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Researchers build VistA interoperability into digital health platform demo

Even as the Department of Veterans Affairs signals its intent to move off its Veterans Health Information Systems and Technology Architecture (VistA) and adopt a commercial electronic health records system, researchers have demonstrated a scalable proof-of-concept, interoperable digital health platform that could modernize VA’s record keeping and patient management process.

Working with a number of partners, a team led by Georgia Tech created 21 interoperable, standardized application programming interfaces to exchange information among different systems, including VistA; Cerner’s electronic medical records system, used by the Department of Defense and a community hospital; Duke University Medical Center records; DocSnap records for a Navy medicine pilot project; and personal health monitoring devices via Apple Healthkit and Validic.

The project’s goal was to build a platform that combined the best components from the health records systems of the VA, the Veterans Heath Administration and private-sector companies, then liberated the data.

Data that is freed from deep inside individual systems and moved to the cloud where it can be managed by APIs offers “a lot of options for reorganizing work flows and processes,” Steve Rushing, senior strategic adviser in Georgia Tech’s Health Extension Services, told Georgia Tech Research News. “We are doing for health care what has already been done for other industries that have used interoperability standards as the foundation for APIs to exchange information among different systems.”

We “kept what works” and added new innovations from the Veterans Health Administration and private industry where needed, he added.

The APIs are based on the Fast Healthcare Interoperability Resources (FHIR), an open standard describing health data formats and elements, and a REST API transport protocol for providing interoperability between computer systems on the internet. These open standards allow connections to and from other web services, apps, devices or electronic health systems that use the FHIR or other accepted industry open standards, Rushing said. The system also makes future tech enhancements possible.

Because much of the original VistA system is still accessible via the API gateway, VA can accelerate the deployment of its existing health IT innovations and protect its investment in the VistA system, he explained.   VistA has been providing electronic health records and administrative tools for the VA for 40 years for 7.6 million active veterans.

LaVerne Council, the VA’s CIO at the time the project was conducted, said it took eight weeks to connect the 21 APIs to the Georgia Tech FLIR server, VistA, a customer relationship management system and a real-time analytics system.

“We also developed a veteran-facing mobile app,” Council told Georgia Tech Research News. “We integrated low-cost, high-quality video communication into the fabric of the veteran experience, and we integrated internet-connected health devices that track activities and vitals including blood pressure, weight and blood glucose.”

An analytics layer studies the health records of service members to make recommendations on their care, such as enrollment in specialized services for veterans suffering from traumatic brain injury.

The same way Facebook and Amazon provide a custom experience,  “the system learns about you from your records to help health professionals precisely meet your personal needs,” Rushing told Georgia Tech Research News. Rather than wait until a veteran has a seizure because of a service-related injury, the system would use the analytics to recommend a protocol for proactively managing the problem.”

Project partners include the VA’s Office of Information and Technology, the VHA, the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology, the Georgia Institute of Technology and private-sector companies providing services in analytics, customer relationship management, and application program interfaces.


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