Other3/6/15

Predicting the trajectory of health: the future of VA care

Charu Raghu

Special Projects Associate

I had the chance to chat with Kathleen L. Frisbee, the Co-Director of Connected Health in the Veterans Health Administration. Dr. Frisbee oversees the rollout of system-wide Veteran digital health strategies, including a suite of mobile health apps designed to support family caregivers providing home health care help to veterans.  Recently, Dr. Frisbee was recognized as one of FierceHealthIT’s “Top-10 influential women in health IT.”

What’s the most exciting project your team worked on in 2014?

The Family Caregiver Pilot was definitely one of the most exciting projects the VA Mobile Health team worked on in 2014. Between May 2013 and September 2014, nearly 1,000 Caregivers of seriously injured post 9/11 Veterans received VA-loaned iPads loaded with a suite of apps to test and evaluate. The suite is comprised of nine mobile applications (apps) designed to support Caregivers and the Veterans they assist. By using the mobile technology, Veterans and Caregivers received secure access to health care information, the ability to track personal health-related information, and additional functionality in sharing personal health information with their VA care teams.

How did the pilot go?

The pilot was deployed June 2013 and we collected data through September 2014. We used that data to inform the revisions on those apps. Those were iOS apps and we are in the process of revising and converting to HTML5 apps based on the feedback we received. Once that is done, they will be deployed to the VA app catalogue. The data from the Veterans will be routed to the patient-generated database where it will be shared with the clinicians. The next piece is to roll it out to the general veterans’ population and have that data provided to the clinicians.

Do you see more features of certain apps being used than others?

We did. The apps that were used the most frequently were those that provided information from the electronic medical record and those that helped in transactions—for example, the prescription refill app and the notification app. Some of the apps that were used less frequently were the support apps intended for management of PTSD and pain.

What’s happening is a paradigm shift in healthcare—we’re moving to virtual healthcare. We’re doing a text messaging program that’s designed to help patients in self-management via automated text messages that are initiated and received based on disease management protocols. Patients are now being put in a position where they can control their data. Their data will be portable—so information that they enter, as well as electronic medical records from different healthcare organizations, will be owned by them. Making it portable, and directing where it goes, can really leverage predictive analytics. Even things like genetic information—patients will be able to own that data and it will be portable. Quite honestly, I’ve never seen anybody do with predictive analytics what it really has the potential to do. If you own your data, and you’re directing where it goes, you can also have predictive analytics associated with it, so that it can look at what’s happening to you between visits and provide prediction about the course of your healthcare—your health trajectory. I really think predictive analytics has a lot of potential in this area, and we’re just beginning.

How can entrepreneurs work with the VA?

In addition to the standard procurement process, businesses and developers interested in working with VA on developing software solutions can work with the Open Source Electronic Health Record Alliance (OSEHRA), a nonprofit corporation that advances open source electronic health record software and related health information technology. OSEHRA facilitates community-based open source software development, market stimulation and education.  It provides a powerful platform and infrastructure repository for software development and distribution. Members of the OSEHRA community openly collaborate on a full range of planning, development, and deployment activities. Ultimately, these solutions can integrate into real-world solutions for VA.

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