Special Notice - DoD and VA Electronic Health Records

It is the intent of Department of Defense (DoD) and Department of the Veterans Affairs (VA) to develop, to the maximum extent practical, an open Electronic Health Records (EHRs) system consistent with generally accepted commercial and federal health information standards to ensure full information interoperability with other federal and private sector health partners. The VA is joining with the DoD to ensure interoperability between the two agencies. Such interoperability will allow service members medical information to be seamlessly shared from enlistment through Veteran status. To achieve interoperability, the EHR architecture will, to the maximum extent practical, seek to be built to open standards, to be modular, and to utilize publically available non-proprietary interfaces. As the first step toward interoperability, the VA is placing its Veterans Health Information Systems and Technology Architecture (VistA) system into the open source community. Based on the imperative for information interoperability in the health sector-not only among government agencies, but also with private sector health care providers and government trading partners-DoD and VA have determined that an important course of action is to encourage the use of openly available models of information and terminology to the maximum extent practical. Adoption of an open model for these elements of the information architecture will assist in the interoperability between the DoD and VA as well as with other health care providers. To assist in the development of this architecture, our strategy includes encouraging our industry partners to develop or modify their potential solutions to fit into an open architecture model. While proprietary solutions, built using standard non-proprietary interfaces are acceptable for applications software, we encourage the use of open solutions in areas, including, but not limited to, information models and terminologies, data dictionaries, and coding (nosologic structures). With respect to software applications related to the EHR, DoD and VA are also moving toward an open, modular architecture that uses non-proprietary standard open interfaces. As an example, the VA recently awarded a contract for a Custodial Agent to provide support services in organizing activities to create an effective VistA open source community. DoD and VA encourage broad-based contribution of existing and new code to this open source community to advance the use of EHRs in health care delivery across the nation, accelerate development of new EHR capabilities for DoD and VA, and promote innovation and efficiency in health care delivery. As recognized by the DoD CIO memorandum entitled "Clarifying Guidance Regarding Open Source Software (OSS)," dated October 16, 2009, open (publically available) methods, including open source for software, have proven many times to provide the standards, concepts, and software products needed to address a broad variety of enterprise needs, including information interoperability. DoD and VA believe there are significant benefits to be realized with respect to enhanced agility to meet future needs and improved innovation. Toward this end, DoD and VA are seeking to encourage the designation and distribution of heretofore proprietary information models and terminologies under an open license structure that maximizes the flexibility to utilize the licensed materials in existing, even proprietary, applications or solutions. As the Departments move forward with EHR, there will be opportunities in the future for interested parties to obtain more information and engage the Government on this topic. No questions pertaining to this Notice will be accepted at this time; this is a Special Notice ONLY.