By fostering an open source ecosystem around their joint iEHR, the DoD and VA are not only tapping into less expensive software and development, but also training industry on how to work with them,  sparking innovation and, ultimately, reaping the rewards of those IT advancements. 

Harris Healthcare Solutions works with the DoD and the VA and recently won a contract to manage the SOA piece of the iEHR puzzle. Government Health IT spoke with Harris president Jim Traficant about what the services approach enables the VA and DoD to accomplish, the “genius” vision of working with the open source community on a project so vast in scale and projects where the federal government has succeeded by using this model.

Q: Harris was awarded an $80 million contract to develop the SOA portion of the VA DoD joint iEHR – what will an SOA enable that the agencies could not otherwise manage?
A: When we look at where the DoD and VA are headed, joint is the answer. They need a common platform to do a better job on continuity of care as service members move from the DoD into the VA system. So the service-oriented architecture is foundational to that future state of an integrated electronic health record, and will be the architectural foundation upon which all of the other capabilities will be integrated.

Q: Is the SOA the entire integration layer? One of many pieces? How does that all work?
A: It will be the foundational piece, I don’t know if it will be the only piece. The SOA allows you to go to the application layer because you can plug into a common service bus and be vendor-agnostic, application-agnostic and you can future-proof the architecture so you’re no longer dependent on individual systems being tightly integrated with each other. Now they can be commonly integrated into the architectural SOA, and the SOA will handle the communications, from an infrastructure standpoint, between the applications.

[Q&A: 3M president Lindekugel on how Open HDD and VA, DoD iEHR will trigger innovation.]

Then when you get up to the data layer and the UI, it allows you to bring that up to the screen and organize the data according to workflow. Harris is also doing single sign-on across the VA and DoD to make it possible for those applications to function as a common system so clinicians can enter into the architecture with a single log-in and then move between the applications with the information organized in the context of the patient, and according to workflow.

Q: Another thing the VA has talked about is deploying iEHR at two military health facilities in the next two years: San Antonio and Hampton Roads, Va.
A: And a lot of that will be applications, so we’ll see things like pharmacy, lab, electronic medical record and all of those things riding on top of this SOA architecture. There will be separate procurement and separate contracts around the tasking of those applications within the overall architecture the SOA framework undergirds.

Q: One of the aspects of iEHR is that open source components will be available via OSEHRA, will any SOA pieces be among those?
A: What we’re seeing is the DoD and VA want to take advantage of open source as much s they can – and that’s why it’s also part of the service-oriented architecture. We’ve got some COTS with IBM, we also have open source elements. The goal of this is that, if you look at it, over half the care provided for active-duty and retired service members comes from the private sector, so if we’re going to get to this transformation, it’s great that we’re connecting the enterprises, but there’s still more to be done. We’ve got to enable an ecosystem, an infrastructure, a collaboration between the government and the private sector so we can do full continuity of care, not only between the DoD and the VA, but also when patients go to their hometown hospital or physician and then come back into the VA so that information can flow. Open source is going to provide cost-effective solutions to enable this future state of continuity of care. I think it’s a great vision.

Q: And how does open source advance that vision?
A: I think there’s an opportunity for it to work much like what ONC did with the Nationwide Health Information Network. What we saw there was solutions created in the federal sector by the Federal Health Architecture were able to be adopted and embraced because they are standards-based and open and I think you’ll see a similar model coming to the OSEHRA effort and they will proliferate out into the industry. Once that happens, it enables the vendors to build solutions that will work in the federal space so the VA and DoD don’t have to build it from scratch and maintain these complex applications.

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