§ 1635. FULLY INTEROPERABLE ELECTRONIC PERSONAL HEALTH INFORMATION FOR THE DEPARTMENT OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS.

3,147 words·~14 min read·/usc/title-10/section-1635

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

In General .— The Secretary of Defense and the Secretary of Veterans Affairs shall jointly— develop and implement electronic health record systems or capabilities that allow for full interoperability of personal health care information between the Department of Defense and the Department of Veterans Affairs; and accelerate the exchange of health care information between the Department of Defense and the Department of Veterans Affairs in order to support the delivery of health care by both Departments.

Department of Defense-Department of Veterans Affairs Interagency Program Office.— In general .— There is hereby established an interagency program office of the Department of Defense and the Department of Veterans Affairs (in this section referred to as the ‘Office’) for the purposes described in paragraph (2). The Office shall carry out decision making authority delegated to the Office by the Secretary of Defense and the Secretary of Veterans Affairs with respect to the definition, coordination, and management of functional, technical, and programmatic activities that are jointly used, carried out, and shared by the Departments.

Purposes .— The purposes of the Office shall be as follows: To act as a single point of accountability for the Department of Defense and the Department of Veterans Affairs in the rapid development and implementation of electronic health record systems or capabilities that allow for full interoperability of personal health care information between the Department of Defense and the Department of Veterans Affairs. To accelerate the exchange of health care information between the Department of Defense and the Department of Veterans Affairs in order to support the delivery of health care by both Departments.

To develop and implement a comprehensive interoperability strategy, which shall include— the Electronic Health Record Modernization Program of the Department of Veterans Affairs; and the Healthcare Management System Modernization Program of the Department of Defense. To pursue the highest level of interoperability for the delivery of health care by the Department of Defense and the Department of Veterans Affairs. To accelerate the exchange of health care information between the Departments, and advances in the health information technology marketplace, in order to support the delivery of health care by the Departments.

To collect the operational and strategic requirements of the Departments relating to the strategy under subsection

(a)and communicate such requirements and activities to the Office of the National Coordinator for Health Information Technology of the Department of Health and Human Services for the purpose of implementing title IV of the 21st Century Cures Act (division A of Public Law 114–255 ) [see Tables for classification], and the amendments made by that title, and other objectives of the Office of the National Coordinator for Health Information Technology. To plan for and effectuate the broadest possible implementation of standards, specifically with respect to the Fast Healthcare Interoperability Resources standard or successor standard, the evolution of such standards, and the obsolescence of such standards. To actively engage with national and international health standards setting organizations, including by taking membership in such organizations, to ensure that standards established by such organizations meet the needs of the Departments pursuant to the strategy under subsection (a), and oversee and approve adoption of and mapping to such standards by the Departments. To express the content and format of health data of the Departments using a common language to improve the exchange of data between the Departments and with the private sector, and to ensure that clinicians of the Departments have access to integrated, computable, comprehensive health records of patients. To inform the Chief Information Officer of the Department of Defense and the Chief Information Officer of the Department of Veterans Affairs of any activities of the Office affecting or relevant to cybersecurity. To establish an environment that will enable and encourage the adoption by the Departments of innovative technologies for health care delivery. To leverage data integration to advance health research and develop an evidence base for the health care programs of the Departments. To prioritize the use of open systems architecture by the Departments. To ensure ownership and control by patients of personal health information and data in a manner consistent with applicable law. To prevent contractors of the Departments or other non-departmental entities from owning or having exclusive control over patient health data, for the purposes of protecting patient privacy and enhancing opportunities for innovation. To implement a single lifetime longitudinal personal health record between the Department of Defense and the Department of Veterans Affairs. To attain interoperability capabilities— sufficient to enable the provision of seamless health care by health care facilities and providers of the Departments, as well as private sector facilities and providers contracted by the Departments; and that are more adaptable and far reaching than those achievable through biodirectional information exchange between electronic health records of the exchange of read-only data alone. To make maximum use of open-application program interfaces and the Fast Healthcare Interoperability Resources standard (or successor standard). Leadership.— Director .— The Director of the Office shall be the head of the Office. Deputy director .— The Deputy Director of the Office shall be the deputy head of the Office and shall assist the Director in carrying out the duties of the Director. Reporting .— The Director shall report directly to the Deputy Secretary of Defense and the Deputy Secretary of Veterans Affairs. Appointments.— Director .— The Director shall be appointed by the Secretary of Defense, with the concurrence of the Secretary of Veterans Affairs, for a fixed term of four years. For the subsequent term, the Secretary of Veterans Affairs, with the concurrence of the Secretary of Defense, shall appoint the Director for a fixed term of four years, and thereafter, the appointment of the Director for a fixed term of four years shall alternate between the Secretaries. Deputy director .— The Deputy Director shall be appointed by the Secretary of Veterans Affairs, with the concurrence of the Secretary of Defense, for a fixed term of four years. For the subsequent term, the Secretary of Defense, with the concurrence of the Secretary of Veterans Affairs, shall appoint the Deputy Director for a fixed term of four years, and thereafter, the appointment of the Deputy Director for a fixed term of four years shall alternate between the Secretaries. Minimum qualifications .— The Secretary of Defense and the Secretary of Veterans Affairs shall jointly develop qualification requirements for the Director and the Deputy Director. Such requirements shall ensure that, at a minimum, the Director and Deputy Director, individually or together, meet the following qualifications: Significant experience at a senior management level fielding enterprise-wide technology in a health care setting, or business systems in the public or private sector. Credentials for enterprise-wide program management. Significant experience leading implementation of complex organizational change by integrating the input of experts from various disciplines, such as clinical, business, management, informatics, and technology. Succession .— The Secretary of Defense and the Secretary of Veterans Affairs shall jointly develop a leadership succession process for the Office. Additional guidance .— The Department of Veterans Affairs-Department of Defense Joint Executive Committee may provide guidance in the discharge of the functions of the Office under this section. Information to congress .— Upon request by any of the appropriate committees of Congress, the Director and the Deputy Director shall testify before such committee, or provide a briefing or otherwise provide requested information to such committee, regarding the discharge of the functions of the Office under this section. Function .— The function of the Office shall be to implement, by not later than September 30, 2009 , electronic health record systems or capabilities that allow for full interoperability of personal health care information between the Department of Defense and the Department of Veterans Affairs, which health records shall comply with applicable interoperability standards, implementation specifications, and certification criteria (including for the reporting of quality measures) of the Federal Government. Implementation Milestones.— Evaluation .— With respect to the electronic health record systems of the Department of Defense and the Department of Veterans Affairs, the Office shall seek to enter into an agreement with an independent entity to conduct an evaluation by not later than October 1, 2021 [,] of the following: Whether a clinician of the Department of Defense, can access, and meaningfully interact with, a complete patient health record of a veteran, from a military medical treatment facility. Whether a clinician of the Department of Veterans Affairs can access, and meaningfully interact with, a complete patient health record of a member of the Armed Forces serving on active duty, from a medical center of the Department of Veterans Affairs. Whether clinicians of the Departments can access, and meaningfully interact with, the data elements of the health record of a patient who is a veteran or is a member of the Armed Forces which are generated when the individual receives health care from a community care provider of the Department of Veterans Affairs or a TRICARE program provider of the Department of Defense. Whether a community care provider of the Department of the Veterans Affairs and a TRICARE program provider of the Department of Defense on a Health Information Exchange-supported electronic health record can access patient health records of veterans and active-duty members of the Armed Forces from the system of the provider. An assessment of interoperability between the legacy electronic health record systems and the future electronic health record systems of the Department of Veterans Affairs and the Department of Defense. An assessment of the use of interoperable content between— the legacy electronic health record systems and the future electronic health record systems of the Department of Veterans Affairs and the Department of Defense; and third-party applications. System configuration management .— The Office shall— maintain the common configuration baseline for the electronic health record systems of the Department of Defense and the Department of Veterans Affairs; and continually evaluate the state of configuration and the impacts on interoperability; and promote the enhancement of such electronic health records systems. Consultation.— Annual meeting required .— Not less than once per year, the Office shall convene a meeting of clinical staff from the Department of Defense, the Department of Veterans Affairs, the Coast Guard, community providers, and other leading clinical experts, for the purpose of assessing the state of clinical use of the electronic health record systems and whether the systems are meeting clinical and patient needs. Recommendations .— Clinical staff participating in a meeting under subparagraph

(A)shall make recommendations to the Office on the need for any improvements or concerns with the electronic health record systems. Clinical and patient satisfaction survey .— Beginning October 1, 2021 , and on at least a biannual basis thereafter until 2025 at the earliest, the Office shall undertake a clinician and patient satisfaction survey regarding clinical use and patient experience with the electronic health record systems of the Department of Defense and the Department of Veterans Affairs. Pilot Projects.— Authority .— In order to assist the Office in the discharge of its function under this section, the Secretary of Defense and the Secretary of Veterans Affairs may, acting jointly, carry out one or more pilot projects to assess the feasibility and advisability of various technological approaches to the achievement of the electronic health record systems or capabilities described in subsection (d). Sharing of protected health information .— For purposes of each pilot project carried out under this subsection, the Secretary of Defense and the Secretary of Veterans Affairs shall, for purposes of the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 [ Pub. L. 104–191 ] ( 42 U.S.C. 1320d–2 note), ensure the effective sharing of protected health information between the health care system of the Department of Defense and the health care system of the Department of Veterans Affairs as needed to provide all health care services and other benefits allowed by law. Staff and Other Resources.— In general .— The Secretary of Defense and the Secretary of Veterans Affairs shall assign to the Office such personnel and other resources of the Department of Defense and the Department of Veterans Affairs as are required for the discharge of its function under this section, including the assignment of clinical or technical personnel of the Department of Defense or the Department of Veterans Affairs to the Office. Additional services .— Subject to the approval of the Secretary of Defense and the Secretary of Veterans Affairs, the Director may utilize the services of private individuals and entities as consultants to the Office in the discharge of its function under this section. Amounts available to the Office shall be available for payment for such services. Cost sharing .— The Secretary of Defense and the Secretary of Veterans shall enter into an agreement on cost sharing and providing resources for the operations and staffing of the Office. Hiring authority .— The Secretary of Defense and the Secretary of Veterans Affairs shall delegate to the Director the authority under title 5, United States Code, regarding appointments in the competitive service to hire personnel of the Office. Reports.— Annual reports .— Not later than September 30, 2020 , and each year thereafter through 2024, the Director shall submit to the Secretary of Defense and the Secretary of Veterans Affairs, and to the appropriate committees of Congress, a report on the activities of the Office during the preceding calendar year. Each report shall include the following: A detailed description of the activities of the Office during the year covered by such report, including a detailed description of the amounts expended and the purposes for which expended. With respect to the objectives of the strategy under paragraph (2)(C) of subsection (b), and the purposes of the Office under such subsection— a discussion, description, and assessment of the progress made by the Department of Defense and the Department of Veterans Affairs during the preceding calendar year; and a discussion and description of the goals of the Department of Defense and the Department of Veterans Affairs for the following calendar year, including updates to strategies and plans. A detailed financial summary of the activities of the Office, including the funds allocated to the Office by each Department, the expenditures made, and an assessment as to whether the current funding is sufficient to carry out the activities of the Office. A detailed description of the status of each of the implementation milestones, including the nature of the evaluation, methodology for testing, and findings with respect to each milestone under subsection (e). A detailed description of the state of the configuration baseline, including any activities which decremented or enhanced the state of configuration under subsection (e). With respect to the annual meeting required under subsection (e)(3)— a detailed description of activities, assessments, and recommendations relating to such meeting; and the response of the Office to any such recommendations. Availability .— Each report under this subsection shall be made publicly available. Comptroller General Assessment of Implementation .— Not later than six months after the date of the enactment of this Act [ Jan. 28, 2008 ] and every six months thereafter until the completion of the implementation of electronic health record systems or capabilities described in subsection (d), the Comptroller General of the United States shall submit to the appropriate committees of Congress a report setting forth the assessment of the Comptroller General of the progress of the Department of Defense and the Department of Veterans Affairs in implementing electronic health record systems or capabilities described in subsection (d). Technology-Neutral Guidelines and Standards .— The Director, in consultation with industry and appropriate Federal agencies, shall develop, or shall adopt from industry, technology-neutral information technology infrastructure guidelines and standards for use by the Department of Defense and the Department of Veterans Affairs to enable those departments to effectively select and utilize information technologies to meet the requirements of this section. Definitions .— In this section: The term ‘appropriate congressional committees’ means— the congressional defense committees [Committees on Armed Services and Appropriations of the Senate and the House of Representatives]; and the Committees on Veterans’ Affairs of the House of Representatives and the Senate. The term ‘configuration baseline’ means a fixed reference in the development cycle or an agreed-upon specification of a product at a point in time that serves as a documented basis for defining incremental change in all aspects of an information technology product. The term ‘Electronic Health Record Modernization Program’ has the meaning given that term in section 503 of the Veterans Benefits and Transition Act of 2018 ( Public Law 115–407 ; 132 Stat. 5376 ) [38 U.S.C. note prec. 5701]. The term ‘interoperability’ means the ability of different information systems, devices, or applications to connect, regardless of the technology platform or the location where care is provided— in a coordinated and secure manner, within and across organizational boundaries, and across the complete spectrum of care, including all applicable care settings; with relevant stakeholders, including the person whose information is being shared, to access, exchange, integrate, and use computable data regardless of the origin or destination of the data or the applications employed; with the capability to reliably exchange information without error; with the ability to interpret and to make effective use of such exchanged information; with the ability for information that can be used to advance patient care to move between health care entities; and without additional intervention by the end user. The term ‘meaningfully interact’ means the ability to view, consume, act upon, and edit information in a clinical setting to facilitate high-quality clinical decision making. The term ‘seamless health care’ means health care which is optimized through access by patients and clinicians to integrated, relevant, and complete information about the clinical experiences of the patient, social and environmental determinants of health, and health trends over time, in order to enable patients and clinicians to— move efficiently within and across organizational boundaries; make high-quality decisions; and effectively carry out complete plans of care. The term ‘Secretary concerned’ means— the Secretary of Defense, with respect to matters concerning the Department of Defense; the Secretary of Veterans Affairs, with respect to matters concerning the Department of Veterans Affairs; and the Secretary of Homeland Security, with respect to matters concerning the Coast Guard when it is not operating as a service in the Department of the Navy. The term ‘TRICARE program’ has the meaning given that term in section 1072 of title 10 , United States Code. [As amended Pub. L. 110–417 , [div. A], title II, § 252, Oct. 14, 2008 , 122 Stat. 4400 ; Pub. L. 113–175, title I, § 105 , Sept. 26, 2014 , 128 Stat. 1903 ; Pub. L. 114–58, title IV, § 411 , Sept. 30, 2015 , 129 Stat. 536 ; Pub. L. 114–228, title IV, § 414 , Sept. 29, 2016 , 130 Stat. 941 ; Pub. L. 116–92, div. A, title VII, § 715(a) –(g), Dec. 20, 2019 , 133 Stat. 1446–1451 .]

Connectionstraces to 6

Traces to 6 documents

public-private-law