Nearly one year ago, Secretary David Shulkin of the Department of Veterans Affairs (VA) announced that the VA’s electronic health record (EHR) is moving away from custom built software products and development in favor of commercial-off-the-shelf (COTS) solutions to provide for Veteran healthcare. This shift in the VA’s approach to software development represents a challenging decision: whether to build custom software systems from a general-purpose programming language, or whether to buy existing COTS solutions that seem to fit business needs and user requirements. In fact, many businesses outside government face this same difficult question, whether they are large corporations or small startups. It can be a dilemma to determine which route to choose.
Beyond Agile: Ellumen Inc. Brings Silicon Valley Testing Practices to VA/DoD Data Sharing Initiative
The Agile movement hasn’t just changed Federal government software procurement and development – it has undoubtedly whet the most influential Federal Government DoD and VA leaders’ appetites for more Silicon Valley innovation. But what else is out there – what is the next big thing to emerge? Beyond Agile, another technique called dark launch has been used in the VA’s DoD FHIR service for sharing healthcare information between the agencies’ enormous healthcare systems. It is just one of the ways that Ellumen is bringing Silicon Valley’s proven and successful testing methods to Federal Health IT customers.
The Federal Government's efforts to develop a truly robust health data information exchange among the various clinical providers, particularly the Department of Defense, Department of Veterans Affairs and their commercial providers, presents a challenging environment for those that must test software being developed to support their missions. There are inumerable stakeholders, challenges with live data and all its variances, and multiple systems and system owners that must be considered. Add to this the configuration changes that ripple through a system of systems--the job of conducting quality testing becomes its own unique, complex and frequently daunting engineering problem.
The dream of a robust, interoperable EHR (Electronic Health Record) begins and ends with simple standards. Logic would tell us that if we all just implement using the same standards, then all of our EHR/PHR (personal health records) software systems could just discover each other and interoperate, providing us a way to:
- Find other organizations’ services
- Establish secure communications with other organizations
- Search for a patient
- Search for a patient’s data
- Transfer a patient’s data
- Comply with HIPAA/Privacy Act and other regulations governing the sharing of health data
FHIR (pronounced 'Fire') stands for Fast Healthcare Interoperability Resources.
FHIR is the latest standard developed under the HL7 organization, and contains the promises to serve as a good alternative to the HL7 standards. According to HL7: