Javier Monterrosa

VA Interoperability: How Better Health IT Helped Address COVID

November 10, 2021

When the pandemic struck, America’s largest health system (the VA) unleashed its full digital arsenal to inform care.

In last week’s blog post, we explored how the Department of Veterans Affairs (VA) began a digital transformation. By turning scattered patient data into longitudinal records, the VA built sustainable long-term practices.

Fortunately, the VA’s efforts came just in time to address the coronavirus pandemic. In this second half of our VA Interoperability series, we take a look at how this government agency used its new capabilities to treat COVID-19 on behalf of America’s veterans, according to their retrospective COVID-19 Response Report.

Digital Records = Vaccine Wins

By December 2020, the VA population had experienced over 130,000 cases of the virus. Once vaccinations became available, the VA was able to rush vaccinations to this prioritized population due to the digital transformation it underwent earlier in the year.

At the beginning of 2020, it might not have been possible to efficiently distribute the vaccine across the VA where it was needed most. But by mid-2020, the VA used a software tool to launch longitudinal patient records. 

Longitudinal patient records, or integrated patient records, combined patient data across the VA. These master records unified data from hundreds of different EHR systems and 1,000 care locations. Longitudinal records helped the VA create an accurate list of vaccine-eligible patients to the CDC at a time when vaccines couldn’t be wasted.

On a local care delivery level, the VA’s improved data sharing allowed providers to follow up with patients. Care teams were able to find more accurate information with less effort, which had previously been a struggle. For some vets, getting contacted in time could make the difference in whether or not they received care.

Even dealing with a mobile patient population, many of whom are vulnerable and facing difficulty keeping their vaccine cards, the VA’s newly-integrated systems shined. They helped accurately match patients with their health records, ensuring they received the correct second dose vaccine.

Interoperability Powers A Capacity Management Database

Providing care was also compounded by the challenge of hot spots, various clinics, and regional health authorities all clamoring for attention..

This is where interoperability paid off on a national scale, thanks to the VA’s renewed focus on connectivity and its push for data sharing between other government agencies.

The VA combined its different coronavirus tech efforts into a platform it calls the National Surveillance Tool (NST). The NST is a centralized system that combines bed capacity, staffing levels, EMR data, PPE data to inform the VA’s clinical response.

Veterans Affairs COVID National Surveillance Tool screenshot
The VA's National Surveillance Tool for COVID cases came from a focus on interoperability.


The NST also helped manage distribution of vaccines to the right facilities across the country. The things that veterans and the public expected to work, actually worked! 

Healthcare product teams might find their work mapping social determinants of health (SDoH) to be very similar to the NST. COVID-19 tracking is a challenge that local health systems don’t necessarily have. Local data needs, however, are as common as they are unique.

In an example of best practices, a great deal of NST data is available in multiple machine-readable formats for researchers to use too.

Better Data Leads to Cutting Edge Algorithms

Basic data interoperability enabled remarkably advanced applications for the VA. 

Once COVID-19’s impact was apparent, the VA used AI to scan digital health records from January 2020. These records showed patients that potentially had undiagnosed COVID-19.

That means health IT teams gave new and useful information to medical staff, at scale, based on existing data!

Once interoperability was in place, it was relatively easy to implement algorithms at scale. Later, the VA ran 15 million documents through a natural language processing (NLP) algorithm to find missed coronavirus-related keywords.

In fact, the main stumbling block for the VA’s innovative practices was old infrastructure. Their largest challenge “at the very early stages of NST implementation [was] servers supporting data analysis crashed due to the large amount of processing power needed to run complex data queries through billions of records,” the VA’s Response Report said.

The Road Leading to Interoperability

The VA’s digital transformation shows how smaller health systems can come together to find new value in their health data. 

It’s clear that while the road to interoperability is long, the future is bright. The VA has many platforms, but they’re all working together. Change is accelerating at a famously slow agency. 

There may be challenges along the way, but with the right technologies, interoperability can make a difference in all types of organizations. It’s change that affects countless lives.