The Department of Veterans Affairs is leveraging lessons learned from its initial COVID-19 response experience to guide the agency's next steps, advancing data interoperability to fuel new dashboards and reach underrepresented populations. Agency representatives described the process in mid-March at the Healthcare Information and Management Systems Society (HIMSS) conference in Orlando, Florida.
VA overlaid its data on patient demographics, COVID-19 infections, socioeconomic status and race to pinpoint additional vaccine outreach to connect with veterans at highest risk because of their social determinants.
“Interoperability and innovation really must be at the core of what we do. If not, we would fail,” VA Product Line Manager Niriksha Patel said.
Health care leadership at the agency created a surge plan in response to COVID-19 in the form of support for providers and medical centers, focusing on increasing bed capacity, testing capacities and workforce to meet new demands. Veterans Health Administration developed in-person, online and simulation training to expand provider care capabilities, said Dr. Julie Flynn, acting assistant under secretary for health for community care.
During this pivot, Flynn said the agency faced two key challenges: care coordination and case management. To solve these challenges, VA looked to interoperability to ensure the right data was available to the right people at the right time.
“Regionally and nationally, VA needed not just visibility of our own data, but to be able to share data on bed capacity, [personal protective equipment] supply and ventilator usage so that we could make rapid decisions on patient transfers and load balancing of supplies. We needed to be able to seamlessly communicate with our community providers to ensure patient medical data was at our community providers fingertips,” Flynn said.
In tandem, VA’s Office of Community Care and Office of Information and Technology implemented a variety of process changes to improve veteran experience with timely access to quality care. A foundational element to VA’s COVID-19 care delivery was its electronic health record (EHR), which enabled better data sharing within the newly remote environment.
“All of this had to be supported by IT integrating with community providers to ensure two-way data flow in real time. The two-way data flow was obviously key during this time for coordination and case management,” Flynn said.
VA said automation improved speed of delivery and reduced workforce burden, consolidated technology to reduce redundancies and costs, and led to developing data dashboards to better display veteran health data. Flynn said these upgrades enabled VA to optimize its approach to emergency care by simplifying processes for veterans and community providers. Now, the authorization of emergency care is part of the IT workflow that supports business processes.
The agency also developed new data dashboards to visualize veteran health data and improve decision-making. The dashboards are updated daily to reflect COVID-19 infections, staffing, bed capacity and more. Through these dashboards, VA was able to analyze comorbidities and social determinants of health to focus care on more vulnerable populations.
“The speed at which VA rolled out dashboards and surveillance tools during this time was stunning,” Flynn said. “It not only helped with our local response, but also up to regional level and nationally. We were able to scale up, and that was key.”