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Virtual Lifetime Electronic Record Health Information Exchange Initiative

The Virtual Lifetime Electronic Record Health Information Exchange Initiative (VLER HIE) securely connects health and benefit information systems from the Department of Defense (DoD), Department of Veterans Affairs (VA) and other federal and private sector partners. 

What is VLER HIE?

The VLER HIE is a secure network that shares health information. For decades, the Military Health System (MHS) has operated its own HIE that has shared our health information electronically between providers at military treatment facilities (MTF) and VA facilities. Now, this capability is expanding to our TRICARE network providers. With the VLER HIE, all health providers—whether at an MTF or from the TRICARE network—can access beneficiary records and health information electronically.

View a List of eHealth Exchange Participating Providers

By sharing through the eHealth Exchange, health care providers have a more complete view of a patient’s health record. This can help the health care team make the best decisions. 

VLER HIE Privacy and Security

The VLER HIE allows MHS providers to securely access and share a patient’s health information with authorized health partners. VLER HIE fully complies with the most rigorous privacy and security standards.  

HIE Benefits through VLER

Access to a patient’s medical history is very important to health care providers. By using the eHealth Exchange, DoD health care providers can have a more complete view of a patient’s health record. This allows each patient and their health care team to make informed decisions for their health. 

Through the eHealth Exchange, your health care providers can share information, such as:

  • Prescriptions
  • Allergies
  • Illnesses
  • Lab and radiology results
  • Immunizations
  • Past medical procedures
  • Clinical notes

* To improve your care experience, health information may be shared as permitted by the Health Insurance Portability and Accountability Act (HIPAA) with other authorized organizations who partner with the MHS.  To enhance coordination among care teams, this includes notes written by your clinicians, which could contain information about sexual assault, domestic violence, child/elder abuse, substance abuse, mental health, and sexually transmitted diseases.

Frequently Asked Questions

Q1:

What is electronic Health Information Exchange (HIE)?

A:

Electronic Health Information Exchange (HIE) allows your participating health care providers from different health care delivery organizations to appropriately access and securely share your health care information. Using HIE, health care information can follow you whenever and wherever it is needed. HIE makes it possible for the various providers involved in your care to gain access to the same information.

Q2:

What is VLER HIE?

A:

Virtual Lifetime Electronic Record (VLER) Health Information Exchange (HIE) is an initiative to share parts of the Department of Defense (DoD) medical record electronically, safely, and securely.

Q3:

What is the eHealth Exchange?

A:

The eHealth Exchange is a rapidly growing health information exchange network for securely sharing clinical information over the Internet nationwide. It is the largest health information exchange infrastructure in the United States (U.S.). Current eHealth Exchange participants include large provider networks, hospitals, pharmacies, regional health information exchanges and many federal agencies, representing 40% of all U.S. hospitals, tens of thousands of medical groups, more than 8,000 pharmacies and 100 million patients.

Q4:

How secure is HIE?

A:

HIE protects the privacy and security of your health care information by following the rules set in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The HIPAA Privacy Rule provides federal protections for individually identifiable health information and gives patients’ rights about that information. The Privacy Rule permits the sharing of health information for patient care and other important purposes. The Security Rule lists administrative, physical, and technical safeguards that must be used to protect the privacy and security of your health care information.

Q5:

What are the benefits of VLER HIE and the eHealth Exchange?

A:

Access to your medical history is very important to the health care providers caring for you. Using eHealth Exchange, your health care providers have a more complete view of your health record. This allows you and your health care team to make informed decisions about your health. Through the eHealth Exchange, your health care providers can share information on your prescriptions and medications, allergies, illnesses, laboratory and radiology results, immunizations, procedures, and clinical notes*.

*To improve your care experience, health information may be shared as permitted by the Health Insurance Portability and Accountability Act (HIPAA) with other authorized organizations who partner with the MHS. To enhance coordination among care teams, this includes notes written by your clinicians, which could contain information about sexual assault, domestic violence, child/elder abuse, substance abuse, mental health, and sexually transmitted diseases.

Q6:

What does it mean to Opt Out?

A:

If you choose to opt out, the Military Health System (MHS) will not be allowed to electronically share your health care information through the eHealth Exchange for any reason, even in case of emergency where you may be unconscious. Your provider may not have the necessary information to save your life.

Q7:

What does it mean to Opt Back In?

A:

A patient can request to opt back in at any time by submitting a VLER HIE Opt Back In Letter. When you opt back in, you allow your health care providers access to important health care information about you when you visit a medical facility connected with the eHealth Exchange and participating with the MHS.

Q8:

What is the downside of choosing not to participate Opting Out of VLER HIE and eHealth Exchange?

A:

If you have opted out, in the case of an emergency where you may be unconscious, your health care providers may not have immediate and complete access to important health care information necessary to save your life.

Q9:

Are active duty service members able to opt out?

A:

No, due to medical readiness and DoDI 6040.45 Active Duty are not able to opt out of VLER HIE.

VLER HIE Opt Out

The VLER HIE benefit is available to all TRICARE beneficiaries. All beneficiaries except active duty service members may choose to opt out of the VLER HIE.

  • TRICARE eligibility and status will not change if a patient chooses not to participate.
  • If a patient chooses to opt out of the VLER HIE, the MHS may not be allowed to electronically share that patient’s health care information through the eHealth Exchange, not even in cases of emergency.
  • Civilian health care providers who participate in the eHealth Exchange may also require patients to complete an opt out or opt in request.

Choosing not to participate won’t affect HIPAA-authorized DoD exchange of healthcare information, or the sharing of paper records with the VA. >>Learn More about how to opt out of the MHS VLER HIE 

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This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (e) and (g): establishes the Defense Health Agency’s (DHA) procedures to implement DoD policy, assigns responsibilities, and provides instructions for extending the VLER HIE Initiative capability to non-active duty beneficiaries of the Military Health System (MHS); establishes the options available to beneficiaries and others who receive care who do not want to share their information through the VLER HIE Initiative with eHealth Exchange or similar partners who are outside the MHS; does not apply to Active Duty Service members, nor to Reserve Component Service members eligible to receive care in MHS facilities. In accordance with Reference (e), the information of beneficiaries in these categories will be included in MHS HIE participation, and they may not opt out; and incorporates, updates, and cancels Reference (f).

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