The Convener is a neutral organization contracted by the Department of Veterans Affairs to establish and facilitate the Veteran Interoperability Pledge (VIP) Community of Practice (CoP). The Convener serves as an independent facilitator that brings together healthcare organizations, industry participants, and stakeholders across the digital health community with no proprietary interest in the outcomes.

The Convener's primary responsibilities include:

• Facilitating the VIP CoP: Managing a collaborative Community composed of providers, payers, digital health vendors, standards development organizations, and federal entities focused on improving Veteran care and interoperability
• Neutral coordination: Ensuring all voices are heard equally and that no segment is disadvantaged in discussions, providing confidence to all participants through signed non-disclosure agreements and conflict-of-interest statements
• Administrative support: Organizing regular meetings, developing agendas, tracking actions, maintaining a collaboration repository, and distributing meeting minutes
• Sustainability: Providing long-term continuity and professional facilitation to ensure the VIP Community of Practice remains effective as membership grows and evolves

The Convener operates independently outside the VA firewall, making the VIP Community of Practice accessible to all stakeholders while maintaining neutrality and confidentiality.

• The use case for Phase 1 of Veteran Identification is for access by community healthcare providers and is assumed to be covered under HIPAA Treatment or Payment provisions.
• There is no requirement to obtain express consent from the patient to query VA for his/her Veteran status; however, without express consent the access must be covered under HIPAA Treatment or Payment provisions.

VA strongly suggests that the health system and its legal/compliance teams evaluate their current NPP to include obtaining information from the VA under access related to their own treatment or payment activities related to the patient under HIPAA Treatment and Payment provisions.

We anticipate future use cases that would fall under the Health Care Operations exception, such as bulk data access for Quality Assessment; however, this is a little more of a tricky nuance and we recommend working with VA to outline requirements.

A BAA is not required for this exchange; however, VA notes that the health system may have an existing BAA or Veterans Care Agreement (VCA) that may address data access rights. VA recommends the health system and its legal/compliance teams review these and other related documents, if applicable.

VA does not dictate whether a health system permits a Veteran or patient to opt out of queries for information from other entities, such as VA, or the placement of information from other entities in the health system's EHR on the Veteran or patient. This is a decision for the health system following its applicable laws and policies.

VA does not impose any audit requirements on health systems for querying the VA Confirmation API to obtain the Veteran's status. VA has audit requirements for its own systems that include, but are not limited to, those required by HIPAA.

VA API Terms of Service include provisions regarding data rights and usage, including privacy, and must be reviewed and agreed upon before access to the Sandbox is granted. These terms can be accessed here: [VA API Platform | Terms of Service](https://developer.va.gov/terms-of-service)

• 38 U.S.C. 101 defines Veteran as "a person who served in the active military, naval, air, or space service, and who was discharged or released therefrom under conditions other than dishonorable."
• A person may have served without being entitled to the VA benefits of a Title 38 Veteran. If so, the Veteran Confirmation API will return a "not confirmed" status. As stated in the API documentation, reasons for this can include dishonorable character of service or insufficient length of active-duty service, dates of service, disability details, and so on. This API does not provide details about a person's service experience or insight into why a person is "not confirmed" as a Title 38 Veteran.
• Future use cases may include access to a VA API that confirms additional information about a Veteran, such as benefits eligibility, and will be revisited at that time.

In healthcare interoperability, "white noise" refers to irrelevant, unstructured, or low-value data exchanges that clutter workflows and obscure meaningful information. This noise arises from non-standardized formats, redundant transmissions, or legacy system artifacts, complicating semantic understanding despite structural data flow.

Causes in HL7 contexts: Proprietary HL7 v2 customizations and optional fields create variability, generating inconsistent messages that systems must filter amid routine ADT or ORU traffic. In FHIR, unprofiled resources or incomplete implementations add similar noise, diluting focus on critical workflows like order fulfillment.

Mitigation strategies: Semantic interoperability standards (e.g., FHIR profiles, USCDI data classes) enforce precise definitions, reducing noise through validation and conformance testing. Tools like IHE profiles coordinate HL7/DICOM usage, ensuring only purposeful data crosses boundaries.

The Veterans Health Administration (VHA) uses a standardized, nationally recognized methodology to define rurality for Veteran healthcare planning and resource allocation. To ensure consistency across programs, VHA follows the definition used by the Office of Rural Health (ORH), which is based on the U.S. Department of Agriculture's Rural-Urban Commuting Area (RUCA) codes.

How VHA classifies rurality, according to ORH guidance (ORH_RuralityFactSheet_508):

• Urban: RUCA codes 1.0 or 1.1. Located in an urban core with the majority of workers commuting within that core.
• Rural: RUCA codes 2 through 9 and 10.1 through 10.3. Areas outside urban cores that are not classified as highly rural.
• Highly Rural: RUCA code 10.0. The most remote occupied land areas, where less than 10% of workers commute to urbanized areas.
• Insular Islands: Veterans residing in U.S. territories (e.g., Guam, U.S. Virgin Islands). Designated separately and not coded using RUCA.

Learn more: [VHA Office of Rural Health Home](https://www.ruralhealth.va.gov/)