As joint initiatives develop between the Departments of Defense (DoD) and Veterans Affairs (VA), the methods by which information is shared and exchanged are a critical component. The Wounded, Ill, and Injured Senior Oversight Committee (SOC) aligned all issues relating to both DoD and VA under the Joint Strategic Plan (JSP). The JSP details the collaborative future plans to strengthen the capabilities of both Departments to better serve our beneficiaries. A major component of the JSP is information management and information technology.

As detailed in the JSP, the DoD/VA Interagency Program Office (IPO) was established in April 2008, as mandated by Section 1635 of the National Defense Authorization Act (NDAA) for Fiscal Year 2008 (FY08). The IPO acts as the single point of accountability for the development and implementation of electronic health record (EHR) systems and capabilities and provides oversight and management of the delivery of interoperability goals and objectives. At the direction of the SOC, the IPO expanded their original focus to include electronic data sharing of personnel and benefits information. Responsibility for development of requirements and execution of information technology solutions remain with the respective DoD and VA organizations.

Some significant DoD/VA goals and objectives the IPO oversees and manages are:

the implementation of full interoperability of health care information for the provision of clinical care (by September 2009);

development of a master integrated schedule of interoperable electronic health record systems or capabilities;

assistance and guidance on program budget planning for data sharing and recommendations for program budget requirements;

development and maintenance of metrics to monitor performance against goals;

assistance in obtaining the input and concurrence of relevant stakeholders; and

accelerating the exchange and delivery of health care information.

The IPO receives direction from the Department Secretaries and the VA/DoD Joint Executive Council (JEC) Co-chairs, and is responsible for submitting an annual Report to Congress through 2014 describing activities, purpose of expenditures, and an assessment of progress. The IPO is also subject to a Government Accountability Office audit every six months.

The IPO kicked off with the delivery of high-level schedules and milestones to Congress and the Government Accountability Office in April 2008. The quick pace continued with the Joint DoD/VA Information Interoperability Plan written and delivered to Congress along with the Joint Report to Congress, 2008 Activities of the DoD and VA IPO signed December 29, 2008. The IPO finished 2008 on a high note with the DoD Delegation of Authority Memorandum, Establishment of the Department of Defense/Veterans Affairs Interagency Program Office within the Under Secretary of Defense for Personnel and Readiness signed on December 30, 2008. The IPO Charter was signed in January 2009, beginning in what promises to be another fast paced year as the Departments continue toward the goal of fully interoperable EHRs for the provision of clinical care by the end of September 2009.

More recently, the IPO’s scope was expanded to facilitate the creation of a Virtual Lifetime Electronic Record (VLER). The VLER vision is that health, benefits, and personnel information of a Service member or Veteran from the time of accession to internment will be available to those who need the data. The VLER will use a data-centric common services approach based on national standards, and will provide information assurance, member privacy and visibility, and enable role-based access. This approach captures the primacy of our business processes and the functional community’s requirements, including those of our Service members, veterans, and their beneficiaries.

The IPO, DoD, and VA understand that well-defined standards are the essential foundation for interoperability between systems. A common services approach is in development that will be based on national standards for health-related data. These standards will be guided by the Department of Health and Human Services (HHS), and will be consistent with the Nationwide Health Information Network (NHIN) model based on the Federal Health Architecture. Together we will work in collaboration, and maintain consistency with HHS standards, to develop and determine interoperability specifications, implementation, acquisition, and upgrade of health information technology systems.

Since the endorsement of this approach by the Secretaries of VA and DoD, much work has been done. Senior key department officials have been appointed to ensure VLER meets applicable interoperability standards and implementation specifi cations. The IPO, along with DoD and VA, have drafted and staffed a governance structure, have begun establishing high-level workgroups to oversee progress, and will continue to leverage existing groups within both departments to help make this effort successful.

The IPO’s near-term goals remain on track – to achieve full interoperability of DoD and VA EHRs for the provision of clinical care by September 2009 and to expand its involvement in personnel and benefits electronic data sharing. The IPO will continue planning for the creation of the VLER by empowering and launching some of the work groups and defining the lifetime data required for Service members and veterans. The IPO understands that there will be challenges along the way and one near-term goal toward the creation of the VLER is to identify barriers to progress. By identifying problems early, we can work together collegially to resolve them.

The DoD and VA Secretaries have expressed high interest in achieving this Virtual Lifetime Electronic Record, and I am fully confident that the IPO has made important steps in achieving these goals. This important step is just the beginning of what will prove to be a great advancement in health care technology for the nation, starting with providing seamless support to our Service members and veterans, to whom we owe the greatest debt of gratitude.

Michael E. Kilpatrick, M.D., is Director of Strategic Communications for the Military Health System in the Office of the Assistant Secretary of Defense for Health Affairs.