Pilot Project Brief - CareSpark

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Project Brief: HIP-TN/VA Direct Pilot Project


  • Tim Cromwell, VA
  • Keith Cox, Health Information Partnership for Tennessee (HIP-TN)
  • George Beckett, TN State HIE
  • Becky Paslick, C3 Consulting
  • Didi Davis, Serendipity Health, LLC
  • Daniel Heller, Axolotl



  • Health Information Partnership for Tennessee (HIP-TN) is a non-profit organization formed in 2009 that works to improve access to health information through a statewide collaborative process by providing services and infrastructure for the secure electronic exchange and use of health information. HIP-TN brings together stakeholders representing the state’s health care providers, health plans, physicians, businesses and consumers to create a health information exchange that will enable the right medical information to get to the right provider at the right time to enhance patient care. For more information, please visit www.hiptn.org
  • VA’s James H. Quillen VA Medical Center in Mountain Home, Tennessee provides services to more than 170,000 veterans living in a 41-county area of Tennessee, Virginina, Kentucky, and North Carolina.
  • Mountain States Health Alliance (MSHA) is a locally owned and managed healthcare system based in Johnson City, Tennessee. Today, MSHA is integrated both vertically and horizontally and is a large regional healthcare system with 13 hospitals. MSHA provides an integrated, comprehensive continuum of care to people in 29 counties in Tennessee, Virginia, Kentucky, and North Carolina.
  • This project will demonstrate the exchange of text-based mammography reports from a private-sector provider to a VA medical center. The provider will be a TN provider participating in the HIP-TN health information exchange network.
    • Female veterans receiving care within the VA are often referred to private-sector providers for periodic mammograms. This project will simulate an improved process for exchanging referrals and consultation reports between VA providers and those in the private sector by demonstrating the exchange of text-based mammography interpretation reports from a private-sector provider to the VA. If possible, the project may also demonstrate the routing of a mammography referral from the VA to the private sector provider.


  • HIP-TN as a HISP, VA as a HISP
  • Participating James H. Quillen VA Medical Center, Mountain Home, TN
  • Pilot Support provided by TN State HIE

Resources Anticipated Being Available for Pilot

  • Source code made available from the Direct Project work groups
  • EHRs with Direct Project capability (optional)

Success Metrics

  • This project seeks to demonstrate Direct Project-based exchange between a Federal agency and providers in a private-sector HIE. The project will prove the technical concepts around this exchange and also enlighten other DURSA, policy, procedural, and operational considerations that may arise in the production use of this solution. This project’s success is not intended to be measured by the number of connected physicians or number of transactions processed

Other Notes

  • Demonstration did not use production data.
  • It is the intention of the participants to move to limited production across the state of TN once the policies and procedures have been fully approved by the appropriate parties
  • It is also the intent of the participants that this project once fully vetted could be expanded to include all VA sites.