Veterans Affairs

Background

VA provides healthcare services to over 9 million enrolled veterans in the United States in over 1200 outpatient sites, 300 vet centers, and 144 VA hospitals. The interoperability of Electronic Health Records (EHRs) is critical to increasing care quality, improving decision making, and reducing healthcare costs nationally. All EHRs certified for the Meaningful Use program are required to output data in a standardized format, called the Continuity of Care Document (CCD).1

While the CCD standard is widely used across the nation, many obstacles exist to seamless data exchange:

  • EHRs produce CCDs that encode the same information in different ways
  • Clinicians record the same patient information differently, such as branded drug names or generic equivalents
  • Clinicians and EHRs often omit data relevant for care transitions, such as dates of historic observations or future appointments
  • Quantitative clinical data often require normalization, such as body temperature measured in °F or °C

Research2-7 has documented hundreds of errors and validated a need to monitor data quality during real-world exchange to address variations that limit interoperability.

VA Solution

Together with our partner, Four Points Technology, L.L.C. (award information) we are delivering Diameter Health’s CCD Analyzer Data Quality Tool in a highly secure Software as a Service (SaaS) environment to support VA’s effort to improve the quality of clinical information by analyzing and validating the documents’ syntactic structure and semantic meaning to determine both completeness and correctness.

References:
1 Meaningful Use Regulations on CCD & C-CDA http://www.healthit.gov/policy-researchers-implementers/consolidated-cda-overview
2 D’Amore et al. (2014) http://www.ncbi.nlm.nih.gov/pubmed/24970839
3 Bryne et al. (2014) http://www.ncbi.nlm.nih.gov/pubmed/24845146
4 Botts, N et al. (2014) http://knowledge.amia.org/56638-amia-1.1540970/t-004-1.1544972/f-004-1.1544973/a-125-1545298/an-125-1.1545299?qr=1
5 SMART C-CDA Collaborative Infographic https://smartplatforms.org/wp-content/uploads/SMART-CCDA-infographic-011014.pdf
6 D’Amore et al. (2011) http://www.ncbi.nlm.nih.gov/pubmed/22195080
7 Phansalkar et al. (2009) http://www.ncbi.nlm.nih.gov/pubmed/20351911
8 NIST C-CDA validation engine http://transport-testing.nist.gov/ttt/
9 Ten-year ONC roadmap on interoperability http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf

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