The Veterans Health Information Exchange (VHIE) allows for the exchange of textual reports and computable data between the VA and other government and private sector health organizations. Initial data exchanged includes: outpatient pharmacy, allergy, conditions, and demographics. The exchange is conducted compliant with national standards as defined by the Health IT Standard Panel (HITSP) and the Nationwide Health Information Network (NwHIN).
NwHIN is the initiative for the exchange of healthcare information developed under the auspices of the United States Office of the National Coordinator for Health Information Technology (ONCHIT). ONCHIT has been facilitating development of NwHIN technology and standards to provide a secure, nationwide, interoperable health information infrastructure that connects health providers, consumers and others involved in supporting health and healthcare, serving our nation’s military service Veteran population. By consent of the Veterans, the NwHIN enables bi-directional exchange and sharing of VA and non-VA health records with partnering entities.
The VA NwHIN Adapter project is a HealtheVet-Veterans Health Information Systems and Technology Architecture (VistA) application that acts as a gateway between the VA and other health information exchanges (HIE) to share Veteran patient clinical records. The Adapter is deployed as a single, national instance at AITC. Payloads are standards-based Clinical Document Architecture (CDA) Extensible Markup Language (XML) documents. VistA data is retrieved through the use of VistALink-mediated Remote Procedure Calls (RPCs), and the clinical data retrieved by the Adapter is displayed to users through VistAWeb. Note: The Adapter is a read-only service; it does not create a clinical repository with the data it mediates.
The Adapter interacts with all services up to the VA Gateway. The Adapter 5.0.1 release supports Virtual Patient Record (VPR) Remote Procedure Call (RPC) version 1.1.
The VA Adapter Gateway communicates directly with the Veterans Authorization and Preferences (VAP) application for authorization since the orchestration in the gateway has the call to the policy component of the system. VAP communicates with the Adapter for the publishing of Veteran preference changes and the receipt of HIE subscriptions to Veteran preferences. Note: VistA Web is the VA front end that VA clinicians use to consume NwHIN documents. The Adapter 5.0.1 release supports VistAWeb versions 16.0.
The Adapter is an enterprise application designed to provide standards-based exchange of VA medical data with external Federal agencies such as the United States Department of Defense (DoD) and the Social Security Administration (SSA), as well as with public sector Health Information Exchanges (HIEs). The Adapter supports multi-divisional capabilities by enabling:
• VA treatment facilities to perform clinical care activities by receiving data about the medical treatment provided to the patient outside the VA at NwHIN partner organizations.
• External NwHIN partner organizations to perform clinical care activities by receiving data about the treatment provided to the patient at the VA.
• Veterans to receive continuity of care by enabling their VA and non-VA medical information to travel with them as they move geographically in the U.S.
The current phase of Adapter development is a patch release referred to as Adapter 5.0.1.
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