A team from Georgia Tech has successfully demonstrated a new technology platform for the Department of Veterans Affairs. The digital health platform delivers capabilities that VA and VHA leadership had identified as strategically important to support clinical and operational policy and program transformation plans. If implemented, the platform would address expected changes in veteran populations, service needs and care delivery models.
The platform is designed to help the VA modernize its records keeping and patient management processes. It can take in information from a broad range of military and commercial electronic records systems and can also pull in digital health data from devices like FitBits.
The public-private collaboration, established in partnership with the VA’s Office of Information and Technology, included the VHA, Office of the National Coordinator for Health Information Technology (ONC), the Georgia Institute of Technology and private-sector companies providing services in analytics, customer relationship management, and application program interfaces. Georgia Tech served as the project’s lead architect and provided overall project management.
“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,” said Steve Rushing, senior strategic adviser in Georgia Tech’s Health Extension Services of the project.
The impetus for the project was VHA strategic planning in the spring of 2016, which started developing a successor to VistA, which has served the agency for 40 years.
The team – including partner organizations Salesforce, Mulesoft, Apervita and UCB – conducted its first demonstration just six weeks after the contract with the VA was signed. Salesforce provided the CRM technology; Mulesoft the API gateway; Apervita provided real-time analytics capability and UCB offered a portfolio of predictive analytics solutions for epilepsy.
Using Fast Healthcare Interoperability Resources (FHIR), a standard describing health data formats and elements, and a REST API transport protocol, the team built an API gateway surrounding VistA and Georgia Tech’s testing and teaching electronic health record system, known as GTonFHIR. The project used anonymous patient data.
The overall project created 21 system APIs, which control how specific types of data flow into and out of the DHP. This included data exchanges with the Cerner EHR representing the Department of Defense and a community hospital; Duke University Medical Center as an academic medical provider; DocSnap personal health record connecting to a Navy medicine pilot project, and personal health monitoring devices via Apple Healthkit and Validic.
Because the architecture is not tied to any proprietary system, the proof-of-concept accommodates future developments by connecting to and from other web services, apps, devices or electronic health systems that use the FHIR or other accepted industry open standards, Rushing said.
Among the innovations is an analytics layer. By studying the health records of service members transitioning from active duty to veteran status, the analytics layer makes recommendations about care, such as enrollment in specialized services for veterans suffering from traumatic brain injury (TBI).
As an independent third party, Georgia Tech combined the best components from the VA/VHA and private sector companies, negotiated any differences and worked with private-sector staff in five different programming teams to meet the VA’s goals. The demonstration addressed the specific challenges of three groups of former service members: Iraq war veterans with traumatic brain injuries, women veterans who need gender-specific services not traditionally provided by the VA, and Vietnam-era veterans who are now suffering age-related illnesses such as diabetes and congestive heart failure. TBIs alone affect some 87,000 veterans.
Image source: Georgia Tech