The Integration of Home Collected Data into the Veterans Administration Health System - The Home Telehealth VistA Integration Project: The Sharing of Computable Data

摘要

In 2004, the US Department of Veterans Affairs was confronted with the creation of an enterprise application based upon multiple triage systems supplied by vendors who had dramatically different levels of experience with system integration or with Health Level 7 International Standard. One objective of the application was to leverage the capabilities of the existing Electronic Medical Record and medical software wherever possible. In order to accomplish the objective a strong integration approach was required. The selected approach was the development of a reference engine that could be used to validate the communication between existing applications and newly procured triage systems. The approach also included the development of supplements that are specific to the usage of the international standards. The triage system validation is performed in three phases. The first two phases are directed by a set of functional validation objectives. The third phase is a limited deployment supporting actual patients to minimize risk to patient care during a national rollout. The objectives are the slaving of patient identity and demographics to the enterprise identity management, the collection of patient survey responses, and the placement of triage system generated progress notes and home collected vital signs in an enterprise database. A direct result of this integration is the automatic inclusion of the Home Telehealth program in the standard enterprise outcomes analysis and availability of the program data to whole clinical team. This paper describes the integration process and problems that were confronted during the first five years of the program. The paper represents the opinion of the authors and is not a statement of any official position of the Department of Veterans Affairs.