CHDR_2-1.TXT

TO:
G.IRM CHIEFS (NATIONAL) & STAFF
G.SITEMANAGERSNATIONAL
G.SSA
G.PATCH
G.CS STAFF

FROM: CHDR (Clinical Data Repository/Health Data Repository) TEAM

RELEASE INFORMATION  CHDR version 2.1

TARGET RELEASE DATE: December 3, 2011

There are no VAMC site installs associated with the release of CHDR 2.1. 
The following is for informational purposes only. 

CHDR works in the background to facilitate the exchange of virtual lifetime 
electronic health records (VLER) between the Health Data Repository (HDR) 
at VA, and the Clinical Data Repository (CDR) at DoD for Active Dual 
Consumers (ADC). Dual consumers are patients eligible to receive healthcare 
under both DoD and VA health plans, and/or patients being treated at both 
DoD and VA medical facilities.
Most patients are marked active by an automated process developed by DoD. 
At the VA, patients can be marked active manually using VAs CHDR 
Administration Application Interface (CHDR Admin GUI). The CHDR Admin GUI 
can also be used by local IT staff to view specific audit log transactions.

NOTE:   Patients must be marked Active before the data can be exchanged.

The clinical data to be exchanged consists of the outpatient pharmacy and 
drug allergy domains (limited only to drug allergies). Once this data is 
exchanged it can be used by each agencys native healthcare system. At VA, 
the integrated data can be viewed through VistAWeb, while triggered 
Drug/Drug and/or Drug/Allergy alerts will manifest in the Computerized 
Patient Record System (CPRS).
This release includes minor enhancements and defect fixes identified by 
end-users using the CHDR 2.0 Admin GUI currently in production. Many of the 
CHDR system design improvements work in the background to deliver improved 
information sharing of outpatient clinical data for ADC patients between 
DoD and VA. The CHDR Admin GUI can be accessed by visiting: 
https://hdrchdr.aac.va.gov:5024/CHDR/

The changes you will see in the CHDR Admin GUI include:
Fixed the patient lookup field to clear upon refresh of field or screen.
Removed the portrait (camera icon) feature from the Person Service Lookup 
(PSL) capability when looking up a patient to manually set the ADC status.
Fixed the timeout message displayed to read: 
Patient ADC Status. Processing Temporarily Delayed. The request to change 
the status of patient name to INACTIVE was sent to Department of Defense. 
The response from Department of Defense (DoD) has not been received. The 
system will process this status change request as soon as the response is 
received from DoD. Please continue with other activities and check back 
later for the outcome of the request.

 
FUNTIONALITY PROVIDED by CHDR:
Supports the DoD patient ADC Automation process.
Provides bi-directional, real-time, exchange of computable, standardized 
data in the outpatient pharmacy and drug allergy data domains. Computable 
data refers to data elements passed individually rather than in text blocks 
so that the data can be individually sorted and queried, allowing the 
clinical systems to perform medication and allergy checks.
Provides integrated outpatient medication lists and integrated drug allergy 
lists. Includes updates of medications and outpatient pharmacy 
transactions.

Enables interagency Drug-Drug and Drug-Allergy checks, supported in CPRS 
automatic alerts and reminders.
VA receives historical clinical data on separated service members. 

VA and DoD share current health data in a viewable format. At the VA, this 
is displayed through VistAWeb. Provides the ability to manually mark a 
patient as active ADC utilizing the CHDR Admin GUI.

The CHDR 2.1 Release will also coincide with an upgrade from STS to VTS 
2.0. VTS is a remote terminology translation service that is used by CHDR 
for translating VA proprietary terminology codes known as VUIDs. The VTS 
upgrade to 2.0 provides:
Improved order/drug-allergy checks across VA for data exchanged between VA 
and DoD, and increased flexibility to manage legacy allergy data.
Improved mediation/translation of one or many DoD mediation codes to a 
single VUID.

NOTE: Not all mappings have been fixed. Due to the difficulty in 
comprehending the way physicians document allergies, it is impossible to 
map all too current standard terms. 

SITE REQUIREMENTS

CHDR 2.0 was installed in the spring of 2010. Sites should already be setup 
to communicate with the CHDR server and have their security keys assigned, 
as appropriate for each VAMC.
Each site should have a selected clinical user identified as the 
Administrative User (admitting clerk or similar) who can manually mark a 
known dual consumer that somehow failed in automation.
This administrative user should be given the CHDRUSER key. With the DG 
CHDRUSER key, one can search for ADC patients and set their ADC status to 
active or inactive.
 
Security Keys:
1.    The DG CHDR USER security key is assigned to users by the local 
VAMCs OIT staff.
2.    If you haven't already, Local IRM security personnel must assign the 
DG CHDRUSER key to the appropriate users. Please ensure that the CHDR users 
you select have valid access credentials to the appropriate parent division 
and/or subdivision(s) where you assign the key.

Remember:  DG CHDR USER allows users to look up and to manually mark 
patients as active ADC.

3.    Basic steps to allocate the keys:
   a. Select OPTION NAME: KEY MANAGEMENT
   b. Select Key Management Option: Allocation of Security Keys.
   c. Allocate key: DG CHDRUSER.
   d. Holder of key: <username>.
   e. You are allocating keys. Do you wish to proceed? YES//

Related documentation can be found at:
http://vista.med.va.gov/chdr/index.asp- CHDR Site Home Page.
http://www.va.gov/vdl/application.asp?appid=155 CHDR VDL
http://vaww.vistau.med.va.gov/VistaU/chdr/default.htm- VistA University  
CHDR link from the left menu.