1. JOINT LEGACY VIEWER (JLV)
JLV Team
Health Solutions Management, Health Informatics, Office of Informatics and Analytics
Veterans Health Administration (VHA) and Office of Information and Technology (OI&T)
Department of Veterans Affairs (VA)
APRIL 2016

2. JOINT LEGACY VIEWER (JLV)
JLV provides an integrated read-only view of health data from VA, Department of Defense (DoD) and VA VLER partner sources in a common viewer
Features
Web-based Graphical User Interface (GUI) with national-level patient search
Displays health data from DoD legacy (CHCS), inpatient (Essentris) and outpatient (AHLTA) systems, Theater Medical Data Store, VLER partners and all VistA hosts
Context managed with other VA context aware applications ( e.g. CPRS, VistA Imaging) for sync to same patient
Benefits
Easy-to-learn, intuitive user interface
Faster and easier to use than existing viewers.
No onsite hardware or software installation
Quick user startup with virtual on-demand training
Designed to support frequent enhancements and upgrades
JLV v2.3.1 current version released September 2015
Next release July 2016

3. CLINICAL DATA IN JLV
Clinical Data Widget
Description of data displayed (additional data available in expanded view of widgets)
Admissions
Dates of admission and discharge for each episode as well as diagnosis, ward and site.
Allergies
Allergen, reaction, severity and site where recorded.
Appointments
Date, provider, clinic and site
Clinical Reminders
VA only reminder information including due date, when last completed, reminder type and site where reminder is in effect
Community Health Summaries
Patient's VA approved community partner information, including C32 documents and source
Consults
Consult information including date, type, status and site
Discharge/Essentris Notes
Discharge notes, including date, type and site and other DoD inpatient care notes
Encounters
Date, clinic, diagnosis, provider and site for each encounter
Immunizations
Immunization history including date, vaccine name, reaction if any and site
Lab Orders/Panel Results
Lab orders and panels and the associated results
Lab Results
Lab results including microbiology and anatomic pathology

4. CLINICAL DATA IN JLV
Clinical Data Widget
Description of data displayed (additional data available in expanded view of widgets)
Inpatient Medications
Inpatient medications including status and where prescribed
Outpatient Medications
Outpatient medications including last fill, status, expiration date and site where prescribed
Orders
Patient orders with order date, status and site where written
Problem List
Problem, onset, when updated, status and site where recorded
Procedures
Procedure, date, location and provider.
Progress Notes
Progress notes including the type, author and site where written
Questionnaires and Deployment Assessments
Pre and Post-Deployment Assessments as well as other Questionnaires administered from DoD only
Radiology Exams
Radiology exams ordered along with the corresponding report and image if available
Social, Medical and Other Histories
History records from DoD only and includes the date reported, type, any findings, status and site where recorded
Vitals
Vital sign information including date taken, type, result, the units and where taken

5. DATA DOMAINS/TYPES NOT CURRENTLY SUPPORTED BY JLV
Scanned & Imported Paper Records & Non-Radiology Images
Radiology Images
Advance Directive Postings
Functional Status
Medical Equipment
Clinical Warnings Postings (e.g. MRSA +, Deceased Patient)
Blood Bank
Blood Transfusion

6. VA JLV ACCESS JLV is accessed via a website
Access is controlled through an authorized user list built from the invitation process
All VA approved users must be:
VA Health Care Professionals
VA Benefits Professionals
JLV has two layers of authentication
Login requires PIV card and PIN
Entry of existing CPRS or CAPRI credentials on a production system

7. JLV DEVELOPMENT JLV Release 3 – Installed September 20, 2015
Ability to view DoD Sensitive Notes and Data
Enhanced patient search functionality that enables selection of a record from a list of your recently viewed patients
Display of Primary Care Team information
Abnormal results are highlighted
New data or enhanced details in several JLV widgets
Addition of Age and Service Connection % to demographics display
VA Operative Notes and VA IV medications and infusions added
JLV Release 4 – 3rd Quarter FY2016
DoD Scanned documents will be viewable in JLV
Report Builder Functionality

8. JLV TRAINING & SUPPORT Training – Optional, On Demand and Self-Paced
VA Talent Management System (TMS) JLV v2.3.1 Introductory Training module (Course catalog #: 27975) 
Additional short training videos available on JLV Network
Extensive Built-in JLV Help feature - click “?” icon
IT support provided by the VA National Service Desk and Clin3 Product Support team

9. JLV QUICK TIPS Add a widget:
The type of data you are looking for might be in a widget that isn’t in your workspace yet.  To add a  widget to your workspace,  click the “+” plus sign in the lower right corner of the screen.  This opens the widget tray.  Click/drag and release widgets you choose to your workspace.   
Adjust the date range JLV is searching:
The default look back is only 120 days for most widgets. Use the funnel shaped filter icon in the upper right corner of each widget to adjust the dates JLV is searching.   
See expanded view of a widget Click on the “More…” link at the bottom right corner of any widget.  This view includes more details and additional sort/filter capabilities 
Create a tab:
You can create custom Tabs to support different workflows. Add a Tab and name it then use the widget tray and date filter to build a custom view

10. JLV QUICK TIPS
JLV doesn’t have Search feature, how can I find what I need?
Use the Problem List, Procedures and/or and Encounters widget to identify key dates and providers for a diagnosis or type of care to drive your search or associated notes in the Progress Notes, Consults or other widgets
Use the expanded view of widgets. In Progress Notes for example you can Filter by Note Type/Title, Provider or Provider Specialty and sort by dates and locations to speed your access to specific information
A global “Google-like”search feature is being built by eHMP as part of VistA Evolution and will replace JLV in the future

11. FOR MORE INFORMATION VistA Evolution JLV SharePoint
JLV - All Documents
JLV Network on VA Pulse
Group: JLV Network | VA Pulse

12. ADDITIONAL INFORMATION
Joint Legacy Viewer (JLV)
ADDITIONAL INFORMATION

13. VA JLV TEAM
VHA Clinical Lead: Shane McNamee, MD VHA Clinical Subject Matter Expert: Reese Omizo, MD OI&T Project Manager: Renae Facundus Health System Specialist: Amanda Cournoyer Program Analyst: Jerald “Jerry” Rutherford Program Analyst: Rachel Wiebe Applied Informatics Deployment Lead: Phil Odle VBA Office of Field Operations POC: Sarah Classy

14. WHAT IS JLV USED FOR?
A sample as shared by field JLV users with our team
Clinical Care (e.g. Primary Care, Mental Health, Women’s Health, Specialty care, Polytrauma System of Care)
Disability Evaluation (e.g. Compensation and Pension clinical evaluation)
Crisis care (e.g. Veterans Crisis Line) 
Intake evaluations/reviews (e.g. Pre- Admission, Homeless intake, Pre-Surgical and Transplant evaluations)
Care reviews (e.g. Peer Reviews, VA External Peer Review Program, OIG and Office of Medical Legal Affairs clinical case reviews)
Care Coordination (e.g. OIF/OEF/OND, Transplant, Homeless program, Admissions, Joint Ventures and sharing agreements
Benefits and Claims Processing (e.g. Missing or incomplete records, claims quality reviews, identification of potentially sufficient confirming evidence in DoD medical records to order a C&P exam without waiting for other records, Vocational Rehabilitation and Employment counseling 
Pharmacy (e.g. verify immunizations, check drug allergies, process inpatient-medications-for- outpatients, assist ED care plans)
Traveling/Mobile Veteran Care (e.g. Pharmacy needs/bridging supplies, Emergency/Urgent care
Registries ( e.g. VA/DoD Eye Injury Registry chart abstraction) 
Administrative (e.g. VA/DoD National Reimbursement initiative)

15. WHAT JLV USERS ARE SAYING
"JLV is working well for me overall and provides info I can't get any other way (especially in a timely fashion).” - Psychiatrist, Hampton VAMC "This is a much needed system and I'm impressed with both the interface and the training in TMS that was provided.“ - OEF/OIF/OND Transition Case Manager, VA San Diego Healthcare System “This thing is MAGIC.“ – Clinical Pharmacy Specialist, Battle Creek VAMC “The set-up and graphics are amazing. It’s so easy to use." - Clinic Nurse Manager/Care Manager, Capt. James A. Lovell Federal Health Care Center
“LOVE JLV. It is so much better/quicker, easier to navigate than VistaWeb or Remote Data for transfers from other VA’s & an even bigger benefit with New pts w/ mostly DoD past care as DoD access in VW & RD are so spotty.” – Physician, White River Junction VAMC
"The format, the layout, and the customize-ability is fabulous; JLV may knock about a minute off the time to complete a teledermatology consultation. When I'm doing 50 or 60 a day, that's a BIG deal." -Dermatologist, VA Puget Sound HCS, Seattle
More JLV feedback at: What are real users saying about JLV? | VA Pulse

16. JLV ORIGINS
Janus is an innovative application developed jointly by Tripler Army Medical Center and the VA Pacific Islands Health Care System (VA PIHCS) over the past decade to improve VA/DoD interoperability & provide a common view of VA/DoD records
Custom version of Janus (Janus 3.0) in use at Tripler and VA PIHCS. Another custom version, Janus 4.0 also called “iEHR” at James A. Lovell Federal Health Care Center in North Chicago
JLV is a 4th generation Janus product
JLV is the VA enterprise standard product going forward 16