[Federal Register Volume 63, Number 29 (Thursday, February 12, 1998)]
[Notices]
[Pages 7196-7198]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-3545]


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DEPARTMENT OF VETERANS AFFAIRS


Privacy Act of 1974; Amendment of Systems of Records

AGENCY: Departmnet of Veterans Affairs.

ACTION: Notice.

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SUMMARY: As required by the Privacy Act of 1974, 5 U.S.C. 552a(e), 
notice is hereby given that the Department of Veterans Affairs (VA) is 
amending three systems of records notices to update the ``Access/
Safeguards'' statements.

DATES: These amendments are effective on February 12, 1998.

FOR FURTHER INFORMATION CONTACT: Bill Lanson, Legal Consultant, 
Compensation & Pension Service, Veterans Benefits Administration, (202) 
273-7267; Celia Winter, Privacy Act Officer, Veterans Health 
Administration, (202) 273-6274.

SUPPLEMENTARY INFORMATION: The Department of Veterans Affairs (VA) has 
decided, as a matter of policy, to provide direct, on-line, remote 
access to its automated medical treatment and benefits records to 
certain employees of the Veterans Health Administration (VHA) and the 
Veterans Benefits Administration (VBA) who need to have access to the 
information contained in the records in order for them to make 
decisions about veterans' benefits (medical care and other benefits) in 
a more timely and efficient manner.
    VHA is responsible for the medical treatment of veterans and 
claimants, and maintains individually identified and retrieved records, 
both paper and electronic, reflecting the care and treatment rendered. 
VBA is responsible for determining entitlement to compensation and 
pension benefits for veterans and claimants under title 38, United 
States Code. VBA also maintains individually identified and retrieved 
paper and electronic records of this claims administration activity.
    The status of a veteran's compensation, pension, retirement, and 
other benefits may be affected while the veteran is receiving 
hospitalization, domiciliary care, nursing home care, or other medical 
services. Information maintained by the VA medical centers often is 
relevant to determinations by VBA about these benefits. Similarly, 
there may be some change in a veteran's eligibility to receive medical 
care and treatment without charge. Information maintained by VBA often 
is pertinent to the ability of a VA medical center to make a 
determination on this matter.
    In both situations, VBA and VHA personnel need timely access to the 
appropriate records in order to ensure that veterans receive the 
medical care or other title 38 benefits that they are entitled to 
receive as expeditiously as possible.
    Historically, VBA and VHA exchanged necessary information to make 
these determinations by the appropriate, authorized employees at the VA 
medical center treating the veteran or at the VBA regional office 
administering the delivery of benefits to the veteran, by submitting a 
paper form to the other for the necessary records. The relevant 
portions of the medical treatment records or claims records were 
photocopied (and in the case of electronic medical records, printed 
out) and mailed back and forth between the medical center and the 
regional office.
    VA replaced the use of paper forms for VBA to request copies of 
records with the AMIE (Automated Medical Information Exchange) software 
package. The use of AMIE allows regional offices to electronically 
request copies of the relevant veterans' medical records from the 
medical centers, particularly hospital admission and discharge reports, 
outpatient treatment reports and other patient care records. The 
medical center then provides either paper copies of the records or 
electronic reports if available. The use of AMIE greatly reduced the 
time it takes to exchange patient information between the medical 
centers and the regional offices, reduced the number of paper forms 
exchanged, provided better monitoring of the examination process, and, 
most importantly, allowed the veterans to receive benefits due them in 
a more timely and efficient manner.
    VA medical centers currently maintain significant portions of their 
clinical records in electronic format on the computer system known as 
VISTA/DHCP (Veterans Information Systems Technology Architecture/
Decentralized Hospital Computer Programs). Other clinical records are 
maintained in a variety of hardcopy forms, e.g., paper and X-ray film. 
VHA is eventually migrating all of its clinical records to an 
electronic environment. The electronic clinical records can be accessed 
within a medical center and downloaded or printed out by authorized VHA

[[Page 7197]]

personnel, such as the treating physician, as needed.
    VA created the BDN (Benefits Delivery Network) HINQ (Hospital 
Inquiry) screen to allow VHA to request relevant treatment eligibility 
information from VBA on individual veterans. HINQ provides access to 
discrete electronically stored data fields containing VBA information 
that VA medical centers need to determine the care that can be provided 
to a veteran free of charge and that portion of care the veteran may be 
billed for. The use of HINQ also shortened the time necessary for VA 
medical centers to receive the information needed to ensure that 
veterans received the medical care due them without being billed.
    VBA maintains standardized data fields on veterans in electronic 
form in addition to those accessible through HINQ. These VBA data 
fields are accessible to authorized VBA personnel through the VBA's 
BDN. VBA personnel can download or print the field from the BDN. VBA 
contemplates moving to an electronic claims record in the future.
    VA has determined that direct, real-time, remote electronic access 
to veterans' electronic medical records maintained at VA medical 
centers by authorized VBA personnel for claims development and 
adjudication purposes should expedite the processing of veterans' 
claims by VBA, allowing veterans' to receive benefits due them in a 
more timely and efficient manner. Also, VA has determined that direct, 
real-time, remote electronic access to the BDN by authorized VHA 
personnel will result in a more timely and accurate determination of 
appropriate billing for medical care to veterans. When VBA moves to an 
electronic claims folder, it would be equally useful for VHA to have 
access to that electronic folder.
    Accordingly, authorized VBA personnel will be provided direct, 
remote access to VHA clinical medical records maintained on the VISTA/
DHCP computer systems at the medical centers for the purposes of 
reading and downloading veterans' medical records relevant to the 
development and adjudication of the veterans' claims, such as final 
hospital summaries and compensation and pension examination reports, to 
reduce claims' processing time. To the extent that medical records do 
not exist in electronic form, VBA will continue to use the AMIE 
software to request those records. Further, this policy supports 
providing VA medical centers with personal computers configured 
specifically for access to the BDN for health care eligibility 
verification. VHA personnel will be able to read and download data from 
the BDN, or any other databases later developed by VBA, as well as 
electronic claims records at some future time.
    Therefore, VA is amending Access/Safeguards statements in the 
``Policies and practices for storing, retrieving, accessing, retaining 
and disposing of records in the system'' portion of the following three 
systems of records notices: ``24VA136''--Patient Medical Records 
``58VA21/22''--Compensation, Pension, Education and Rehabilitation 
Records ``38VA23''--Veterans and Beneficiaries Identification and 
Records Location Subsystem--VA

    Approved January 29, 1998.
Togo D. West, Jr.,
Acting Secretary.

    1. The system of records identified as 24VA136, ``Patient Medical 
Records--VA,'' published at 40 FR 38095, August 26, 1975, and amended 
at 40 FR 52125, November 7, 1975, 41 FR 2881, January 20, 1976, 41 FR 
11631, March 19, 1976, 42 FR 30557, June 15, 1977, 44 FR 31058, May 30, 
1979, 45 FR 77220, November 21, 1980, 46 FR 2766, January 12, 1981, 47 
FR 28522, June 30, 1982, 47 FR 51841, November 17, 1982, 50 FR 11610, 
March 22, 1985, 51 FR 25968, July 17, 1986, 51 FR 44406, December 9, 
1986, 52 FR 381, January 5, 1987, 53 FR 49818, December 9, 1988, 55 FR 
5112, February 13, 1990, 55 FR 37604, September 12, 1990, 55 FR 42534, 
October 19, 1990, 56 FR 1054, January 10, 1991, 57 FR 28003, June 23, 
1992, 57 FR 45419, October 1, 1992, 58 FR 29853, May 24, 1993, 58 FR 
40852, July 30, 1993, and 58 FR 57674, October 26, 1993, is amended by 
revising paragraphs 2 through 6 of the safeguards statement, the entire 
storage statement and the system manager statement in the ``Policies 
and practices for storing, retrieving, accessing, retaining and 
disposing of records in the system'' as follows:
24 VA 136

System Name:
    Patient Treatment Records--VA.
* * * * *

Policies and practices for storing, retrieving, accessing, retaining 
and disposing of records in the system:

Storage:
    Records (or information in records) are maintained on paper 
documents in the consolidated heath record at the last VA health care 
facility where care was rendered and at Federal records centers. 
Subsidiary record information is maintained at the various respective 
services within the health care facility (e.g., Pharmacy, Fiscal, 
Dietetic, Clinical Laboratory, Radiology, Social Work, Psychology, 
etc.) and by individuals, organizations, and/or agencies with whom VA 
has a contract or agreement to perform such services as VA may deem 
practicable. All or portions of the consolidated health record is 
stored or maintained on-line in VISTA or DHCP (Veterans Information 
Systems Technology Architecture or Decentralized Hospital Computer 
Program) computer systems in each VA health care facility and back-up 
computer files maintained at off-site locations, and may also be 
stored, in part, at VA Central Office, the National Institutes of 
Health, the VA Boston Development Center, Chief Information Officer 
Field Offices (CIOFOs), VA regional offices (VAROs), and the Austin 
Automation Center (AAC), Austin, Texas.
* * * * *

Safeguards:
* * * * *
    2. Access to the VISTA or/and DHCP computer rooms within the health 
care facilities is generally limited by appropriate locking devices and 
restricted to authorized VA employees and vendor personnel. ADP 
peripheral devices are generally placed in secure areas (areas that are 
locked or have limited access) or are otherwise protected. Information 
in DHCP and VISTA systems may be accessed only by authorized VA 
employees. Access to file information is controlled at two levels: The 
system recognizes authorized employees by a series of individually 
unique passwords/codes as a part of each data message, and the 
employees are limited to only that information in the file which is 
needed in the performance of their official duties. Information that is 
downloaded from PTF, OPC, DHCP and VISTA files and maintained on 
personal computers must be afforded similar storage and access 
protections as the data that is maintained in the original files.
    3. Authorized Veterans Benefits Administration (VBA) regional 
office personnel are provided direct, on-line remote access to VHA 
patient treatment records maintained on DHCP or VISTA systems at VA 
health care facilities for the purposes of reading and downloading 
veterans' medical record relevant to the development and adjudication 
of the veterans' claims. To the extent that medical treatment records 
do not exist in electronic format, VBA will continue to access 
treatment records via AMIE (Automated Medical Information Exchange) 
software.

[[Page 7198]]

    4. Access to the Austin Automation Center (AAC) is generally 
restricted to AAC employees, custodial personnel, Federal Protective 
Service and other security personnel. Access to computer rooms is 
restricted to authorized operational personnel through electronic 
locking devices. All other persons gaining access to computer rooms are 
escorted. Information stored in the AAC databases may be accessed by 
authorized VA employees at remote locations including VA health care 
facilities, VA Central Office, VISN (Veterans Integrated Service 
Network) Offices, and OIG headquarters and field staff. Access is 
controlled by individually unique passwords/codes which must be changed 
periodically by the employee.
    5. Access to records maintained at VA Central Office, the VA Boston 
Development Center, the CIOFOs, and the VISN Offices is restricted to 
VA employees who have a need for the information in the performance of 
their official duties. Access to information stored in electronic 
format is controlled by individually unique passwords/codes. Records 
are maintained in manned rooms during working hours. The facilities are 
protected from outside access during non-working hours by the Federal 
Protective Service or other security personnel.
    6. Information stored on computers at the CIOFOs may be accessed by 
authorized VA employees at remote locations including VA health care 
facilities and VISN Offices. Access to electronically stored 
information is controlled by individually unique passwords/codes. 
Records are maintained in manned rooms during working hours. The 
facilities are protected from outside access during non-working hours 
by the Federal Protective Service or other security personnel.
    7. Access to PTF information stored by VA Central Office at the 
National Institutes of Health Computer Center is limited to quality 
assurance program staff at VA Central Office and the VISN Offices. VA 
Central Office staff may access the nationwide data and staff of the 
VISN Offices may access data for their network area. Access to file 
information is controlled by individually unique passwords/codes.
    8. Information downloaded from OPC, PTF and VISTA/DHCP files and 
maintained by the OIG headquarters and field offices on automated 
storage media is secured in storage areas or facilities to which only 
OIG staff have access. Paper documents are similarly secured. Access to 
paper documents and information on automated storage media is limited 
to OIG employees who have a need for the information in the performance 
of their official duties. Access to information stored electronically 
is controlled by individually unique passwords/codes.
* * * * *

System manager(s) and address:
    Chief Information Officer (19), Veterans Health Administration, VA 
Central Office, Washington, DC 24020.
* * * * *
    2. The system of record identified as 38VA23, ``Veterans and 
Beneficiaries Identification and Records Location Subsystem (BIRLS)--
VA,'' published at 40 FR 38095, August 26, 1975, 41 FR 11631, March 19, 
1976, 43 FR 23798, June 1, 1978, 45 FR 77220, November 21, 1980, 47 FR 
367, January 5, 1982, 48 FR 45491, October 5, 1983, 50 FR 13448, April 
4, 1985 and 60 FR 32210, June 20, 1995, is amended by revising the 
first paragraph of the storage policies and practices for the record in 
this system of record to read as follows:
38 VA 23

System name:
    Veterans and Beneficiaries Identification and Records Location 
Subsystem (BIRLS)--VA.
* * * * *

Policies and practices for storing, retrieving, accessing, retaining, 
and disposing of records in the system:
storage:
    The basic file is on automated storage media (e.g., magnetic tapes 
and disks), with backup copies of the information on magnetic tape. 
Such information may be accessed through a data telecommunication 
terminal system designated the Benefits Delivery Network (BDN). BDN 
terminal locations include VA Central Office, VA regional offices, VBA 
Debt Management Center, VA health care facilities, Department of 
Defense Finance and Accounting Service Centers and the U.S. Coast Guard 
Pay and Personnel Center. An adjunct file (at the Records Processing 
Center (RPC) in St. Louis, MO) contains microfilm and paper documents 
of former manual Central Index claims numbers registers, partial files 
of pensioners with service prior to 1930, personnel with service 
between 1940 and 1948 with VA insurance, and partial lists of other 
Armed Forces personnel indexed by service number. A duplicate of the 
microfilm is also located at VA Central Office.
* * * * *
    3. The system of records identified as 58 VA 21/22, ``Compensation, 
Pension, Education and Rehabilitation Records--VA,'' published at 41 FR 
9294, March 3, 1976, 43 FR 3984, January 30, 1978, 43 FR 15026, April 
10, 1978, 43 FR 23797, June 1, 1978, 45 FR 57641, August 28, 1980, 45 
FR 77220, November 21, 1980, 47 FR 367, January 5, 1982, 47 FR 16132, 
April 14, 1982, 47 FR 40742, September 15, 1982, 48 FR 1384, January 
12, 1983, 48 FR 15994, April 13, 1983, 48 FR 39197, August 29, 1983, 48 
FR 52798, November 22, 1983, 49 FR 23974, June 8, 1984, 49 FR 36046, 
September 13, 1984, 50 FR 10886, March 18, 1985, 50 FR 26875, June 28, 
1985, 50 FR 31453, August 2, 1985, 51 FR 24781, July 8, 1986, 51 FR 
25141, July 10, 1986, 51 FR 28289, August 6, 1986, 51 FR 36894, October 
16, 1986, 52 FR 4078, February 9, 1987, 54 FR 36933, September 5, 1989, 
55 FR 28508, July 11, 1990, 55 FR 42540, October 19, 1990, 56 FR 15667, 
April 17, 1991, 56 FR 16354, April 22, 1991, 57 FR 12374, April 9, 
1992, 57 FR 44007, September 23, 1992, 58 FR 38164, July 15, 1993, 58 
FR 54643, October 22, 1993, and 60 FR 20156, April 24, 1995 is amended 
by revising the first paragraph of the storage policies and practices 
for the records in this system of records to read as follows:
58 VA 21/22

System name: 
    Compensation, Pension, Education and Rehabilitation Records--VA.
* * * * *

Policies and practices for storing, retrieving, accessing, retaining 
and disposing of records in the system.
Storage:
    Records (or information contained in records) are maintained on 
paper documents in claims file folders (e.g., ``C'' file folders, 
educational file folders and vocational rehabilitation folders) and on 
automated storage media (e.g., microfilm, microfiche, magnetic tape and 
disks.) Such information may be accessed through a data 
telecommunication terminal system designated the Benefits Delivery 
Network (BDN). BDN terminal locations include VA Central Office, VA 
regional offices, VA health care facilities, VISN offices, Department 
of Defense Finance and Accounting Service Centers and the U.S. Coast 
Guard Pay and Personnel Center.
* * * * *
[FR Doc. 98-3545 Filed 2-11-98; 8:45 am]
BILLING CODE 8320-01-M