How patients can help close gap between VA and non-VA care

Interoperability

Consumer-mediated health information exchange can help address lack of continuity in health records to improve care from multiple providers, according to new research published online in Telemedicine and e-Health.

The study involved training patients to use My HealtheVet, the patient portal of the Department of Veterans Affairs, to obtain their VA Continuity of Care Document (CCD); the CCD includes essential information such as allergies, medications, diagnoses and recent lab results from VA’s electronic health record system. Patients then could share this information with community-based providers outside the VA system.

After training, the veterans had 277 community appointments where they gave their doctors a packet, which included surveys about their perceptions of the program.

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Among patients, 78 percent reported the CCD would help them be more involved in their healthcare, and 86 percent said they intended to use it regularly. However, 31 percent reported some frustration creating the document; these users also were more likely to rate their computer skill level as "beginner."

The majority of patients (71 percent) discussed their VA care with their non-VA providers.

Among providers, 94 percent received a paper copy of the CCD and only 8 percent received it electronically through an HIE. They reported interest in receiving it electronically so it could be integrated with their EHR systems, and in receiving it prior to the patient visit.

Ninety-six percent of providers reported they want to continue receiving the CCDs. Its greatest value, they said, was in providing an accurate medication list and helping to make medication treatment decisions. Fifty percent said they did not order a laboratory test or another procedure after reviewing the CCD.

The CCD is being transitioned to a new form that will include more data classes and progress notes. It serves two audiences, patients and providers, and the challenges include meeting the needs of both groups, the authors say.

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