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Frequently Asked Questions

What is the Federal Electronic Health Record Modernization office’s role in the electronic health record space?

Chartered in December 2019, the Federal Electronic Health Record Modernization (FEHRM) office works within the federal space to implement a single, common federal electronic health record (EHR) that enhances patient care and provider effectiveness. The FEHRM unites efforts and delivers common capabilities that enable the Department of Defense (DOD), Department of Veterans Affairs (VA), Department of Homeland Security’s U.S. Coast Guard (USCG) and other federal agencies to deploy the federal EHR. Common capabilities refer to common solutions, tools and activities identified as needed to effectively deploy the federal EHR.

The common capabilities the FEHRM delivers in support of the federal EHR include managing the Federal Enclave; managing the joint health information exchange; leading analysis and integration of deployment activities at joint sharing sites; overseeing EHR configuration and content changes; providing software updates and solutions; tracking joint risks, issues and opportunities as well as lessons learned; maintaining an integrated master schedule; and advancing interoperability.

These capabilities are also helping drive federal solutions to support effective health care delivery within the federal space that puts patients in the center. Through the FEHRM’s contributions and solutions, federal agencies like DOD, VA and USCG can lead the deployment of the federal EHR.

Visit the What is the FEHRM section of the FEHRM website to learn more about the FEHRM.

How is the Federal Electronic Health Record Modernization office different from the Interagency Program Office?

The Interagency Program Office (IPO) served as a successful coordinating body providing measurable impact on setting health data standards for the Department of Defense and Department of Veterans Affairs. It no longer exists. The Federal Electronic Health Record Modernization (FEHRM) office’s mission—to implement a single, common federal EHR to enhance patient care and provider effectiveness, wherever care is provided—is much more expansive than the IPO's mission. The FEHRM has a broader focus and more authority than the IPO had.

What is the Federal Electronic Health Record Modernization office's level of authority?

The Federal Electronic Health Record Modernization (FEHRM) office's Director and Deputy Director report to the Deputy Secretary of Defense and the Deputy Secretary of Veterans Affairs. The FEHRM Charter and the National Defense Authorization Act for Fiscal Year 2020 (NDAA FY2020) give the FEHRM decision-making authority within the joint space. The NDAA FY2020 specifies that the FEHRM "shall carry our decision making authority delegated to the Office by the Secretary of Defense and the Secretary of Veterans Affair with respect to the definition, coordination, and management of functional, technical, and programmatic activities that are joint used, carried out, and shared by the Departments."

The implementation of a single, common federal electronic health record (EHR) is a massive transformation with multiple cabinet-level offices involved, and it will not succeed with a command-and-control approach. Instead, the FEHRM works through collaboration, facilitation, consensus building and the commitment of its partners to provide the best health care experience for patients and providers.

If there is an irrevocable dispute, then the FEHRM will execute its authority and act as an arbiter as needed. However, the FEHRM has created an environment, including collaborative processes, procedures and forums, to enable joint decision-making and issue resolution at the lowest possible levels.

Why is a single, common federal electronic health record necessary?

A single, common federal electronic health record (EHR) means the Department of Defense (DOD), Department of Veterans Affairs (VA), Department of Homeland Security's U.S. Coast Guard (USCG) and other partners will be able to document care from the time a Service member enters the military through their care as a Veteran in one, complete patient health record. This record will be accessible to DOD, VA, USCG and private sector providers and, of course, to patients themselves.

To effectively deliver health care and benefits to our beneficiaries, DOD, VA and USCG need to be able to access a patient’s longitudinal health record. The separate, legacy EHR systems are outdated and unable to create a seamless care experience as provided by the federal EHR.

Having a federal EHR among DOD, VA and USCG puts patients at the center. It allows the Departments and other partners to achieve the following:

  • Support Service members from the time they join the military through their care as a Veteran in one, complete patient health record that the patient can access—enabling an integrated, patient-centered continuum of care.
  • Access data such as service treatment records, Service medals and honors, housing status and other information to ensure a transitioning Veteran receives all the benefits they have earned in a seamless, timely fashion.
  • Minimize the number of times patients need to share their health histories, undergo duplicative tests or manage printed health records.
  • Enable comprehensive patient data, whether recorded by a DOD, VA, USCG or private sector provider, to be readily available wherever care is provided—the more patient data clinicians have, the more informed care they can deliver to their patients.

Who owns the patient health data in the electronic health record?

Patient data is owned by the patient. Patients have the right to access their personal health record. They retain control over their own health data.

Will the Federal Electronic Health Record Modernization office collaborate with the Office of the National Coordinator for Health Information Technology and standards development organizations?

Yes, the Federal Electronic Health Record Modernization office engages with federal and national standards organizations, including the Office of the National Coordinator for Health Information Technology, and private sector partners to advance interoperability standards that enable the exchange of information across all sectors of the industry and government, a key driver to effective transformation. This effort improves the continuity of care among and between public and private sector providers.

What are the Federal Electronic Health Record Modernization office’s top priorities for the next year? 

Some of our top priorities include operationalizing the Federal Electronic Health Record Modernization (FEHRM) office and focusing on convergence.

We are operationalizing the FEHRM by evolving the FEHRM to become the single provider of the federal electronic health record (EHR), providing a common set of capabilities across the health care industry.

We focus on convergence by figuring out how to converge EHR workflows and configurations to streamline the patient experience. While the Department of Defense (DOD), Department of Veterans Affairs (VA) and Department of Homeland Security's U.S. Coast Guard (USCG) have unique clinical and business issues that differ based on their missions, the FEHRM is focused on converging DOD, VA and USCG clinical and business capabilities where appropriate. The FEHRM overseas configuration and content changes to the federal EHR that are agreed on by the Departments through a joint decision-making process facilitated by the FEHRM. The goal is that DOD, VA and USCG providers in the same roles will have a common user experience with the federal EHR defined by evidence-based best practice. Providers won't need to relearn things depending on where they provide care. From the patient perspective, this means health care will be delivered the same way regardless of where they get care. They have a consistent patient care experience. Convergence ultimately helps us enable more standard workflows and practices to enhance clinical decision-making and health care. Workflows are the series of tasks required to complete a health care function (for example, ordering a medication). Standard workflows are considered best practices because they guidance compliance with clinical best care guidelines. Convergence helps us determine the best workflow solutions that are safe, effective and efficient.

We are also prioritizing joint sharing sites, which are sites where DOD and VA resources (like staff and facilities) are shared. Leading the deployment of the EHR joint sharing sites, the FEHRM has the potential to enable the DOD and VA health care systems to work together in new ways to deliver health care to Service members, Veterans and their families.

We are also focusing on bringing additional federal agencies to the federal EHR and determining what that looks like.

What are some of the lessons learned to date with the federal electronic health record?

At the Federal Electronic Health Record Modernization office, we are capturing and sharing lessons learned and best practices as we work in a common environment and deploy the federal electronic health record.

We’ve learned that the technology works. So, it’s really about change management—the processes, people, culture, training and communications that need to be in place to be successful. The infrastructure also cannot be antiquated. It must be able to support the newer technologies.

We adapted to the current pandemic environment and used it as a catalyst: How can we do things better, smarter and take advantage of tools at our disposal now?

It takes the right people, and the right people are coming together every day. It takes a team. No individual or organization possesses all the expertise to make this a reality. We will continue to build on the team.

Looking to the future, what does the Federal Electronic Health Record Modernization office see as a vision for using information technology to improve health care services?

The efforts and successes with the federal electronic health record (EHR) and with our partners are only the beginning. We are just scratching the surface on what is possible with EHR, joint health information exchange (HIE) and other health information technology capabilities to transform health care delivery.

Partnerships between the federal government, community providers and commercial vendors will continue to be critical. These partnerships will drive integration, interoperability and the best possible health care for all patients regardless of where they receive care and who provides it.

The Federal Electronic Health Record Modernization office's vision is that we take technology out of the equation, so providers and administrators can make the best decisions together on care delivery. We want to remove technology as a barrier. It’s about getting the right data to the right person at the right time to make informed health care decisions.

We are energized and excited to continue to work with our federal, community and industry partners to improve health care for all our beneficiaries. The possibilities are limitless now that we have a foundation in place.

How can industry support the Federal Electronic Health Record Modernization office?

We continue to look to industry for partnerships, for relationships that can help us shape our path moving forward. We highly value the innovative ideas vendors bring to the table, and we rely on those steadfast partnerships, such as those with the Leidos Partnership for Defense Health for the Department of Defense and that we see between the Department of Veterans Affairs and Cerner.

There are a lot of other relationships and partnerships being developed as we look toward new technologies and available capabilities

In navigating the future, we look for innovative ideas for improving the patient experience and enhancing the quality of care delivery during this time. For example, how do we implement the EHR and train end users with the social distancing precautions in place during the pandemic? Or, how do we deliver technology at the frontlines of care—whether it’s in theater, in rural America or while a patient is being transported?

Also, the federal electronic health record and joint health information exchange means our providers now have access to more information about their patients than ever before to make the best care decisions. We need to make sure this data is usable and built into provider workflows. We need vendor engagement as we do this.

When we are all focused on delivering high-quality care seamlessly as patients move from one delivery system to another, innovation, integrating new capabilities through expanded partnerships and collaboration will move us ahead.

Are the Department of Defense, Department of Veterans Affairs and Department of Homeland Security’s U.S. Coast Guard using different electronic health records or one single, common electronic health record?

The Departments are implementing the same single, common federal electronic health record (EHR). The Department of Defense (DOD) calls the federal EHR MHS GENESIS, while the Department of Veterans Affairs and Department of Homeland Security’s U.S. Coast Guard use other names for the federal EHR. However, they are deploying, using and updating the same federal EHR. If one Department adds new capabilities to the federal EHR, the other Departments have access to the same capabilities.

How is the Federal Electronic Health Record Modernization office partnering with the private sector/commercial partners to advance interoperability?

We rely heavily on community providers to provide health care to Service members, Veterans and their families. In April 2020, the Federal Electronic Health Record Modernization office launched the joint health information exchange to enhance data sharing between the Department of Defense, Department of Veterans Affairs, Department of Homeland Security’s U.S. Coast Guard and community providers.

COVID-19 showed us how important such efficient electronic health information sharing is for clinicians on the front lines. The more information they have about their patients, the better they can meet their needs.

We also work closely with federal and standards organizations and private sector partners to advance interoperability standards that enable the exchange of information across all sectors of industry and government. 

What is the joint health information exchange?

Launched in April 2020 by the Federal Electronic Health Record Modernization (FEHRM) office, the joint health information exchange (HIE) builds upon the success of the Department of Defense (DOD) and Department of Veterans Affairs (VA) HIE work.

The joint HIE is an enhanced network of community providers across the United States who agree to securely share clinical information with the DOD, VA and Department of Homeland Security’s U.S. Coast Guard (USCG) providers.

The joint HIE enhances the ability of DOD, VA and USCG providers to quickly and securely access patient electronic health information from participating community providers and vice versa. Participating community providers now have a single point of entry to request and access DOD, VA and USCG patient information to support the continuity of care for Service members, Veterans and their families.

The launch of the joint HIE is a critical step forward in significantly expanding DOD, VA and USCG partnerships and interoperable capabilities. The FEHRM will continue to optimize and expand the joint HIE.

What information is shared through the joint health information exchange?

The information shared through the joint health information exchange includes prescriptions, allergies, illnesses, lab and radiology results, immunizations, past medical procedures and clinical notes.

What are the benefits of the joint health information exchange?

COVID-19 showed us how important efficient electronic health information sharing is for clinicians on the front lines. The more information they have about their patients, the better they can meet their needs.

We launched the joint health information exchange (HIE) in the middle of the pandemic. During this critical time, the joint HIE is enhancing the ability of providers to quickly and securely share patient electronic health information with participating community providers.

It’s magical when a patient shows up at a health care system and that system already knows what happened in a different health care system and acts like its normal. This is the experience we are building toward.

With 60% of Department of Defense (DOD) beneficiaries accessing private sector care, and 30% of Department of Veterans Affairs (VA) beneficiaries doing so, we have a lot of intersection with community partners and need to be able to efficiently exchange data.

By combining DOD and VA’s individual HIEs into a single joint HIE, we significantly expanded the data available to all clinicians.

Our recent expansion to include the CommonWell Health Alliance in our joint HIE brings a nationwide network of 15,000-plus hospitals and clinics to the 46,000-plus community partners already part of the joint HIE.

This means our providers have access to even more information about their patients to make the best care decisions. Learn more about the benefits of the joint HIE to providers and to patients.

How has the data gained from the federal electronic health record and joint health information exchange been used to enhance health care? How did it help in 2020 during the COVID-19 crisis?

The federal electronic health record (EHR), along with the joint health information exchange (HIE), is empowering health care administrators and providers with more data. The data we gain from the federal EHR and joint HIE helps enable more standard workflows and practices to enhance clinical decision-making and health care. It also helps drive business decisions, inform population health initiatives and improve patient outcomes through innovations. 

For example, the Department of Defense (DOD) and Department of Veterans Affairs (VA) joint data management and analysis efforts led to our ability to improve the process for prescribing opioids. Patients at risk of an opioid overdose who receive opioid pain medication will also receive a life-saving drug that counteracts the opioid prescribed along with education.

Another example of effective HIE, is our integration of an Immunization Forecaster into the EHR. The forecaster embedded into the EHR leverages Centers for Disease Control and Prevention clinical decision support of immunizations to help pediatricians know when patients need the next round of appropriate vaccines. This new functionality also reduces clinician time and effort, assessing and deciding which vaccines may be due. Even if a child falls behind, it recommends a catch-up schedule. This effort is especially timely with regard to the forthcoming COVID-19 vaccine.

DOD is also looking into developing a trauma registry to capture battlefield injuries and the impact of such injuries throughout a beneficiary’s lifetime.

The EHR and subsequent data we now have available help make all these innovations in health care possible so beneficiaries can get the best health care as soon as possible. We are just scratching the surface on what is possible with EHR data to transform health care delivery to Veterans.

Has COVID-19 impacted the Federal Electronic Health Record Modernization office's activities and the future of electronic health record modernization?

The Department of Defense (DOD) and Department of Veterans Affairs (VA) did disengage with providers at the start of COVID-19, so the providers could focus on responding to the national pandemic. In the meantime, the Departments re-planned continuously, seeking ways to enhance capabilities and gain efficiencies, so they were ready to respond once the providers could focus on electronic health record (EHR) deployments again. For example, the Department of Homeland Security’s U.S. Coast Guard (USCG) shifted to an entire virtual training model that DOD and VA are learning from and incorporating into their training techniques.

COVID-19 has demonstrated the ability of the single, common federal EHR to quickly adapt to changing demands and support providers during the pandemic. For example, when providers needed to order COVID-19 tests, and the EHR didn’t yet have that capability, we were able to make those changes in four hours within the new EHR versus four weeks within the legacy system. The new EHR is much more responsive to changes driven by COVID-19.

So, we have not slowed down our progress with EHR modernization during the pandemic. We remain focused on delivering capabilities to those we serve: clinicians on the front lines delivering care and their patients.

As for how it has impacted the future of EHR modernization, COVID-19 demonstrated virtual health as a priority. In response, the FEHRM pivoted toward accelerating the adoption of tools, platforms and joint capabilities to deliver telemedicine solutions that meet the operational requirements driven by the pandemic. For example, the FEHRM is leveraging VA’s patient-facing video platform to develop a parallel platform for DOD.

Moving forward, there are many opportunities to understand and think about the impact of the new normal of health care delivery and how the EHR and information technology capabilities the FEHRM delivers can support the new normal.