Differing Electronic Health Record Systems
Each joint venture has developed workarounds for managing patients seen by both VA and DoD providers. The most advanced is Janus, the graphical user interface developed by the Hawaii joint venture, which has been chosen to be the basis for developing a joint user interface for the VA/DoD integrated EHR system. Janus was originally developed to manage prescriptions for VA patients being admitted to the Tripler Army Hospital. The planners of the Lovell FHCC were well aware of the importance of having the capability of accessing and updating VA and DoD patient health records simultaneously, and they insisted on having some basic interoperability capabilities in place. The delays in delivering those capabilities have subjected the Lovell FHCC to the same limits on seamless patient care as the joint ventures have faced.
Collaborations are challenging, time-consuming, and expensive, even in the best of circumstances. A literature review focused on private-sector health care collaborative ventures (see Appendix D) leads to the conclusion that there is much we do not know about how to reduce the uncertainty and to increase the success of sharing resources. Additional interdisciplinary work in this area is critical to expanding our ability to create collaborations that achieve the desired outcomes.
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