CAPRI for State Veteran Homes

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CAPRI for State Veteran Homes
Mr. Shawn Hardenbrook Health Information Access
Project Coordinator shawn.hardenbook_at_va.gov
July 23, 2009
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HIA Overview

• The HDI Health Information Access (HIA) program
  under the Privacy program is responsible for
  approving, tracking, auditing, and managing
  requests for Special User Access. 
• Privacy and HIA ensure that access is managed in
  accordance with Federal law and VA policy.
  Privacy and HIA works with the Office of General
  Counsel (OGC), the Office of Research
  Development (ORD), the Office of Patient Care
  Services (PCS), the Office of Information
  Technology (OIT), the VHA Security program
  within HDI, and individual program offices.

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SVH CAPRI Pilot Overview

• Compensation and Pension Records Interchange
  (CAPRI) for State Veteran Home (SVH) Employees
  will allow authorized SVH employees read-only
  access to a specified residents VHA electronic
  health records (EHRs). 
• SVH access to CAPRI is contingent upon the
  Veteran executing a VA Form 10-5345 (release of
  medical records), authorizing the SVH employee
  unlimited and unrestricted access to all medical
  records, including sensitive records protected by
  title 38 U.S.C. 7332.

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VHA Electronic Health Records

• Three software applications can be used to view
  VHA electronic health records (EHRs)
• Compensation Pension Record Interchange (CAPRI)
• Provides full read-only access to the complete
  EHR
• Central Management Capabilities
• Restricted Patient lists can be set up by
  organization and by user
• VistaWeb
• Web interface
• Provides read only access to the patient record
• Does not have the ability to restrict access
  records to specific patients.
• CAPRI access provides link to VistaWeb
• Computerized Patient Record System (CPRS)
• Managed at the local site level
• CPRS with full read/write access for VA
  clinicians
• CPRS Read Only version available for other users

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CPRS Read Only

• Software only available at VHA sites
• Access must be managed by individual VAMCs
• VAMCs have established their own guidelines and
  may or may not allow access.
• No central management of restricted patient lists
• CAPRI/VistAWeb is preferred over CPRS Read Only
  due to central management capabilities
• Look and feel for CAPRI/VistaWeb resembles CPRS
  more than CPRS Read Only.

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CAPRI

• Used by VA staff at all VAMCs and ROs
• Only 1 access/verify code needed to all 130
  VistA systems
• Restricted Patient lists can be set up by
  organization and by user
• Complete access to current and past AMIE claims
  activity
• Full read-only access to EHR data lab graphs
• Access to FHIE/DoD data
• Access to VistAWeb

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CAPRI Snapshot
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SVH Access is Limited to the Records of Specific
Patients

• VHA is required to restrict each state veteran
  home employees access to those veterans that
  have completed the VA Form 10-5345
• A restricted patient list is used to limit a
  users access to the records of specific veterans
• Each users account can be linked to a patient
  list
• Each patient list specifies the name(s) of the
  veteran(s) whose records the user is allowed to
  see
• Patient lists can be controlled at the user-level
  or for a group of users

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Release Form for EHR Access

• Access to a veterans EHR through CAPRI will
  require
• VA Form 10-5345 Request for and Authorization to
  Release Medical Records or Health Information

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SVH Access Requires the Release Without
Limitations

• Currently, CPRS and CAPRI do not allow us
• To limit access to specific parts of a veterans
  medical record, or
• To limit access to specific time periods covered
  in the record, as required under HIPAA
• For electronic access, the SVH must have the
  authority to view all the information in the
  veterans medical record

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VA FORM 10-5345 Example
Specify the SVH authorized to view the EHR.
All check boxes must be checked to authorize
access to sensitive records protected by title
38 U.S.C.  7332
The Other check box must be checked with the
text Complete Electronic Health Record inputted
below.
The bottom portion must be completed by the VA.
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Preparation for the SVH Pilot

• To support central management of CAPRI access for
  State Veteran Homes, VA has developed
• Access Request Forms Access form will go
  through OMB approval process
• Processes standard operating procedures
• Tracking system (VA Form 10-5345, user
  compliance, and restricted patient lists)
• Website materials
• CAPRI User Guide
• Pilot Training (Train the Trainer)

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CAPRI Pilot

• SVH access will be coordinated centrally by the
  VHA Office of Health Data Informatics (HDI)
• SVH employees will submit requests and
  documentation to hia_at_va.gov .
• SVH employees will submit VA Form 10-5345
  directly to HDI by fax
• HDI will
• Set up SVH accounts
• Track VA Form 10-5345 , access request forms, and
  training certificates
• Manage and track patient lists based on the VA
  Form 10-5345
• Monitor and track training compliance
• Audit user access

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Timeframe

• August 2009
• Initiate a Pilot consisting of three State
  Veteran Homes in VISN16.
• October 2009 -
• Analyze feedback from the pilot.

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Next Steps

• Once the access request form has received OMB
  approval, HIA will expand the pilot.

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Questions?

• Questions can be emailed to
• hia_at_va.gov
• Additional information is located on the HIA
  website at
• http//www.va.gov/VHA_OI/page.cfm?pg49

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