical Pathology Reports;  Cytology Results;  Radiology Text Reports;  Microbiology Results;  Chemistry & Hematology Results;  Laboratory Orders  CliniComp/Essentris Emergency Department Notes and Discharge Summaries  Medical Images (as of 3 May 2007)

8. DRAFT 7 BHIE Implementations  Madigan AMC - Oct 04*  William Beaumont AMC - Feb 05  Dwight D. Eisenhower AMC - Sep 05  Naval Hospital Great Lakes - 14 Sep 05  NMC, San Diego – Balboa - 21 Sep 05  National Capital Area - 14 Nov 05  Mike O'Callaghan Federal Hospital - 30 Nov 05  Landstuhl Regional MC, Germany - 20 Mar 06  Tripler Army Medical Center - 05 Apr 06*  Womack Army Medical Center - 26 Apr 06*  David Grant Medical Center - 18 Apr 06  Wilford Hall Medical Center - 10 May 06 * BHIE-CIS Implemented  Brooke Army Medical Center – 10 May 06 *  Bassett Army Community Hospital - 26 May 06  NH Jacksonville – 7 Jul 06  NH Charleston – 1 Aug 06  NH Pensacola – 3 Aug 06  NH Camp Lejeune – 11 Sep 06  NACC Groton – 16 Sep 06  NH Lemoore – 27 Sep 06  NMC Portsmouth – 27 Sep 06  Leonard Wood ACH – 12 Mar 07  Darnall AMC – 27 Mar 07  Fox Army Health Clinic – 3 Apr 07  Martin Army Community Hospital – 4 Apr 07  Interagency installation and training completed at:

9. DRAFT 8 BHIE Sites: Current and Pending BHIE operational BHIE implementations planned during FY2007 NCA LRMC Mike O’Callaghan Federal Hospital David Grant MC Bassett ACH Elmendorf AFB Madigan AMC NHC Great Lakes Eisenhower AMC NHC Charleston 25 DoD host sites = 15 DoD Medical Centers, 18 DoD Hospitals & over 190 DoD Clinics (Access to over 2.1 Million correlated patients) Tripler AMC William Beaumont AMC NMC San Diego NH Camp Pendleton NH Camp Lejeune Womack AMC NH Pensacola Darnall AMC MacDill AFB NH Jacksonville NACC Groton NH Corpus Christi Wright-Patterson AFB Martin ACH NH Lemoore NMC Portsmouth Minot AFB BHIE-CIS operational Leonard Wood ACH Fox AHC Kirtland AFB Brooke AMC Wilford Hall Evans ACH

10. DRAFT 9 Questions