Only 20% of VA facilities use VA Direct health information exchange: OIG report

More than three quarters of the Department of Veterans Affairs' facilities do not use its healthcare information exchange program, according to an Aug. 6 VA Office of the Inspector General report.

For the report, the OIG examined how 140 VA facilities participate in the Veterans Health Information Exchange, which uses two methods to share health records with community providers: VA Exchange and VA Direct. Veterans Health Administration uses VA Exchange to allow community partners to find or request health information for a specific patient through a portal, while VA Direct allows providers to send and receive secure information to other providers over the internet via encrypted and secure messaging.

Six report insights:

1. The OIG found that while all 140 VA facilities have access to VA Exchange and VA Direct, only 28 (20 percent) of the facilities have implemented VA Direct. The facilities that do not use VA Direct said it is due to lack of training or their community partners don't use DirectTrust, the VA's secure exchange framework. 

2. The OIG report claimed that community members could not use VA Direct to exchange health information without being a member of DirectTrust; however, DirectTrust President and CEO Scott Stuewe said that VA community partners are not required to be a member to send and receive messages from the VA via Direct Secure Messaging, according to an emailed statement sent to Becker's Hospital Review after publication.  

"The VA became an Accredited [health information services provider] in 2019 and retains this status through September 2021," Mr. Stuewe said. "All VA community partners using 2014 and forward Editions of certified EHR technology can use Direct Secure Messaging within their platform." 

3. Twenty-two of 48 lower-acuity VA facilities said they still exchange information via scanning, faxing or mailing.

4. Challenges for sharing information include the need for additional training, an increase in community partners and a better understanding of how to use the HIE program.

5. VA has 56 VHIE community coordinator positions to support facilities, but some staff said turnover has created a barrier in staff knowledge and use of the programs.

6. The report noted that VA's Cerner EHR implementation will help improve health records exchange among the VHA, Department of Defense and community providers because it will eliminate the need for dual sign-in to review community care documents.

Editor's note: This articles was updated at 4:55 p.m. CT on Aug. 13 to include a statement from DirectTrust. 

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